Older People

Last updated May 15, 2023

Abuse of older people is the harmful treatment of a person over 65 years old by a trusted individual.

Like other forms of DFV, it can include physical, psychological, emotional, social, financial or sexual abuse. It can also include neglect.

Older people may be at increased risk of abuse if:

The carer is experiencing high levels of stress, for example, health or financial pressures
The older person is unable to stop or report abuse due to cognitive impairment or physical limitations
There is isolation as a result of location, cultural or language barriers, or health complications
The carer or older person is dealing with addiction
The carer or older person is dependent on the other person for support, for example, financially, socially, or physically.’ (Relationships Australia, 2018)

Clinical Indicators

Where older people are impacted by DFV, they are likely to display some of the clinical indicators present in other adult victim/survivors of DFV. Older people may also display other clinical indicators including:

General Behaviour

Being afraid of one or many person/s
Irritable or easily upset
Worried or anxious for no obvious reason
Depressed, apathetic or withdrawn
Change in sleep patterns and/or eating habits
Rigid posture and avoiding contact
Avoiding eye contact or eyes darting continuously
Contradictory statements not from mental confusion
Reluctance to talk openly

Physical Abuse

A history of physical abuse, accidents or injuries
Injuries such as skin trauma, including bruising, skin tears, burns, welts, bed sores, ulcers or unexplained fractures and sprains
Signs of restraint (e.g. at the wrists or waist)
Unexplained behaviour changes suggesting under-medication or over-medication
Unusual patterns of injury

Sexual Abuse

Bruising around the breasts or genital area
Unexplained genital or urinary tract infections\
Damaged or bloody underclothing
Unexplained vaginal or rectal bleeding
Bruising on the inner thighs
Difficulty in walking or sitting

Emotional Abuse

A history of psychological abuse
Reluctance to talk, fear, anxiety, nervousness, apathy, resignation, withdrawal, avoidance of eye contact
Rocking or huddling up
Loss of interest in self or environment
Insomnia/sleep deprivation
Unusual behaviour or confusion not associated with illness

Economic Abuse

History of fraudulent behaviour or stealing perpetrated on the patient
Lack of money to purchase medication or food
Lack of money to purchase personal items
Defaulting on payment of rent or residential aged care facility fees
Stripping of assets from the family home or use of assets for free

Neglect

A history of neglect
Poor hygiene, bad odour, urine rash
Malnourishment, weight loss, dehydration (dark urine, dry tongue, lax skin)
Bed sores (sacrum, hips, heels, elbows)
Inappropriate or soiled clothing, overgrown nails, decaying teeth
Broken or missing aids such as spectacles, dentures, hearing aids or walking frame

Taken from the RACGP White Book (Royal Australian College of General Practitioners, 2021)

Supporting Disclosure

Older people who are impacted by DFV may face additional barriers to disclosure and accessing support. These include:

Physical or social isolation
Disability
Lack of knowledge of available services
Dependency on the individual who is perpetrating harm as a primary care giver, and the fear of being placed into institutional care

Fear of legal and social consequences of reporting their family member
Fear of further abuse
Shame

Responding to Abuse of Older People

Where an older patient discloses that they are impacted by abuse, a practitioner can respond as they would with other presentations of DFV.

Where the abuse of the older person is reported to have occurred in a Commonwealth-funded Residential Aged Care setting, mandatory reporting applies and a report is to be made to the Ageing and Disability Abuse Helpline.

Contacts

The five–step approach to identify and respond to abuse of an older person provides a framework for people in positions where the abuse of an older person may be suspected, witnessed, or disclosed.

Ending Abuse through Simple Interventions (E.A.S.I)

Ending Abuse through Simple Interventions has been designed and informed by practices that are known to strengthen community capacity and raise awareness about abuse of older people and adults with disability in their family, home and community.

The Ageing and Disability Commission encourages all organisations and services to consider what works for them and their community to better detect and respond to abuse. In particular, we believe that local councils play a significant role in supporting initiatives that better protect and promote of the rights of older people and adults with disability in their local area to live free from abuse.

References

Relationships Australia. (2018). What is Elder Abuse?
Royal Australian College of General Practitioners. (2021). Abuse and violence: Working with our patients in general practice.

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