How are abusers related to older victims of abuse? Are
the majority of abusers adult children, spouses/partners
or other family members? The answers to these questions
are important in designing services and interventions that
meet the needs of victims. This paper will examine research
that provides information about the relationships between
the victim and the abuser.
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 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) |
| 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)
·
Wives reported significantly more abuse
than did daughters. (134) |
| 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 |
Relationship
to victim included:
- Family member in household (7.5%)
- Non-relative in household (5.0%)
- Non-relative living outside household (5.0%)
- Facility staff (7.5%)
- Facility resident (75%) (10)
|
| Brownell, et
al
|
401 elder
abuse cases 60+ known to Victims Resource Center in
New York City |
Physical (including
one case of sexual abuse), psychological, financial
abuse and neglect |
·
39% of abusers adult children (86)
·
22% of abusers non-relatives (86)
·
15% of abusers relatives other than
child/spouse (86)
·
8% of abusers partners/spouses (86) |
| 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 |
·
Spouse was perpetrator in 48% cases;
adult child in 30% of the cases. (101) |
| Vladescu, et
al
1999 |
26 abused
elders (age limit unspecified) served between 1/1/97
- 1/1/99 by Seniors' Case Management program in Hamilton,
Ontario; focus group of 3 case managers |
Physical,
psychological, and financial abuse |
·
Son or daughter (including in-law)
was abuser in 61.5% of cases. (13)
·
Spouse was abuser in 23.1% of cases.
(13) |
| NCEA National
Elder Abuse Incidence Study
1998 |
APS reports
and community "sentinel" reports of abused and neglected
persons age 60+ from 20 counties in 15 states in U.S. |
Physical abuse,
sexual abuse, emotional or psychological abuse, neglect,
abandonment, financial or material exploitation |
·
"[F]amily members were the perpetrators
in nine out of ten (89.7%) substantiated incidents
of domestic elder abuse and neglect." Actual breakdowns:
o
47.3% adult children of victim
o
19.3% spouses
o
8.8% other relatives
o
8.6% grandchildren
o
5.7% siblings (7, 4-28) |
| Otiniano
1998 |
24,648 Hispanic
elders referred to the Texas APS system from 1991-1995 |
Cases referred
to APS |
·
The most common perpetrator was adult
children (47.7%), followed by spouse (12.3%). (194) |
|
|
Data from
National Crime Victimization Survey for 1992 - 1994,
approximately 50,000 housing units and 101,000 persons
annually. |
Robbery and
assault |
·
"The majority of [assault] victimizations
[for both younger and older men and women] are perpetrated
by friends and acquaintances." (193)
·
"Females.have a distinctive vulnerability
to assault by intimates (husbands, boyfriends etc)
and other family members. Approximately one-quarter
of all lone-offender assaults against women were perpetrated
by intimates or other family members." (193) |
| Lachs, et al
1997 (a) |
2,812 adults
65 and older from a stratified sample of residences
in Connecticut; 47 were substantiated cases |
Physical abuse,
neglect, and exploitation |
·
The most common perpetrators of mistreatment
were adult children (45%), followed by spouses (26%).
(471) |
| 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) |
| 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 |
·
57% of adult child abusers were sons;
43% were daughters. (328)
·
"[W]ives were more apt to experience
physical abuse from their husbands than the mothers
from the sons (77.3% vs. 48.3%)." |
| Seaver
1996 |
132 women
aged 50+ who have attended older abused women's program
in Milwaukee, WI |
Unspecified |
·
58% of the abusers were husbands (16)
·
42% were adult children or other kin.
(16) |
| Pittaway
1993 |
605 adults
aged 55-100 who accessed health and social service
organizations in London, Ontario during a 3-month
period |
Physical abuse
(including sexual abuse), chronic verbal aggression,
material abuse (actual and attempted), and neglect
(intentional and unintentional) |
·
"Most physical abuse and all cases
of sexual assault in later life are perpetrated by
spouses." (84)
·
"Spouses are the most common source
of chronic verbal aggression." (86) |
| Vinton
1992 |
25 battered
women's shelters in FL; "older" was defined as 60+ |
Unspecified |
·
95% of older women were battered by
spouse; 3% by son; 2% by daughter, and 2% by other
relative or nonrelative. (68) |
| Podnieks
1992 (a) |
Random sample
telephone survey of 2008 persons 65+ living in community
settings in Canada |
Physical abuse,
neglect, and financial exploitation |
·
Of 11 physical abuse cases, spouse
was the abuser in 9 cases, a son and a roomer the
abuser in the other 2 cases. (26) |
| 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 |
·
"In 81% of the cases, the suspected
offenders were caregivers, and 78% were family members
(primarily sons and husbands.) (81)
·
Relationship to victim (n = 28)
husband--7; boyfriend--1; son--11;
grandson--1; brother--2; boarder--2; friend--1; distant
relative--1; and unrelated caregiver--1 (81) |
| 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 |
·
61% of perpetrators were sons, 39%
daughters. (77)
·
Dyads were 43% mother-son; 33% mother-daughter;
19% father-son; 5% father-daughter. (77)
·
67% of father-son cases involved physical
abuse. (78) |
| 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 |
·
In all but 12% of cases, the abuser
was a family member. (212)
·
Husbands were abusers in 25% of cases;
sons in 23%, and daughters in 18.6% of cases. (212) |
| 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 |
·
Nearly three-fifths of the perpetrators
were spouses (23 wives, 14 husbands); in 15 cases
the abusers were adult children (10 sons, 5 daughters);
and in 11 cases, the abusers were grandchildren, siblings,
or boarders. (54)
·
43% of the physical violence cases
were of wife assaulting husband, and 17% were of husband
assaulting wife. (54)
·
"Many more elders were abused by spouses
(58%) than adult children (contrary to predominant
image)." (55)
·
"There were no statistically significant
differences between spouse perpetrators and child
perpetrators in the level of violence they inflicted,
in the number of injuries they caused or in the degree
of upset they engendered in their victims." However,
only 6% of males abused by wives were injured versus
57% of women abused by husbands, and the abused women
were almost twice as likely as the abused men to be
"very upset" by the abuse. (55-56) |
GENERALIZED FINDINGS
In the vast majority of cases, family members are the abusers
of elders. In the National Elder Abuse Incidence Study,
the abusers were family members in 90 percent of cases (NEAIS,
1998). This is contrary to the image that elder abuse
is caused primarily by paid caregivers and/or strangers.
