What is the definition of Exploitation of Vulnerable Adults?

Definition of Exploitation of Vulnerable Adults

Exploitation of vulnerable adults refers to the misuse, mistreatment, or taking advantage of a person age 18 years or older whose ability to perform normal activities of daily living or provide for their own care is impaired due to mental, emotional, physical, or developmental disability or dysfunction or brain damage. 1

Types of Exploitation

Exploitation of vulnerable adults can take several forms:

• Financial or material exploitation: The unauthorized use of funds, property, or resources of a vulnerable adult
• Physical abuse: Causing physical harm or injury
• Sexual abuse: Non-consensual sexual contact or activity
• Emotional or psychological abuse: Causing mental anguish or distress
• Neglect: Failure to provide necessary care, goods, or services
• Abandonment: Desertion by a caregiver
• Self-neglect: Failure of the vulnerable adult to provide for their own essential needs 1

Who Is Considered a "Vulnerable Adult"

A vulnerable adult is defined as a person age 18 years or older who:

• Has impaired ability to perform normal activities of daily living
• Cannot provide for their own care or protection
• Has impairments due to:
  • Mental disability or dysfunction
  • Emotional disability or dysfunction
  • Long-term physical disability
  • Developmental disability
  • Brain damage 1

Definitions may vary by state and sometimes include individuals who receive personal care services from others.

Risk Factors for Exploitation

Vulnerable adults are particularly susceptible to exploitation due to:

• Cognitive impairment: Particularly those with dementia or other cognitive deficiencies 1
• Developmental disabilities: Affecting decision-making capacity 1
• Dependence on perpetrators: Reliance on caregivers who may be the exploiters 1
• Social isolation: Particularly those without children or trustworthy friends/relatives 2
• Living in a care-taking environment: Increased vulnerability due to dependence on others 1
• Financial decision-making impairment: Difficulty managing finances or making sound financial decisions 3

Conceptual Frameworks of Vulnerability

Different disciplines define vulnerability in distinct ways:

Bioethical Perspective

• Vulnerable populations are more susceptible to abuse and require additional protections
• The "vulnerable" are those likely to be misled, mistreated, or taken advantage of 1

Social Sciences Perspective

• Vulnerability is conceptualized as group status characterized by powerlessness and potential for exploitation
• Includes those who lack power and/or resources to speak out and make voluntary choices
• Requires attention to both individual and social vulnerabilities 1

Mental Health Perspective

• Vulnerability is defined in opposition to resilience
• From a biomedical perspective, populations are inherently vulnerable to adverse mental health reactions
• From a social sciences perspective, focus is on interactions between individual and community levels 1

Emerging Forms of Exploitation

Recent research has identified new forms of exploitation targeting vulnerable adults:

• Benefits Trafficking: The systematic recruitment, harboring, neglect, and financial exploitation of elderly and disabled adults who receive government benefits such as Social Security, Veteran's Benefits, Medicaid, and Medicare 4
  • Traffickers pose as caregivers offering in-home care
  • Victims are stripped of government benefits
  • Often held against their will
  • Denied basic needs like food, clothing, and adequate shelter

Prevalence and Reporting

• An estimated 14% of noninstitutionalized older adults experience some form of abuse, neglect, or financial exploitation annually 1
• Only 1 in 5 or fewer cases are actually reported 1
• Women with disabilities are 4 times more likely to experience sexual assault compared to women without disabilities 1

Prevention and Protection

Protection of vulnerable adults requires:

• Awareness of the individual's specific vulnerabilities
• Recognition of the potential for exploitation in care-taking environments
• Monitoring of participant wellbeing in changing contexts 1
• Reducing social isolation to enhance protection 2
• Assessment of financial decision-making capacity in cases of suspected financial exploitation 3

The exploitation of vulnerable adults represents a significant public health and human rights issue that requires comprehensive approaches to prevention, identification, and intervention.