Elder Abuse: Definitions
An intentional act or failure to act by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult. An older adult is defined as someone age 60 or older. Forms of elder abuse include (definitions have been truncated; for full, formal definitions please see the newly released document “Elder Abuse Surveillance: Uniform Definitions and Recommended Core Data Elements, Version 1.0”):
- Physical Abuse: the intentional use of physical force that results in acute or chronic illness, bodily injury, physical pain, functional impairment, distress, or death. Physical abuse may include but is not limited to such acts of violence as striking (with or without an object or weapon), hitting, beating, scratching, biting, choking, suffocation, pushing, shoving, shaking, slapping, kicking, stomping, pinching, and burning.
- Sexual Abuse or Abusive Sexual Contact: Forced and/or unwanted sexual interaction (touching and non-touching acts) of any kind with an older adult. This may include but is not limited to forced and/or unwanted completed or attempted contact between the penis and the vulva or the penis and the anus involving penetration, however slight; forced and/or unwanted contact between the mouth and the penis, vulva, or anus; forced and/or unwanted penetration of the anal or genital opening of another person by a hand, finger, or other object; forced and/or unwanted intentional touching, either directly or through the clothing, of the genitalia, anus, groin, breast, inner thigh, or buttocks. These acts also qualify as sexual abuse if they are committed against an incapacitated person who is not competent to give informed approval.
- Emotional or Psychological Abuse: Verbal or nonverbal behavior that results in the infliction of anguish, mental pain, fear, or distress. Examples of tactics that may exemplify Emotional or Psychological Abuse include behaviors intended to humiliate (e.g., calling names or insults), threaten (e.g., expressing an intent to initiate nursing home placement), isolate (e.g. seclusion from family and friends), or control (e.g., prohibiting or limiting access to transportation, telephone, money or other resources) an older adult).
- Neglect: Failure by a caregiver or other responsible person to protect an elder from harm or the failure to meet needs for essential medical care, nutrition, hydration, hygiene, clothing, basic activities of daily living or shelter, which results in a serious risk of compromised health and/or safety. Examples include not providing adequate nutrition, hygiene, clothing, shelter, or access to necessary health care; or failure to prevent exposure to unsafe activities and environments.
- Financial Abuse or Exploitation: The illegal, unauthorized, or improper use of an older individual’s resources by a caregiver or other person in a trusting relationship, for the benefit of someone other than the older individual. This includes, but is not limited to, depriving an older individual of rightful access to, information about, or use of, personal benefits, resources, belongings, or assets. Examples include forgery, misuse or theft of money or possessions; use of coercion or deception to surrender finances or property; or improper use of guardianship or power of attorney.
Why is a Consistent Definition Important?
A consistent definition is needed to monitor the incidence of elder abuse and examine trends over time. Consistency helps to determine the magnitude of elder abuse and enables comparisons of the problem across locations. This ultimately informs prevention and intervention efforts.
Unfortunately, elder abuse has been 1) poorly or imprecisely defined, 2) defined specifically to reflect the unique statutes or conditions present in specific locations (e.g., states, counties, or cities), or 3) defined specifically for research purposes. As a result, a set of universally accepted definitions does not exist.
Related Topic: Self Neglect
Elder abuse and self-neglect are two separate yet related sets of behaviors and interactions. The main difference is with self-neglect, the harm or the potential for harm is created by one’s own behaviors rather than resulting from others’ actions. Both elder abuse and self-neglect are important, because both compromise health, decrease quality of life, and threaten longevity.
Self-neglect occurs when an older adult fails or refuses to address their own basic physical, emotional, or social needs in a way that threatens his/her own health and safety. Examples of such needs include self-care tasks such as nourishment, clothing, hygiene, and shelter; proper/appropriate use of medications; and managing or administering one’s finances. This excludes situations in which a mentally competent older adult, who understands the consequences of his/her decisions, makes a conscious and voluntary decision to engage in acts that threaten his/her health or safety as a matter of personal choice.
Additional Reference Material
Choi NG and Mayer J. 2000. Elder abuse, neglect, and exploitation: risk factors and prevention strategies. Journal of Gerontological Social Work;33:5–25.
Ingram E. 2003. Expert panel recommendations on elder mistreatment using a public health framework. J Elder Abuse and Neglect;15(2):45–65.
National Research Council. 2003. Elder mistreatment: abuse, neglect, and exploitation in an aging America. In: Bonnie RJ and Wallace RB, editors. Panel to review risk and prevalence of elder abuse and neglect. Washington DC: The National Academies Press.
Tatara T. 1990. Elder abuse in the United States: an issue paper. Washington DC: National Aging Resource Center on Elder Abuse.
Teaster P, Dugar T, Mendiondo M, Abner E, Cecil K, Otto J. 2006. The survey of state adult protective services: abuse of adults 60 years of age and older. National Center on Elder Abuse.
Thomas C. 2002. First national study of elder abuse and neglect: contrast with results from other studies. J Elder Abuse and Neglect;12:114.