Last week I considered how abuse affects teenagers. This week I consider the other end of the age spectrum; domestic abuse and older people.
A review of research in this area reveals a surprising fact: Although we are starting to accept and know about elder abuse in a caring context, outside of this we know relatively little about domestic abuse (DA) and older women.
- Many studies exclude women over 59 years
- Many healthcare and social care professionals do not recognise DA occurring in this age group
- DA in this age group is subsumed under the generic term elder abuse which fails to recognise gender differences. Whilst DA is viewed as a gendered abuse of power in earlier adulthood, later in life it is treated as a sub-set of abuse against older people and this fails to recognise the nature of the relationship between abuser and abused.
What we do know relates to women and in an earlier blog I explored the gendered nature of Domestic Abuse.
What do we know?
Julie McGarry et al published a literature review in the Health and Social Care in the Community journal in January 2011 which is a great summary of the slim evidence base.
- Older women’s experience of abuse correspond to those in younger age groups ie domestic abuse remains a significant and prevalent problem in older age
- Under-reporting is likely to be significant,
- “misdiagnosis” is likely to be significant with injuries often attributed to falls and confusion attributed to age related conditions
- Older women face barriers to disclosing abuse,
- Fear that disclosure will exacerbate the abuse
- Traditional attitudes to marriage (divorce a taboo) and dependency of perpetrators on abused later in life
- Financial dependency
- Lack of awareness of existence of services
- Inappropriate services eg refuges, generic support groups focus on younger age groups
- Focus of health care on younger age groups such as antenatal screening rather than older people accessing hospital services
- Blurring of issues due to grouping together older victims and survivors of domestic abuse in older people with other forms of elder abuse
Health Related Facts
- Older women who experience abuse are more likely to also experience and increased incidence of physical and mental health problems compared with those who have not experienced abuse.
- Older women who are abused suffer a higher incidence of trauma related injuries and physical conditions
- The consequence of prolonged exposure to physical abuse is significant long term health problems and premature death
- Older women reporting abuse have significantly increased risks of depression or anxiety
Anne Lazenbatt et Al of Queen’s University Belfast also published new research in 2010 finding:
- Domestic Violence is common in the second half of life
- Psychological abuse has the strongest impact on health
- Abuse increased the risk of heavy drinking and prescribed medication abuse
- Economic dependence and lack of family support are barriers to seeking support or leaving an abusive relationship
- Protective services have few methods for dealing with domestic violence among older women
We have much to learn about domestic abuse and older people and much more to do to tackle this issue.