Do cultural values play a role in defining what is considered
abusive behavior? Are members of some cultural groups less
willing to report abuse or accept services? Do cultural
groups have different perceived roles for elders in their
communities? Are family members expected to provide care
for their aging parents? Are aging parents expected to
provide support (emotional and financial) for their adult
children?
Professionals must understand how cultural differences
can affect how community members define abuse and what services
victims may be willing to accept. This paper will examine
the research on domestic abuse in later life that focuses
on cultural considerations.
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
Twelve articles published between 1989 and 2000 were reviewed
for this article. The studies gathered data by interviewing
older persons from cultural groups and comparing attitudes
of different cultural groups. Populations studied included
African American, Caucasian/European American, Hispanic,
Japanese American, Korean American, Mexican, Native American,
Navajo, Puerto Rican, and Vietnamese American. This paper
focuses on racial/ethnic groups because the authors did
not find studies describing issues for other cultural (e.g.,
gay, lesbian, bisexual, transgender) or religious/spiritual
groups.
| Author(s)
Pub. Date |
Sample
size and demographics |
Type(s)
of abuse covered |
Selected
finding(s)
(page number/s in parentheses) |
| Moon and Benton
2000 |
Interviews
of 100 African American, 95 Korean American and 90
white elders age 60 or older living in LA County,
CA in 1997. Purposive and convenience sampling methods
were used to find participants. 2/3 participants
were female. |
Physical,
medical, verbal, psychological, financial, and neglect. |
·
In general, African Americans and White
elderly had similar responses compared to Korean American
elderly. (298)
·
"White elderly respondents were significantly
more likely to tolerate verbal abuse than the other
groups." 30% of whites, 8.4% of Korean Americans,
and 3% of African Americans said it was okay for adult
children to occasionally yell at their parents. (293)
·
45.3% of Korean Americans agreed it
was okay for an adult child to use his parent's money
for himself, compared to 2.2% of whites and 2% of
African Americans. (293)
·
58.1% of Korean Americans, 37% of African
Americans, and 24.4% of white elders believed elder
abuse is committed mostly by mentally ill persons
or substance abusers. (295)
·
"Korean American respondents were
significantly more likely than respondents in the
other groups to blame the victims for the occurrence
of elder abuse." (299)
·
"Korean American elderly respondents
held significantly more negative attitudes toward
involvement of persons outside the family in elder
abuse incidents, as well as toward reporting of such
incidents to the authorities and the consequences
for perpetrators." (299)
·
"[T]he majority of respondents from
all 3 groups studied believed that incidents of elder
abuse should not be reported to the authorities until
they are absolutely sure that abuse has occurred."
(300)
·
"Ethnic-specific approach to public
outreach and educational efforts may be more effective
than a more general approach in increasing the awareness
and understanding of elder abuse issues pertinent
to each ethnic community." (301)
·
"Public educational outreach efforts
for prevention of and intervention in elder abuse
should target recent immigrant populations who are
not familiar with the American legal and social service
systems related to elder abuse." (301) |
| Hudson and
Carlson
1999 (a) |
|
Elder abuse
(not including neglect) |
·
"[Responding to 37 possible abuse scenarios,]
[t]he Native Americans ranked [4] more items as abusive
and 22 items at a higher level of severity than did
the African Americans, who rated [3] more items as
abusive and 15 as more severe than did Caucasians."
(196) |
| Hudson, et
al
1999 (b) |
Interviews
of 944 community dwelling persons in NC ages 40 -
93 years old. 424 White Americans; 318 African American;
and 202 Native Americans. Half of the sample was
aged 40-64, half 65+. Half were female, half male. |
"Elder mistreatment:
destructive behavior that is directed toward an older
adult, occurs within the context of a relationship
connoting trust and is of sufficient intensity and/or
frequency to produce harmful physical, psychological
social and/or financial effects of unnecessary suffering,
injury, pain, loss, and/or violation of human rights
and poorer quality of life for the older adult."
