Elder Abuse : Agencies\u27 Experiences and Seniors\u27 Relationships

This study examines elder abuse in an Australian context and comprises two parts: agencies\u27 experiences with elder abuse; and seniors and their relationships. The first part sought baseline data on elder abuse as recorded by a range of agencies in New South Wales (NSW) and Western Australia (WA). A mailed questionnaire was sent to a random sample of 400 agencies per State, seeking information for the 1994 calendar year regarding abused elders 65 years of age or older, and resulted in an overall return rate of 57.62%. Data was analysed using SPSS for Windows. The second part of the study was qualitative, exploratory and phenomenological in nature. The objectives were: to increase the knowledge and understanding of elder abuse within an Australian context by examining the experiences and feelings of care givers and care recipients in the transition from independence to dependence for one partner; to identify factors contributing to the abuse of elderly persons in private accommodation; to determine the relevance of a disability-related dependency to the likely occurrence of elder abuse; and to explore the applicability of a range of theories, in particular social exchange theory and the situational model, to caring situations. A purposive, nonrandom sample of nine cases was drawn totalling 12 persons who were interviewed using a semi-structured questionnaire. Four general research questions examined the characteristics of the participants prior to the onset of caring; explored the impact of the change from the pre-caring stage to the caring stage on the respondents; assessed caring demands on the care giver; and sought to determine the impact of continuous care provision on the care giver/care recipient relationship. Seven ancillary research questions addressed more specific aspects of the care giver/care recipient relationship. Qualitative data analysis utilised NUD.IST. The major findings from part 1 of the study revealed 92 (44%) agencies in NSW and 66 (26.2%) in WA had seen cases of elder abuse in 1994. In both States, female elder abuse victims as care recipients, were represented three times more often over a greater range of victims per agency than male counterparts. Psychological, physical, material/financial and sexual forms of abuse, plus neglect, were represented in both States\u27 findings. Psychological abuse was most frequent in NSW, and in WA, neglect. Sexual abuse was reported with least frequency in both States. In each State, victims were represented in a ratio of approximately 1:6 (care giver to care recipients). For care givers, the most common forms of abuse received were physical, psychological and material/financial. No reliable Australian data exists on the incidence and prevalence of elder abuse. These research findings indicated its presence and found similarities with findings in the USA, Canada and the UK for perpetrators and abuse types. Perpetrators of elder abuse included: spouses; sons; sons-in-law; de facto partners; daughters; and daughters-in-law. Spouses were cited most often as perpetrators in both States followed by sons and daughters in NSW and daughters-in-law and sons in WA. Direct agency services for victims were found wanting. Where available, they provided information; counselling; mediation; and referral. Mandatory reporting of elder abuse was supported in both NSW ( 4 7 .1 % ) and WA (44.8%). One-third of the agencies in both States were undecided on the issue and the remainder were opposed. However, many agencies ignored the question, leaving the results inconclusive. The major findings from part 2 of the study revealed eight of nine care givers interviewed to have been in long-term marriages and of having satisfying relationships prior to the onset of the partner\u27s disability. Trauma, loss and grief experiences prior to their partner\u27s disability, for some, exacerbated the demands of caring in later years. The onset of the disability-related dependency whether sudden, or gradual, determined how the care giver coped initially. Regardless of the type of disability, common feelings expressed by care givers included: social isolation; change or loss in communication; a sense of coping alone; lack of external supports; feeling trapped; a loss of intimacy with the partner; stress, both structural and situational; having health problems related to carer stress; physical and mental exhaustion; anger; disappointment; frustration; general loss and grief; resentment; sadness; anxiety; and the monotony of the caring role. Environmental factors were rarely mentioned as being stressful. There appeared to be a connection between care giver stress and elder abuse in eight of the nine cases studied, notably psychological abuse. Physical abuse was indirect, and only one possible instance of neglect was noted. Sexual and material/financial abuse were not represented in the sample of case studies. Theories associated with elder abuse explored in the study included: stress theory; crisis theory; learned violence; issues of dependency; mental impairment; loss and grief; societal ageism and sexism. The findings lend only partial support to the situational model as a possible explanation for elder abuse. This study identified as situational factors: physical dependency; poor health; impaired mental status; difficult personalities in the care recipients; and corresponding care giver health problems. Only one structural factor was identified, namely social isolation. The concepts associated with social exchange theory - including power advantage/disadvantage, positive sentiments, rewards and punishments, instrumental services and personal resources - were evident across the nine cases. However, without the application of additional variables, it could not be concluded that social exchange theory, on its own, adequately explained elder abuse. No one theory emerged as offering a satisfactory explanation for the causes of elder abuse, suggesting that its complex and diverse nature defies a single causal theory