Elder Abuse FORTHCOMING TITLES Research Methods for Therapists Avril Drummond Stroke: Recovery and Rehabilitation Polly Laidler Caring for the Neurologically Damaged Adult Ruth Nieuwenhuis HIV and AIDS Care S. Singh and L. Cusack Speech and Language Disorders in Children Dilys A. Treharne Spinal Cord Rehabilitation Karen Whalley-Hammell THERAPY IN PRACTICE SERIES Edited by Jo Campling This series of books is aimed at 'therapists' concerned with rehabili tation in a very broad sense. The intended audience particularly includes occupational therapists, physiotherapists and speech thera pists, but many titles will also be of interest to nurses, psychologists, medical staff, social workers, teachers or volunteer workers. Some volumes are interdisciplinary, others are aimed at one particular profession. All titles will be comprehensive but concise, and practical but with due reference to relevant theory and evidence. They are not research monographs but focus on professional practice, and will be of value to both students and qualified personnel. 1. Occupational Therapy for Children with Disabilities Dorothy E. Penso 2. Living Skills for Mentally Handicapped People Christine Peck and Chia Swee Hong 3. Rehabilitation of the Older Patient Edited by Amanda ]. Squires 4. Physiotherapy and the Elderly Patient Paul Wagstaff and Davis Coakley 5. Rehabilitation of the Severely Brain-Injured Adult Edited by Ian Fussey and Gordon Muir Giles 6. Communication Problems in Elderly People Rosemary Gravell 7. Occupational Therapy Practice in Psychiatry Linda Finlay 8. Working with Bilingual Language Disability Edited by Deirdre M. Duncan 9. Counselling Skills for Health Professionals Philip Burnard 10. Teaching Interpersonal Skills A handbook of experiential learning for health professionals Philip Burnard 11. Occupational Therapy for Stroke Rehabilitation Simon B.N. Thompson and Maryanne Morgan 12. Assessing Physically Disabled People at Home Kathy Maczka 13. Acute Head Injury Practical management in rehabilitation Ruth Garner 14. Practical Physiotherapy with Older People Lucinda Smyth et al. 15. Keyboard, Graphic and Handwriting Skills Helping people with motor disabilities Dorothy E. Penso 16. Community Occupational Therapy with Mentally Handicapped Adults Debbie Isaac 17. Autism Professional perspectives and practice Edited by Kathryn Ellis 18. Multiple Sclerosis Approaches to management Edited by Lorraine De Souza 19. Occupational Therapy in Rheumatology An holistic approach Lynne Sandles 20. Breakdown of Speech Causes and remediation Nancy R. Milloy 21. Coping with Stress in the Health Professions A practical guide Philip Burnard 22. Speech and Communication Problems in Psychiatry Rosemary Gravell and Jenny France 23. Limb Amputation From aetiology to rehabilitation Rosalind Ham and Leonard Cotton 24. Management in Occupational Therapy Zielfa B. Maslin 25. Rehabilitation in Parkinson's Disease Edited by Francis I. Caird 26. Exercise Physiology for Health Professionals Stephen R. Bird 27. Therapy for the Burn Patient Annette Leveridge 28. Effective Communication Skills for Health Professionals Philip Burnard 29. Ageing, Healthy and in Control An alternative approach to maintaining the health of older people Steve Scrutton 30. The Early Identification of Language Impairment in Children Edited by James Law 31. An Introduction to Communication Disorders Diana Syder 32. Writing for Health Professionals A manual for writers Philip Burnard 33. Brain Injury Rehabilitation A neuro-functional approach Gordon Muir Giles and Jo Clark-Wilson 34. Living with Continuing Perceptuo-motor Difficulties Theory and strategies to help children, adolescents and adults Dorothy E. Penso 35. Psychology and Counselling for Health Professionals Edited by Rowan Bayne and Paula Nicholson 36. Occupational Therapy for Orthopaedic Conditions Dina Penrose 37. Teaching Students in Clinical Settings Jackie Stengelhofen 38. Group Work in Occupational Therapy Linda Finlay Elder Abuse Concepts, theories and interventions Gerald Bennett Consultant Geriatrician Royal London Hospital and Paul Kingston Lecturer in Nursing North Staffordshire College of Nursing and Midwifery SPRINGER-SCIENCE+BUSINESS MEDIA B.V. First edition 1993 © 1993 Gerald Bennett and Paul Kingston Originally published by Chapman & Hall in 1993 Typeset in 10112 pt Palatino by Best-set Typesetter Ltd, Hong Kong ISBN 978-1-56593-038-4 ISBN 978-1-4899-6936-1 (eBook) DOI 10.1007/978-1-4899-6936-1 Apart fom any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the UK Copyright Designs and Patents Act, 1988, is publication may not be reproduced, stored, or transmitted, in any form or by any means, without the prior permission in writing of the publishers, or in the case of reprographic reproduction only in accordance with the terms of the licences issued by the Copyright Licensing Agency in the UK, or in accordance with the terms of licences issued by the appropriate Reproduction Rights Organization outside the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publishers at the London address printed on this page. The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made. A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication data available Contents Foreword by Anthea Tinker X Acknowledgements xii Introduction xiii 1 Historical background: definitions and theories 1 2 The abused and the abuser 23 3 Recognition and assessment of abuse 32 4 Interventions 47 5 Legal issues 66 6 Health authority and social service co-operation 82 7 Prevention 98 8 Institutional abuse and neglect 116 9 Research 130 Index 158 Foreword A book which summarizes what is known about elder abuse has been needed for a long time in this country. A major problem has been the absence of both interest in the subject and research. At long last interest, by academics, practitioners and the media, has stirred. Unfortunately comparisons have too rapidly been made with child abuse. This book by two of the leading professionals concerned with abuse in the United Kingdom sets out to remedy the gaps in knowledge. In so doing they show how dangerous it is to draw parallels with child abuse and they plead for more theoretical and practical research on the subject. The com parisons which they draw with the United States, where research is more highly developed, are striking. One of the values of this book is that it starts from first principles and defines what is meant by elder abuse. Starting from what was known as 'granny battering' they show how both definitions and concepts have moved forward. Following the early concentration on physical abuse it is now known that many other kinds are just as pernicious. They include financial, emotional, sexual, psychological abuse and neglect. A particularly useful part of the book shows how research is moving from a study of the abused to that of the abuser. In the course of this the authors destroy some myths such as, for example, that abuse is largely a result of caregiver stress. As the authors say 'The initial stereotyped plot with the victim depicted as female and "old" with physical and mental dis abilities being abused by a caring but overburdened daughter has had to undergo rewriting'. The chapter on prevention also destroys some myths such as that professional service providers are trained to assess and treat sexual abuse or that