"Elder abuse: aggressive or invasive behavior/action(s)
or threats of same, inflicted on an older adult and
resulting in harmful effects for the older adult." |
·
"[T]he majority of each of the groups
indicated that one incidence of yelling or swearing
at, slapping, or hitting an elder is sufficient to
warrant the label of elder abuse. This view contrasts
with the experts' view.[that abuse must be] 'of sufficient
frequency and/or intensity.'" (925)
·
"What may not be perceived as abuse
by a professional who represents one racial or cultural
group, may well be perceived as such by the abuse
participants who represent another racial or cultural
group. The reverse may also be true." (936) |
| Moon and Evans-Campbell
1999 |
Interviews
of 95 Korean-Americans and 90 Caucasian elders age
60 and over in Los Angeles |
Awareness
of formal or informal sources of help for elder mistreatment
or abuse |
·
"Only 28% of Korean-Americans, compared
to 62% of Caucasians, knew of an agency, organization,
or a professional to turn to for help if they were
abused or mistreated." (8)
·
Of the 27 Korean Americans who knew
of a professional source of help, 22 named Korean
American agencies. The remaining 5 mentioned the
police. (8-9)
·
"Over one-quarter of Korean Americans
(28%) and 3% of Caucasians could not identify a signal
source of help, informal or formal, to turn to if
they were being abused." (10)
·
"Most elderly respondents, regardless
of ethnicity, would turn to an informal source of
help, the police, or a general social service agency
providing services to the elderly rather than APS."
(20) |
| Sanchez
1999 |
62 individuals
age 60+, Mexican immigrants or Mexican-American,
from community centers in Detroit, MI, and Carson
City, NV |
Physical abuse,
neglect, financial abuse, and denial of shelter |
·
"40 respondents (64.5%) believe parents
are responsible for helping their children with care
for grandchildren and with providing money/resources
as needed and do not consider this exploitative."
(71)
·
"Conversely, 52 respondents (83.9%)
believe adult children are responsible for helping
their parents with care and, if necessary, financial
assistance." (71)
·
If a neighbor were being hurt, fewer
than ¼ would report to authorities; more than half
would talk to family members; the remainder would
say nothing. (72)
·
If the elder themselves were being
abused, 2/3 would talk with family members before
contacting authorities. 15% would contact authorities.
(73)
·
"Admitting abuse brings shame to the
family." (75) |
| Tomita
1999 |
Two focus
groups of Japanese-Americans (age unclear) and 25
interviews of Japanese Americans in Seattle and Hawaii,
aged 65+ |
Purpose of
study was to "capture the Japanese American definitions
of mistreatment" (120) |
·
The primary Japanese approach to conflict
is "group above self," conflict avoidance and an acceptance
of suffering. (125-136)
·
"The cultural message is to protect
the community by not discussing with outsiders anything
that would dishonor it [including abuse]." (129) |
| Anetzberger1998 |
62 adults
from Cleveland and Seattle, divided by racial group
(European-American, African-American, Puerto Rican,
and Japanese Americans) and age ("baby boomer caregiver"
and elders 60+) |
"What are
the three BEST things (in order of importance) that
a family member can do for an elderly person?" "What
are the three WORST things (in order with the worst
thing first) that a family member can do to an elderly
person?" |
·
Answers varied based on racial background.
The worst thing for older European American and Puerto
Ricans was psychological neglect. For older Japanese
Americans and African-Americans, it was psychological
abuse.
·
For the younger generations, Puerto
Ricans and Japanese Americans said psychological abuse,
but European Americans and African Americans named
physical neglect as worst. (144)
·
100% of the older Japanese Americans
but only 28.6% of younger Japanese Americans said
providing emotional support was the most important
thing family members could offer elders. (144) |
| Otiniano
1998 |
24,648 Hispanic
elders referred to the Texas APS system from 1991-1995 |
Cases referred
to APS |
- "Reluctance of Hispanic victims to become involved
in services to ameliorate their situation is a major
barrier to effective intervention." (194)
|
| Le
1997 |
20 Vietnamese
age 60+, living in a house headed by an adult child,
at least somewhat dependent on child, in Southern
California |
Verbal, emotional,
financial and physical abuse |
·
Victims were more likely than non-victims
to be female, unable to speak English, and financially
dependent on their child/ren. (57)
·
80% do not know how to report abuse;
70% would not want to complain about family mistreatment.
