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Elder abuse is a highly complex social problem. The abuse takes many forms, including: financial, physical, psychological, social and sexual as well as the more passive form of neglect. It can be deliberate or inadvertent. It is difficult to measure as the type of abuse and setting in which it occurs differ markedly. It is also difficult to know when an intervention to prevent or manage abuse has been successful as this will depend on the type of abuse and the definition of success. A service provider may define success as cessation of abuse but an older person may not regard cessation as successful if it has meant that they have had to move house or lost contact with the family member perpetrating the abuse. It is also difficult to design interventions that focus on the perpetrator, unless they are also the carer of the older person. For these reasons, there is a lack of high quality research evidence to support the effectiveness of most elder abuse interventions.
This review begins with a broad discussion of elder abuse by considering the definition of the term and the prevalence of the behaviour, the impact elder abuse has on older people and the wider population, and the family context within which elder abuse most often occurs. It then considers the different ways elder abuse is conceptualised, and how it intersects with a range of other issues including ageism, family violence and conflict, caregiving, gender and sexuality, and culture and suggests that an applied ecological approach (which considers the individual and their place within their community and society) is the most comprehensive way of conceptualising elder abuse. Finally, interventions that show some evidence or promise, and which should be further and more rigorously researched and evaluated are described.
‘Elder abuse’ is best used as a descriptive umbrella term that encompasses a broad range of behaviours. Elder abuse should be considered in the context of ageism, family violence and conflict, caregiving, gender and sexuality, and culture, and any policies or interventions aimed at addressing the mistreatment of older people need to take these factors into consideration.
Blanket approaches to prevention and intervention are unlikely to address the complex nature of elder abuse. Different types of abuse (financial, psychological, physical, sexual and social abuse and neglect) are related to different risk factors, each of which need to be considered to ensure a long-term solution for any individual.