Elder Abuse, Neglect, and Exploitation
Chris Herman, MSW, LICSW
NASW-DC Senior Practice Associate
In recent years, the problems of elder abuse, neglect, and exploitation have garnered increasing attention within the United States. Although much work remains to establish reliable data, integrate policy solutions, and disseminate effective practice approaches to prevent and address elder abuse, significant advances have been made. This publication describes the nature, incidence, and risks of elder mistreatment; highlights recent federal elder justice initiatives; and provides strategies, tools, and resources to help social workers address elder abuse, neglect, and exploitation.
Understanding Elder Abuse
The National Center on Elder Abuse (NCEA), a resource center of the Administration on Aging (AoA)/Administration for Community Living (ACL), differentiates seven types of elder mistreatment, often described collectively as elder abuse:
physical abuse, which includes not only physical violence but also force-feeding, physical restraints, and inappropriate medication use
emotional or psychological abuse, which includes not only verbal interactions but also infantilizing treatment and social isolation
sexual abuse, which includes sexually explicit photographing or videotaping
financial or material exploitation, which includes any illegal, improper, or coerced use of money, property, or assets
neglect, defined as failure to meet an older adult’s basic needs, such as housing, nutrition, clothing, hygiene, personal care, medical care, safety, or agreed-upon financial support
self-neglect, in which an older adult engages in behavior that jeopardizes the person’s own health and safety, without understanding the consequences of those decisions
abandonment, which may occur not only in health care settings but also in public locations (NCEA, n.d.-b).
At the same time, definitions and categorizations of elder abuse vary widely, and each state’s definition guides service providers’ responses to cases of suspected abuse (Anetzberger,2012; Institute of Medicine [IOM], 2013)
Extent of Elder Abuse
Recent research indicates that elder abuse, neglect, and exploitation are widespread.
In one national study, 9 percent of older adults reported experiencing verbal abuse within the preceding year; 3.5 percent reported financial exploitation and 0.2 percent reported physical abuse (Laumann, Leitsch, & Waite, 2008). This study of community-dwelling older adults did not examine the prevalence of either elder neglect or elder sexual abuse.
A subsequent national study found that as many as 11 percent of older community-dwelling adults had experienced neglect or emotional, financial, physical, or sexual mistreatment in the preceding year (Acierno,Hernandez-Tejada, Muzzy, & Steve, 2009).
A survey of family caregivers yielded reports of elder mistreatment of almost three in 10 older adults residing in assisted living or nursing homes or receiving paid home care in Michigan, with neglect being most commonly reported (Page, Conner, Prokhorov,Fang, & Post, 2009). Follow-up interviews revealed that almost one in four older adults using nursing home care had been physically abused by nursing home staff; types of abuse included physical mistreatment, sexual abuse,and caretaker mistreatment,“including inappropriate use of restraints, forced toileting, or unjustified forced feeding” (Schiamberg et al., 2012).
A recent New York State study revealed an abuse rate of 7.6 percent in the preceding year, with nearly three-quarters of those cases having been unreported to any program or agency serving older adults who experience either elder abuse or domestic violence (Lifespan of Greater Rochester, Inc., Weill Cornell Medical Center of Cornell University, & New York City Department for the Aging, 2011). These results reflect both self-reports from community-dwelling older adults and documented case studies from agencies serving people across care settings.
Thus, the incidence and prevalence of elderabuse, neglect, and exploitation are difficult to determine and may be much greater than figures from various governmental sources indicate.
Moreover, differences in eligibility criteria among state Adult Protective Services (APS) programs and lack of a nationwide APS data system pose challenges to gathering comprehensive data regarding the scope of elder abuse, neglect, and exploitation (U.S. Government Accountability Office [GAO], 2011a)...
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- Risk Factors Associated with Elder Abuse
- Effects of Elder Abuse
- Federal Initiatives to Address Elder Abuse
- Strategies to Prevent and Address Elder Abuse, Neglect, and Exploitation
- Tools Social Workers Can Use to Identify, Address, and Prevent Elder Abuse
- Other Related Resources