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Elder abuse, while not a new phenomenon, has gradually gained more recognition as a social problem, with terminology and definitions changing during the past 30 years. Research has tended to be undertaken in more developed countries, but cultural, social, and economic differences between societies affect how researchers, organizations, and citizens view abuse. Consequently, the findings of incidence and prevalence studies differ. Elder abuse can occur for many different reasons; it can be the result of carers’ stress but there is now more acknowledgment that perpetrators of abuse can deliberately target and groom their victims.
- Elder Abuse Definition
- Stranger Abuse – The Debate
- Domestic Abuse – To Include or Not to Include in Elder Abuse
- How Victims Define Abuse
- Categories of Abuse
- General Overview of the Categories of Elder Abuse
- Physical Abuse
- Emotional/Psychological Abuse
- Financial/Material Abuse
- Sexual Abuse
- Discriminatory Abuse
- Incidence and Prevalence of Elder Abuse
- Practice Issues and the Law
Elder abuse is not a new phenomenon, having existed for many centuries. Awareness about it increased during the twentieth century after two British geriatricians wrote about their patients (Baker, 1975; Burston, 1975, 1977). However, elder abuse has never had the same level of attention or interest as child, family, or domestic abuse. For many years, it remained a taboo subject for a number of reasons: the ageism that exists in some societies, older people not being seen as emotive as children, one’s fear of growing old, and acknowledging that abuse could happen to oneself.
During the past 30 years, terminology has changed, with various terms being connected to the current term ‘elder abuse’:
- Granny bashing/battering.
- Old age abuse.
- Adult abuse (this term was introduced in the 1990s and is used for all vulnerable adults aged over 18 years, so that elder abuse would be incorporated into this term).
- Safeguarding adults (introduced in the United Kingdom in 2005 (ADSS, 2005) and includes older people).
Professionals are confronted with many practice dilemmas when working with elder abuse. It is vital that organizations in the statutory, voluntary, and independent sectors define elder abuse in their policies and also gives detailed guidance in procedures so that practitioners are clear about how and when to intervene. Training is also essential to develop safe and best practices when investigating, empowering, and supporting victims of abuse.
Elder Abuse Definition
The term ‘elder abuse’ can be interpreted to mean harm, mistreatment, or neglect and may be carried out in many different ways including definitions and then specific categories of abuse. Researchers and policymakers can define elder abuse differently, but since the beginning of the twenty-first century there has been more usage of a definition that originally was developed by the UK Charity Action on Elder Abuse but then adopted by the World Health Organization (WHO) and other important organizations worldwide that focus on the prevention of elder abuse (AEA Bulletin, 1995; WHO, 2002, 2011):
Elder abuse is a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person. (http://www.who.int/ageing/projects/elder_abuse/en/ – accessed 30.07.2016)
This definition like many others focuses on the older person being abused by someone in a position of trust. It does not consider that an older person can be targeted, befriended, and groomed for financial or sexual exploitation by strangers, which will be discussed below. The root of this stems from studies conducted from the 1980s onward that indicated that older persons were likely to be abused by their carers and consequently carers’ stress dominated that literature (O’Malley et al., 1983; Steinmetz, 1978; Eastman, 1984; Pritchard, 1990).
Another common theme in definitions of elder abuse regards the violation of human rights
…a violation of an individual’s human and civil rights by any other person or persons. (Department of Health, 2000: p. 9)
Elder abuse is a violation of human rights and a significant cause of injury, illness, lost productivity, isolation and despair. Confronting and reducing elder abuse requires a multisectoral and multidisciplinary approach. (Australian Network for the Prevention of Elder Abuse: http://www.eapu.com.au/anpea – accessed 30.07.2016)
Around the world, definitions of elder abuse will differ because of cultural differences; behaviors acceptable in one society may be considered abusive in another. How older people are regarded within society will also affect how people identify and work with elder abuse. There may be denial that such a social problem exists, especially in societies that have great respect for their older citizens (Shankardass, 2009). Research has been limited in Asia, yet some countries are beginning to highlight the issues. For example, HelpAge India undertook a survey in 24 cities across 20 states in 2013 and reported that 23% of older people had experienced abuse (HelpAge India, 2013).
In Africa, elder abuse is gradually being recognized as a social problem (Mba, 2007):
Despite their acknowledged social and economic contributions, as well as their role in traditional and cultural affairs, many older adults in Africa experience abuse and are largely excluded in socioeconomic and political affairs. The processes of modernization and urbanization are beginning to erode the traditional social welfare system of Africa, the extended family. The abuse and violence against older persons and their vulnerability to financial exploitation is a key challenge faced by many African countries. Older persons, particularly women, have to care for their dying children and orphaned grandchildren. They suffer from financial hardship and social isolation thereby endangering their health (p. 230).
