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When an elder is the abuser

Improving the recognition and management of domestic violence among elderly couples

Separate paradigms and services for elder abuse and domestic violence raise the concern that intimate partner violence in older couples is under-recognised (Box). These paradigms are associated with age-specific characteristics, with very different implications for management when compared with younger age groups. In addition, there is also a higher risk of death in older domestic violence victims compared with younger people and in incidents involving strangers.1

The neglect in this area can be attributed to two main reasons. First, our understanding of elder abuse does not easily accommodate a focus on physical violence perpetrated by elderly people against an intimate partner. The paradigm of elder abuse views the elder as vulnerable and frail, characteristics that are perceived to be intrinsic to advanced age. In most cases of elder abuse, the elder is prey to a younger aggressor — 60% of perpetrators are children and less than 10% are a spouse or partner.3 Neglect, psychological and financial abuse are more common and, therefore, tend to be emphasised over physical abuse by elder abuse information sites.4

Second, domestic violence guidelines have not highlighted the specific needs of older…

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