Applied Research Forum National Online Resource Center on Violence Against Women Domestic Abuse in Later Life Bonnie Brandl and Loree Cook-Daniels Nearly 77 million people, more than a quarter victims, age 50 and older, abused by someone in a of the total U.S. population, are age 50 or older trusted, ongoing relationship such as spouse or (U.S. Census Bureau, 2000). In Canada the per- partner, family member, and/or some caregivers. centage is similar with 28.7% of Canada’s 31 million This paper focuses primarily on victims living in the residents age 50 or older (Statistics Canada, 2001). community, not institutions (e.g., nursing homes). National surveys also suggest that domestic violence This paper includes research addressing is widespread in the United States and Canada domestic abuse in later life or older battered women. (Bureau of Justice Statistics Special Report, 1995; We also include more general domestic violence or Family Violence in Canada, 2002). elder abuse studies that have findings that are So there must be many of victims of domestic specifically about abuse in later life. Fifty-four violence in later life, correct? articles published from 1988 to 2002 were re- For the most part, the answer is lost in the viewed. Studies focusing on younger victims of cracks between the domestic violence and elder domestic violence, other forms of elder abuse, and abuse service systems. Domestic violence programs those conducted outside the United States or predominately serve women between the ages of 18 Canada were excluded. and 45 abused by intimate partners. Most adult Comparing results across these studies is protective services (APS) have focused primarily on practically impossible. The lack of a standard frail elderly and incompetent victims. Although older definition of elder abuse and domestic abuse in later battered women should have at least two systems life creates research widely varied in the types of they can turn to for help, in practice neither system abuse studied, the specific definitions of abuse used, has been particularly successful at understanding and whether abuse was self-reported or from agency meeting the needs of older women (let alone older records, the age of respondents (which ranged to a men) who are abused by intimate partners and low of 40 years), whether the target audience was family members. predominately healthy elders or vulnerable adults, Likewise, although both domestic violence and and whether only women or men and women were elder abuse research would seem to cover domestic included in study samples. In addition, some elders abuse in later life, researchers often define their may deny that what they are experiencing is abuse, target populations in ways that exclude these victims. introducing potential underreporting. Studies have For example, many domestic violence studies focus shown that elders’ definitions of abuse do not on women ages 18 – 59. Elder abuse research correspond to professionals’ definitions, which may examines self-neglect, institutional abuse, and confound findings (Brown, 1989; Hudson, et al., financial exploitation, as well as family violence. 1999). For the purposes of this paper, domestic Not only did the studies reviewed here often abuse in later life is defined as male and female look at different forms of abuse and/or target Domestic Abuse in Later Life (December 2002) Page 1 of 12 *The production and dissemination of this publication was supported by Cooperative Agreement Number U1V/CCU324010-02 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC, VAWnet, or the Pennsylvania Coalition Against Domestic Violence. VAWnet Applied Research Forum populations, often the methodology was significantly Rovi, Furniss, and Lasser (1999) found that 4.3% of flawed. In part because of the lack of financial their sample of older women responding to a health resources, only a few studies have been large survey were currently in an abusive relationship. experimental studies with more than 1,000 randomly Using data from the 1985 U.S. Family Violence assigned respondents (Lachs, Williams, O’Brien, Resurvey, Harris (1996) found that 5.8% of the Hurst, Kossack, Siegal, et al., 1997b; Podnieks, older couples responding to the survey had experi- 1992b; Pillemer and Finkelhor, 1988). Even these enced domestic violence in the past year. A third larger studies ultimately based their conclusions on study that examined APS records found that 1.6% relatively small numbers of actual abuse victims, of elders had been abused, neglected, or exploited ranging from 47 to 80. Only one of the random over a nine year period (Lachs et al., 1997b). sampled studies included cognitively impaired elders Hudson and Carlson (1999b) found 6.2% of the (achieved by interviewing other family members), older adults in their North Carolina sample admitted but using such reports may be considered unreliable