What do perpetrators of domestic abuse in later life have
in common? To end elder domestic violence, abusers must
stop hurting their victims. To begin this process of determining
whether criminal justice, social service, other approaches
or a combination is most effective in changing abusers'
behavior, research identifying common traits of abusers
can be a starting point. This paper will examine the research
that provides information, including gender, about abusers.
This series of papers
defines domestic abuse in later life as male and female
victims, age 50 and older, abused by someone in a trusted,
ongoing relationship like a spouse/partner, family member,
or caregiver. The victims lived primarily in the community,
not institutions (e.g., nursing homes). Studies from the
United States and Canada were included.
ARTICLES REVIEWED
Twenty-one articles published between 1988 and 2000 were
reviewed for this article.
| Author(s)
Pub. Date |
Sample
size and demographics |
Type(s)
of abuse covered |
Selected
finding(s)
(page number/s in parentheses) |
| Dunlop, et
al
2000 |
319 substantiated
cases of abused persons aged 60+ in Miami-Dade County,
Florida |
APS substantiated
cases of abuse, neglect, and exploitation |
·
53.5% of all abusers were female; 56.2%
of abusers of elder men were female. (108) |
| Phillips, et
al
2000 |
93 cases of
women aged 55+ caring for dependent spouse or other
elder family member |
Verbal and
physical abuse; threatened with gun/knife; gun or
knife used -- all by the elder for whom they were
caring |
·
29% of the caregivers had been abused
by the elder they were caring for. (128) |
| Teaster, et
al
2000 |
42 substantiated
cases of sexual abuse against persons 60+, collected
over a 3-year period in Virginia |
APS-substantiated
cases of elder sexual abuse |
·
Of the 42 victims, 40 were female.
All of the identified perpetrators were male. (5,
9) |
| Brownell, et
al
1999 |
401 cases
of abuse of elders 60+ (with 404 identified abusers)
known to Elderly Crime Victims Resource Center in
New York City; subanalysis done of 218 abusers for
whom mental health status was reported |
Physical,
psychological, financial abuse and neglect (one case
of sexual abuse was counted as physical abuse) |
·
56% of abusers male; 44% female (86)
·
74% of abusers suffered from impairment
(substance abuse, mental illness, mental illness/chemical
addiction, or dementia). (86)
·
Of the 161 abusers who were impaired,
82 were alcohol/drug abusers; 42 were mentally ill;
27 were both; 10 had dementia. (86)
·
Impaired abusers were more likely to
live with victims, be unemployed and have a history
of encounters with the criminal justice system. (81) |
| Crichton et
al
1999 |
50 Canadians
age 60+ abused by adult child; 50 abused by spouse,
from Elder Abuse Resource Center in Winnipeg |
Agency-substantiated
cases of physical, psychological, and material abuse;
neglect |
·
Of 50 adult child cases, 34 perpetrators
were sons, 19 daughters. (122)
·
Of 50 spouse cases, 43 perpetrators
were husbands, 7 wives. (122) |
| Lithwick and
Beaulieu
1999 |
128 cases
of mistreatment of adults aged 60+ brought to the
attention of community service agencies in Quebec |
Physical,
sexual or psychological abuse; financial and material
exploitation; neglect by family members and acquaintances |
·
65% of the perpetrators were men.
(101) |
| Anetzberger
1998 |
29 Cleveland
APS cases from 1987 to 1995 |
Psychological
abuse and psychological neglect |
·
"The perpetrator of psychological neglect
[3 cases] was always a woman (wife or niece)." (146)
·
"The perpetrator of psychological abuse
[26 cases] was slightly more likely (57.1%) to be
a man (son, husband, ex-husband, or male companion)."
