Elder abuse
Definition Harmful behavior toward the aged
As the U.S. population became increasingly older and as
more people survived longer than ever before, the significant
increase in the physical and financial abuse of dependent
elderly persons that began in the 1980’s continued in the
1990’s.
The federal Administration on Aging breaks elderly
abuse into four types: physical abuse, including sex-
ual assault; emotional or psychological abuse; finan-
cial exploitation; and neglect or abandonment. It is
estimated that the number of cases of elder abuse in-
creased threefold between 1980 and 1990.
In the 1990’s, there were fewer children in fami-
lies to share the burden of care for elderly incapaci-
tated parents than in earlier times, and families were
increasingly becoming more geographically dis-
persed. Other demographic developments also con-
tributed to the problem of elder abuse, most notably
the striking increase in life expectancy and the grow-
ing proportion of older person in the U.S. pop-
ulation. In 1980, 3 percent of the population was
sixty-five years or older; that figure had climbed to
11 percent by 1990.
Measuring Elder Abuse The National Elder Abuse
Incidence Study, released in 1998, reported that
there were 450,000 instances of elder abuse and ne-
glect by family members or caregivers of persons
aged sixty and older that took place in the victim’s
residence or the caregiver’s home during 1996. Data
were gathered from a sample of twenty representa-
tive counties. More than two-thirds of the perpetra-
tors of abuse were family members. Elderly women
had a higher rate of abuse than men after adjusting
for the larger proportion of women in the study pop-
ulation. Those eighty years or older were abused and
neglected at a rate three times higher than that for
the remainder of the group studied.
Most elder abuse occurs in a domestic setting and
involves the husband as perpetrator and the wife as
victim. In other settings, sons are the most frequent
offenders when offspring abuse elderly parents. In-
juries inflicted on elderly women are more serious
than those suffered by elderly men.
In nursing homes and long-term care facilities,
where caregivers have a contractual obligation to
provide satisfactory care, mistreatment of residents
generally is tied to the overburdened and stressful
work conditions of employees who often are poorly
paid and not satisfactorily trained or supervised. A
1998 research probe found that in California, nearly
one in three nursing homes had been cited by in-
spectors for serious or potentially life-threatening
care problems. The inquiry followed allegations in
1993 that 3,113 California nursing home residents
had suffered from malnutrition, dehydration, and
similar conditions resulting from substandard care.
In the 1990’s, states began to establish registries of
persons convicted of elder abuse so that employers
would be forewarned of their past wrongdoing.Reporting Requirements The primary approach to
dealing with elder abuse rests on state laws requiring
a variety of persons, such as physicians and nurses,
social service workers, and law-enforcement person-
nel, to report episodes of elder abuse to designated
authorities. The laws typically require such report-
ing if the specified person “reasonably believes” that
abuse has occurred, and they usually provide ex-
emption from civil liability if the report has been
made in good faith.
By the end of the 1990’s, forty-two states and the
District of Columbia had reporting statutes. In a
1991 congressional hearing held by the House of
Representatives Subcommittee on Human Services
of the Select Committee on Aging, a government
agency reported that the absence of reliable data
meant that no meaningful comparisons could be
drawn between the value of mandatory as compared
to voluntary elder abuse reporting requirements.
Other witnesses appearing before the subcommittee
maintained that the laws were at least partly respon-
sible for the 150 percent increase in reported cases
of elder abuse in 1996 compared to ten years earlier.
The failure to report elder abuse was estimated to
be characteristic of 80 to 90 percent of the cases.
Many persons fail to report episodes of elder abuse
because they are convinced that there are not ade-
quate services and resources available to deal effec-
tively with the problem.
The reauthorization by Congress in 1992 of the
Vulnerable Elder Rights Protection Act created om-
budsmen to field complaints of mistreatment and
provided funds for states to launch prevention pro-
grams. Guidelines promulgated in 1997, for in-
stance, noted that protective service workers should
be suspicious if there has been an unreasonable de-The Nineties in America Elder abuse 293