hurting an elder. The figure was 2.0% in another (Robert Wood Johnson Foundation, 2001). study (Hudson, 1999a). All the other studies included here had serious Five studies asked questions about abuse sampling biases because they were based on elders occurring at any point across the lifespan. Hudson who were using services of some sort or were (1999b) found 19.1% of women in six North known to APS or domestic violence programs. Such Carolina counties experienced domestic violence at samples may reveal information about only some some point in their lives. Both Mouton et al. (1999) elders because many abused elders are isolated and and Pittaway and Westhues (1993) found 31.9% do not come to the attention of professionals or seek had experienced some form of domestic violence in help. With one exception (Otiniano, Herrera, and their lives. The Mouton et al. sample was of women Teasdale 1998), these studies also involved rela- only, whereas Pittaway and Westhues surveyed both tively small samples – 10 to 401, with the majority men and women. Fifty-nine percent of a study of studies being under 100 subjects. Very few involving 37 Navajos said they had experience some studies used control groups. form of abuse in their lives (Brown, 1989). Despite these acknowledged weaknesses, this By comparison, three other studies attempted body of literature is important since it sheds light – to estimate the incidence of elder abuse that included even if partial – on key issues of domestic abuse in domestic violence in later life as well as other forms later life. These issues, as reflected in study findings, of abuse against the elderly. Pillemer and Finklehor include: 1) prevalence and incidence; 2) types of (1988) estimated 701,000 to 1,093,560 older abuse, including sexual abuse; 3) culture; 4) relation- Americans were victims of abuse each year. In the ships; 5) causation; 6) abuser issues; 7) victim early 1990’s, Podnieks (1992b) estimated 98,000 issues; and 8) services and interventions. Eight to 137,000 older Canadians are elder abuse victims detailed papers on each of these topics can be found each year. More recently, the U.S. National Elder at the National Center on Elder Abuse website and Abuse Incidence Study (NEAIS) estimated ap- a related website. Here we summarize major proximately 450,000 older people were being findings of this larger review. abused in 1996 (National Center on Elder Abuse, 1998). Cook-Daniels (1999) and Otto and Quinn (1999) suggest that methodological flaws may Key Findings explain why the NEAIS figures are much lower than previous studies. These articles suggest, among Prevalence and Incidence other flaws, that the NEAIS study used substanti- Ten of the reviewed articles examined preva- ated APS cases and community sentinels (trained lence and incidence rates of both elder abuse in volunteers to look for elder abuse) but did not general and domestic violence specifically. Mouton, Domestic Abuse in Later Life (December 2002) Page 2 of 12 VAWnet: The National Online Resource Center on Violence Against Women www.vawnet.org VAWnet Applied Research Forum include the large (but unmeasured) segment of elders later life to parent abuse, spouses were more likely that are isolated and do not come in contact with than adult children to physically abuse and adult community services. children were more likely than spouses to financially abuse (Lithwick et al., 1999; Wolf and Pillemer, 1997). Crichton, Bond, Harvey, and Ristock (1999) Types of Abuse likewise found that adult children were the more Most of the 28 studies in which a type of likely financial abusers, although that study did not abuse in later life was identified involved more than find a difference in how often spouses and adult one type. For instance, 19% of victims were abused children committed physically abuse. In contrast, the or neglected in more than one way in Podniek’s NEAIS found that adult children were the more study (1992b) and 20% in Greenberg, McKibben, frequent abusers in all types of abuse cases (NCEA, and Raymond’s study (1990). In Anetzberger’s 1998). study (1998), psychological abuse accompanied It appears that homicide-suicide among elders other types of abuse in 89.7% of the sample. is higher than reported in previous studies, 0.4 – to Fourteen of the 28 articles reviewed com- 0.9 per 100,000 for persons age 55 and older pared the frequency of different types of abuse in (Cohen, Llorente, and Eisdorfer, 1998). Men are later life. Making comparisons is difficult because the perpetrators in the vast majority of these homi- studies used different definitions of elder abuse and cides. A need to control the relationship appears to forms of abuse are included in some studies and not play an important role leading to spousal homicide- others. Given this caveat, six studies found verbal or suicide (Malphurs, Eisdorfer, and Cohen, 2001).