(146) |
| Cohen et al
1998 |
137 spousal/consortial
homicide-suicides from 7 Florida counties between
1988 - 1994. 48 involving perpetrators 55+ were compared
to 89 involving perpetrators <55. |
Instances
of homicide/suicide |
·
All older perpetrators were men; 2
younger perpetrators were women. (392)
·
29% of older perpetrators were depressed
and 18.7% had talked of suicide, but only one tested
positive for antidepressants at autopsy. (393) |
| NCEA National
Elder Abuse Incidence Study
1998 |
APS reports
and community "sentinel" reports of abused and neglected
persons age 60+ from 20 US counties in 15 states |
Physical abuse,
sexual abuse, emotional or psychological abuse, neglect,
abandonment, financial or material exploitation |
·
34.3% of perpetrators were aged 60
years or older. (7)
·
"Overall, men were the perpetrators
of abuse and neglect 52.5% of the time. Of the substantiated
cases of abuse and neglect, males were the most frequent
perpetrators for abandonment (83.4%), physical abuse
(62.6%), emotional abuse (60.1%) and financial/material
exploitation (59.0%). Only in cases of neglect were
women slightly more frequent (52.4%) perpetrators
than men." (7) |
| Reis and Nahmiash
1998 |
341 cases
of elders (aged 55+) being cared for by unpaid family
or friends, in Montreal, Canada. Abuse was assessed
as "likely" in 69 cases; "not likely" in 272 cases |
Physical,
psycho-social, and financial abuse; both passive and
active neglect |
·
Ranking 27 caregiver and care receiver
characteristics associated with abuse, caregiver characteristics
were:
- Has behavior problems
- Is financially dependent
- Has mental/emotional difficulties
- Has alcohol/substance abuse problems
- Has unrealistic expectations
- Lacks understanding of medical condition
- Caregiving reluctancy
- Has marital/family conflict
- Has poor current relationship (with care receiver)
- Caregiving inexperience
17. Is a blamer
24. Had poor past relationship (478) |
| Lachs, et al
1997 (b) |
182 victims
of physical abuse aged 60+ from New Haven, Connecticut |
APS-substantiated
cases of physical abuse |
·
Adult son was abuser in 28.9% of cases.
(450)
·
Spouse was abuser in 26.8% of cases.
(450)
·
Adult daughter was abuser in 21.6%
of cases. (450)
·
Abusers cohabitated with victims in
87% of cases. (451) |
| Reis and Nahmiash
1997 |
6 groups from
Montreal, Canada were compared: a family caregiver
group (total caregivers 136) and a care receiver (age
55+) group (total care receivers 128) for confirmed
abuse cases receiving services; confirmed nonabuse
cases receiving services; and confirmed nonabuse cases
not receiving services. |
Physical,
psycho-social, and financial abuse; both passive and
active neglect |
·
"The abusive group were more depressed
and had fewer available social supporters than each
of the two nonabusive groups." (347)
·
"Abusive caregivers are, on the whole,
no less agreeable or more neurotic than are nonabusive
ones." (347)
·
"Less social support (according to
caregiver reports rather than care receiver ones)
and greater caregiver depression are confimed in this
study as abuse markers." (347) |
| Wolf and Pillemer
1997 |
73 abused
women aged 60+ from 4 U.S. cities. 22 were abused
by husband, 51 by children (review of written case
assessment data) |
Physical abuse,
psychological abuse, neglect, financial exploitation |
·
54.2% of adult child abusers were single;
20.8% divorced. (328)
·
76.6% of adult child abusers were somewhat
to entirely financially dependent on abused mother.
(331)
·
64.6% of adult child abusers were somewhat
to entirely dependent on abused mother for housing.
(331) |
| Seaver
1996 |
132 women
aged 50+ who have attended older abused women's program
in Milwaukee, Wisconsin |
Unspecified |
·
Eleven of the husbands (14%) were dependent
on the women for caregiving. (15)
·
35 (66%) of the adult children were
financially dependent on their mothers. (15)
·
38% of the abusers had problems with
drugs and/or alcohol. (16)
·
51% of the adult kin had substance
abuse problems, and 30% had psychiatric problems.