Regarding South Africa, Ferreira and Lindgren (2008) discuss:
The problem of elder abuse and neglect in South Africa is widespread but the definition of abuse remains problematic. An expanded typology is needed to classify certain types of abuse reported commonly such as marginalization, disrespect, exploitation and violence (p. 91).
Research into elder abuse in some countries of the world is still very limited, whereas in more developed countries, it can be difficult to identify elderly victims within black minority ethnic groups for research purposes because they do not ordinarily access statutory services (Bowes, Avan and Macintosh 2008; Patel 2003) but in Europe may access black and minority ethnic services (Patel, 2003).
Definitions can change and develop over time as knowledge increases. For example, at one time it was thought that elder abuse had to be ongoing:
The systematic maltreatment, physical, emotional, or financial, of an elderly person . this may take the form of physical assault, threatening behavior, neglect and abandonment or sexual assault. (Eastman, 1984: p. 3)
Later it was recognized that it could be a one-off incident:
Abuse . causes harm to the older person, either temporarily or over a period of time. (Department of Health, 1993: p. 3)
Abuse may consist of a single act or repeated acts. (Department of Health, 2000: p. 9)
It is important to have a clear definition of elder abuse but there are additional definitions (institutional abuse, stranger abuse, and domestic violence) that help further understanding of how abuse might be inflicted. Institutional abuse is defined as follows:
Neglect and poor professional practice also need to be taken into account. This may take the form of isolated incidents of poor or unsatisfactory professional practice, at one end of the spectrum, through to pervasive ill treatment or gross misconduct at the other. Repeated instances of poor care may be an indication of more serious problems and this is sometimes referred to as institutional abuse. (DH, 2000: p. 10)
…where the environment, practices and rules become abusive in themselves. (Decalmer, 1993: p. 59)
In this context, consideration is given to abuse in actual institutions rather than in the community, e.g.,
- Residential care home
- Day care facility
Like abuse in the community, there can be perpetrators from different backgrounds. Carer’s stress has been discussed at length again in regard to this type of abuse as Pillemer and Moore (1989, 1990) highlighted during the late 1980s. Care staff can become abusive when overwhelmed by having to care for residents/patients with high dependency needs (Pritchard, 1996, 2007). Other possible causal factors are:
- Lack of education/training for staff.
- Staff groups/factions developing (staff groups becoming competitive).
- Ineffective management.
- Existing rules and regimes, resulting in restriction of choice and rights, e.g., having to get up at a certain time, being made to go to the toilet before meals, and not being allowed to do something.
- Poor environment/conditions (damaged furniture, old decoration, few windows, and poor ventilation).
- Low staff morale.
- Low staffing levels.
- Staff characteristics (little patience, not caring, not suited to the job, or doing it because they need employment rather than wanting or choosing to work in the care sector).
- Characteristics of residents (high dependency needs).
A key question regularly put forward is ‘When does bad practice cross that fine line and become abuse?’ The debate will continue just as many scandals will be highlighted in the media. But there may also be staff members who have deliberately chosen to work in the care sector to gain access to vulnerable older people, whom they can abuse. On one level, money and/ or possessions can be stolen or a person can be persuaded to sign documents that transfer assets; on another level, sexual abuse can occur.
Many people visit institutions and can have the opportunity to perpetrate abuse including:
- family members,
- volunteers, and
Also, many older people in prisons can be abused by fellow inmates or prison officers. Additionally, their physical needs can be neglected (Hayes and Fazel, 2008).
Stranger Abuse – The Debate
Much has been written about the fact that older people are abused by people who they know. However, they can also be targeted and groomed by complete strangers (Pritchard, 1993). Some organizations see this as a criminal activity that is outside the definition of elder abuse. However, others see parallels with child abuse and believe that it should also be considered.
Older people can become very lonely and isolated when family and friends die, so much so that it can make them vulnerable and susceptible to exploitation. The older person may be willing to hand over money to someone to have them visit the house. Children of a very young age can be involved in this type of abuse as can groups of teenagers. Sometimes an adult will be organizing gangs of children to engage in this activity (Pritchard, 1993).
