Letter From the Guest Editors: Elder Abuse as a Gendered Issue

Given the longer life expectancy of women, the aging population is predominately a female one. Living longer, however, does not necessarily mean living well. Compared to older men, older women are more likely to outlive their spouses, live in poverty and rely on social welfare, and suffer chronic health conditions, disabilities, and limitations in activities of daily living. All of these factors marginalize older women in society, increase their risk of abuse and neglect, and limit their access to services and support.

Cumulative disadvantages acquired throughout a lifetime of gender discrimination, combined with ageism, which diminishes and renders older women invisible or subject to negative stereotyping, can lead to the abrogation of their right to live free of abuse (U.N. General Assembly, 1991). This was recognized as a gap in the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) by the United Nations General Assembly, which ratified General Recommendation No. 27 on older women and protection of their human rights in December 2010. In this document, states parties are charged with the obligation to recognize and prohibit violence against older women in legislation on domestic violence, sexual violence, and violence in institutional settings and resulting from traditional practices and beliefs (Martin, Rodrigues-Pinzón, & Brown, 2015).

Despite older women being the likely victims of abuse, violence against older women has not been adequately represented in the literature. The Abuse and Violence against Older Women (AVOW) study is one of few prevalence studies to address this issue. The AVOW study investigated neglect and abuse experienced by older women in five European countries: Austria, Belgium, Finland, Lithuania, and Portugal. Among the 2,880 women surveyed, 28.1% reported experiencing some kind of violence or abuse. The highest rate was reported in Portugal (39.4%) and the lowest in Lithuania (21.8%). Emotional abuse was the most common form of violence reported (23.6%), followed by financial abuse (8.8%), violation of rights (6.4%), neglect (5.4%), sexual abuse (3.1%), and physical abuse (2.5%; Luoma et al., 2011).

In view of the knowledge gap in violence against older women, the United Nations focal point on ageing organized an expert group meeting (UN EGM) on “Neglect, Abuse and Violence of Older Women” in New York in November 2013. This meeting brought together experts from Asia, Africa, Europe, and North America to discuss issues relevant to violence against older women—definitional challenges and changing perceptions, as well as prevalence, potential risk factors, and existing approaches to prevention and intervention.

THE PRESENT SPECIAL ISSUE

This special issue on neglect, abuse, and violence against older women is part of the outcome of the UN EGM. It includes work from participants at the meeting and colleagues from other parts of the world.

THEORY BUILDING AND PARADIGM CONSTRUCTION

A comprehensive understanding of violence against older women should be guided by sound theories. Much of the existing theories used in violence against older women research, however, were borrowed from either the elder abuse or the intimate partner violence frameworks. In “Survivors in the Margins: The Invisibility of Violence Against Older Women,” Crockett, Brandl, and Dabby identify how the lack of gender analysis in the elder abuse literature exacerbates older survivors’ invisibility while the wider violence against women field lacks a lifespan approach to abuse. Based on the data from 31 qualitative interviews with abused women in Eastern Europe, Band-Winterstein proposes a phenomenological framework for understanding intimate partner violence (IPV) against older women in, “Aging in the Shadow of Violence: A Phenomenological Conceptual Framework for Understanding Elderly Women Who Experienced Lifelong IPV.”

RESEARCH FROM AN INTERNATIONAL PERSPECTIVE

Smith uses a qualitative approach to investigate the experiences a group of low income minority older women in the New York metropolitan area who were abused by their adult daughters. In “Expanding Constructions of Elder Abuse and Neglect: Older Mothers’ Subjective Experiences,” she highlights the struggles that older abused women have in interacting with their abusive daughters.

Looking at violent relationships from the perspective of an abuser, Pickering and her colleagues conducted telephone interviews with 13 adult daughters who identified themselves as having an abusive relationship with their mothers. The sample came from California, Pennsylvania, and New York. In “Adult Daughters’ Descriptions of Their Mother–Daughter Relationship in the Context of Chronic Conflict,” they examine how adult daughters’ perceptions of past childhood injustices and their negative emotional impact coupled with the daughters’ sense of filial obligation lead to chronic conflict and confrontation in the caregiving relationship.

Violence against older women is intertwined with a host of complicating factors, among which unattended psychiatric problems is a prominent one. In “Physical, Financial, and Psychological Abuse Committed Against Older Women by Relatives With Psychiatric Disorders: Extent of the Problem,” Labrum, Solomon, and Bressi analyzed data from 217 older women living across the US who have a relative with psychiatric disorders, and provide a preliminary estimate of the scale and characteristics of abuse arising from these situations.

