Elder Abuse: A Hidden Epidemic and the Call for Safeguarding Action

Elder abuse—defined as any act or lack of action within a relationship of trust that causes harm or distress is a hidden epidemic, with at least 1 in 6 older adults globally affected. In the UK, elder abuse is particularly concerning, with older adults with dementia being among the most vulnerable.

Understanding the Scope of Elder Abuse

Elder abuse manifests in various forms:

• Physical Abuse: Inflicting physical harm.
• Emotional Abuse: Intimidation, humiliation, or verbal assault.
• Financial Abuse: Exploitation of an elder's assets, including manipulation of powers of attorney or wills.
• Neglect: Failing to meet basic care needs.
• Sexual Abuse: Non-consensual sexual contact.
• Self-Neglect: The inability or unwillingness to care for oneself.

Despite the level of abuse, there is systematic underreporting, with gaps in data collection making any estimates of prevalence difficult. For instance, the Crime Survey for England and Wales excluded respondents over 59 years old until 2017 and continues to omit older adults in care homes, where much of the abuse is likely to occur.

Challenges in the UK Context

While recent legislative advances, such as the Domestic Abuse Act 2021, provide a framework to address abuse, systemic challenges persist. Health professionals may face challenges in balancing confidentiality with their duty to escalate concerns. Moreover, gaps in data collection and enforcement mean many cases go undetected or unresolved.

Key challenges include:

• Social Isolation: Many elderly individuals experience social isolation and loneliness, often due to limited support and infrequent family contact.
• Caregiver Stress: Overburdened caregivers dealing with challenging behaviours may resort to punishing behaviours.
• Power Dynamics: The elderly are often dependent on their caregivers and may feel unable to express their concerns.
• Financial Risks: Lasting powers of attorney can increase financial abuse risks, particularly for older adults with diminished capacity.

The Role of Psychologists and Other Care Professionals

Primary care settings are at the front line in identifying and responding to elder abuse. General practitioners often maintain regular contact with older patients, thereby giving them a vital role in safeguarding their health. However, psychologists can play an equally important role:

• Recognition and Identification: Psychologists are trained to identify signs of abuse, including emotional and behavioural indicators, even when older adults cannot clearly describe what has happened to them.
• Intervention and Support: Psychologists provide trauma-informed care to victims of abuse, addressing emotional and psychological impacts. They also work with caregivers to manage the secondary trauma, which can lead to abusive behaviours.
• Community Education: By participating in public awareness campaigns, psychologists educate communities to recognise and address elder abuse.
• Research and Data Collection: Psychologists could help research elder abuse, particularly in underrepresented populations such as those in care homes.
• Promoting Social Connection: Addressing the causes of isolation and increasing community support to reduce one of the main risk factors for abuse.

Safeguarding Measures and a Call to Action

Protecting older individuals from abuse requires a multifaceted approach:

1. Raise Awareness: Through the education of communities, caregivers, and professionals about elder abuse.
2. Strengthen Legal Protections: Enforce laws like the Care Act 2014 and address gaps in proposed reforms to prevent abuse.
3. Support Caregivers: Provide resources, respite, and mental health services to reduce caregiver stress.
4. Encourage Reporting: Promote accessible reporting systems and train professionals to act on concerns.
5. Combat Isolation: Foster community engagement and support initiatives to enhance social connections for older adults.

Responding to Abuse

When elder abuse is suspected, immediate action is essential. Professionals and community members should prioritise the safety and wishes of the affected individual, seek support from authorities when needed, and utilise resources such as Age UK and Action Fraud for guidance.

Towards Meaningful Change

Elder abuse is a complex issue demanding collective effort. WEAAD highlights not only the challenges but also the opportunities to effect change. By raising awareness, empowering professionals, and strengthening protective frameworks, we can ensure our older generations live with the dignity, respect, and care they deserve.