Background Paper for INSTRAW Electronic Discussion Forum Gender Aspects of Violence and Abuse of Older Persons 15-26 April 2002
Violence and Abuse in the Lives of Older Women: Is it Elder Abuse or Violence Against Women? Does It Make Any Difference? By Jill Hightower 1
Women are the majority of the older population in virtually all nations of the world (WHO/INPEA 2002, 3) In
both the developing and developed world older women are victims of poverty, of inequality, and of violence
and abuse.
The purpose of this essay is to stimulate informed discussion around the interrelationships among gender,
age, power and control, and violence. The primary sources for this literature review reflect the western,
developed world perspective of the author, whose experience is primarily Canadian and who has found
useful research primarily in North America, Australia and Great Britain. The knowledge that is most useful is
that which comes out of interactions between practice-oriented research and efforts to pull conceptual and
forward-looking ideas and policies out of front-line work, both informed by actively seeking the collaboration
of erstwhile victims. The hope that motivates all this, of course, is that the goal of eliminating abuse of all
kinds may be achieved, and the faith that appropriate policies and programmes can move us toward that
goal both by helping victims more effectively and by raising public awareness, concern, and revulsion
against violence in all its forms.
Violence against women is debated by some and recognized by most as a significant social, economic and
health problem, but there is a general perception that it is a problem for younger women and that violent
behavior within a family setting ceases at some mature age. This perception has resulted in a gap in the
wealth of information on intimate partner violence, as the problems and specific needs of older women are
very rarely recognized or addressed, within the research literature or by service providers. Violence and
abuse in the lives of women over the age of fifty is viewed as an issue of age victimization, and thus
categorized as elder abuse. Research and practice in the elder abuse field is framed within a medical
model. It focuses on people who are frail and require support to meet their daily living needs, if they are not
in chronic need of medical care. This model supports a view of the elderly as sexless, in which male and
female victims of elder abuse are indistinguishable. The 'Elder Abuse' label reflects a societal predisposition
to homogenize older people by not taking into account individual differences, including gender.
This perspective on older adults has resulted in the failure of advocates and service providers in the area of
violence against women to view the abuse of older women through the lenses of gender and power, and to
recognize that older women too need services such as shelter, crisis intervention, safety planning,
counseling, advocacy and peer support groups. Furthermore, as has been suggested by Aitken and Griffin,
older women at present have no lobby in the human rights forum as addressed by feminists (1996,155).
The realities of the lives of many older women are lost when age alone becomes the focus and central
element of an issue of abuse and neglect common to both men and women. The fact is that older women
may experience abuse at the hands of their partners throughout life. To paraphrase a popular love song,
"What's age got to do with it"?
Should age, and not the act or the relationship between the perpetrator and victim,
determine whether the violence is identified as elder abuse or violence against
women? A woman who has been physically abused during her marriage does not
become a victim of elder abuse at the age of sixty five. While it may be relevant to
know that the victim is an older woman, that does not change the nature of the
violence (Anike, 1999, 1).
1 President of the British Colombia Coalition to Eliminate Abuse of Seniors and Vice-Chair of the British Colombia Institute Against Family Violence. 2 Our empirical work (see endnote for a brief description and reference to Silent and Invisible) has confirmed
what was suggested by the limited research that was available, that domestic violence is present in the lives
of older women.
. .... Abuse is not primarily about old age at all but about certain damaging patterns which
have continued into old age. This applies mainly to situations within the family; for example
elder abuse is sometimes simple marital violence which has continued into old age.
(Vinton 1992)
As demonstrated in Silent and Invisible (2001), abuse of women in later years within the family may be a
continuation of long term partner abuse, it may begin with retirement or the onset of a health condition, or it
may occur in an intimate relationship started in later life. Within the broader family setting, it is recognized
that some older women suffer violence and abuse at the hands of their adult children and even
grandchildren. In these cases the term family violence may be a more appropriate label.
. Defining the Issue: Violence Against Women The term 'violence against women' refers to many types of harmful behavior directed at women and girls
because of their sex. As defined in Article 1 of the United Nations Declaration on the Elimination of Violence
Against Women, these include:
Any act of gender-based violence that results in, or is likely to result in, physical, sexual or
psychological harm or suffering to women, including threats of such acts, coercion or
arbitrary deprivation of liberty, whether occurring in public or private life.
(United Nations 1993) Obviously, there is nothing in this statement which implies that older women, or women of any age, are excluded from this definition. An epidemiological report from the School of Public Health, Johns Hopkins
University (1999) suggests that research and advocacy activities demonstrate that there is growing
consensus that abuse of women and girls is best understood within a gender framework since this abuse
stems in part from womens and girls subordinate status in society. This report further states that one of the
most common forms of violence against women, world wide, is abuse by their husbands or other intimate
male partners. It also concludes that research and personal accounts of women victims show abuse by an
intimate partner is generally a part of a pattern of abusive behavior and control.
