April is Sexual Violence Awareness Month. A lot of emphasis is placed on prevention for the younger victims of this crime, as it well should be, yet this is a crime that is perpetrated on older people, too.
Unfortunately, too few seniors actually report being abused in this way, and it’s not hard to see why, if statistics are correct. According to Rape Response Services, a rape crisis service organization in Maine, one study of elder female sexual abuse victims showed that 81 percent of the abuse was perpetrated on the elder by a primary caregiver.
Elders receiving care may be reluctant to report abuse, because they fear losing the assistance that the caregiver may be providing, which would threaten their independence. Also, if the caregiver is a family member, a victim may wonder if other family members would believe them, or shun them instead, leaving them nowhere to turn for assistance with daily tasks. The elder may also fear that reporting the abuse will lead to being placed in a nursing home.
Older victims without family support may be more likely to have a limited support system otherwise, possibly leading non-familial perpetrators to believe that few people may care about the person, or even notice indications of abuse.
People with dementia, or related disorders, may lack the capacity to consent to intimate sexual contact, as well as the capacity to report it should it occur.
Indeed, while studies have shown little correlation between functional impairment and abuse, cognitive impairment does seem to be a risk factor, especially if the victim is someone who exhibits abusive behavior themselves.
In a climate of such secrecy and fear, how can we make it more likely that an elder can report, or that we can discover, possible sexual, or other, abuse?
Physicians can inquire of all patients how their domestic situation is. Also, they, and other medical professionals, can familiarize themselves with the signs of elder abuse of all types and report any concerns. Some possible red flags are: if a senior delays a medical appointment after an injury; if a caregiver is reluctant to leave the exam room when asked; if caregivers provide substandard care for an individual even after being instructed by medical staff on what should be done; or if the elder seems “rehearsed” in his or her story regarding their care, or about an injury.