From the Guidelines
Physical abuse of an older adult by a caregiver constitutes any form of physical harm, including hitting, pushing, or restraining.
Types of Abuse
- Physical abuse: includes physical harm, such as hitting, pushing, or restraining, as well as the use of physical or chemical restraints 1
- Sexual abuse: includes any form of non-consensual sexual contact or behavior
- Emotional or psychological abuse: includes verbal or non-verbal behaviors that cause emotional distress or fear
- Neglect: includes the failure to provide necessary care or support, such as food, water, or medical attention
- Abandonment: includes the desertion or abandonment of an older adult by a caregiver
- Financial or material exploitation: includes the misuse or theft of an older adult's financial resources or property
Risk Factors
Factors that elevate the risk of abuse include young age, substance abuse, marital difficulties, and economic hardships 1.
Screening Instruments
Several screening instruments have been developed to identify older potential victims of abuse or their abusive caretakers, including the Caregiver Abuse Screen (CASE) and the Hwalek–Sengstock Elder Abuse Screening Test (HSEAST) 1.
Prevalence of Abuse
The National Elder Abuse Incidence Study (NEAIS) estimates that approximately 551 000 older adults in domestic settings were abused and/or neglected during 1996, with 90% of cases perpetrated by a family member, usually an adult child or spouse 1.
From the Research
Definition of Physical Abuse of an Older Adult by a Caregiver
Physical abuse of an older adult by a caregiver refers to intentional acts that cause harm or injury to a vulnerable older person [(2,3,4,5)]. This can include, but is not limited to:
- Physical violence, such as hitting, pushing, or kicking
- Use of restraints or confinement
- Withholding of essential needs, such as food, water, or medication
Forms of Elder Abuse
Elder abuse can take many forms, including [(3,4,5)]:
- Physical abuse
- Emotional or psychological abuse
- Financial abuse or exploitation
- Sexual abuse
- Neglect or self-neglect
Risk Factors for Elder Abuse
Several risk factors can increase the likelihood of elder abuse, including [(2,3,4,5)]:
- Social isolation
- History of dysfunctional family relationships
- Psychopathologic factors of the caregiver
- Caregiver burden related to the care of the impaired elder
- External life events, such as financial stress or lack of support
Detection and Reporting of Elder Abuse
Detection of elder abuse can be obstructed by denial or shame of the abused older adult and denial or improper assessment by health care professionals [(2,4)]. Reporting laws exist in all states, and health care practitioners must become familiar with the laws in their states [(2,4)]. A multidisciplinary approach is recommended when making an assessment for elder abuse, including attention to physical indicators, social and family history, and psychological history of the patient and caregiver 4.