(56)
·
Most of the respondents preferred to
keep their problems to themselves because of their
reluctance to reveal family problems and risk potential
embarrassment and fear of raising conflicts among
their children/relatives. (56-57) |
| 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) |
·
"African American perpetrators of elder
abuse are adults involved in dependent, mutually beneficial
relationships with elders. These relationships may
involve emotional maltreatment of the adult children
in the form of 'encouraged' infantilism." (23) |
| Moon and Williams
1993 |
30 African
American, 30 Caucasian American and 30 Korean American
women aged 60-75 in Minneapolis, Minnesota |
|
·
"[C]onsiderable ethnic group differences
exist in the perceptions of elder abuse, and the Korean
Americans on the average were less sensitive to or
more tolerant of potentially abusive situations than
the other two groups." (389)
·
"The data.clearly indicate that perceiving
a situation as abusive or problematic is a strong
predictor of the person's intention to seek help."
However, "the overall average percentage of those
who would seek help was somewhat lower than the percentage
of those who identified the scenarios as elder abuse
cases." (390-1)
·
Only 17.7% of the African American
elders would turn to family for help with abuse, vs.
55.5% of the Korean Americans and 30.1% for the Caucasian
Americans. (391) |
| Brown
1989 |
Random sample
of 37 Southwest reservation-dwelling Navajo aged 60+
and their family members; 22 cases of elder abuse
found |
Neglect, verbal/
psychological abuse, physical abuse, financial exploitation |
·
Most elders perceived by researcher
as "financially exploited" felt they were voluntarily
sharing their income. (23) |
GENERALIZED FINDINGS
Four studies compared perceptions by members of different
racial and ethnic groups about behavior that constituted
elder abuse and found significant differences in the definitions
(Moon, 2000; Hudson, 1999a; Anetzberger, 1998; Moon, 1993).
Moon found Caucasian elders were more likely to tolerate
verbal abuse and Korean Americans more likely to tolerate
financial exploitation than her other studied populations
(Moon, 2000). Hudson found that Native Americans rated
behaviors as more abusive than African Americans, who rated
items more severe than did Caucasians (Hudson, 1999). Anetzberger
found that European Americans and Puerto Ricans differed
from Japanese Americans and African Americans on whether
psychological neglect was worse than psychological abuse.
This study also found differences between older and younger
members of the same ethnic groups (Anetzberger, 1998).
Moon found that Korean Americans were more tolerant of abuse
than African Americans or Caucasian Americans (Moon, 1993).
Hudson (1999b) found that while minority elders agreed with
elder abuse professionals' definitions most of the time,
there were some discrepancies between what the elders defined
as abuse versus what the professionals said.
One potential reason for the different definitions of abusive
behavior is that cultures have a range of expectations about
the responsibility of grown children and elders to provide
care, financial assistance, and emotional support to one
another (Sanchez, 1999; Tomita, 1999; Anetzberger, 1998;
Griffin, 1994; Moon, 1993; Brown, 1989).
In general, most of the participants in these studies were
reluctant to report abuse (Moon, 2000; Sanchez, 1999; Tomita,
1999; Otiniano, 1998; Le, 1997; Moon, 1993). Moon (2000
and 1999) found that Korean American elders were also more
likely to blame the victim for elder abuse, which could
affect willingness to report, and were less likely to know
of an agency to which they could report. Some study participants
were more likely to report abuse if they defined the behavior
as abusive, but still often would not report (Moon, 1993).
The research indicates that some reasons for non-reporting
include shame, embarrassment, not wanting to create conflict
in the family, and protecting the community. Some participants
expressed willingness to talk to family members rather than
professionals (Sanchez, 1999; Moon, 1993).
Moon (2000) suggested that because of ethnic differences
around abuse definitions, ethnic-specific approaches to
public outreach and educational efforts may be more effective
than a general approach.
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
Existing research indicates that background and cultural
values impact how an older person will define abuse. Professionals
need to recognize these differences when doing public awareness
to discuss prevention, reporting and services. Victims
may see some behaviors as normal within their culture and
not consider asking for help.
Given the percentages of older persons who say they will
not report abuse to authorities but who may talk with family
members, training on domestic abuse in later life is needed
for the general public. Heightened awareness will give
more lay people the tools needed to talk with older people
about abuse, available services and safety planning.