Power, and the misuse of power, is central to the issue of gender based violence (Bowker 1983, Browne
1997, Brandl and Raymond 1997, Seaver 1996, Vinton 1992). Accepting the position that violence against
women hinges on control and domination (Kaufman, 1994, 146) and as we examine the different
approaches to abuse in the lives of younger women and older women one needs to acknowledge the over
arching elements of ageism that affect the lives of older women. Issues of violence and abuse in the lives of
older women may be best researched and addressed within a framework of gender, power and control and
age.
This approach clearly recognizes that domestic or partner or family violence is a fact in many older womens
lives. It recognizes that older women like younger women can suffer physical, sexual, financial and
emotional abuse at the hands of their intimate partners, and that older women may also be vulnerable to
abuse from adult children and grandchildren.
Crimes reported to the police provide one kind of evidence on sources of violence against older women.
Data from most parts of Canada included 359 Criminal Code violent offenses against women aged 65 and
older in which the perpetrator of the violence was a relative of the victim. Among these perpetrators, 40%
were the victim's husband, 40% her adult child, 12% a sibling, and 8% other family including extended
family (Statistics Canada 1998a, 9, 24).
Statistics Canada notes that "current statistics on abuse of older adults likely underestimate the extent of
the problem since victims may be reluctant to identify themselves due to embarrassment, guilt or fear, or a
lack of awareness that an offence has taken place" (1998a, 23). Women who are emotionally involved with 3 and financially dependent on their abuser are likely not to report physical abuse within the family to the
police.
The abuse that is least likely to go unreported is murder. Nearly a third (30%) of homicides in Canada from
1978 to 1997 in which the victim was a woman aged 65 or older were committed by a spouse or former
spouse of the victim. Other perpetrators included sons (15%), daughters (3%), and other family (10%)
(Statistics Canada 1998a, 38).
The high proportion of spousal homicides supports the suggestion that abuse of older
women is often a continuation of wife assault. In contrast, the risk of homicide against
older men was far greater outside of the family than within. (Statistics Canada,
1999, 38)
A recent community project on mistreatment of older adults in Quebec found that almost one half (61 of
128, 48%) of situations of abuse of older women occurred in a spousal relationship. In many of those cases,
violence had been a problem for over 25 years (Lithwick, Beaulieu and Gravel 1999). At least 5% of older
British Columbians have suffered from one or more serious forms of abuse at the hands of a spouse,
relative or other close contact (Podnieks et.al. 1990).
Defining the Issue: Elder Abuse Elder Abuse is defined as single or repeated act, or lack of appropriate action,
occurring within a relationship where there is an expectation of trust, which causes
harm or distress to an older person. (Action on Elder Abuse, quoted by WHO/INPEA
2002)
While there are some differences in the research literature as to what is defined as elder abuse in general,
within most research, policy and practice it is categorized as physical abuse, psychological or emotional
abuse, financial abuse, sexual abuse and neglect. However, within some definitional frameworks violation
of human and civil rights are also included.
Historically, elder abuse service providers have emerged from a more professional approach based on a
strong medical model of service. This approach often leads workers to view all older adults as vulnerable
and dependent. Harbison supports this view, suggesting that Elder Abuse and Neglect was constructed as
a social problem by experts and a product of expert knowledge (1999, 59) Those who provide services for
older adults are trained to understand the processes and complexities of aging and deal with age related
issues such as dementia and impaired mobility. For this reason, they are believed to be well equipped to
manage issues of violence toward older people. (Sedger 2001) Difficulties with this approach include its
paternalistic and ageist implications, and ignoring the criminality of acts that would be treated as criminal if
the victim were of a younger age.
Using the elder abuse label for spousal violence has very unfortunate consequences in terms of public
perceptions. There has been much improvement with respect to violence in the lives of younger women
where the common understanding of violence in intimate relationships has shifted, from seeing it as a
private matter in which others have no right to intervene, to seeing it as a crime which the state has an
obligation to address. The elder abuse label for violence in intimate relationships tends to leave crimes
against older women, and they are crimes, back in the closet (Sedger 2001). As noted in the report Missing
Voices (WHO/INPEA 2002), research in the field of Elder Abuse within a medical framework emphasizes
pathology, and a focus on the characteristics of the perpetrator and the victim. Substance abuse, mental
illness and cognitive disabilities are given major roles in causing or explaining elder abuse. There is little
attention given to gender issues and there seems to be an underlying thread of blaming the victim
particularly in research on caregiver stress. These rationalizations seem to blame victims for being too
needy and relieve perpetrators of responsibility for abusive action.
