Understanding Elder Abuse
Elder abuse, neglect and exploitation are largely hidden, shrouded in secrecy and shame. Older adults are often reluctant to reveal incidents of abuse, particularly when the abuser is a family member. Adding to the problem, many health care, law enforcement, financial and aging service professionals often do not understand or recognize elder abuse, neglect or exploitation. When they do recognize the problem, they often do not know where to turn for help.
The population of older adults is growing and Americans are living longer.
During the 20th Century, the number of Americans age 65 or older increased dramatically and will continue to do so in the first half of this century. In 2007, one in eight Americans was in this age group, and by the year 2050, the number of Americans age 65 or older is expected to increase to over 80 million. Older adults who are frail or the oldest old, those 85 or older, are the fastest growing population segment in the United States. In 2010 the oldest old numbered 5.7 million. By 2050 this number is expected to increase to 19 million or 24% of older adults and 5% of the total United States population. Additionally, older adults who are minorities will represent 24% of the older adult population in 2020 (U.S. Department of Health and Human Services, 2010).
What does this mean for our Communities?
Most older adults live outside of nursing homes; just 4% of those age 75-84 live in a nursing home. Many older adults live alone, including an estimated 50% of women age 75 and older (U.S. Department of Health and Human Services, 2010). As more people live to an older age, many face chronic illnesses and other limiting conditions that decrease their independence. Each older adult’s functionality and ability to remain independent in his or her home varies. Some may require assistance with activities of daily living (ADLs) from others such as family members, friends or home health aides; others can remain more independent. All older adults are vulnerable to the growing problem of elder abuse, neglect and exploitation. Vulnerability to all forms of abuse increases with cognitive impairment.
The Growing Problem of Elder Abuse
Elder abuse is a growing, serious problem that exists in every community and every neighborhood, whether rich or poor. It is often hidden and thrives in silence. Two recent studies demonstrate its severity.
The 2010 New York State Prevalence Study, which surveyed over 4,100 older New Yorkers and their caregivers, found that 7.6%, or 1 in 13 older persons experienced elder mistreatment in a one year period (Lifespan, et al., 2011). The 2009 National Prevalence Study found that 11% of those surveyed self-reported one form of mistreatment within the past year (excluding financial exploitation), with 1.2% reporting two or more forms of past mistreatment (Acierno, et al., 2009).
Studies and reports from professionals in the fields of Protective Services for Adults (PSA) and aging services suggest that elder abuse in domestic settings is a widespread and escalating problem. As people live longer, and as frailty and vulnerability increase, there is greater potential for abuse, neglect and exploitation. Elder abuse occurs more often in people’s homes than in nursing homes. Adult children and grandchildren are often the abusers; sometimes it’s an acquaintance or other caregiver. Substance abuse is a factor in a large number of elder abuse cases. Recent studies confirm what aging experts have long believed. Elder mistreatment is a growth industry.
While there is no universally accepted definition of elder abuse, N.Y. Social Services Law § 473 (6) does offer some guidance:
The non-accidental use of force that results in bodily injury, pain
or impairment, including but not limited to, being slapped, burned, cut, bruised or improperly physically restrained.
Non-consensual sexual contact of any kind, including but not limited to, forcing sexual contact or forcing sex with a third party.
Willful infliction of mental or emotional anguish by threat, humiliation, intimidation or other abusive conduct, including but not limited to, frightening or isolating an adult.
Active Neglect – willful failure by the caregiver to fulfill the caretaking functions and responsibilities assumed by the caregiver, including but
not limited to, abandonment, willful deprivation of food, water, heat, clean clothing and bedding, eyeglasses or dentures, or health related services.
Passive Neglect – non-willful failure of a caregiver to fulfill caretaking functions and responsibilities assumed by the caregiver, including but
not limited to, abandonment or denial of food or health related services because of inadequate caregiver knowledge, infirmity, or disputing the value of prescribed services.
Self Neglect – an adult’s inability, due to physical and/or mental impairments to perform tasks essential to caring for oneself, including but not limited to, providing essential food, clothing, shelter and medical care; obtaining goods and services necessary to maintain physical health, mental health, emotional well-being and general safety; or managing
Improper use of an adult’s funds, property or resources by another individual, including but not limited to, fraud, false pretenses, embezzlement, conspiracy, forgery, falsifying records, coerced property transfers or denial of access to assets.