Elders at Risk for Abuse in Every Culture

Patient Expert

Elder abuse is, unfortunately, part of society's ills - but many don't realize how prevalent it can be. And whereas many Americans think of it as physical or financial abuse, different cultures have different definitions of this situation.

To draw attention to this issue, the Institute of Medicine of the National Academies held a workshop on elder abuse in order to shed light on this overlooked issue. Participants discussed the prevalence of elder abuse around the world as well as the characteristics of this type of abuse. Risk factors for abuse and potential adverse health outcomes also were addressed. Participants also discussed the role of culture and community in preventing this type of abuse.

So why is this important? It is believed that 10 percent of older adults in the United States experience some sort of elder abuse. This abuse can include physical, psychological or sexual abuse as well as neglect and financial exploitation.   While that in itself is awful, the number of elder abuse cases is believed to be more prevalent in low-income and middle-income countries. "With the global population of adults older than 60 expected to double to 1.2 billion by 2025, the number of older adults will exceed the number of children for the first time in history," the IOM website states. "Despite the growing magnitude of elder abuse, it has been an underappreciated public health problem."

Interestingly, abuse takes on different forms that I wouldn't have considered. For instance, one presenter said in China, a major form of elder abuse can entail disrespect and being ignored or not invited to family gatherings. Research on Native American populations finds that elder abuse can consist of spiritual abuse through being denied access to ceremonies that are considered essential and important. Abuse in this population can also include the elder being denied access to a traditional healer. In African American communities, elders want their children nearby, even if those family members are abusive. Therefore, these elders often will not report abuse so they will not injure the family's reputation in the community.

And changing paradigms are also causing more elder abuse. For instance, Chinese communities have traditionally held the Confucian belief in filial piety that requires children to provide assistance to aging parents. "However, modernization has led to more mobility of adult children from rural to urban settings, affecting traditional family structures and intergenerational caregiving," the workshop summary states. "Within Chinese American communities, filial piety is being affected by a shift from the traditional Chinese conception of collectivism towards the Western individualistic tradition."

The workshop summary also identified six risk factors for elder mistreatment. These include:

  • The dependency and/or vulnerability of the elder. This could include poor health, disability, functional impairment, poor personal defenses, poverty and dementia.
  • Gender. Women are more often mistreated than men.
  • Abuser dependency on alcohol or drugs. Mental illness and poor employment record also are part of this category.
  • Social isolation where the abuse can go on undetected. There's lack of social support to buffer the stress of the abuser.
  • Living arrangements also can be a risk factor. In this case, the elder shares living arrangements which brings a greater opportunity for tension and conflict. Long-term care facilities also can be a place where elder abuse takes place.
  • Resources can be exploited.

The risk factors that can cause a person to become a perpetrator of elder abuse include:

  • Abuse of alcohol and other substances.
  • Mental health issues, including depression, personality disorder, behavioral problems, caregiver burnout and inexperience.
  • Poor interpersonal relationships.
  • Conflict in the marriage and/or family.
  • Lack of empathy and understanding of the care needs and issues of an elder.
  • Being dependent financially on the elder who is victimized.

I'll cover more topics related to elder abuse more in future shareposts, but I thought that this information is important to think about for caregivers, family members and people who have dementia.

Primary Source for This Sharepost:

The National Academies Press. (2013). Elder abuse and its prevention: Workshop summary.