In health and social services practice, in what we often call the helping professions, there is often a fine line
between education and manipulation. While understanding that service providers want to do what is best
for their older client, their concern, empathy and desire to make things better for the client may lead them 4 to unintentionally limit their access to information and their rights to take what time they need to reach their
own goals and expectations. Professionals may inadvertently disempower older adults, implicitly
categorizing them as children. Terminology like adult day care exemplifies this. For example, staff of a
shelter for battered women reported that the nurses responsible for continuing care eligibility assessments
in their area had poor knowledge of causes of violence against women and support for its victims.
Stereotyping and judgmental attitudes were observed, including a continuing care assessor reprimanding
an elderly women resident in the shelter, for putting herself in a dire situation. Dignity and independence
are core values that apply to seniors, as to all adults. Perhaps they become more important to seniors as
they age and ageism takes its toll on their perceived value in society.
Age and Ageism
Throughout our research on this problem, it has been clear that much of the on going research on the issue
of womens human rights in regard to equality and social justice ignores the realities of the lives of many
older women. It is suggested that the specter of ageism blocks contemporary attention to these issues.
The elderly in our society are generally rejected, but we are particularly disdainful of
older women. The discrimination begins in infancy and escalates as we become
mature women. But it doubles as we grow older, for then we are not only women, but
old women, perceived as unattractive, unneeded and parasitical. (Cohen 1984, 11)
When one compares the different approaches to abuse in the lives of younger women and older women,
the effects of ageism are clearly seen. Harbison suggests that a major contributing factor influencing
research, policy and practice in addressing abuse in the lives of older adults is the underlying fact that older
persons status in society has flowed from the needs of the economy and the labour market (1999, 63).
Since Adam Smith, we have been taught that our value to society is our economic productivity. Economic
institutions and values permeate our society and shape the perceptions and actions of individuals, even in
their homes. These are issues of power and control.
As newspapers, magazines, and radio were supplanted by television, there was a shift from a verbal to a
visual and then multimedia system of mass communications. Now, the contemporary meaning of elderly is
communicated by stereotypical visual and auditory images rather than words. The second effect has been
to deliver a mass audience to advertisers and entertainment producers with vested interests in
communicating stereotypes that support the products, services, and values they sell. Consumerism means
equating value with price and valued objects with ownership. But if consumerism replaces human relations,
unproductive people become chattels. Thus it is a concern that in the media, the word retired is being
equated with words like vulnerable and unproductive. We are talking about institutional prejudices that
are reflected in both attitudes toward and treatment of older people.(Hightower 1995) Similarly, it appears
that older people have been encouraged to think of themselves as disengaged, giving up responsibility for
their own lives to professional experts and caregivers. This approach to age and aging obviously supports
the professional medical approach to issues of abuse in later life, and to older women being ignored in
feminist scholarship.
Background research and our own experience support Aitken and Griffin's assertion (1996, 57) that on the
whole , feminism has distanced itself from older women", and, they continue, our literature, our music, our visual images, our political analysis and organizing tell us less about old women than about how thoroughly
we younger women have absorbed male societys avoidance of our aging selves (Macdonald and Rich,
quoted by Aitken and Griffin 1983, 57).
Feminist theorists, advocates and providers of services for women have given scant attention to issues of
violence and abuse in the lives of older women, seemingly accepting the popular culture and its
institutionalized stereotyped view of old age in general and older women in particular. The homogenizing of
older people into a frail gray neuter anonymity creates a picture of old age which is consistent with the
assumption of dependency which dominates the medical model of service to clients dependent on
professional service providers. The attitudes, assumptions and approach to issues of abuse in older life
within the medical model is exemplified by the development of elder abuse services that parallel the child
abuse model (Sacco 1990, Vinton 1997). Some Canadian provinces have legislation on reporting and
investigation of elder abuse. As in the United States, the underlying philosophy in this legislation, similar to 5 child protection legislation, is one of protecting vulnerable and dependent persons (Gordon & Tomita 1990,
American Association of Retired Persons, 1992).
