A Systematic Review of Approaches Used to Address Sexual Assault Among Older Adults: Exploring the Hidden Needs of a Growing Yet Underrepresented Population

Background: 

For many years, rape stereotypes have involved  the assault of young females and older adults have largely been excluded in research, policies, and education on sexual violence (Bows & Westmarland, 2015).  However sexual assault accounts for the most underreported type of abuse experienced by this population (Vierthaler, 2008), highlighting a need to expand our knowledge base in this area.  Thus a systematic review was conducted to explore the ways sexual assault has been recently addressed among older adults and to identify implications for social work researchers and practitioners as they aim to meet the needs of this population.

Methods:

A systematic review of peer-reviewed scholarly literature was conducted using the search words “aging,” “elder,” “older adult,” “rape” “sexual abuse,” “sexual assault,” and “sexual violence” to locate articles within EBSCO, Sage Journals, Oxford Journals, Clinical Key Flex and Taylor and Francis Online databases.  Peer-reviewed articles published in the English language during or after 2006 were deemed eligible if their focus involved approaches used to address sexual assault among older adults as well as implications for practitioners and researchers.  Twenty six scholarly articles met this criteria and were included in the review.

Findings:

Findings suggest that both older adult men and women are sexually abused, often by employees or residents when dwelling in nursing homes, however for many, such cases are not appropriately addressed, suggesting a need for increased clinical knowledge as well as for specific guidelines for response (Malmedal et al., 2015).  Training should be provided on further screening for employment and residence, addressing the possibility of visitors harming residents, and education on the signs of sexual assault (Ramsey-Klawsnik et al. 2009).  Adequate training on evidence collection involving greater cooperation with law enforcement (Ramsey-Klawsnik et al. 2009), nurses, doctors and other service providers (Poulos  & Sheridan, 2008) is needed as well.  Further, practitioners should use appropriate measures and pose questions in a bias-free and gender-neutral manner when screening for ongoing or previous sexual assault (Probst et al., 2011). 

Moving forward, further prevention –focused research is needed, such as on ways long-term care industries can serve former perpetrators while prioritizing the safety of other residents  (Poulos & Sheridan, 2008).  Such studies must consider culture and ethnicity as well as ways to address rape myths, particularly among service providers (Poulos & Sheridan, 2008).  Beyond this, research is needed to evaluate screening tools and explore risk and resilience factors as well as the psychological and physical impacts of sexual violence in later life (Cook et al., 2011). 

Implications:

This systematic review provides an overview of the ways sexual assault among older adults has been addressed over recent years.  Results demonstrate the need for social work researchers and practitioners to collaborate with other professionals who serve older adults to develop and evaluate effective screening tools, training models, guidelines for reporting, community-based interventions and awareness raising initiatives.  Further, the products of such efforts should be free or affordable and user-friendly for those responsible for protecting older adults, as a critical need persists for these resources.