How Many Are Out There?

According to the Journal of Elder Abuse & Neglect, published by Michigan State University, medicine and the social sciences have been dedicating more research to the problem of elder abuse, but few empirical studies have focused on abuse in nursing homes. In a study conducted by MSU researchers, 24.3% of respondents said that an elderly family member had suffered at least one incident of physical abuse at the hands of a staff member.

When people like these respondents can’t be with their aging loved ones, what goes on can be shocking. Minnesota’s newspaper The Star Tribune reported that between 2014 and 2015, caregivers at two Twin Cities-area senior homes were caught on camera beating residents. Not long before, three employees of the Genesis Healthcare Edmonson Center Nursing Home were indicted on 69 charges for how they mistreated seniors at the Kentucky facility. The charges included criminal abuse, first-degree abuse, fourth-degree assault, knowingly neglecting an adult, and more.

The year before, The Sacramento Bee reported that abuse complaints were leveled against one of California’s nursing home chains seven times faster than the statewide rate—while one of its large competitors placed one out of every 15 long-term residents in restraints. These findings were part of a series on how nursing home chains muddy their ownership and track records to dodge accountability. The reporters spoke at length with Charlene Harrington, professor emerita of sociology and nursing at the University of California, San Francisco. “It’s a huge maze to try and figure out who owns what. And that’s deliberately done,” said Harrington, who spent more than 35 years researching the nursing home industry.

It’s something we don’t like to think about. But our aging loved ones are vulnerable to sexual abuse—perhaps even more than most other people.

Like anyone else, elders are victims of sexual abuse if they receive, or are forced to perform, any sexual contact they don’t want or can’t consent to. This can include rape or sodomy, coerced nudity or touching, or sexually explicit photography.

It is disturbing to imagine, seniors are targeted because these victims have relatively little power and because they may be socially isolated or easily confused—allowing the abusers to feel confident that they will get away with their crimes. In fact, many victims of elder sexual abuse are unable to even communicate what has happened to them. This makes seniors suffering from Alzheimer’s or other forms of dementia especially vulnerable: even if a victim is able to speak out, their abuser feels secure that no one will believe their charge of mistreatment.

Where and Why?

The National Elder Abuse Incidence Study revealed a disturbing finding. The largest percentage of sexual abuse cases occurred inside nursing homes: 70.7%. (And it’s estimated that only 30% of all victims report their abuse to the authorities.)

This is shocking, but shouldn’t be surprising. Nursing home residents embody many of the major risk factors for elder sexual abuse: social isolation from loved ones, frailty, physical disability, cognitive impairment, and complete or near-complete dependency on caretakers.

And the nursing homes themselves may pose potential risks. One example is when staff and residents are out of the view of security cameras. This was the case in a Riverdale, New York facility, where a janitor sexually assaulted an 81-year-old woman in a third-floor dementia ward.

Other risk factors were identified in an article published by the Marquette University School of Law: inadequate staffing and insufficient training in abuse detection and prevention. These are rampant across the nursing home industry. But there’s something more. If victims and their loved ones have a difficult time talking about elder sexual abuse (for various reasons), so do healthcare professionals. A study published in the journal Nursing Research and Practice found that even among this community, the idea of elder sexual abuse is taboo—so unthinkable, they struggle to believe it even happens.  

If they can’t believe it, then they can’t see it. And if they can’t see it, then it’s harder to protect our loved ones from it.

What To Look For

Because there are so many ways predators can take advantage of the elderly, there are many warning signs that may indicate abuse has occurred—if you know what to look for. Some are physical. Some are behavioral. All should be taken seriously.

According to the NCEA and others, physical indicators may include:

• Bruises around the breasts, genital area, or inner thighs
• Unexplained genital infections or STDs
• Injuries to the pelvic area
• Pain, irritation, or bleeding from genital or anal areas
• Torn, stained, or bloody underclothes
• Increased difficulty sitting or walking

Elder sexual abuse may also leave behind behavioral or psychological indicators such as:

• Severe agitation
• Social withdrawal
• Depression
• Sudden changes in mood
• Panic attacks or symptoms of post-traumatic stress disorder
• Unusual or inappropriate sexual acting-out
• Anxiety or fear around caregiver
• Suicide attempts

And of course, if an aging loved one claims to have been sexually abused, we must listen and advocate for them.