Author(s)

Pub. Date

Sample size and demographics

Type(s) of abuse covered§

Selected finding(s)

(page number/s in parentheses)

Burgess, et al

2000

20 civil cases brought by/on behalf of a sexually assaulted nursing home resident; 2 were under age 55

Sexual assault of a nursing home resident

·        Eleven of the victimized residents died within a year of their assault.  (16)

Dunlop, et al

2000

319 substantiated cases of abused persons aged 60+ in Miami-Dade Co, FL

APS substantiated cases of abuse, neglect, and exploitation

·        Nearly one-half of victims (48.5%) were aged 80+, although this age group comprises only 18.9% of the population 60+.  (106)

·        66.3% of victims were female.  (107)

Phillips, et al

2000

93 cases of women aged 55+ caring for dependent spouse or other elder family member

Verbal and physical abuse; being threatened by or having  gun or knife used on them - all by the elder for whom they were caring.

·        29% of caregivers reported that they had been mistreated by the elder; however, 39% answered positively when asked whether specific abusive behavior had occurred.  "This suggests that for at least some women, mistreatment was viewed as normal behavior for the elder and not mistreatment at all.."  (139-140)

·        This study did not find that living in the same household was related to abuse.  (139)

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

·        Victims were primarily female (95.2% of cases).  (5)

·        Victims were ages 60 - 69 (7.1%); 70 - 79 (31%); 80 - 89 (47.7%); 90+ (14.2%). (5)

·        Living arrangements: with family members (16.7%); in adult care residence (2.4%); in nursing home (80.9%). (5)

·        The majority of victims were unable to care for or protect themselves. (6)

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 spouse cases, 43 victims were women, 7 were men.   (122)

·        Of abused parents, 40 victims were mothers, 10 victims were fathers. (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

·        Three-quarters of the victims were women, 65% of the perpetrators were men.  (101)

·        "Almost half of spousal mistreatment involved cognitive impairment on the part of one spouse."  (102)

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

·        "Victims often justified [violent elder abuse], claiming they had instigated the violence."  (75)

Vladescu, et al

1999

26 abused elders (age limit unspecified) served between 1/1/97 and 1/1/99 by Seniors' Case Management program in Hamilton, Ontario

Physical, psychological, and financial abuse

·        84.6% of the victims were female.  (13)

·        57.7% of victims lived with their abusers; 26.9% lived alone.  (13)

Anetzberger    1998

29 Cleveland APS cases from 1987 to 1995

Psychological abuse and psychological neglect

·        Effects of psychological abuse/neglect included:  fear (60%); depression (50%); anxiety (20%), hopelessness (10%) and denial (10%). (147)

Bachman, et al

1998

Data from National Crime Victimization Survey for 1992 - 1994, approximately 50,000 housing units and 101,000 persons annually

Robbery and assault

·        "Elderly female assault victims were still more likely than other assault victims to sustain injuries and require medical care for these injuries." (195)

·        "Elderly women were more likely to be assaulted in their homes than in any other location." (195)

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

·        People aged 80+ were 19% of the elder population in 1996, yet made up 51.8% of neglect, 48.0% of exploitation, 43.7% of physical abuse, and 41.3% of emotional/psychological elder abuse cases.  (6)

·        Women make up 76.3% of emotional/psychological abuse victims; 71.4% of physical abuse cases; 63.0% of financial/material exploitation victims, and 60.0% of neglect cases.  Men make up 62.2% of abandonment cases.  (6)

·        "Approximately one-half (47.9%) of the substantiated incidents of elder abuse involved persons who were not able to care for themselves, 28.7% were somewhat able to do so, and 22.9% were able to care for themselves."  (6)

·        About 60% of victims experienced some degree of confusion.  (6)

·        About 44% of victims were depressed.  (7)

Older Women's Network

1998

106 Canadian women aged 50+ suspected of being victims of domestic abuse (58% voluntarily disclosed abuse) and 134 stakeholders