(16) |
| Griffin
1994 |
10 abused
African Americans age 60+ and 6 of their perpetrators
from 3 rural counties in North Carolina |
APS-substantiated
cases of financial exploitation (6), self-neglect
(5), verbal abuse (2), and neglect (1) |
·
Victims and perpetrators minimize and
neutralize abusive behavior. (21) |
| Ramsey-Klawsnik
1991 |
28 community-dwelling
older (ages 65 - 101) women suspected by MA APS workers
of being sexually abused |
APS suspicion
elder was sexually abused |
·
All but 1 perpetrator was male. (73) |
| Greenberg et
al
1990 |
204 cases
of abuse of person 60+ by adult child in Wisconsin |
APS-substantiated
cases of physical abuse, material abuse, and neglect |
·
25% of abusers were financially dependent
on elder. (78)
·
44% of male abusers and 14% of female
abusers had alcohol/drug problems. (78)
·
11% of abusers had mental illness;
58% of these were primary caregivers to the elder
parent. (82) |
| Brown
1989 |
Random sample
of 37 Southwest reservation-dwelling male and female
Navajo aged 60+, and their family members |
5 types of
neglect; 5 types of verbal/ psychological abuse; 4
types of physical abuse; financial exploitation |
·
Caregivers with personal problems were
more likely to physically abuse; this was not true
of perpetrators of other types of abuse. (31) |
| Godkin, et
al
1989 |
59 abused
elders (60 years and older) compared to 49 non-abused
elders, both served by a Massachusetts home care program |
Physical,
psychological, and material abuse; active and passive
neglect by a caregiver |
·
"[M]embers of abusive families are
more likely to have emotional problems which contribute
to interpersonal difficulties. Abused elders are
not more dependent on caregivers for many of their
daily needs. However, the abused elderly and their
caregivers have become increasingly interdependent
prior to the onset of abuse because of the loss of
other family members, increased social isolation,
and the increased financial dependency of the perpetrator
on the elderly person." (207)
·
55.9% of abusers were under the age
of sixty. (212)
·
"A significantly higher percentage
of caregivers in abuse/neglect cases had a history
of mental or emotional illness (40.7%) or had suffered
a decline in their mental health prior to the abuse
(45.8%) than the caregivers in the non-abuse samples
(5.3% and 5.0%, respectively)." (212)
·
Alcohol abuse occurred in one-third
of abuse cases but was absent in the comparison group.
(212)
·
74.4% of abusing caregivers were financially
dependent on the elder, compared to 36.8% of the non-abusing
caregivers. (217)
·
"Nearly two-thirds (60.3%) of the abusers
had undergone a recent change in their family relationships
and two-fifths (41.4%) in living arrangements prior
to the onset of abuse or neglect compared to 15.0%
and 0.0%, respectively, for the caregivers in the
non-abuse situations." (218)
·
".it appears that both abused elders
and the abusers experience emotional problems which
contribute to interpersonal difficulties in their
relationship." (223) |
| Pillemer and
Finkelhor
1989 |
Random sample
of 2020 community dwelling people aged 65+ in Boston,
Massachusetts; 63 cases of elder abuse found |
Physical assault,
psychological abuse, and neglect |
·
The abusers had a very high incidence
of socioemotional maladjustment such as having been
arrested, hospitalized for psychiatric condition,
or involved in other violent behavior. (183 - 184)
·
Abusers were likely to be dependent
on victim for financial assistance, household repairs,
transportation, and housing. (184) |
| Pillemer and
Finkelhor
1988 |
Random sample
of 2020 community dwelling people aged 65+ in Boston,
Massachusetts; 63 cases of elder abuse found |
Physical assault,
psychological abuse, and neglect |
·
43% of the physical violence cases
were of wife assaulting husband, and 17% were of husband
assaulting wife. (54) |
GENERALIZED FINDINGS
A number of the studies found that a significant number
of abusers suffer some form of impairment (Brownell, 1999;
Cohen, 1998; Reis, 1998 and 1997; Seaver, 1996; Greenberg,
1990; Lachs, 1997b; Godkin, 1989; Pillemer, 1989). These
impairments included substance abuse, mental illness and
depression, or cognitive impairments.
