Risk factors associated with stressors on the caregiver include the following:
• Feeling overwhelmed or resentful at having to care for the elderly person • Having a history of substance abuse or a history of abusing others • Being dependent on the older person for housing, finances, or other needs • Having a history of mental health problems • Being unemployed • Sharing a living situation with the elderly person • Lacking caregiver support, including breaks from care, assistance with care, as well as time for self-care to reduce caregiver burnout
Another growing concern is elder abuse in nursing homes and other care facilities. More than 3.2 million adults live in nursing homes and other long-term care facilities in the United States, with up to 40 percent of all adults needing care at some point in their lives. Nursing home abuse can take all of the forms of abuse listed earlier. Abuse in nursing homes increases the potential for death by 300 percent, according to the Nursing Home Abuse Guide (n.d.). The need for care can be a barrier to detection and reporting and to getting care in the future. Those who report abuse have often experienced abuse at other facilities, and they can be hesitant to move to another facility.
A number of factors have been shown to help prevent abuse according to Pillemer, Burnes, Riffin, and Lachs (2016). The first is caregiver support that includes housekeeping, meal preparation, respite care, and adult day care, all of which gives the caregiver a break or relieves some of the duties they have to perform. Other important forms of caregiver support include education on care and support groups. A second factor to mitigate elder abuse is the use of money management programs. These programs can include people who help set up automatic bill pay and direct deposits for income and who keep an eye out for unusual activity on their client’s accounts. A third factor is the use of a multidisciplinary treatment team, put in place when abuse is noticed, to prevent future abuse and to help the elder recover from abuse. Team members can be drawn from criminal justice, health, and mental healthcare services, victim services, legal services, adult protective services, financial services, and long-term care.
Statistics on Abuse and Neglect
According to the National Center on Elder Abuse, around 10 percent of all elders are abused. The most common forms are verbal mistreatment, financial mistreatment, and physical mistreatment. The Office of Victims of Crime (2012) found that more than 90,000 persons over the age of 65 were the victims of violent crime in 2010. In addition, people age 60 and older made 14 percent of fraud complaints and 13 percent of identity theft complaints, and a dramatic rise of these crimes has been noticed among this population. According to Lifespan of Greater Rochester et al. (2011), financial abuse costs around $3 billion annually, and most of the children of the exploited elderly were not aware of the problem regardless of how involved they might be.
According to the National Council on Aging, in almost 60 percent of elder abuse and neglect incidents, the perpetrator is a family member, two thirds being adult children or their spouses. In addition, a study by New York State found the incidence rate was nearly 24 times greater than the number of cases referred to social services or law enforcement. This demonstrates the prevalence of elder abuse and neglect and just how underreported it is (Lifespan of Greater Rochester et al., 2011). The National Elder Abuse Incidence Study showed that only 20 percent of cases of neglect, exploitation, abuse, or self-neglect are reported (Tatara, Blumerman, Kuzmeskus, & Duckhorn, 2015). In addition, the National Research Council (2003) reported around 20,000 complaints of exploitation, neglect, and abuse coming from nursing homes and assisted-living facilities, including physical and sexual abuse.
Elder abuse is underreported because there is a lack of detection by others, a lack of knowledge about how to report abuse by the elderly, and a lack of ability for the elderly to report because of social isolation, access to transportation, and communication technology such as phones and computers.