In the United Kingdom, the Department of Health introduced the definition of stranger abuse into the No Secrets guidance:
Stranger abuse will warrant a different kind of response from that appropriate to abuse in an ongoing relationship or in a care location. Nevertheless, in some instances it may be appropriate to use the locally agreed inter-agency adult protection procedures to ensure that the vulnerable person receives the services and support that they need. Such procedures may also be used when there is the potential for harm to other vulnerable people. (Department of Health, 2000: p. 11)
Domestic Abuse – To Include or Not to Include in Elder Abuse
Many types of abuse are interlinked; within families abuse can happen across the generations. In the United States and Canada, a great deal of attention has been given to the concept of family violence by researchers (Straus et al., 1980; Gelles and Cornell, 1985; Gelles, 1997). Much debate over the years concerns whether domestic abuse should be considered a form of elder abuse and how it should be addressed (Ingram, 2001). It was recognized that older women could have been living in domestic violence situations for most of their married lives. More recently, domestic abuse has been acknowledged as a form of elder abuse. Research is now being undertaken regarding intimate partner violence against older women (Nagele et al., 2010). Attention has been given to the role reversal, i.e., where the male abuser becomes the victim, the typical scenario being when the man becomes dependent on the woman later in life and the woman gets her own back because she knows he can no longer physically attack her (Friday et al., 2007).
Men can also be victims of domestic violence throughout a marriage. Although not a new concept, this remains a taboo subject. Steinmetz (1978) highlighted the problem back in 1978 and as a result had her life threatened, while the controversy continued for the next two decades (Straus, 1999). When undertaking research into the needs of older women who had been abused, Pritchard (2000, 2001) was approached by male victims who wanted to disclose the abuse they had experienced. In 2007, there was a special issue of the Journal of Abuse and Neglect devoted to the abuse of older men (Kosberg, 2007).
In domestic situations, mutual abuse can occur where both the older man and older woman are abusive toward each other.
Domestic Abuse is any incident of threatening behavior, violence or abuse (psychological, physical, sexual, financial or emotional) between adults, aged 18 and over, who are or have been intimate partners or family members regardless of gender and sexuality.
Family members include mother, father, son, daughter, brother, sister, grandparents, whether directly related, in-laws and stepfamily.
The definition includes ‘same sex’ partners and ex-partners (irrespective of how long they have been apart). (Association of Chief Officers of Police and National Policing Improvement Agency, 2008: p. 7)
How Victims Define Abuse
It is crucial that when developing definitions of any type of abuse, the views and opinions of victims are taken into consideration. Eight countries – Argentina, Austria, Brazil, Canada, India, Kenya, Lebanon, and Sweden – participated in the study Missing Voices (WHO, 2002) to address this issue. Their analysis of the major themes revealed remarkable similarities across participating countries. Older people perceived abuse under three broad areas:
- Neglect – isolation, abandonment, and social exclusion.
- Violation – of human, legal, and medical rights.
- Deprivation – of choices, decisions, status, finances, and respect.
(WHO, 2002: p. v)
Categories of Abuse
Some definitions make a statement about elder abuse that includes what some may consider categories or forms of abuse. Thus, there can be some disparity depending on how people view what actions or behaviors actually constitute elder abuse and their importance.
It is helpful for professionals and workers to have clear guidance regarding categories of abuse to work from; however, there is some overlap between the individual categories. When investigating cases of abuse, it is useful to consider on the balance of probabilities which categories of abuse have been substantiated. Policies and procedures around the world may differ in format but there is some general consensus about what constitutes abuse, i.e., what actions and behaviors may cause an older person to be physically or emotionally harmed (DH, 2000; Payne, 2013). In England, for many years, elder abuse was considered to have just three categories:
The systematic maltreatment, physical, emotional or financial, of an elderly person . this may take the form of physical assault, threatening behavior, neglect, abandonment or sexual assault. (Eastman, l984: p. 3)
In the early 1990s, after the Department of Health had undertaken research into elder abuse (DH, 1992), neglect and sexual were added as separate categories:
Abuse may be described as physical, sexual, psychological or financial. It may be intentional or unintentional, or the result of neglect. (Department of Health, l993: p. 3)
Then, in 2000, a further category was added – discriminatory abuse:
…including racist, sexist, that based on a person’s disability, and other forms of harassment, slurs or similar treatment. (Department of Health, 2000: p. 9)
Around the world, it would seem that other forms of abuse are often highlighted within definitions or as stand-alone categories of abuse. For example, the WHO states:
This type of violence constitutes a violation of human rights and includes physical, sexual, psychological, emotional; financial and material abuse; abandonment; neglect; and serious loss of dignity and respect. (WHO Fact Sheet, October 2015 – http://www.who.int/mediacentre/factsheets/fs357/en/ – accessed 31.07.2016)
Sometimes particular abuses are highlighted as separate categories because organizations think they are very important or particularly significant in the country concerned. Examples include
- Social: such as restricting the older person’s social freedom and isolating him or her from family and friends (Australia).
