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

Risk Factors for Abuse and Neglect

Risk factors are elements within the individual, family, community, or environment that increase the probability of an event or behavior. Understanding risk factors for elder abuse is critical to eliminating ongoing violence and preventing it in the future.

In the 1970's, elder abuse began to emerge from the shadows. Much of the literature focused on caregiver stress as a predominant risk factor. Caring for an older adult who is frail and declining in physical or cognitive abilities is demanding work that challenges the caregiver's skills and abilities.

However, current research shows a higher degree of caregiver stress does not necessarily lead to elder abuse. In fact, many caregivers under undue stress provide top-quality care to older adults.

Experts today emphasize the interpersonal dynamics between the abuser and the abused, particularly prior to the abuse. Recent studies also distinguish between caring for an individual with cognitive decline and one with other types of disabilities. ref

Caregiving is not the primary cause of elder abuse, but rather, a context for interaction in which abuse can occur. The characteristics of perpetrators, their problems, pathologies, perceptions, and characteristics of care recipients may trigger abuse. ref

A major report published by the National Research Council on the prevalence of elder abuse and neglect identified the following risk factors for elder abuse based on current research:

• Living arrangements, such as cohabitation of family member and older adult or an older adult who is living alone.
• Social isolation of abuser and victim.
• Presence of Alzheimer's disease or related dementia.
• Presence of mental illness or increased levels of hostility in the abuser.
• Alcohol abuse on the part of the perpetrator.
• Dependency of perpetrator on the victim. ref

Research also shows that a history of marital violence, also known as intimate partner violence, may continue into later years. ref The American Psychological Association notes that the best predictor of future violence is often previous violence. Men who abuse their elderly partners may be continuing a pattern of abuse that has been going on throughout the life cycle. ref