Ending the Silence Surrounding Elder Abuse

In honor of World Elder Abuse Awareness Day (June 15), our Abuse in Later Life Coordinator Megan Monts and Randolph W. Thomas (former President of the National Committee for the Prevention of Elder Abuse and co-author of Elder Abuse Detection and Intervention: A Collaborative Approach) write about the under-recognized and underreported issue of the sexual assault and abuse of older adults.

With terrifying frequency, the news is flooded with reports of child sexual abuse. Due to their trusting nature and the ease with which they can be kept silent, children are quite vulnerable to sexual assault and abuse. However, we think far less often about the vulnerability of another population at the opposite end of the lifespan – the elderly.

As we age, we become increasingly frail and may have to rely on someone else for care. It becomes all too easy for a caregiver, often a family member, to wield the power, violence, and control that are at the core of sexual assault and abuse. As with child sexual abuse, the abuse of a vulnerable adult often comes from someone the survivor knows – for example, an adult grandson living with his aging grandmother, or an unrelated caregiver of a dementia patient. Either way, the issue of abuse among this growing and vulnerable population is one that is gravely under-recognized, underreported, and too often silenced.

The true prevalence and rate of incidence of the sexual assault of older adults is unknown. This is partly because there are differences in how these crimes are reported across the nation; for instance, in some areas, a sexual assault might get reported as physical abuse, leaving it out of rape statistics. Also, some incidents remain unreported, as those with dementia or communication difficulties may lack the ability to tell someone about the assault. For all instances of the abuse of older and vulnerable adults substantiated by Adult Protective Services, only 1% are reported as sexual abuse. However, this number can be misleading. Based on numerous studies by a variety of experts, it is believed that the problem is, in fact, much larger. Only 30% of older adults that are sexually victimized report to the police, meaning that 70% suffer in silence (Pennsylvania Coalition Against Rape). While there have been few studies of sexual abuse that are focused on older adults, they have been consistent in low reporting to either APS or law enforcement. Additionally, of those reported to law enforcement, few result in the offender being held accountable.

Since sexual abuse of this special population is a problem of unknown dimensions, it is difficult to craft an effective response. Studies and anecdotal information reveal several barriers to holding offenders accountable and protecting victims. First, and probably most disconcerting, is the lack of awareness on the part of first responders and other professionals that sexual assault can and does happen to older adults. Adding to this the reluctance of victims to report (if they can even do so, given cognitive issues), you have a formula for failure. Even if the assault or abuse is reported to Adult Protective Services or law enforcement, there is a lack of training regarding the collection and preservation of evidence needed to conduct a thorough investigation. In one study of sexual assault in facilities (nursing homes, assisted living, etc.), none of the cases that were reported to law enforcement were prosecuted. This failure to provide the victim with a successful resolution within the legal system only contributes to the problem of under-reporting. When one closely examines cases of sexual assault that do receive some type of investigation, either by APS or law enforcement, it becomes obvious that professionals often lack the necessary understanding of victim dynamics and suspect typology.

As we honor World Elder Abuse Awareness Day (WEAAD), it is important to realize that while we have made substantial progress in drawing attention to this important issue, there is more to do. One of the first steps we must take is to increase awareness of this vastly underreported form of elder abuse among professionals and the public. In studies that have focused on the sexual abuse of the elderly, common threads include low reporting, inadequate training, and the need for better victim services. All of these factors contribute to the inability to hold offenders accountable and provide for victim safety. Sexual Trauma Services of the Midlands’ Abuse in Later Life Program, funded by the Office on Violence Against Women, addresses these community needs through trainings to law enforcement, prosecutors, and service providers in this area. The program also provides a mechanism to create a coordinated community response to elder abuse, utilizing collaboration among victim service providers. However, this is just one step, and much more will be needed to address this issue as time goes on. Funding the Elder Justice Act, funding victim services at the local level, and increased training are all necessary to an effective response. So spread the word about World Elder Abuse Awareness Day. By shining a light on the sexual abuse of older adults through World Elder Abuse Awareness Day, we can take one step on a long road toward better meeting the needs of victims.