Research also indicated that the abusers tended to be dependent
on their victims. This goes against the prevalent notion
that elder abuse is primarily caused when frail, elderly
are dependent on others for their care. Often this dependence
is seen to cause stress as care needs increase and the care
provider "snaps" and become abusive. However, a number
of studies found that the abuser often depends on the victim
for housing, transportation and sometimes care (Brownell,
1999; Wolf, 1997; Seaver, 1996; Pillemer, 1989). Financial
dependency of adult children also seems to be a key factor
(Reis, 1998; Wolf, 1997; Seaver, 1996; Greenberg, 1990;
Godkin, 1989; Pillemer, 1989).
Some research also suggests that abusers have problems
with relationships, may be more isolated and lack social
supports (Reis, 1998 and 1997; Godkin, 1989). Brown (1989)
suggests that abusers with personal problems may be more
physically abusive. Perpetrators may minimize or deny their
abusive behavior (Griffin, 1994).
Most studies found the majority of perpetrators to be male
(Brownell, 1999; Crichton, 1999; Lithwick, 1999; NEAIS,
1998). Sexual abusers were almost exclusively male (Teaster,
2000; Ramsey-Klawsnik, 1991). Of the cases reviewed, only
older men (not women) perpetrated homicide-suicide in later
life (Cohen, 1998).
A few studies found more female perpetrators than male
(Dunlop, 2000; Anetzberger, 1998). These studies included
neglect, where women tend to exhibit higher rates of abuse
than men (possibly because women provide more care than
men). Pillemer (1988), using the Conflict Tactics Scale,
also found women more likely to use physical violence than
men. Unfortunately, the Conflict Tactics Scale does not
differentiate between levels of physical violence. Throwing
something across the room rates equally to choking a victim.
The scale also does not take into account which party may
be living in fear or have changed their lifestyle as a result
of the abuse.
The NEAIS study (1998) identified that more than 1/3 of
perpetrators are age 60 or older. These abusers are predominately
spouse/partner abusers but may also include older adult
children abusing their parents who are in their 80's or
90's. In addition, Phillips (2000) found that many older
caregivers (age 55+) were being abused by their (older)
care recipient.
LIMITATIONS OF STUDIES
Numerous limitations in the research on abuse in later
life were found. In part because of the lack of financial
resources, only a few studies have been large (more than
1,000 respondents) random sample studies (Lachs 1997a; Podnieks,
1992a; Pillemer, 1988). Even these large studies ultimately
based their conclusions on relatively small numbers of abuse
victims, ranging from 47 to 80. Only one of the random
sample studies included cognitively impaired elders (achieved
by interviewing other family members), but using the reports
of proxies is considered unreliable (The Robert Wood Johnson
Foundation, 2001).
All the other studies had serious sampling biases because
they were based on elders who were using services of some
sort and/or were known to adult protective services or domestic
violence programs. This is problematic, because it is clear
that many abused elders are isolated and do not come to
the attention of professionals or seek help. With one exception
(Otiniano, 1998), these studies also involved relatively
small samples - 10 to 401, with the majority being under
100. Respecting the confidentiality and safety of victims
creates problems with many scientific methods. Very few
studies used control groups.
In addition, some elders deny that
what they are experiencing is abuse (see, for example, Phillips,
2000), introducing another source of underreporting. Perhaps
more importantly, studies have shown that elders' definitions
of abuse do not always correspond to professionals' definitions,
which may confound findings.
Comparing results across studies is practically impossible.
These studies varied widely in: the types of abuse studied,
the specific definitions of the types of abuse studied;
whether abuse was self-reported or from agency records;
the age of respondents (which ranged all the way down to
40); whether the target audience was predominately healthy
elders or vulnerable adults; and whether only women or men
and women were included.
