Engaging with older people can help policymakers create policies and programs that better prevent elder abuse

Killick C, Taylor BJ, Begley E, Anand JC, O’Brien M.  Older people’s conceptualization of abuse: A systematic review  Journal of Elder Abuse and Neglect. 2015; 27(2): 100-120.

Review question

How do older adults living in the community demonstrate their understanding of the term abuse? Do these definitions vary based on older adults’ background and experiences, and how do they compare to policymakers’ and caregivers’ definitions of abuse?

Background

In recent years, much research has been conducted on the topic of elder abuse. However, there is not much research on older people’s views on what constitutes elder abuse, so their perception of abuse is not likely encompassed by researchers.

Most of the existing definitions of “abuse” have been created by professionals such as researchers and policymakers. Internationally, many policymakers rely on the World Health Organization’s definition of elder abuse, which characterizes this abuse as an “act or lack of appropriate action” which “causes harm or distress to an older person.”

This study seeks to describe and examine how older people perceive abuse. It seeks to identify differences between these perceptions and policymakers’ definitions of abuse, so that it is possible to identify ways in which policies regarding elder abuse can change to encompass older people’s valuable perspectives.

How the review was done

A detailed search of four electronic databases for studies published between 1995 and 2015 was conducted.

A total of 295 studies were identified in searches, and 15 were included in the review after assessments for eligibility.

This review was funded by the Centre for Ageing Research and Development in Ireland (CARDI).

What the researchers found

This review found that in characterizing abuse, older people refer to many of the same themes as professionals (psychological abuse, neglect, financial abuse, emotional abuse, sexual abuse, etc.). However, as a whole, the participants in the included studies placed different levels of emphasis on each of these themes, compared to researchers, policymakers and each other.

The review also found that within the limited amount of research on older people’s perceptions of abuse, there are many differences between the ways in which various individuals and populations understand abuse. In examining current literature, it is difficult to separate incidences of elder abuse from broader social issues that contribute to elder abuse and shape older people’s perceptions of abuse.

A society’s attitudes regarding family, gender, race and age can contribute to older people’s experience of feeling abused or neglected. The review calls for policymaking processes that include and empower older people, in order to support a human rights approach to caring for older people.

Conclusion

This review found that while many older adults have an understanding of the concept of abuse, between and within older populations there is much variation regarding which behaviours they view as abuse, and which behaviours they consider to be tolerable. The review encourages professionals to engage with older people in order to create systems of support and protection for older populations.