Learning Objectives

1. Describe the definition and scope of intimate abuse of people with disabilities and the elderly, including problems inherent in measuring this form of abuse.
2. Identify the various risk factors associated with both abuse of people with disabilities and the elderly.
3. Summarize the consequences associated with abuse of people with disabilities and the elderly.
4. Discuss the various intervention and prevention efforts that focus on abuse of people with disabilities and the elderly, including evidence of their effectiveness.

Chapter Summary

In this chapter, we discussed intimate violence and abuse against two understudied and underserved groups, people with disabilities and the elderly. We noted that one challenge in studying intimate abuse of people with disabilities is inconsistent definitions of the term disability. A disability is a physical or mental impairment that substantially
limits a major activity of daily living. In addition to physical and mental impairments, disabilities may be developmental or sensory.
People with disabilities may experience all of the types of abuse we have discussed throughout this book, but they also often experience disability-related abuse, which is abuse specific to their particular limitation. Accurate estimates of intimate abuse of people with disabilities are difficult to calculate because most studies use small, nonrandom, nonrepresentative samples. Nevertheless, the best data available indicate that both men and women with disabilities are at elevated risk of intimate violence victimization.
Risk factors for intimate abuse of people with disabilities are similar to the risk factors for people without disabilities—for example, low income, unemployment, and poverty. Additional victimization risk factors that we examined include increased exposure to multiple potential perpetrators, greater social isolation, low social support, and dependency. Perpetrator risk factors include a desire to dominate one’s partner and sexual proprietariness.
Although there has been relatively little research on the consequences of intimate abuse for victims with disabilities, available data show the potential for worsening existing conditions and elevated rates of depression, anxiety, and suicidal ideation.
We learned that despite these serious outcomes, however, interventions for victims with disabilities are limited, and to some extent this is because of widespread ableism in our society. More programs are needed to meet the unique service needs of this population and to increase their safety-promotion behaviors.
In this chapter, we also examined the problem of intimate abuse of the elderly, which we learned is arguably the most understudied form of intimate abuse. Elder abuse is any maltreatment or neglect of a person aged 60 or older by a caregiver or another person in a trust relationship with the elder, but most perpetrators are family members. One of the reasons intimate abuse of the elderly has not been extensively studied is societal ageism (i.e., negative prejudicial attitudes toward and discrimination against the elderly).
Intimate abuse of the elderly is difficult to estimate at least in part because victims often do not report it for a variety of reasons. Risk factors for elder intimate abuse victimization include being female, low social support, high social isolation, and physical and financial dependence on others. Perpetrator risk factors include financial dependence on the elderly victim, substance use, and mental health problems.
Elderly victims of intimate abuse experience numerous negative consequences, including high rates of depression and other mental health problems, severe injury, and even death. Their abusers, however, may not experience any consequences because the abuse goes largely unreported.
The most common intervention in elder intimate abuse is an investigation by APS. However, we noted that underfunding and inconsistencies across states and jurisdictions hamper these efforts. Law enforcement and prosecutors do not consider elder intimate abuse cases a high priority, so arrest and prosecution rates are low, but many elderly victims also do not wish to prosecute their abusers. More public awareness campaigns, home visitation programs, and programs to increase elders’ social networks are needed, but these programs must be rigorously evaluated to determine their success in reducing intimate abuse of the elderly.