Elder abuse is a pervasive global challenge, causing severe harm, including psychological damage, financial devastation, and physical injury, with victims facing a mortality rate three times higher than non-victims. Despite its critical nature, rigorous scientific study and specialized intervention for elder abuse have only recently gained significant traction.
This comprehensive literature review, drawing on 198 studies, including meta-analyses, literature reviews, and empirical research, provides crucial insights into the empirically supported risk factors for elder abuse and neglect. The primary aim of this work is to equip practitioners with a practical understanding of these factors to inform their professional practice and lay the groundwork for an empirically derived risk assessment instrument.
Key Contributions and Findings from the Review:
- Identifiable Risk and Vulnerability Factors: The review identifies eight perpetrator risk factors that increase their likelihood of engaging in continued elder abuse and eight victim vulnerability factors that heighten an older person’s risk of being abused. These factors are broadly categorized and supported by convergent research from various professional settings over decades.
- Focus on Dynamic Risk Factors: A significant strength of this review is its emphasis on dynamic risk factors. Unlike static factors (e.g., historical criminality), dynamic factors are variables that can be changed or modified through short- or long-term interventions, making them crucial targets for risk management and the prevention of future abuse.
- Examples of dynamic perpetrator risk factors include problems with physical health, mental health, substance use, dependency, stress and coping, attitudes, previous victimization, and relationships.
- Victim vulnerability factors include similar categories: problems with physical health, mental health, substance use, dependency, stress and coping, attitudes, previous victimization, and relationships.
- Practical Utility for Professionals: The identification of these risk and vulnerability factors is of immense utility for practitioners such as psychologists, social workers, healthcare workers, and criminal justice professionals. They can use this knowledge to:
- Identify situations where there is a risk of current or ongoing elder abuse.
- Target risk management efforts to mitigate these dynamic factors, thereby reducing the likelihood of future abuse. For instance, addressing a perpetrator’s substance abuse through treatment or a victim’s social isolation through support networks can directly reduce risk.
- Foundation for Advanced Risk Assessment: The review underscores the critical need for a structured method to assess and manage elder abuse risk. Currently, most available tools are designed for screening or detecting the presence of abuse, leaving practitioners to rely on unstructured professional judgment to determine the risk of continued abuse, which has been widely discredited as unreliable and invalid.
- Introducing the Elder Abuse Risk Level Index (EARLI): Building directly on the findings of this review, the Elder Abuse Risk Level Index (EARLI) is currently under development. This innovative instrument aims to provide a structured professional judgment (SPJ) method for assessing and managing elder abuse risk, similar to best practices in related fields like intimate partner violence. The EARLI will fill crucial gaps by:
- Being empirically based on a recent systematic review.
- Focusing on assessing the level of risk and managing that risk to predict or prevent future abuse, rather than just detection.
- Considering cases with male or female victims.
- Providing clear, individual risk factors that can be targeted for intervention.
- Incorporating a strong focus on perpetrator risk factors, which are often overlooked in other instruments.
This research highlights that effective intervention in elder abuse cases requires a comprehensive understanding of both perpetrator risk factors and victim vulnerability factors, emphasizing a holistic approach aligned with the ecological model of violence. By providing a robust empirical foundation, this work is a vital step toward improving the assessment and management of elder abuse, ultimately aiming to prevent future harm to older adults.
Reference: Storey, J. E. (2020). Risk factors for elder abuse and neglect: A review of the literature. Aggression and Violent Behavior, 50, 101339. https://doi.org/10.1016/j.avb.2019.101339
