When non-institutionalized elderly people are abused, the explanation often runs something like this: The son or daughter who is taking care of the elderly person becomes exhausted, and unthinkingly lashes out.
A new study by the Family Research Laboratory at the University of New Hampshire, however, suggests this stereotype may be largely inaccurate. For one thing, only 23% of the abused elderly in the study had been maltreated by their children, while 58% had been abused by their spouses.
Secondly, the mistreated elderly were far more likely to describe their abuser as relying on them for assistance in a number of areas, including finances, housing, transportation, cooking and cleaning.
This dependency, according to the study of 2,020 Boston-area people age 65 or older, appeared to be related to mental or emotional problems. The abusers were also likely to have experienced stressful life events, such as an illness or the death of a loved one.
"The prevailing image of elder abuse is that an old person has become a burden to his overstressed relatives," says sociologist Karl Pillemer, who conducted the study with sociologist David Finkelhor. "In a way, that blames the victim--it says these otherwise well-meaning caretakers just can't handle it anymore. That scenario is true in some cases, but our study indicates that these situations are in a minority."
Says Linda Harootyan of the Gerontological Society of America: "It's a significant study because we now have a better sense of who is abusing whom, and that has important implications for how we address the problem."
Overall, 3.2% of the elderly surveyed had been abused in one of the following ways since they turned 65: verbal aggression (insults or threats that were repeated at least 10 times in the preceding year); physical violence (ranging from a shove, push or grab to having something thrown at them, being slapped or beaten up); or neglect (the regular failure of a care-giver to provide what was needed). On a national basis, that translates into 700,000 to 1.1 million abused elderly, but Pillemer says the figures could easily be higher.
"This study was done in the Northeast, and since that region ranks lower on most rates of violence, it may be that there is less elder abuse as well," he says. "Our study underrepresented blacks and other minorities, which some studies have shown to have higher rates of intrafamily violence. Thirdly, surely people underreport this phenomena. And finally, our rates of elder abuse don't include some kinds of maltreatment, such as financial exploitation."
With regard to the higher rates of abuse by spouses, the underlying cause seems to stem from the fact that most elder abuse occurs in a shared living situation. "Nearly 40% of the elderly in the U.S. live with their spouses, and about 10% live with children," Pillemer says. "More spouses live with each other, so there's simply more opportunity."
Since spouse abuse of all ages has generally been ignored until recently, the actual rate may be even higher, he says, citing studies that "a fairly large proportion of the American population see spouses hitting one another as normal."
These results suggest, says Harootyan of the Gerontological Society, that more retired people need to be prepared for the difficulties of constant companionship. "We need to look at preretirement counseling for the husband and wife who are going to be living together on a 24-hour basis, and preparing them for some of the stresses they might encounter. We also need to start thinking of shelters for this sort of abuse. It's not as if the abuser was a daughter or son whom you could stop from coming into the home. The abuser is often already in the home."
The New Hampshire study, financed by the National Institute on Aging, is billed as the first reliable estimate of the extent of elder abuse in the general population. Earlier researchers, Pillemer says, had obtained their data from agencies that serve the elderly.