- Witchcraft: occurs mainly in the more rural provinces of South Africa. Women, especially black women, living alone who are particularly dark skinned and wrinkled, are accused of being witches. This is usually prompted by disasters in the area, e.g., storm or lightning damage and crop failures. The victims are in danger of suffering physical harm and/or having their homes (huts) burnt down.
- Systemic abuse: this is denying older persons the right to be treated with respect and dignity when accessing services, both those belonging to the state or the private sector (South Africa).
General Overview of the Categories of Elder Abuse
- Being physically attacked/hurt/assaulted with hand or implement: slapping, hitting, punching, pushing, kicking, shaking, pinching, hair pulling, spitting and burning
- Force feeding
- Rough handling
- Imprisonment: keeping in confined space
- Medication: overmedicating, withdrawal, hiding medication, not giving correct dosage, being given another person’s medication, and not reviewing medication regularly
- Verbal: shouting, swearing, name-calling, misuse of names, use of nicknames, and derogatory comments
- Threats/coercion: causing fear/anguish, unjust emotional pressure
- Lack of acknowledgment/ignoring
- Overprotection: not being allowed to do things
- Lack of social interaction/contact
- Denial of human rights
- Mismanagement of money/pension/benefits/assets
- Denying access to money/assets
- Taking/spending money without consent (e.g., out of the automated teller machine)
- Shopping: saying things cost more than they did
- Selling without consent: objects, assets
- Using own reward points cards for personal financial gain
- Not paying bills
- Falsifying documents
- Forgery/forcing/obtaining signatures
- Forcing transfer of money, accounts, assets
- Forcing changes to bank accounts, wills
- Charging for services that should be free or are included in fees
- Abusing position of trust, especially as attorney or appointee
- Obtaining a credit card in the older person’s name and using it for oneself
- Writing of wills
- Failure to meet physical and/or emotional needs
- Act of omission: failure to do something
- Deprivation/lack of basic care
- Lack of light/heat
- Lack of food, drink, appropriate diet
- Lack of appropriate/new/desired clothing, no access to washing facilities
- Leaving older person sitting/lying in urine/feces
- Not providing appropriate accommodation/environment
- Absence of mobility aids (e.g., walking frame), movement being restricted
- Not aiding communication
- Not allowing social contact
- Lack of stimulation
- Imprisonment, kept in confined area
- Not replacing essential items (e.g., batteries for hearing aid, ill-fitting dentures, and old/broken spectacles)
- Denying access to services (e.g., medical/health/community) when needed
- Not providing transport
- Not providing access
- Not providing information/education/options in order to make choices
- Not assessing/reassessing when needs arise or change
- Religious/spiritual/cultural needs not being met
- Being forced into sexual activity without consent
- Penetration of mouth, anus, or vagina (with finger, penis, object)
- Indecent assault
- Inappropriate touching/kissing/fondling
- Inappropriate/sexualized language or conversation
- Masturbation: being forced to masturbate or to watch someone else
- Sexual harassment
- Pornography: forced to engage in, look at magazines, watch digital video disc
- Sex trafficking
- Ritual/satanic abuse
- Making discriminatory/derogatory comments
- Hate crime: attacks on person/property
- On grounds of age, gender, race, culture, religion, sexual orientation, or disability not allowing access to:
- a place
- a service
- Forced marriage
- Honor Based Violence
Incidence and Prevalence of Elder Abuse
Researchers’ and organizations’ differing definitions of ‘abuse’ can affect the statistics presented in incidence and prevalence studies and the way in which people work with victims and abusers (including which cases they will/will not take on). Studies may also differ regarding the age of an ‘older’ person. Organizations working with older people can define old age as 50, 55, 60, 65 years or more. These differences cause problems in estimating how much elder abuse is being perpetrated. Also significant is the large amount of underreporting for various reasons. An older person may feel shame or embarrassment that someone close to them is harming them. Victims may love their perpetrator and choose to stay in the situation, although they may want the abuse to stop because maintaining their relationship with the perpetrator is more important than leaving or doing something about it. They may feel that no one will believe them if they disclose abuse. The victim may have a communication problem (e.g., physical disability – deafness, speech impairment after a stroke, or a learning disability) or a cognitive problem (dementia: brain injury) that could impede disclosure. An older person living in a care setting may be scared to speak out, fearing reprisals from staff caring for them. Workers themselves may not report abuse they see perpetrated by colleagues because they need their job and do not want to be considered whistle-blowers.
