1. Domestic Violence in Later Life Online Training
Florida Coalition Against Domestic Violence
Contact Information: Maggie Cveticanin
Disability Compliance and Later in Life Specialist
cveticanin_maggie@fcadv.org

2. Objectives
By the end of this online course, you should be able to:
 Identify three types of abuse in later in life.
 Recognize the role of family in elder abuse
 List three consequences of abuse and neglect for:
 the older adult,
the abuser,
 and society
 Identify risk factors for perpetration

3. Vulnerable Adult Legal Definition
Person(s) 18 + whose ability to perform the normal activities of
daily living, and/or to provide for his or her own care or
protection, is impaired due to a mental, emotional, long-term
physical, or developmental disability or dysfunctioning, or brain
damage, or due to the infirmities of aging.
3 Florida Statute Section 415.102(26)

4. Distinction Between Intentional and
Unintentional Abuse
 Intentional abuse is a  Unintentional abuse is an
conscious and deliberate inadvertent action
attempt to inflict physical, resulting in physical,
emotional, or financial emotional, or financial
harm. This type of abuse harm. This type of abuse
is most often due to the is usually due to
abuser’s desire to ignorance, inexperience,
maintain power and lack of desire, or inability
control over the survivor. to provide proper care.

5. Intentional Abuse
This training will focus solely on intentional abuse, some
examples of this type of abuse are:
Harm to pets
Name calling
Hiding necessary medications
Hitting, punching, pushing
Rape
Destroying assistive technology

6. Dynamics of Elder Abuse and Neglect
The reasons are complex and multifaceted. Family
dynamics often play a role. Some older adults may
rely on their children or other family members for
their physical care. In other cases, family members
may depend on the older adult for housing or
financial support.

7. Dynamics of Elder Abuse
 Elder abuse, neglect, and exploitation often go
unrecognized and unreported for many reasons:
Isolation caused by the perpetrator.
The victim may have valid fears that they will have
to go to a nursing home if they report the abuse.
An age related illness such as dementia may make it
difficult for law enforcement to build a strong case
and successfully prosecute the perpetrator.

8. Trust Is a Necessary Factor in Elder Abuse
Unlike random acts of violence, elder abuse implies the
presence of a personal relationship, usually with someone
in a position of trust, such as a caregiver, lawyer, or family
member who has caused injury or harm and could be;
Intentional, or
Unintentional
In these relationships of trust, the elder person and
perpetrator often have strong emotional ties.

9. Types of Elder Abuse in Intimate Partner
Violence Situations
 Physical abuse is the use of  Sexual abuse is nonconsensual
physical force that may result sexual contact of any kind with
in bodily injury, physical pain, an elderly person. It includes,
or impairment. Physical abuse but is not limited to:
may include, but is not limited  Unwanted touching
to, such acts of violence as:  All types of sexual assault or
 Striking (with or without an battery such as rape,
object) sodomy, and coerced nudity
 Hitting, beating, pushing,  Sexual harassment
shaking, slapping, kicking,
and burning
 Unwarranted administration
of drugs and physical
restraints or force-feeding
 Physical punishment

10. Types of Elder Abuse in Intimate
Partner Violence Situations
 Emotional or Financial exploitation is
psychological abuse the illegal or improper use
involves inflicting anguish, of an elder's funds,
emotional pain, or property, or assets.
distress. Examples Examples include, but are
include, but are not not limited to:
limited to:  Cashing checks without authorization
or permission
 Verbal assaults, insults, and threats
 Forging an older person's signature
 Intimidation, humiliation, and
 Misusing or stealing an older person's
harassment
money or possessions
 Physically or socially isolating an
 Coercing or deceiving an older person
elderly person from family, friends, or
regular activities into signing a document (e.g.,
contracts or a will).
 Giving an older person the "silent
treatment"

11. Types of Elder Abuse in Intimate Partner
Violence Situations
 Medication abuse can  Violation of rights refers
include: to denial of an elderly
 Misuse of an older adult's person's fundamental
medication and
rights, such as:
prescriptions, such as
 Withholding information
withholding medication or
overmedicating  Denying privacy (personal or
 Theft or illegal use of an financial)
older person's medications  Denying visitors
 Censoring mail

12. Most Common Perpetrators in Later Life
1.Spouses
2.Adult children
3.Grandchildren
4.Other family members
5.Siblings
*In order of incidence rates, spouses and adult
children being the most common perpetrators.
2005 National Center on Elder Abuse,
Washington D.C.

13. Elder Abuse: Who is Most at Risk?
Female and
male older
adults
Seniors 85
and older
Seniors who
have a
physical or
cognitive
disability
National Center on Elder Abuse

14. Some Signs of Elder Abuse
•Withdrawal
from routine
activities
•Sudden
changes in
behavior
•Bruises
•Difficulty
walking or
sitting
•Appears
afraid
•Depression

15. Age-Related Vulnerabilities
 Medical knowledge regarding elder abuse and neglect is
years behind that of child abuse and intimate partner
violence.
 Many health practitioners have difficulty distinguishing
between changes related to aging and signs of abuse or
neglect. For example, bruises on an older patient could be
the result of an accident or an act of abuse.

16. Age-Related Vulnerabilities
 Older people are subject to psychological and physical
challenges inherent in aging as well as "ageist" attitudes
that discount the value or ability of older adults to
contribute to society.
 Due to this attitude elders are not always believed by law
enforcement or family.