POTENTIAL IMPLICATIONS
Given the number of studies identifying mental health or
substance abuse problems among abusers, professionals in
domestic violence/sexual assault, aging and adult protective
services must work closely with providers in these systems.
These services must include or be in addition to programs
focusing on ending abusive behavior.
Professionals and community members require training to
consider an adult child's dependence (emotional, daily living
or financial) as a potential red flag for abuse. Too often
professionals look for the dependency of the victim as a
red flag rather than the dependency of the potential abuser.
Focusing questions on all parties' financial dependency
may help providers begin to identify other forms of abuse.
While the research identified men as the primary abusers
of older people, a higher percentage of women were abusers
than is seen in younger domestic violence. More services
for women abusers, particularly those who neglect older
people they provide care for, will need to be created.
Finally, services must be created to hold older abusers
accountable and change their behavior to truly keep victims
safe. Currently, batterers treatment programming is not
designed for older batterers or adult children/grandchildren
who are abusive. Like services tailored for older battered
women, age-specific services may be needed to work with
older perpetrators and adult children, other family members
or caregivers who abuse elders.
Authors
Bonnie Brandl, M.S.W.
Project Coordinator
National Clearinghouse on Abuse in Later Life/WI Coalition
Against Domestic Violence
(608) 255-0539
bonnieb@wcadv.org
Loree Cook-Daniels
Consultant
National Center on Elder Abuse
(202) 898-2586
Loree@wordbridges.net
September 2002
ADDITIONAL RESOURCES
Nexus. (1999). Moving Beyond Violence: Treating Older
Batterers. (Available from the Institute on Aging, 3330
Geary Boulevard, San Francisco, CA, 94118, (415) 447-1989,
ext. 513.)
Ramsey-Klawsnik, H. (2000). Elder Abuse Offenders: A Typology.
Generations. Vol. XXIV, No. II, 17 - 22. [CANE File
No. L4550-6]*
For a list of research questions on elder abuse and domestic
abuse in later life, go to http://www.elderabusecenter.org/research/agenda.html.
For other articles in this series, see:
·
Causation theories
www.WordBridges.net/ElderAbuse/Research/2002-09-04R.html
(html) or
www.WordBridges.net/ElderAbuse/Research/2002-09-04R.pdf
(Adobe Acrobat format)
·
Culture
www.WordBridges.net/ElderAbuse/Research/2002-09-05R.html
(html) or
www.WordBridges.net/ElderAbuse/Research/2002-09-05R.pdf
(Adobe Acrobat format)
·
Prevalence and incidence
www.WordBridges.net/ElderAbuse/Research/2002-09-06R.html
(html) or
www.WordBridges.net/ElderAbuse/Research/2002-09-06R.pdf
(Adobe Acrobat format)
·
Relationships
www.WordBridges.net/ElderAbuse/Research/2002-09-07R.html
(html) or
www.WordBridges.net/ElderAbuse/Research/2002-09-07R.pdf
(Adobe Acrobat format)
·
Services and interventions
www.WordBridges.net/ElderAbuse/Research/2002-09-08R.html
(html) or
www.WordBridges.net/ElderAbuse/Research/2002-09-08R.pdf
(Adobe Acrobat format)
·
Types of abuse (includes
sexual assault and homicide/suicide)
www.WordBridges.net/ElderAbuse/Research/2002-09-09R.html
(html) or
www.WordBridges.net/ElderAbuse/Research/2002-09-09R.pdf
(Adobe Acrobat format)
·
Victims
www.WordBridges.net/ElderAbuse/Research/2002-09-10R.html
(html) or
www.WordBridges.net/ElderAbuse/Research/2002-09-10R.pdf
(Adobe Acrobat format)
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*CANE - The Clearinghouse on Abuse and
Neglect of the Elderly - is the nation's largest computerized
collection of elder abuse resources and materials. Single
copies of articles in its holdings can be ordered from CANE
for $.20 per page. The digits following the hyphen in the
file number indicate how many pages the article has.
CANE
Department of Consumer Studies
University of Delaware
Newark, DE 19716.