Researchers can face a range of problems when conducting studies (either quantitative or qualitative): developing definitions, gaining access to agencies, and identifying victims to obtain data. It is still useful to read some of the early prevalence studies (Finkelhor and Pillemer, 1988; Podnieks and Pillemer, 1990; Podnieks, 1992; NCEA, 1998) alongside more recent ones (Naughton et al., 2012; Lifespan of Greater Rochester, Inc., 2011; O’Keeffe et al., 2007; NCEA, 2006; Eisikovits et al., 2004; Teaster and Otto, 2007). Prevalence figures vary significantly – from 1 to 10% (Lachs and Pillemer, 2004), making actual rates for prevalence and incidence unclear.
The incidence and prevalence of elder abuse may remain unknown for the following reasons:
- Inconsistency in defining what constitutes abuse
- How statistics are collated
- Differences between countries (cultural): how society and the victims see abuse
- Underreporting because of fear of the abuser, the repercussions, not being believed, shame, and embarrassment.
Despite the vast literature on the quality of care in institutions, no global prevalence or incidence data are available. A survey of nursing home personnel in one US state disclosed that 36% of nursing and aide staff reported having seen at least one incident of physical abuse by other staff members in the preceding year and 10% admitting to having committed at least one act of physical abuse themselves. At least one incident of psychological abuse against a resident was observed by 81% of the sample and 40% admitted to committing such an act (Pillemer and Moore, 1989, 1990). The lessons from this are that all organizations should have whistle-blowing policies in place together with training programs that encourage the reporting of abuse.
Practice Issues and the Law
…elder abuse is an issue to be considered in all domains of social work practice. Intervention in cases of elder abuse is often fraught with ambiguity and ethical dilemmas as the application of professional principles is less than straightforward, bringing to the fore personal, legal, and ethical concerns in the management of the client’s safety and well-being. (Donovan and Regehr, 2010: p. 174)
Practice dilemmas can occur for anyone working with a victim of elder abuse. To promote best practice, workers need knowledge, time for reflection, and experience in dealing with cases. Comprehensive training programs need to be developed so that workers are clear about: what constitutes abuse (acknowledging cultural differences), how to identify and investigate abuse, and how to support a survivor of abuse in the long term. Adequate funding is required to improve professional support and interventions. Working with elder abuse is very different from child abuse because adults have the human right to live their life as they wish. Therefore, it is important to listen to and empower a victim. Workers may recognize that an older person is at risk of harm but she or he chooses to remain in that situation or the victim contacts an agency for help but then refuses to accept services (Linzer, 2004).
Key questions for continued debate concern:
- Mandatory reporting
- Statutory intervention
- Promoting self-determination
- Breaking confidentiality
Adults have human rights to live their life as they wish and the capacity to make decisions (including unwise ones) for themselves unless proven otherwise. However, there will be some older people who become vulnerable and susceptible to abuse because they lack mental capacity regarding some aspects of their life and may need protection. The law covers two main issues regarding abuse: whether there should be mandatory reporting of abuse and whether there should be specialist legislation to protect vulnerable adults. Many abusive acts are crimes and so practitioners across the professions should be aware of the criminal law that needs to be adhered to and utilized. However, some policymakers believe that elder abuse should not be criminalized and a welfare model should be followed (Bennett and Kingston, 1993; Mellor and Brownell, 2006; Nerenberg, 2008).
In certain parts of the world, specialist laws have been developed to protect adults, which include older people. For example, in Scotland, three civil statutes were introduced to form the legal framework for inquiry, assessment, and intervention (Mackay, 2008):
- Adults with Incapacity Act (Scotland) 2000
- Mental Health (Care and Treatment) (Scotland) Act 2003
- Adult Support and Protection (Scotland) Act 2007
Legislation that protects an older person who is being abused will usually cross different parts of the law: criminal, family, or civil. In the United States, older people are protected by federal and state statutes (which differ from state to state) under three categories of law:
- Adult protective services
- Institutional abuse
- Long-term care ombudsman program (Steigel and Klem, 2007).