17. Age Related Vulnerabilities
The living situations of many older adults can make them
vulnerable to abuse and create barriers for intervention.
An abusive family member may be one of the few people
who come in contact with an older victim, creating fewer
opportunities for outsiders to witness the abuse and
intervene. This can make it difficult to detect physical or
emotional abuse, medication misuse, or neglect.

18. Possible Risk Factors for Perpetration
 Lack of family support
 Caregivers who feel forced to provide care
 Too many people in a crowded home
 co-habitation of multi-generations
 Economic issues/financial problems
 Marital conflict
 Medical issues
 Negative beliefs about aging and elders in society
National Clearing on Elder Abuse and the CDC

19. Consequences of Elder Abuse
Psychical Effects: Psychological Effects:
Broken bones Distress
Sleep disturbances Depression
Increased risk for Post Traumatic Stress
premature death Syndrome
Nutrition and hydration Increased risks for
issues developing fear/anxiety
Death reactions
Center for Disease Control 2008

20. Consequences of Abuse and Neglect
Abuse, neglect, and exploitation have consequences
beyond bruises and other physical manifestations. The
consequences also extend to unnecessary suffering, pain,
injury, decreased quality of life, and an overall violation of
one’s human rights.

21. Abuse in Later Life Wheel

22. Who is Effected by Elder Abuse?
Elder abuse impacts people from all ethnic backgrounds,
religions, and socio-economic statuses, it affects older
men as well as women. Although older people who are
infirmed or impaired are at a higher risk, healthy older
people also may be in an abusive situation or relationship.
Due to the high percentage of underreported cases of
elder abuse, the patterns and profiles of victims and
abusers are derived from the smaller number of reported
cases.

23. Where Can Elder Abuse Occur?
 A common misperception about elder abuse is that the
abuse occurs primarily in institutions, such as nursing
homes and other long-term care facilities. Although
nursing homes are not immune to elder abuse, abuse rates
for in home care patients are larger because only 4% of all
adults over 65 live in institutions due to their care needs.
 51% of care recipients live in their own home, 29% live
with their family caregiver, and 4% live in nursing homes
and assisted living.
Caregiving in the United States;
National Alliance for Caregiving in collaboration with AARP. November 2009

24. National and State Statistics
 For every one elder abuse report filed there are five that
are unreported.
 Every five seconds an elderly person is abused.
 California, Florida, New York, Texas and Pennsylvania have
the most cases of elder abuse annually.
 Spouses and adult children are the most common family
member perpetrators of elder abuse.
Elder Assistance Daily

25. Social Consequences of Abuse for Elder
People
Virtually all forms of abuse can have social consequences,
including increased isolation, visits to the emergency
room, and hospital admissions. However, financial abuse
and neglect can also lead to the loss of assets, the inability
to maintain a home, and other limitations on quality of life
and independence.

26. Summary
 Elder abuse includes physical, sexual, and emotional abuse
as well as financial exploitation, neglect or abandonment,
self-neglect, medication misuse, and violation of rights.
 Elder abuse implies the presence of a relationship
between the survivor and the abuser.
 Family members perpetrate most elder abuse. The typical
perpetrator is an adult child or spouse in a family setting.
 Physical and psychological consequences of elder abuse
are long lasting.

27. Case Study
Mr. and Mrs. D are a retired couple living in a large
house in an affluent neighborhood. Mr. B, 81, is a retired
mail carrier who is orderly, controlling, and very “set in his
ways.” He suffers from hearing loss and severe back pain,
for which he takes strong pain medication. Mrs. D., 79, has
always been a housewife and caregiver for the family.
When Mrs. D was 72 she had breast cancer which has left
her weakened and frail. Though quite well off financially,
they always lived a very private and isolated life, with no
real support network. They have had a long-standing
dispute with their immediate neighbor and there are few
friends willing to visit anymore.

28. Case Study
When Mr. D’s needs increased, they hired an in-home caregiver.
The caregiver quit after a few weeks, overwhelmed with the daily
demands of the job. Mr. D refused to hire anyone and said that is
what a wife was for. All of the chores and caretaking of Mr. D fell on
Mrs. D and she started to become physically weaker and depressed.
Mrs. D had only one friend left in the neighborhood, Thelma. Mrs. D is
happy to have a woman her age living across the street that she can
talk to on occasion. One night Mrs. D had a sleepless and difficult
night taking care of her husband. Mrs. D only slept for two hours that
evening. In the morning, Mr. D grabbed her arm and twisted it telling
her she didn’t take care of him the right way the night before because
she slept too long. Mrs. D cried and walked away into the living room
to escape his violent mood. The doorbell rang and it was her neighbor
Thelma from across the street with muffins.

29. Case Study
The neighbor noticed the red marks on Mrs. D’s arm and
also saw the drying tears. Mr. D yelled “who is at the door, tell
them to go away, come here and help me get dressed, I am
hungry.” Mrs. D whispered something to the neighbor, grabbed
the plate of muffins and closed the door. The next time the
neighbor saw Mrs. D, she was on a stretcher with EMT’s and
police all around her. There was a sheet covering her body and
the police were speaking with Mr. D. Later in the week the
perceived details were discussed between all the neighbors on
the block. The neighbors shared that Mrs. D tripped on the
stairs in the night and broke her neck. Mr. D was going to a
nursing home so he could be taken care of since his wife died in
a tragic accident. The truth is that the night before, Mr. D
pushed her down the stairs when she forgot to bring him an
extra blanket.

30. Maggie Cveticanin
Florida Coalition Against Domestic Violence
425 Office Plaza Drive
Tallahassee, Florida 32301
(850) 425-2749
www.fcadv.org
The Florida Abuse Hotline:
(800) 962-2873