Progress On Violence and Abuse in the Lives of Older Women
In 1991 Carol Seaver and the Milwaukee Womens Shelter developed one of the first programs in the
United States to serve older women victims of spousal violence .(Seaver 1995) The issue came to the
forefront in the United States in the middle 1990's when the American Association of Retired Persons took
the lead in encouraging special programming for abused older women. This work included an invitation to
older women to write to the AARP with their stories of abuse, and a national survey of shelters for abused
women to ascertain services being provided for older women (American Association of Retired Persons,
1992, 1994). Linda Vinton (1992, 1998) conducted this national survey of shelters in the United States,
following a survey of shelters in the state of Florida. She noted that perceiving older women as abused
elders rather than battered women has had great ramifications in terms of the types of referrals. In a five
year follow-up to a survey of shelters in Florida regarding services to older women, the researcher noted
that only two or 8% of the shelters had such programming in 1990. In 1995 five (22%) had such
programming. During this time the percentage of older staff, board members and volunteers also increased
(Vinton 1997). Nationally there has been an increased focus on abuse of older women with organizations
such as the Wisconsin Coalition Against Domestic Violence developing training and informational
packages. There has also been an increase in the linkages between those providing refuge and community
services to assist victims of partner violence and the network of aging services (Vinton 1997). This kind of
coordination makes it possible to develop a network of services at the local level to offer support and
options to older women victims of abuse within their family setting (Brandl & Raymond 1997).
From the findings of this research there developed an awareness of a lack of knowledge and understanding
of the dynamics of partner violence on the part of those providing services to older adults (Brandl 1997,
National Centre on Elder Abuse 1996, Seaver 1996, American Association of Retired Persons 1992). This
conclusion was also suggested in a survey of transition houses in British Columbia and the Yukon
(Hightower et.al. 1999)
It is encouraging to see some increase in attention to the issue of abuse of older women, since our initial
survey of shelters in 1998, by those who advocate in the area of violence against women, and some growth
in the United States and in Australia in the numbers of agencies providing services to older abused women.
The understanding that older women are still vulnerable to partner violence has been led by a small group
of women advocates in the United States which has resulted in the evaluation of existing community based
programmes for abused women and the development of new services. As a result of this advocacy some
cross training workshop materials have been developed to bring together social and health services
providers and those providing services in the area of violence against women in order to better serve the
needs of older abused women. In Australia as part of a project on Womens Health an action research
project was undertaken in 1997 on identifying the needs of older women who are isolated and who are living
with or have lived in an intimate relationship with a violent partner. This was followed more recently by a
national study on domestic violence in the lives of older men and women (Morgan Disney 2000). Older women Speak Up" is the title of a collection of stories and vignettes of their lives by abused older women,
subtitled "older women are empowered by telling our stories of violence in the home", recently published in
Australia (Sargent and Mears 2000).
The Violence Against Women Act (VAWA) in the United States, renamed Victim of Violence Prevention Act
of 2000 when re-authorized by Congress and signed into law in October 2000, included important new
provisions directed to older and disabled women victims (National Centre on Elder Abuse 2000). Medical
Journals such as the American Family Physician, in articles on Health Screening of Older Women are
including discussions of screening for domestic violence in older women (Mouton and Espino 1999,
Nudelman 1999). Legal publications are also beginning to address the issue; for example, the Wisconsin
Lawyer published an article on Domestic Violence in later life (Speltz and Raymond 2000). References to
issues of partner violence in later life are appearing on websites of numerous Womens organizations in the
United States. In May of 2000 a report on the needs of older women was released in Britain. While the
framework of the research was age based, the author highlights the long term and complex needs of
abused older women. Seventy seven percent of the study subjects were female. Sixty four percent of the 6 women victims were over 75 years old, sixty six percent of the known abusers were male. Physical abuse
was the most common form of abuse, found in 58% of cases (Pritchard 2000).
Ageism seems to have affected both the elder abuse and the violence against women approaches. Neither
deals with the common fact of a continuum of violence throughout the life span. Neither deals with the role
of the older generation in intergenerational transmission of violence, though Silent and Invisible provides
evidence of three-generation transmission of violence as behaviour learned in the home. Tactics of abuse
and control are elements of child abuse, partner abuse and abuse of older persons. In the medical model
approach to elder abuse there are also elements, perhaps unintentional, of power and control by service
providers over dependent service recipients.
Impacts of Abuse
Our research reinforces what is clear in the literature, that violence and abuse perpetrated by spouses and
children negatively impacts the health and wellbeing of older women. In recent years we have begun to
recognize and address the intergenerational factors of violence. The behaviour of grandparents as well as
parents has a significant effect on young children. When violence is present, it creates the facade that
violence in families is the norm, perpetuating the cycle of violence.
Some of the impacts of living in or ending an abusive relationship are effects on the victim as an individual.
Others may be at a community or societal level. Our findings on this are specific to Canada, and except
where other sources are cited we do not know if they are applicable elsewhere. The unattributed quotations
in this section are from anonymous informants and are taken from Silent and Invisible.