Physical, emotional, financial and sexual abuse; neglect

·        Abused older women most often reported issues of isolation, loneliness, fear, guilt and shame. (23)

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, care receiver characteristics were:

4. Has been abused in the past
5. Has marital/family conflict

8. Lacks understanding of medical condition

11.    Is socially isolated

15.    Lacks social support

16.    Has behavior problems

18.  Is financially dependent
19. Has unrealistic expectations
20.  Has alcohol/medication problem
21.  Has poor current relationship (with caregiver)
22.  Has suspicious falls/injuries
23.  Has mental/emotional difficulties

25.  Is a blamer
26.  Is emotionally dependent
27.  No regular doctor  (478)

Lachs, et al 1998

2,812 adults 65 and older from a stratified sample of residence types in CT

Physical abuse, neglect and exploitation

·        After 13 years, survival rates were:

1. 9% for those who were abused
2. 17% for self-neglecters
3. 40% for those not seen by EPS
4. 39% for those seen by EPS but whose abuse/neglect allegations were not verified.  (430)

·        "Reported and corroborated elder mistreatment and self-neglect are associated with shorter survival after adjusting for other factors associated with increased mortality in older adults."  (428)

Lachs, et al

1997 (a)

2,812 adults 65 and older from a stratified sample of residence types in CT; 47 were substantiated cases

Physical abuse, neglect and exploitation

·        "Several risk factors emerged as potent predictors of reported elder mistreatment including poverty, race [non-White], functional and cognitive impairment, worsening cognitive impairment, and living with someone."  Gender conferred no additional risk.  (Researchers note poverty and race findings may be due to sample coming from APS.)  (473)

·        Elders who suddenly became cognitively impaired were more at risk for abuse.  (473)

Lachs, et al

1997 (b)    

182 victims of physical abuse aged 60+ from New Haven, CT

APS-substantiated cases of physical abuse

·        76.3% of victims were female. (450)

·        Abusers cohabitated with victims in 87% of cases. (451)

Le

1997

20 Vietnamese age 60+, living with an adult child, at least somewhat dependent on child, in Southern CA

Verbal, emotional, financial and physical abuse

·        All of the victims were recently (most <5 years) settled in US. (56)

·        Depression due to abuse and missing homeland was very common. (60)

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

·        Abused care receivers were more unhappy and reported poorer caregiver/care receiver relationships than did nonabused care receivers.  (347)

·        "Abused care receivers are no more disagreeable or more neurotic than care receivers who are not abused."  (351)

Otiniano

1998

24,648 Hispanic elders referred to the Texas APS system from 1991-1995

Cases referred to APS

·        Women were twice as likely as men to suffer abuse of any kind.  (194)

Seaver

1996

132 women aged 50+ who have attended older abused women's program in Milwaukee, WI

Unspecified

·        No common profile of victims, commonality was that they live with an abusive mate or family member. (17)

·        Of 132 women, only 11 have had major impairments; of these, only 5 were directly dependent on their abusers for care.  (15)

·        These women "have been eager to learn, use resources well, and respond enthusiastically to the idea that they deserve more peaceful lives."  (19)

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)

Muram, et al

1992

53 female clients of the Memphis Sexual Assault Resource Center aged 55-87, matched with 53 female clients aged 18-45 as controls

Sexual assault

·        Genital injury was more common and more serious among older women: 50.9% of older women were genitally injured compared to 13.2% of the younger women, and 28% of older women vs. 6% of younger women required surgical repair.  (74)

·        In contrast, "there was no difference in the prevalence of nongenital injuries between the two groups."  (74)

·        "The majority of assaults involving elderly women took place in the victim's home by an assailant who was unknown to the victim. This is in contrast to younger women for whom the majority of assaults occurred outside the home" by friends or acquaintances. (75)

Podnieks 1992 (a)

Random sample telephone survey of 2008 persons 65+ living in community settings in Canada

