Abuse of older adults refers to actions that harm an older person or jeopardize the person's health or welfare. Abuse of older adults is also known as senior abuse or elder abuse.

According to the World Health Organization, abuse and neglect of older adults can be a single or a repeated act. It can occur in any relationship where there is an expectation of trust or where a person is in a position of power or authority. Abuse can be physical (e.g. hitting), emotional, verbal (e.g. name calling), financial (e.g. taking money or property), sexual and spiritual. Some types of abuse of older adults involve violation of their rights. Financial abuse is considered the most common form of abuse of older adults. Neglect can be part of abuse. Neglect involves not doing something, such as not providing the older person with food, shelter, medication, or care.

Older adults often experience more than one form of abuse and neglect. For example, they may be emotionally and financially abused, or emotionally and physically abused. Some older adults may be neglected and have their rights violated.

Who are the Victims?

Abuse or neglect can happen to any older adult. In fact, contrary to commonly held beliefs, most older adults who experience abuse or neglect are mentally competent, are not dependent on other people, and do not require constant care.

It can occur in any relationship, including one where there is an expectation of trust or where a person is in a position of power or authority. Abuse or neglect of older adults can take place in the home, in a residential care setting, or in the community.

Who are the Abusers?

Abuse of older adults most often occurs within the family, by a spouse, children, and/or grandchildren. However, abusers can also include friends, neighbours, paid care providers, landlords and staff, or any individual in a position of power, trust, or authority.

How Many Older Adults are Affected by Abuse or Neglect?

Research on abuse of older adults is relatively new and limited in Canada and throughout the world. Abuse and neglect of older adults is often hidden and under-reported. In many cases, people may not recognize abuse and neglect of older adults when it is happening.They may not understand what it is.

• Canadian research indicates that between 4 and 10% of older adults experience one or more forms of abuse or neglect at some point in their later years from someone they trust or rely on.
• Under-reporting and inconsistencies in collecting information on abuse suggest that these figures are "the tip of the iceberg."
• Some older adults may be more likely to experience abuse or neglect, including those who are isolated, and those who have mental or physical impairments.
• It is estimated that between 177,000 and 442,000 seniors in Canada are experiencing or have experienced abuse or neglect in later life.

Did You Know?

• About 80% of abuse or neglect of older adults is hidden or goes undetected. Only about one in five cases of abuse come to the attention of community agencies or authorities.
• Abuse is not limited to older adults of any particular culture, ethnic group, social background, or religion.
• Spousal abuse can "grow old." It can start earlier in a relationship and continue into later life.
• Older women are the victims in about two-thirds of the cases of abuse or neglect that come to the attention of community agencies.

Abuse is a Form of Family Violence

Many forms of abuse and neglect of older adults are types of family violence. A 2004 national report on family violence that looked at police reports from across Canada found:

• Adult children were involved in 38% of the family assaults against older adults.
• Spouses were involved in 26% of the assaults against older adults.
• Older men were more likely than older women to be victimized by an adult child. Older women were more likely than older men to experience violence at the hands of their spouse.
• The most common type of senior abuse situations that come to the attention of the police involve younger seniors (between the ages of 65 and 69).
• Common assault was the most frequent type of harm to older adults from family members that was reported to police. Common assault may involve hitting or attacking with minor or no injury.
• However, four in 10 older adults who were victims of family violence suffered physical injuries.

The report pointed out that the consequences of family violence can be very serious in some cases. Abuse situations often become worse over time. Older adults can die from family violence. The rates of family homicides against adults aged 65 and over have increased in the last decade.

Why Do Abused Older People Often Keep Silent?

There is no excuse for abuse or neglect. However, there are many reasons why older people might keep silent. Some believe that the abusive situation they are in is a normal part of life. They may think that they are in the wrong or have caused the abuse. In many cases, the person may be afraid of:

• What will happen to them ("Will the situation get worse?")
• "Will I be forced from my home?"
• What will happen to the abuser ("Will he/she go to jail?")
• What the neighbours, family, or community will think ("What will people say?")

Some older adults may feel they have no place to go, or do not want to leave the home they love, and have invested in with both time and money. They may have concerns about leaving family members and beloved pets. These fears and concerns are real. Older adults are becoming aware that they do not have to live with abuse or neglect. They are beginning to feel it is safe to tell, because they know that people care and that help is available.

Sources: World Health Organization & International Network for the Prevention of Elder Abuse (2002). Statistics Canada, "Family Violence: A Statistical Profile, 2004." Canadian Network for the Prevention of Elder Abuse, "What is Senior Abuse?"

Why Does Abuse Happen in Later Life?

Abuse and neglect of older adults is a complex area.The many forms of abuse and neglect are not acceptable; some forms are against the law. There is no one simple explanation for why abuse or neglect occurs.

Some situations involve spouses; some involve adult children or grandchildren or other relatives. Others involve paid caregivers or family members who are giving care. Some abuse and neglect may:

• reflect ageism
• be part of a cycle of family violence, or
• be opportunistic behaviour

Abuse and neglect may also reflect a lack of understanding and knowledge about older adults and aging. Stereotypes and misconceptions about aging and older people may lead to ageist attitudes that older adults are not deserving of respect.

Some people use violence and control in their relationships with other people. Some people have negative beliefs about older people, while others do not treat older adults with respect. Some people incorrectly feel they are entitled to an older adult's property, simply because the person is old, or because they are helping the older adult, or because of their position in the family.

Some people experience personal problems or stresses that may increase their risk of harming or neglecting others. Some simply become overwhelmed or do not know more positive ways of relating. Limited financial resources may create family tensions that may lead to abuse or neglect.

It does not matter who the abuser is, or why the person is abusing an older adult. No one deserves to be abused or mistreated.

Prepared by Penny Bain and Charmaine Spencer for Federal/Provincial/Territorial Ministers responsible for seniors in Canada - Reprinted December 2007