In Canada, four main types of law cover elder abuse cases:
- Family violence laws
- Criminal law
- Adult protection laws
- Adult guardianship laws
In the province of Quebec, human rights legislation can also be used (Canadian Network for the Prevention of Elder Abuse http://www.cnpea.ca/en/)
Japan has introduced a specific elder abuse law – the Elder Abuse Prevention and Caregiver Support Law (April 2006) – which:
- Legally defines and categorizes elder abuse for the first time.
- Clarifies the responsibilities of national and local governments, designating the municipal government as the central agency in charge of elder abuse prevention.
- Establishes the mandatory reporting system for both domestic and institutional abuse cases.
- Emphasizes the importance of caregiver support (Watanabe, Y., International Longevity Center Japan, http://longevity.ilcjapan.org/t_stories/0703.html – accessed 31.07.2016).
A study concerned with the impact of the law concludes “it was a significant step in reporting systems and activities for increasing awareness among service providers. Further policy should address how to establish intervention teams and multi-agency networks, how to conduct home visits to investigate reports, and how to approach cases resistant to outside support.” (Nakanishi et al., 2009, http://www.ncbi.nlm.nih.gov/pubmed/19041151 – accessed 31.07.2016)
In developed countries, policies, procedures, and guidance exist for organizations regarding how to prevent, report, and investigate cases of elder abuse. This is often seen as a social problem with social care agencies taking the lead in conjunction with the police. In Britain, the review of the Department of Health’s guidance No Secrets considered whether the police or social services should take the lead in future: “The Police Service believed that national leadership should lie with Adults Social Care, while the Department of Health and, on a local level, felt responsibility should sit with Safeguarding Adult Boards.” (DH, 2009: p. 7)
Progress is being made around the world in dealing with elder abuse. However, governments and organizations across the statutory, voluntary, and independent sectors ought to continue to raise awareness about the issue. Everyone needs education about how prevalent the problem is, who might become a victim, who perpetrates harm and mistreatment, why this might happen, and where it occurs. Preventative work should be ongoing, while policies, procedures, and guidance should be in place for anyone working with an older person.
- Action on Elder Abuse, 1995. Bulletin, No 11. AEA, London.
- Association of Chief Officers of Police and National Policing Improvement Agency, 2008. Guidance on Investigating Domestic Abuse. NPIA, London.
- Association of Directors of Social Services, 2005. Safeguarding Adults: A National Framework of Standards for Good Practice and Outcomes in Adult Protection Work. ADSS, London.
- Baker, A.A., 1975. Granny battering. Modern Geriatrics 5 (8), 20–24.
- Bennett, G., Kingston, P., 1993. Elder Abuse: Concepts, Theories and Interventions. Chapman and Hall, London.
- Bowes, A., Avan, G., Macintosh, S., 2008. They Put up with It What Else Can They Do? Mistreatment of Black and Minority Ethnic Older People and the Service Response. Age Concern Scotland, Edinburgh.
- Burston, G.R., September 1975. Granny battering. British Medical Journal 3 (5983), 592–593.
- Burston, G.R., May 1977. Do your elderly patients live in fear of being battered? Modern Geriatrics 7 (5), 54–55.
- Decalmer, P., 1993. Clinical presentation. In: Decalmer, P., Glendenning, F. (Eds.), The Mistreatment of Elderly People. Sage Publications, London.
- Department of Health, 1992. Confronting Elder Abuse. HMSO, London.
- Department of Health, 1993. No Longer Afraid: The Safeguard of Older People in Domestic Settings. HMSO, London.
- Department of Health, 2000. No Secrets: Guidance on Developing and Implementing Multi-agency Policies and Procedures to Protect Vulnerable Adults from Abuse. DH, London.
- Department of Health, Criminal Justice System and Home Office, 2009. Safeguarding Adults: Report on the Consultation on the Review of ‘No Secrets’. DH, London.
- Donovan, K., Regehr, C., June 2010. Elder abuse: clinical, ethical, and legal considerations in social work practice. Clinical Social Work Journal 38 (2), 174–182.
- Eastman, M., 1984. Old Age Abuse. Age Concern, London.
- Eisikovits, Z., Winterstein, T., Lowenstein, A., December 2004. The National Survey on Elder Abuse and Neglect in Israel. University of Haifa: Faculty of Social Welfare and Health Studies.
- Ferreira, M., Lindgren, P., 2008. Elder abuse and neglect in South African: a case of marginalization, disrespect, exploitation and violence. Journal of Elder Abuse and Neglect 20 (2), 91–107.