In terms of health, one of our informants, who was at the time still in an abusive relationship, said
This extreme history of abuse has brought on several health challenges; ulcers, irritable bowel syndrome, stress, etc.
One of the oldest women among our informants told of abuse in her second marriage nine years ago, and
about not being able to stand the constant anxiety and confusion. She left the relationship six months ago.
Now, she said,
I feel fairly confused, but Im able to sleep and Im getting some rest.
Some older women are believed to fear that if they disclose their abuse to health care workers or social
workers, they may be institutionalized. Such fears would probably keep a woman from seeking help.
Some of the more elderly women found that since they had left their relationship they felt more isolated and
lonely. Some implied that this isolation reflected their feelings of shame and sense of failure, which made it
difficult for them to interact freely with their neighbours. It increased their sense of isolation if they had to
leave surrounding in which they had spent a great many years of their lives.
There are impacts of spousal violence that affect communities as well as individuals. Some substantial
recent work in the violence against women field has addressed the consequences for children of witnessing
violence in the home (Sudermann and Jaffe 1999, Edleson 1999, Fantuzzo and Lindquist 1989, Markowitz
2001). In our empirical work, we heard from women abused when their children were young about their
great concern for the impact on their children. It is interesting that these women, although they are clearly
not familiar with the academic and clinical research on children who witness violence, express the same
conclusions in similar terms. What many of these older women added to the discussion is their observations
of their children's behaviour as adult partners and parents, thus extending the intergenerational impact of
children witnessing violence to the third generation. This seems to lend support to the theory that violence
and aggression are learned behaviors (DeKeseredy and MacLeod, 1997; Barnett et al, 1997)
An Australian report (Morgan Disney 2000) talks of adult children's concern that their mothers not leave an
abusive marriage in later life, as that would impact on the their inheritance. In our data, there is no mention
of this by the abused women, but some seniors advocates mentioned older women being harassed by sons
and daughters for what they termed their inheritance.
7 Sometimes children more directly take money from a parent. One victim said:
I didnt know that it is quite common for children to rob their parents and go to any lengths to get
control of their savings.
Financial abuse may go so far as to literally deprive older adults of their homes and life savings, forcing
them to either accept being taken into someone elses home, or become homeless.
The impacts on older women of leaving an abusive relationship are associated with various problems and
risks that are not present or are not the same for younger women. The potential losses include financial
means and security, a home in which a woman may have invested a lifetime of care, and decades worth of
the mementos and treasures that become increasingly precious in the later years of life. Many need to find
a place where they can take a dog or cat that has been the major source of support in recent years.
A sixty-eight year old woman whose second husband took off and left her to deal with
their bankruptcy has limited capability in English, and serious health problems. The
only positive support in her life is a dog that she loves very much. It has been
suggested to her that to cut expenses she should get rid of the dog.
Conclusion
Our research has been defined and organized within a feminist perspective on power, control and gender
with the added consideration of age. Tactics of abuse and control are elements of violence and abuse
across the lifespan. We suggest that by looking at issues of violence against older women through this lens
rather than within the framework of elder abuse, the nature of the violence and abuse in their lives is seen to
have a continuity and parallel with violence in the lives of younger women. This is in contrast to the elder
abuse framework that seems to imply that chronological age is sufficient to account for victimization
We have concluded that it is essential in research, policy and practice that observations and actions be
viewed through the frameworks of gender, age, and power and control. Eliminating violence requires action
at many levels, from the societal to the individual. Much of the required changes will have to occur first at a
community level, and it is at this level that victims, advocates, those who provide services to women or older
adults, and opinion leaders in the community can best communicate and develop a shared understanding.
It is that understanding of realities and values that can lead to the societal change that is our goal.
__________
Endnote:
Silent and Invisible (Hightower et.al. 2001) is a research project that examines violence and abuse in the
lives of older women of fifty and older in British Columbia. The first phase of the research project involve a
survey of womens shelters in British Columbia and the Yukon. The major findings were that women age 60
and over were only about 2% of the women served, and those 50 to 59 were also substantially under
represented at 6% of shelter clients. Phase two involve focus groups of health and social services,
womens services and seniors advocates. Issues faced by abused women identified by these groups were
defined as social and geographic isolation , poverty, ageism, housing and health . The final phase involved
a province -wide public outreach campaign. Older women were invited to call in or write in and share their
stories. Other stories came through individual interviews through interpreters, and two groups of women
who had left abusive situations. Sixty four life stories of violence and abuse were received from women 50-
87 years of age. Most of the abusers were husbands and a few were sons or daughters.
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