In Part 3 of this 4 part series, we look at the views of Canadians on elder abuse compared to the evidence on the size of this problem. The public's perception of abuse is important to understand if we are to develop effective strategies to prevent abuse.
In Parts 1 and 2, we defined elder abuse and detailed the risk factors and specific types of abuse. In Part 4, we examine the benefits and harms of interventions to help those experiencing elder abuse.
What do Canadians believe about elder abuse?
We don't yet have good information documenting the size of the problem of elder abuse in Canada. We discussed some of the reasons for this in Part 1 of this series of blogs. These include fear and shame associated with reporting elder abuse and the way in which we define abuse is not consistent. We do, however, have some reasonable information on Canadians' opinions about elder abuse. The Canadian government has sponsored two surveys asking citizens about elder abuse. Evaluating public opinion on elder abuse was important to set up awareness campaigns as a strategy for prevention.
Here are some highlights from a recent survey 2008-09 survey:
- 93% had heard about elder abuse and only 7% indicated that they had not (1)
- 1% rated abuse as the most important problem facing older adults aged 65 and older (2). In contrast, 43% thought that health problems were the most important problem facing seniors, followed by insufficient income/income support (19%) (2)
- 47% believed that over half of all older adults aged 65 years or older would experience some form of abuse (1;2)
- 63% felt that most of the abuse was perpetrated by family members (mostly adult children and to a lesser extent grandchildren) (2)
This survey data suggests that Canadians were certainly aware that elder abuse exists and believed it occurred frequently, but they did not see it as a major concern to older adults.
Based on this same survey data, 43% of Canadians believe that neglect is the most frequent type of abuse, followed by psychological abuse (25%). Only 8% of Canadians believe that physical abuse is the most common form that seniors experience (2). This is surprising since survey participants immediately mentioned physical abuse most often when asked about elder abuse generally. The other noteworthy point is that most survey participants did not see sexual abuse as an issue in the elderly. It is not clear why Canadians believe what they do about elder abuse, as there has been limited scientific evidence about the magnitude of the problem generally and specifically about the different types of abuse.
What is the evidence on the size of the problem of elder abuse?
Attempting to assess how common the problem of elder abuse is in Canada is somewhat complicated. The evidence is limited because it is based on self-report and does not include older people living in institutions. Two surveys have been conducted in Canada on the mistreatment of older people (65 years or older); they asked seniors if they were experiencing abuse.
One telephone survey conducted in 1989 showed that
- 4% of community-dwelling elders (i.e. not living in institutions) reported experiencing any type of abuse over the past year (since they turned 65 years) (3;4)
A second telephone survey conducted in 1999 revealed that
- 7% of community-dwelling elders reported psychological abuse and 1% financial abuse (4;5) over the past five years
It is difficult to say if rates really changed over the 10-year period from the first and second survey. The comparison is further muddied as the elder abuse was measured differently in these two surveys.
A new research project evaluating the rate of elder abuse in Canada in the general population is currently in progress, and will be completed in 2015 (2;6). This new research will be of great assistance in estimating how big the problem of elder abuse is in Canada; we will also have better information about the frequency of different types of abuse.
How do we compare to other countries?
It is difficult to compare the rates in Canada with other countries that have attempted to measure elder abuse. One review compared international studies reporting the frequency of any type of abuse (physical, psychological or emotional, etc.) (4). Most of these studies were done in North America or Europe. The estimates varied widely across countries; in Spain, for example, reported rates of abuse ranged from 2.6% to 29.3%. Although there are several reasons why studies report different rates of elder abuse, one of the key reasons is related to our definition of this health issue. We noted that the cultural context is an important factor in defining abuse. So, it would not be surprising to see differences in rates of elder abuse across countries. What we can be sure of is that elder abuse seems to be found in almost all countries where it has been evaluated.
What is the bottom line about elder abuse?
Although, most Canadians (97%) believe that the abuse experienced by older adults goes undetected, the good news is that most (78%) are aware that there is help available for this problem (1). In fact, most Canadians (77%) believe that many types of elder abuse are crimes (1).
In this four-part series of blog posts we discuss several aspects of elder abuse:
- In Part 1 we examine the general definition of elder abuse
- In Part 2 we look at important risk factors associated with elder abuse and different types of abuse
- In Part 3 we compare what Canadians believe about abuse and the evidence on the size of this health problem in Canada and around the world
- In Part 4 we discuss the benefits and possible harms of elder abuse interventions