- Finkelhor, D., Pillemer, K., 1988. The prevalence of elder abuse: a random sample survey. The Gerontologist 28 (1), 51–57.
- Friday, P., Hartman, J., Lord, V., Exum, M., 2007. Batterers and the Battered: Role Reversals in Domestic Violence. Paper presented at the annual meeting of the American Society of Criminology, Atlanta Marriott Marquis, Atlanta, Georgia, 13 November 2007. http://citation.allacademic.com/meta/p_mla_apa_research_citation/2/0/0/7/0/p200700_index.html (accessed 31.07.2016).
- Gelles, R.J., 1997. Intimate Violence in Families, third ed. Sage, Thousand Oaks, CA.
- Gelles, R.J., Cornell, C.P., 1985. Intimate Violence in Families. Sage, Beverley Hills, CA.
- Hayes, A.J., Fazel, S., 2008. Older adults in prison: vulnerability, abuse and neglect. In: Pritchard, J. (Ed.), Good Practice in Safeguarding Adults: Working Effectively in Adult Protection. Jessica Kingsley Publishers, London.
- HelpAge India, 2013. Report on Elder Abuse in India 2013. HelpAge India, New Delhi.
- Ingram, R., 2001. Is it a domestic? Or is adult abuse? In: Pritchard, J. (Ed.), Good Practice with Vulnerable Adults. Jessica Kingsley Publishers, London.
- Kingsley, B., Johnson, S., 1993. Elder Abuse: The Ethical Dilemma [Unedited. Paper as presented at Conference of 23–25 February 1993]. Australian Institute of Criminology, Canberra. http://www.aic.gov.au/media_library/conferences/olderpeople/johnson.pdf (accessed 31.07.2016).
- Kosberg, J., 2007. Abuse of Older Men. The Haworth Maltreatment and Trauma Press, Binghamton, NY co-published simultaneously as Journal of Elder Abuse and Neglect 19, 1–2.
- Lachs, M., Pillemer, K., 2004. Elder abuse. The Lancet 364 (9441), 1192–1263.
- Liao, S., 2006. Ethical Dilemmas in Elder Abuse: Successful Resolutions of Challenging Cases. Program and abstracts of the American Geriatrics Society 2006 Annual Scientific Meeting; 3–7 May 2006; Chicago, Illinois. Session 0413.
- Lifespan of Greater Rochester, Inc., May 2011. Under the Radar: New York State Elder Abuse Prevalence Study. Weill Cornell Medical Center of Cornell University, New York City Department for the Aging, New York.
- Linzer, N., 2004. An ethical dilemma in elder abuse. Journal of Gerontological Social Work 43 (2–3), 165–173.
- Mackay, K., 2008. Scottish legislative framework for supporting and protecting adults. In: Pritchard, J. (Ed.), Good Practice in the Law and Safeguarding Adults: Criminal Justice and Adult Protection. Jessica Kingsley Publishers, London.
- Mba, C.J., 2007. Elder abuse in parts of Africa and the way forward. Gerontechnology 6 (4), 230–235.
- Mellor, J., Brownell, P. (Eds.), 2006. Elder Abuse and Mistreatment: Policy, Practice and Research. The Haworth Press Inc, Binghamton.
- Nagele, B., Bohm, U., Gorgen, T., Toth, O., December 2010. Intimate Partner Violence against Older Women – Summary Report. Deutsche Hochschule der Polizei and Zoom, Gottingen.
- Nakanishi, M., Hoshishiba, Y., Iwama, N., Okada, T., Kato, E., Takahashi, H., May 2009. Impact of the elder abuse prevention and caregiver support law on system development among municipal governments in Japan. Health Policy 90 (2–3), 254–261.
- National Center on Elder Abuse, September 1998. The National Elder Abuse Incidence Study. NCEA, Washington, DC.
- National Center on Elder Abuse, April 2006. Fact Sheet: Elder Abuse Prevalence and Incidence. http://www.centeronelderabuse.org/docs/ea_stats_fact_sheet_2011.pdf (accessed 31.07.2016).
- Naughton, C., Drennan, J., Lyons, I., Lafferty, A., Treacy, M., Phelan, A., O’Loughlin, A., Delaney, L., 2012. Elder abuse and neglect in Ireland: results from a national prevalence survey. Age and Ageing 41 (1), 98–103.
- Nerenberg, L., 2008. Elder Abuse Prevention: Emerging Trends and Promising Strategies. Springer Publishing Co. LLC, New York.