However, one study (cases of sexual abuse primarily in institutions)
found the majority of sexual assaults were perpetrated by
other facility residents (Teaster, 2000), and Bachman (1998)
found that only about ¼ of "lone offender assaults" against
women (of all ages) were perpetrated by "intimates or other
family members."
Studies that broke out spouse/partner abuse versus adult
children as perpetrators can be divided into 3 categories:
reported cases through aging or adult protective services;
random sample studies; and cases where the victims were
using a domestic violence program. In reported cases, the
abuser was an adult child more often than spouse in every
study (Brownell, 1999; Vladescu, 1999; NEAIS, 1998; Otiniano,
1998; Lachs, 1997a and 1997b; Wolf, 1997; Godkin, 1989)
except one (Lithwick, 1999).
In contrast, both the random sample studies and studies
done on domestic violence services found more spouse/partner
abuse than abuse by adult children. Two random sample studies
found significantly more spouse abuse (Podnieks, 1992a;
Pillemer, 1988). Domestic violence programs also saw significantly
more spouse abuse. Two studies found 58% - 95% of women
they work with abused by spouses (Seaver, 1996; Vinton,
1992). Since domestic violence programs generally focus
their services on "intimate partner" abuse, these percentages
are not surprising.
Two studies had findings regarding whether more husbands
abused wives or wives abused husbands. Crichton (1999)
found more husbands abusing wives where as Pillemer (1998)
found wives reporting more physical abuse against their
husbands than vice versa (Podnieks, 1992a; Pillemer, 1988).
Pillemer used the Conflict Tactics Scales, which does not
distinguish between the harm inflicted by different forms
of abuse and does not gain information about who is afraid
or changes their lifestyle as a result of the abuse. However,
he noted that "only 6% of males abused by wives were injured
versus 57% of women abused by husbands, and the abused women
were almost twice as likely as the abused men to be very
upset by the abuse."
Most studies found sons more abusive than daughters (Crichton,
1999; Lachs, 1997b; Wolf, 1997; Vinton, 1992; Greenberg,
1990; Godkin, 1989; Pillemer, 1988). Sons were found to
be sexual abusers of their mothers in a number of cases
(Ramsey-Klawsnik, 1991).
Phillips found that caregiving wives experienced more abuse
than did caregiving daughters (Phillips, 2000). Wolf and
Pillemer (1997) found that wives were more apt to experience
physical abuse from their husbands than their sons (Wolf,
1997). Similarly, Pittaway (1993) found that spouses were
the primary offenders in cases of physical abuse, sexual
assault, and chronic verbal aggression.
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
Most elder abuse (excluding self-neglect) is family violence.
The dynamics of family abuse are significantly different
than being harmed by a stranger. Victims often encounter
numerous barriers to living free from abuse. Most victims
will be interested in maintaining the relationship (in some
form) while asking professionals to stop the abusive behavior.
This finding mandates collaboration between domestic violence/sexual
assault advocates and professionals in the aging and adult
protective services fields. Workers from these disciplines
must work together to create effective interventions that
focus on victim safety and abuser accountability.
Cases reported to adult protective services and aging units
do not match the findings of random sample studies. Abusive
adult children are seen in higher percentages by adult protective
services (APS) than abusive spouses/partners. However,
random sample studies suggest a significantly higher percentage
of spouse/partner abuse is occurring in communities than
is seen by social services. Several potential explanations
for this phenomenon exist. One is that APS in many states
serve only vulnerable adults, not healthy older victims
of family violence. In these states, if domestic abuse/sexual
assault services are not designed for older victims, there
are probably few, if any, services available for older victims.
Another explanation is that outreach and services offered
by APS may not meet the needs of older victims of spouse/partner
abuse. Often these victims are looking for services such
as safety planning, support groups, legal advocacy and peer
counseling. These are services that typically may not be
offered by APS. Unfortunately, most domestic abuse/sexual
assault programs in the United States do not have these
services tailored for older victims either. In many communities,
older victims are truly invisible because there is no place
to meet their needs and they continue to suffer in silence.
These findings suggest that domestic violence/sexual assault
programs must do outreach to older victims of family violence
(including those abused by adult children or other family
members) who could benefit from the services available to
younger women. Interventions such as safety planning, support
groups, emergency housing, legal advocacy, peer counseling,
and a helpline have been found to be beneficial for older
victims as well as younger ones. It is the responsibility
of domestic violence/sexual assault programs to be sure
that their services are age sensitive.
In addition, adult protective services workers and aging
network professionals can benefit from the work of the domestic
violence/sexual assault fields on effective interventions.
For example, APS workers can be doing safety planning in
the field. APS workers can start support groups for older
victims or co-facilitate a group with a domestic violence
advocate. By working collaboratively, more victims will
have services available that can help them live free from
harm.
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.org
September 2002
ADDITIONAL RESOURCES
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)
·
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)
·
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.
