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In 1995, following funding by the Westminster Department of Health, AEA undertook a level of consultation and then established the following definition of elder abuse. (see Action on Elder abuse (1995) ‘New Definition of Abuse’, London: Action on Elder Abuse Bulletin (May-June 1995, issue no. 11).
This has been subsequently adopted by the World Health Organisation, is promoted by the International Network for the Prevention of Elder Abuse , and has been variously adopted by countries throughout the World, including the Republic of Ireland (with a slight addition):
‘A single or repeated act or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person’.
It has at its heart the ‘expectation of trust’ that an older person may rightly establish with another person, but which may be subsequently violated. For this reason, AEA do not get involved with actions that relate to strangers, unless those strangers have exploited the expectation of trust.
What happens and who is involved?
Any older person can potentially become a victim of elder abuse, which it why is important to consider options to self-protect. People can be abused in many different ways, and this section will help you understand the five common types of abuse: physical, psychological, financial, sexual abuse and neglect. Often these abuses are also crimes.
We do not identify racial abuse or institutional abuse as separate forms of abuse because they manifest in these five types. Racial abuse can be what motivates someone in their actions, and institutional abuse can be used to describe the environment and circumstances that give rise to abuse.
In this context, we also have to recognise family abuse, which additionally manifests in the five types described above, but which can complicate the ability of an older person to accept or confront what is happening to them. And we also need to understand and apply our knowledge and experiences of domestic abuse, as older people are equally affected by such actions.
Both older men and women can be at risk of being abused, and this can potentially happen wherever they live or visit. This may include: someone’s own home, in a carer’s home, in a day centre, in a residential home, in a nursing home, or in a hospital.
The key issue is not about where someone lives or visits, but about whether or not the opportunity exists for another to abuse the relationship of trust and exploit or harm them.
Which is why it is important to think in advance about ways in which someone can reduce the possibility of abuse, by avoiding isolation or dependency, and by having more than one person keeping an eye on matters. Reliance on others does not mean having to be dependent on others, Thinking about self-protection is more about common sense than about being distrustful.
Often, the people who abuse older people are exploiting a special relationship. They are in a position of trust or have created an expectation of trust, whether through family bonds, friendship or through a paid caring role, and they exploit that trust.
In the experience of our helpline, most financial abuse/harm is perpetrated by family members, often sons and daughters, who seek to justify their actions e.g. by claiming that they are taking their inheritance ‘a bit early’.
Sometimes however abuse is not intentional. It can be because someone lacks the skills or external support necessary to adequately care for another person. We call this ‘passive abuse’ because it is unintentional. That does not mean that the impact on the older person is any less, but it can help us to understand how best to address the abuse.
Understanding why and how abuse has happened is the key to understanding how to prevent it in the future. And prevention is always better than intervention.
Both older men and women can be at risk of being abused. The Prevalence Study in 2007, which was undertaken following representations by AEA, indicated that 4% of older people (both men and women) experienced abuse in their own homes – at least 342,000 people. When this data was adjusted to include every instance of abuse – applying the AEA definition - the percentage figure rises to 8.6% based on the current UK population (just over 1 million older people).
The abuser is often well known to the person being abused. They may be: a partner, child or relative, a friend or neighbour, a paid or volunteer care worker, a health or social worker, or other professional. Older people may also be abused by a person they care for.