Risk Factors for Elder Abuse

 

A combination of individual, relational, community, and societal factors contribute to the risk of becoming a perpetrator of elder abuse.

They are contributing factors and may or may not be direct causes.

Understanding these factors can help identify various opportunities for prevention.

 

Risk Factors for Perpetration

Individual Level

• Current diagnosis of mental illness

• Current abuse of alcohol

• High levels of hostility

• Poor or inadequate preparation or training for care giving responsibilities

• Assumption of caregiving responsibilities at an early age

• Inadequate coping skills

• Exposure to abuse as a child

Relationship Level

• High financial and emotional dependence upon a vulnerable elder

• Past experience of disruptive behavior

• Lack of social support

• Lack of formal support

Community Level

• Formal services, such as respite care for those providing care to elders, are limited, inaccessible, or unavailable

Societal Level

A culture where:

• there is high tolerance and acceptance of aggressive behavior;

• health care personnel, guardians, and other agents are given greater freedom in routine care provision and decision making;

• family members are expected to care for elders without seeking help from others;

• persons are encouraged to endure suffering or remain silent regarding their pains; or

• there are negative beliefs about aging and elders.

 

In addition to the above factors, there are also specific characteristics of institutional settings that may increase the risk for perpetration of vulnerable elders in these settings, including: unsympathetic or negative attitudes toward residents, chronic staffing problems, lack of administrative oversight, staff burnout, and stressful working conditions.

 

 

Protective Factors for Elder Abuse

 

Protective factors reduce risk for perpetrating abuse and neglect. Protective factors have not been studied as extensively or rigorously as risk factors. However, identifying and understanding protective factors are equally as important as researching risk factors.

Several potential protective factors are identified below. Research is needed to determine whether these factors do indeed buffer elders from abuse.

 

Protective Factors for Perpetration

Relationship Level

• Having numerous, strong relationships with people of varying social status

Community Level

• Coordination of resources and services among community agencies and organizations that serve the elderly population and their caregivers.

• Higher levels of community cohesion and a strong sense of community or community identity

• Higher levels of community functionality and greater collective efficacy

Factors within institutional settings that may be protective include: effective monitoring systems in place; solid institutional policies and procedures regarding patient care; regular training on elder abuse and neglect for employees; education about and clear guidance on how durable power of attorney is to be used; and regular visits by family members, volunteers, and social workers.

 

 

Consequences of Elder Abuse

 

The possible physical and psychosocial consequences of elder abuse are numerous and varied. Few studies have examined the consequences of elder abuse and distinguished them from those linked to normal aging (NRC, 2004).

 

Physical Effects

The most immediate probable physical effects include the following (Anetzberger G, 2004).

• Welts, wounds, and injuries (e.g., bruises, lacerations, dental problems, head injuries, broken bones, pressure sores)

• Persistent physical pain and soreness

• Nutrition and hydration issues

• Sleep disturbances

• Increased susceptibility to new illnesses (including sexually transmitted diseases)

• Exacerbation of pre-existing health conditions

• Increased risks for premature death

Psychological Effects

Established psychological effects of elder abuse include high levels of distress and depression (Comijs HC, 1999).

Other potential psychological consequences that need further scientific study are

• Increased risks for developing fear and anxiety reactions

• Learned helplessness

• Post-traumatic stress disorder