More research is needed to examine cultural differences
and how to build on the strengths of communities. Future
studies should include examining differences and similarities
among racial/ethnic groups as well as focusing on populations
such as gay, lesbian, bisexual, and transgender persons
and religious communities. Research is also needed on the
effectiveness of culturally specific services.
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
Archstone Foundation (ed.). (1998). Understanding
and Combating Elder Abuse in Minority Communities: An Exploration
of the Growing Epidemic of Elder Abuse. May be ordered
through the Foundation at www.archstone.org
or 562-590-8655.
Cook-Daniels, L. (1997). Lesbian, Gay Male, Bisexual,
and Transgendered Elders: Elder Abuse and Neglect Issues.
Journal of Elder Abuse & Neglect, Vol. 9, No.
2, 35 - 49. [CANE File No. K4197-8]*
Tatara, T. (ed.) (1999). Understanding Elder Abuse
in Minority Populations. Taylor and Francis.
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:
·
Abusers
www.WordBridges.net/ElderAbuse/Research/2002-09-03R.html
(html) or
www.WordBridges.net/ElderAbuse/Research/2002-09-03R.pdf
(Adobe Acrobat format)
·
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)
·
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)
BIBLIOGRAPHY
Anetzberger, G. (1998). Psychological Abuse and Neglect:
A Cross-Cultural Concern to Older Americans. Understanding
and Combating Elder Abuse in Minority Communities, Archstone
Foundation, 141-151. [CANE File No. N4692-17]*
Brown, A. (1989). A Survey on Elder Abuse at One Native
American Tribe. Journal of Elder Abuse & Neglect,
Vol. 1, No. 2, 17 - 37. [CANE File No. G3232-11]*
Griffin, L. (1994). Elder Maltreatment Among Rural African-Americans.
Journal of Elder Abuse & Neglect, Vo. 6, No.
1, 1 - 27. [CANE File No. I3691-14]*
Hudson, Margaret F. and John R. Carlson. (1999a). Elder
Abuse: Its Meaning to Caucasians, African Americans, and
Native Americans. Tatara (ed.), Understanding Elder
Abuse in Minority Populations, 187-204. [CANE File
No. N4678-12]*
Hudson, M. et al. (1999b). Elder Abuse: Some African
American Views. Journal of Interpersonal Violence,
14(9): 915-939. [CANE File No. K4205-13]*
Le, Q. (1997). Mistreatment of Vietnamese Elderly by
Their Families in the United States. Journal of Elder
Abuse & Neglect, Vol. 9, No. 2, 51-62. [CANE File
No. J4079-7]*
Moon, A. and Benton, D. (2000). Tolerance of Elder Abuse
and Attitudes toward Third-Party Intervention Among African
American, Korean American and White Elderly. Journal
of Multicultural Social Work, 8(3/4), 283-303. [CANE
File No. K4162-15]*
Moon, A., and O. Williams. (1993). Perceptions of Elder
Abuse and Help-Seeking Patterns Among African-American,
Caucasian American and Korean-American Elderly Women. Gerontologist,
33, 386-395. [CANE File No. H3282-10]*
Otiniano, M. et al. (1998). Hispanic Elder Abuse. Archstone
Foundation Understanding and Combating Elder Abuse in
Minority Communities, 194. [CANE File No. N4696-7]*
Robert Wood Johnson Foundation. (2001). Designing
Effective Survey Methods for Frail Elders: Symposium Proceedings.
[CANE File No. N4889-34]*
Sanchez, Y. (1999). Elder Mistreatment in Mexican American
Communities: The Nevada and Michigan Experiences. Tatara
(ed.), Understanding Elder Abuse in Minority Populations,
67-77. [CANE File No. N4669-8]*
Tomita, S. (1999). Exploration of Elder Mistreatment
Among the Japanese. Tatara (ed.), Understanding Elder
Abuse in Minority Populations, 119-139. [CANE File
No. N4672-13]*
*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.
Please note that a check made out to CANE-UD must accompany
your order. For further information on ordering materials
or conducting a customized search of the database, contact
CANE at (302) 831-3525, or at CANE-UD@udel.edu.
