Table of Contents

About This Course

1. Introduction to Elder Abuse
2. The Basics of Elder Abuse
3. Substance Use and Other Risk Factors
4. Screening and Assessment
5. Intervention and Treatment
6. Preventing Elder Abuse

Supplements
Case Studies
References
Resources

Out of the Shadows
Uncovering Substance Use and Elder Abuse

Where Does Elder Abuse Occur?

A common misperception about elder abuse is that the abuse occurs primarily in institutions, such as nursing homes and other long-term care facilities. Although nursing homes are not immune to elder abuse, only 4 to 5 percent of all adults over 65 live in institutions due to their care needs.

Home

Family members and friends provide nearly three-quarters of the care to impaired older adults living in the community. ref More than 22.4 million people provide unpaid help to spouses, parents, or other relatives and friends who have at least one limitation on their activities of daily living (ADLs). The economic savings of this care in terms of health and long-term care expenses have been estimated at $257 billion a year. ref

Caregivers may help with ADL activities, such as bathing, dressing, getting in and out of bed and chairs, and using the toilet. Family caregivers also may provide additional help with housework, grocery shopping, preparing meals, arranging for assistance from agencies or outside service providers, and managing finances and medications.

Some older adults are cared for in their home by nonfamily members paid by the individual receiving the care, family members, private insurance, or State or Federal entitlement programs. Local organizations or agencies also may provide helpers.

Thus, the overwhelming majority of elder abuse episodes occur in the older adult's private home or the family member's home where the older adult lives. This has serious implications for health and mental health professionals who may be visiting older adults at home and providing care in the presence of the family member perpetrating the abuse.