Elder abuse


Updated July 2006

Elder abuse is defined as: 'A single or repeated act or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person'.[see reference 1]

In 1992 a UK national prevalence study by Ogg and Bennett was published. This showed that up to five per cent of older people in the community were suffering from verbal abuse and up to two per cent were the victims of physical or financial abuse. There have been no prevalence studies undertaken in the UK on abuse in care settings.[see reference 1]

Like other forms of abuse, elder abuse is a complex problem, and it is easy for people to have misconceptions about it. Elder abuse is not just associated with those who live in nursing homes and those who live alone and have no visitors.
  • Most incidents of elder abuse do not happen in a nursing home.
  • Most elder abuse and neglect takes place at home.
  • There is no single pattern of elder abuse in the home. Sometimes the abuse is a continuation of long-standing patterns of physical or emotional abuse within the family. Perhaps, more commonly, the abuse is related to changes in living situations and relationships brought about by the older person’s growing frailty and dependence on others for companionship and for meeting basic needs.
  • It is not just infirm or mentally impaired older people who are vulnerable to abuse. Older people who are ill, frail, disabled, mentally impaired, or depressed are at greater risk of abuse, but even those who do not have these risk factors can find themselves in abusive situations and relationships.[see reference 2]
Action on Elder Abuse is a national UK organisation based in London. It provides many resources on the subject and believes it is vital that:
  • it is recognised that elder abuse exists and that it may have a profound effect on the quality of life for older people
  • both the rights and autonomy of the older person, and their possible need to be protected from abuse, are recognised
  • all older people have the confidence, knowledge and support to take the action they choose to counter abuse
  • health and social care practitioners, at all levels, are trained to recognise the different types of abuse and to respond to the needs of both the abused and the abuser
  • both health and social services purchasers and providers have staff and services which are responsive to the needs of the abused and the abuser
  • the responses of all statutory, voluntary and independent agencies should be collaborative and appropriate
  • a broad range of research is undertaken to expand knowledge of the issues
  • social policy work is undertaken to ensure that service provision and underpinning legislation is framed to meet the needs of vulnerable older people.[see reference 1]
Health Select Committee report
The Health Select Committee published a comprehensive report (House of Commons Health Committee: Elder Abuse) on 13 April 2004 following their inquiry into the extent and the issues associated with elder abuse. The report contains 40 recommendations that build upon existing Adult Protection processes. Following this Inquiry there should be no doubt that elder abuse is a serious problem that needs to be addressed. The recommendations include:
  • the need for a prevalence study into elder abuse
  • the need for a national recording system for the incidence of adult abuse
  • inclusion of 'adverse events' reporting into the Domiciliary Care standards, inclusion of abuse training for care assistants and home helps and mandatory training for nurses and care workers
  • the need for the Department of Health to review the frequency and effectiveness of inspection of NHS establishments providing care for older people.
The Government has issued a response to this report and some progress has been made toward addressing the recommendations and conclusions. For example, a project has been launched to establish a monitoring and reporting process for adult protection referrals.[see reference 3] In 2006 a nationwide study was commissioned on the extent of elder abuse.[see reference 4]

References:
[1] Action on Elder Abuse
[2] American Psychological Association online: ageing issues
[3] Department of Health (2005) Action on elder abuse: Report on the project to establish a monitoring and reporting process for adult protection referrals made in accordance with 'no secrets'.
[4] Department of Health (2006) Preventing abuse of the elderly

Further information:
  • Action on Elder Abuse, established in 1993 by a group of practitioners from health and social care, academics and representatives of the voluntary sector who were concerned about the lack of information and assistance for those who were abused or were at risk of abusing
  • International Network for the Prevention of Elder Abuse, organisation dedicated to the global dissemination of information as part of its commitment to the worldwide prevention of the abuse of older people
  • WITNESS, formerly POPAN the Prevention of Professional Abuse Network, helps people who have been abused by health or social care professionals and works towards preventing future abuse
  • Victim Support, independent charity which helps people cope with the effects of crime
  • Women’s aid: England’s national charity for women and children experiencing physical, sexual and emotional abuse in their homes

    © British Medical Association 2008

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