- O’Keeffe, M., Hills, A., Doyle, M., McCreadie, C., Scholes, S., Constantine, R., Tinker, A., Manthorpe, J., Biggs, S., Erens, B., 2007. UK Study of Abuse and Neglect of Older People Prevalence Survey Report. Comic Relief and Department of Health, London.
- O’Malley, T.A., Everitt, D.E., O’Malley, H.C., Campion, E.W., 1983. Identifying and preventing family mediated abuse and neglect of elderly persons. Annals of Internal Medicine 98 (6), 998–1005.
- Patel, N., 2003. Minority Elder Care in Europe: Country Profiles. PRIAE Policy Research Institute on Ageing & Ethnicity, Bolton.
- Payne, B.K., 2013. Physical and Emotional Abuse of the Elderly. Community Orientated Policing Services, US Department of Justice, Washington, DC.
- Pillemer, K., Finkelhor, D., 1988. The prevalence of elder abuse: a random sample survey. Gerontologist 28 (1), 51–57.
- Pillemer, K., Moore, D., 1989. Abuse of patients in nursing homes: findings from a survey of staff. Gerontologist 29 (3), 314–320.
- Pillemer, K., Moore, D., 1990. Highlights from a study of abuse of patients in nursing homes. Journal of Elder Abuse and Neglect 2 (1&2), 5–29.
- Podnieks, E., 1992. National survey on abuse of the elderly in Canada. Journal of Elder Abuse and Neglect 4 (1&2), 5–58.
- Podnieks, E., Pillemer, K., 1990. Survey on Abuse of the Elderly in Canada. Ryerson University, Toronto.
- Pritchard, J., 19 October 1990. Charting the hits. Care Weekly, 10–11.
- Pritchard, J., 8 July 1993. Gang warfare. Community Care, 22–23.
- Pritchard, J., 1996. Working with Elder Abuse: A Training Manual for Home Care, Residential and Day Care Staff. Jessica Kingsley Publishers, London.
- Pritchard, J., 2000. The Needs of Older Women: Services for Victims of Elder Abuse and Other Abuse. The Policy Press, Bristol.
- Pritchard, J., 2001. Male Victims of Elder Abuse: Their Experiences and Needs. Jessica Kingsley Publishers, London.
- Pritchard, J., 2007. Working with Adult Abuse: A Training Manual for People Working with Vulnerable Adults. Jessica Kingsley Publishers, London.
- Shanhardass, M.K., 2009. No One Cares about Elder Abuse in India. One World South Asia, New Delhi. http://southasia.oneworld.net/peoplespeak/no-one-cares-about-elder-abuse-in-india (accessed 31.07.2016).
- Steinmetz, S., 1978. The battered husband syndrome. Victimology 2 (3–4), 499–509.
- Stiegel, L., Klem, E., 2007. Adult Protective Services, Institutional Abuse and Long Term Care Ombudsman Program Laws: Citations by State. American Bar Association Commission on Law and Aging for the National Center on Elder Abuse, Washington, DC. http://www.americanbar.org/content/dam/aba/migrated/aging/about/pdfs/APS_IA_LTCOP_Citations_Chart.authcheckdam.pdf (accessed 31.07.2016).
- Straus, M., 1999. The controversy over domestic violence by women. In: Arriaga, X.B., Oskamp, S. (Eds.), Violence in Intimate Relationships. Sage Publications, Thousand Oaks, CA.
- Straus, M.A., Gelles, R.J., Steinmetz, S.K., 1980. Behind Closed Doors: Violence in the American Family. Anchor, Garden City, NY.
- Sukosky, D.G., 1987. Role reversal of the elderly: intervention and prevention. Family Life Educator 6 (1), 14–17.
- Teaster, P.B., Otto, J.M., 2007. The 2004 Survey of State Adult Protective Services: Abuse of Adults 60 Years of Age and Older. National Center on Elder Abuse, Washington, DC. http://www.napsa-now.org/wp-content/uploads/2012/09/2-14-06-FINAL-60+REPORT.pdf (accessed 31.07.2016).
- World Health Organization, 2002. Missing Voices: Views of Older Persons on Elder Abuse. WHO, Geneva.
- World Health Organization, August 2011. Elder Maltreatment – Fact Sheet 357. WHO, Geneva. http://www.who.int/mediacentre/factsheets/fs357/en/ (accessed 31.07.2016).
- Watanabe, Y. The Elder Abuse Prevention and Caregiver Support Law. International Longevity Center Japan: http://longevity.ilcjapan.org/t_stories/0703.html (accessed 31.07.2016).