Caregiving and elder abuse.

Elder abuse is understudied and underreported. Elder abuse can take five forms: psychological or emotional abuse, physical abuse, sexual abuse, neglect, and financial abuse. Two national studies of the prevalence of elder abuse have recently been conducted. Laumann in a survey of 3005 community residing individuals between ages 57 to 85 interviewed either in person or with a leave-behind questionnaire found past-year prevalence was 9.0% for verbal abuse, a form of psychological abuse, 0.2% for physical abuse and 3.5% for financial mistreatment. Acieno, using random digit dialing of a representative sample of 5777 respondents age 60 and older living in the community, found a one-year prevalence of 4.6% for emotional abuse, 1.6% for physical abuse, 0.6% for sexual abuse, 5.1% for potential neglect, and 5.2% for financial abuse. One in ten elders, defined as those over 60 in most studies, had experienced some form of abuse in the past year. By law in Rhode Island, “elder abuse” must involve the willful infliction of physical pain or willful deprivation of services including neglect, abandonment and exploitation, and it must be carried out by a caretaker or other person with a duty of care for the elderly person (RI General Law 42-66.4.1). In Rhode Island and in many states abuse of an elderly person is defined as starting at age 60, although age 65 is used in other contexts. The US National Academy of Sciences has defined elder abuse as “(a) intentional actions that cause harm (whether or not harm is intended), to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder or (b) failure by a caregiver to satisfy the elder’s basic needs or to protect the elder from harm.” This definition has two key points: the elderly individual was injured, deprived or endangered unnecessarily and a caregiver or person in a trust relationship caused or failed to prevent the event.