While there are too few studies on violence against older women, studies addressing sexual violence against older women are particularly scarce. In “The Sexual Victimization of Older Women Living in Nursing Homes,” Teaster and her colleagues address this research gap. The research team analyzed cases referred to Adult Protective Services in the states of New Hampshire, Oregon, Tennessee, and Wisconsin and provide a profile of alleged sexual abuse experienced by female nursing home residents.

On a structural level, older women are more likely than men to live in poverty and be unable to support themselves in old age. Petrusic and her research team present and discuss findings of a survey on financial abuse experienced by older women in Serbia. This article, “Financial Abuse of Older Women in Serbia,” sheds light on a population that is under-represented in the existing literature. Highlighted is how traditional cultural practices, such as surrendering rights of inheritance to adult children and entering into legally binding life-long contracts with caregivers, may expose older women to additional risk for financial exploitation.

Also from an understudied population, Sousou and Yogtiba give us a picture of violence against older women in Ghana. In “Abuse, Neglect, and Violence Against Elderly Women in Ghana: Implications for Social Justice and Human Rights,” they emphasize insidious cultural practices and superstitious beliefs that affect older women in Ghana. They also bring to light the unique situation of elderly women in Ghana as characterized by pervasiveness of poverty, illiteracy, widowhood, and predominantly rural dwelling.

Building their paper around in-depth analysis of two abused women residing in a Hong Kong battered women’s shelter, Cheung, Tiwari, and Wang highlight the complexity of violence against older women in the Chinese cultural context in “Intimate Partner Violence in Late Life: A Case Study of Older Chinese Women.”

INTERVENTION PROGRAMS AND POLICIES

Given the negative outcome of violence and neglect of older women, it is essential that we develop a collective action to prevent and intervene in these cases, particularly with evidence-based outcome studies.

Sirey and her team share the promising results of integrating a brief psychotherapy intervention into an existing elder abuse service program for community-dwelling victims with capacity in New York City. Using a randomized control trial, the investigators show that the program, PROTECT, is effective in alleviating depressive symptoms and in enhancing personal resources and self-efficacy of abused older women.

Through an in-depth analysis and reflection of the legal and clinical assistance available for abused women in Canada, James and her team provide very practical suggestions and recommendation for interdisciplinary collaboration in “Older Women Fleeing Violence and Abuse in Canada: Bringing Together Separate Spheres of Practice.”

Effective prevention and intervention requires collaborative efforts among various professionals. Brossoie and Roberto investigate professionals’ knowledge base and awareness of violence against older women in the rural community in Southwest Virginia. In “Community Professionals’ Response to Intimate Partner Violence Against Rural Older Women,” they highlight the urgent need for multidisciplinary education and training of professionals to heighten their sensitivity and awareness of violence against older women.

Lack of funding has become part of the reality for most government and health and human services agencies around the world. As such, volunteers become a powerful source of person-power for prevention and intervention efforts. Beaulieu and her team used an in-depth analysis of a single case in Quebec to illustrate the dynamics that can underlie cases of financial exploitation of elderly women by adult children and others, as well as the complexities of rights-based interventions. They also note the potential and difficulties of relying on volunteers to intervene with elder abuse cases in “Financial Exploitation of Older Women: A Case Analysis Using the Struggle for Recognition Theory.”

Advocacy groups have an important role in prevention and intervention efforts. Mears describes the achievements of the Older Women’s Network in Australia in “Violence Against Older Women: Activism, Social Justice, and Social Change.”

In “Silent Victims: A Brief Report on Abused Older Women in Taiwan,” Cho presents an overview of the existing literature of violence against older women in Taiwan and reviews existing policies and legislation related to violence against older women in Taiwan. Critical analysis of government policies, programs and legislation is an important step in assessing the extent to which governments, as duty bearers, are responding to older women, as rights bearers, who are or might be experiencing neglect, abuse, and violence (U.N. Office of the High Commissioner for Human Rights, 2012).

CONCLUDING REMARKS

The present issue includes work from around the world on neglect, abuse and violence against older women from diverse perspectives. As is obvious, there is a need for more research on this topic. In particular, much remains to be learned about its prevalence, risk and protective factors, evidence-based prevention and intervention strategies, and the impact of cultural factors, particularly those in developing countries and in minority populations of developed countries. We hope the articles presented here will stimulate further research and advance knowledge about neglect, abuse, and violence against older women from a human rights perspective.

ORCID

Elsie Yan

http://orcid.org/0000-0002-0604-6259