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Adult protective services and other community-based agencies respond to hundreds of thousands of elder abuse cases annually in the United States; however, few studies include elder abuse victims’ voices. This study explored the most distressing aspects of elder abuse, as identified by victims themselves; to date, this is the first known study on this topic.
Methods
Guided by a phenomenological qualitative methodology, this study conducted in-person, semi-structured interviews with a sample of elder abuse victims (n = 30) recruited from a community-based elder abuse social service program in New York City. These qualitative interviews were conducted with older adult participants who had been assessed as elder abuse victims through formal elder mistreatment response programs (EMRP) and had decided to accept involvement with EMRP services. To enhance trustworthiness, two researchers independently analyzed transcript data to identify key transcript codes and themes. Codes were initially inputted as self-standing nodal “themes”; they then became “subthemes” that were manually grouped based on perceived relationships as larger, general themes emerged. Themes were formally identified when at least three nodes, or “subthemes”, were present that related to a particular theme; at times, the subthemes themselves became the theme.
Results
Distressing aspects of elder abuse were identified across three key domains, related to feelings of loss (50% of codes), threats/negative consequences (55%), and client-needs/system incongruity (14%). Specifically, the first theme represented outcomes related to loss of relationships (19% of ‘loss’ codes), personhood (16%), credibility (19%), faith/trust in others (38%), and finances (8%). The second theme looked at threats to physical self (34% of ‘threat’ codes), psyche (39%), and others, including the perpetrator (27%). The third theme focused on mismatches in client and the goals set out by the system (50% of ‘incongruity’ codes) and legal system involvement (50%).
Conclusions and Implications
This study took an inductive and exploratory approach to identifying the most distressing aspects associated with elder abuse, as identified by victims themselves. Three main themes had been identified through a detailed and comprehensive analysis of the transcripts. Although it is imperative for the system to ensure that the victims of elder abuse receive aid, whether this is in the form of legal, medical, or social service assistance, the participants that were interviewed in this study expressed a desire to ensure that the perpetrators received help as well, especially around mental health and understanding that their abusive actions were wrong and hurtful. The findings in this study provide a comprehensive and conceptually organized range of aspects to serve as infrastructure for the development of meaningful interventions to address the needs of victims. This study represents one of the largest efforts to understand and integrate the perspectives and needs of victims into elder abuse intervention practice and research to date.