Physical and psychological abuse, neglect and financial exploitation

·        29% of victims versus 7% of non-victims said they wished their life would end. (44)

·        Nearly 60% of victims reported their health was fair or poor, compared to 37% of non-victims. (45)

·        "Victims of physical violence reported far less satisfaction with their lives than other victims." (46)

·        30% of victims of chronic verbal aggression and 20% of physical abuse victims felt the abuse was their own fault. (47)

·        "[G]ender is not a risk factor associated with elder abuse.. This pattern holds for all forms of maltreatment, with the exception of physical abuse, in which more men than women were victims."  (42-43)

Podnieks 1992 (b)

42 elder abuse victims in Canada identified through Podnieks, 1992(a) study

See Podnieks, 1992(a)

·        Strong evidence of adaptive strengths and hardiness of victims. (59)

·        "[I]t is abundantly clear that they have had a realistic perspective on life and have been able to cope with "the hand dealt to them" - even when this meant enduring mistreatment."  (73)

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 28 victims were female. (78)

·        46% were in their 70's (78)

·        21% were in their 80's (78)

·        "These women were quite limited in their capacity to protect and care for themselves." (78)

Greenberg et al

1990

204 cases of abuse of person 60+ by adult child in WI

APS-substantiated cases of physical abuse, material abuse, and neglect

·        51% of victims were frail. (76)

·        20% of victims were homebound. (76)

·        14% of victims had no health problems. (76)

·        73% of victims lived with an adult child, ¾ of them lived in the parent's home. (77)

·        76% of victims were female, 24% male. (77)

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 and physical abuse, and financial exploitation

·        The more sudden the elder's dependency, the more frequent neglect, psychological abuse, and exploitation. (25)

·        The more the elder perceived as dependent by family, the more frequent neglect.  (26)

·        Elders perceived as depressed and/or confused were abused most.  (27)

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

·        "61% of the elderly cases had suffered a recent decline in mental health prior to their being abused or neglected; for the comparison group the figures was 6.4%."  (213)

·        "There were no significant differences between abused/neglected elderly with respect to the numbers of impairments requiring attention, nor the numbers of prescribed medications.  A significant percentage of the maltreated elderly was reported to have experienced a recent decline in physical health (81.4%) in contrast to about one-fifth (21.3%) of the non-victimized elders."  (213)

·        "Generally, elders who were abused and neglected had significantly lower cognitive functioning when compared to the non-abused group except in the area of remote memory.."  (213)

·        "83% of the abused/neglected elderly reside with their caregivers compared to 42.9% of those elderly with caregivers who are not abused or neglected."  (219)

·        "Almost 19% of the abused elderly have no social contacts, whereas only 6.1% of the controls are without contacts.  Over one-third (35.6%) of this group have suffered recent losses in their support system, compared to 4.3% in the comparison group."  (219)

·        ".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, MA; 46 abused elders were reinterviewed and compared to 215 controls

Physical assault; psychological abuse, neglect

·        "Maltreated elderly did not appear to be more ill or functionally disabled.  The victims of maltreatment showed only a small, nonsignificant trend toward greater sickness in the last year, and scored as no more disabled than other elderly.  Perhaps most important, maltreated elders were no more dependent on their abusers than were other elderly on their relatives."  (184)

·        This study is consistent with other research that indicates that abuser characteristics are a more powerful predictor than victim characteristics. (186)

·        "In this study, roughly equal numbers of abused men and women (52% to 48%) were found; further, the risk of abuse for elderly men is double that of elderly women (51 per 1000 versus 23 per 1000)."  (55)

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, neglect

·        Abuse rates were no higher for older (over 75) than for younger (65-74) elderly.  (54)

·        Elders living alone were abused about one-fourth as often as those living with others; "those living with a spouse and at least one other person seemed particularly vulnerable to maltreatment."  (54)

·        Those in poor health were 3 to 4 times as likely to be abused.  (54)