Relative downfalls behind elder abuse.

Relative downfalls behind elder abuse 

The increasing awareness that some elderly persons are physically abused and neglected by family members has been accompanied by a widespread assumption about elder abuse: that it is inflicted by well-meaning individuals, often the adult children of victims, who are pushed over the edge by the stress of caring for a frail, dependent old person.

But that assumption is turned on its head by findings from the first large-scale random sample of elder abuse in a metropolitan area. Relatively well-functioning elderly people are usually the victims of abuse, which is often inflicted by emotionally disturbed or violent family members, say psychologists Karl Pillemer and David Finkelhor of the University of New Hampshire in Durham. A typical abuser is a spouse who depends on the victim for money, transportation, housing and household repairs.

Pillemer and Finkelhor randomly selected subjects aged 65 and older from 1985 town lists in the Boston area. Interviews with 2,020 individuals identified 61 cases of elder abuse. This yields an estimate of 32 victims per 1,000 elderly people in the area -- "a small but significant percentage," say the researchers, whod escribe their findings in the April AMERICAN JOURNAL OF ORTHOPSYCHIATRY.

The investigators conducted follow-up interviews with 46 abuse victims and a comparison group of 251 nonabused elderly.

Pillimer and Finkelhor defined maltreatment as one or more of the following: at least one act of physical violence toward the victim (ranging from throwing something at them to assault with a gun or knife) since they turned 65; withholding help important to daily life 10 or more times in the preceding year; and verbal aggression, including insults and threats, 10 or more times in the preceding year.

Spouses were responsible for 26 of the 46 abuse cases, the researchers note. Abuse victimes were almost evenly split between men and women. Victims were no more disabled or dependent on their abusers than were comparison subjects on their relatives.

However, abusers were much more likely than relatives in the comparison group to have been arrested, hospitalized for a psychiatric disorder, involved in violent behavior outside the family or limited by a physical problem. In addition to relying on their victims for money, transportation and housing, abusers were more likely to have suffered a physical illness or the death of a relative in the previous year.

The high level of abusers' dependence on victims, seem most clearly in adult children who abused their parents, suggests the victims were also exploited for money and other possessions, the researchers say.

Their findings are consistent with a trend among family-violence researchers to deemphasize the characteristics of victims--whether children, women or the elderly--and concentrate on the psychological problems of abusers.

Revelations about elder abuse have important implications for treatment programs, the investigators maintain. Such programs generally aim to reduce caregiver stress by providing in-home assistance in the care of elderly persons and offering support groups.

But many abusers need psychological counseling, Pillimer and Finkelhor assert. Those who are dependent on their victims may also need help in finding employment and separate housing. Greater police involvement and legal assitance to victims would deter exploitation by abusers, they say. Furthermore, emergency shelters for elder abuse victims, similar to those provided to younger battered women, would provide temporary refuge from abusive situations.

"The view that the elderly cause their own abuse by becoming frail and dependent should be discarded," the researchers conclude.