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Counseling Elder Victims of Sexual Assault



In last week’s blog, I wrote about the sexual abuse of seniors and the signs and symptoms that are associated with this horrendous act. This week, I want to discuss what occurs in the aftermath of such an assault.

First, let’s look at the expectations of staff who may be providing care to seniors whether in a healthcare setting or in the home.

In most states, there are people that fall under the title of mandated reporters. These are people that work in roles where they may have special access to seniors or those with other disabilities and may see or suspect that abuse may be occurring.

The list of mandated reporters include licensed physicians and surgeons and licensed or unlicensed residents and interns; registered and licensed practical nurses; nursing home administrators, nurse's aides, orderlies, and anyone else paid for providing care in a nursing home, patient advocates, medical examiners, dentists, osteopaths, optometrists, chiropractors, and podiatrists, psychologists and social workers, clergy, home health care providers, police officers, pharmacists and physical therapists.

In Rhode Island and other states, there is a mandatory duty for all citizens to report a suspicion of elder abuse and/or financial exploitation.


Once abuse is reported and found to be true, investigators will go to work and make sure that the abuse stops and hopefully apprehend the perpetrator of the abuse. Unfortunately, this is just the beginning of the process for the victim and in many cases, there is a long road ahead for them when dealing with such an traumatic event.

Counseling and understanding is needed in every case of elder sexual abuse. For those seniors with cognitive disabilities in varying stages of competency, an assessment needs to be done with the treatment team to assure that the victim is capable of participating in counseling.

A medical follow-up is also needed including a check for any sexually transmitted diseases. Medical intervention, though needed, can be intrusive and re-traumatizing for someone who has been a victim of a sexual assault. Should a disease be detected, then medication is needed, and some can have side effects that can add to the senior’s discomfort. So, you can see, even when the assaults stop, the victim continues to suffer the results.

So how well will a senior respond to counseling after the assault? Well it depends on a number of things.

Because each of us are individual and bring our own histories and stories to any event, reactions can vary. Everyone recovers from sexual violence differently. What affects this recovery is the following:

  1. Personal and Life History – Issues such as how the individual is dealing with the aging process, is the victim optimistic and have a healthy sense of self-worth, does the person retain a sense of power, control and responsibility? Those who demonstrate these positive attributes tend to respond well to therapy and working through what has happened to them.

  2. Emotional State at the time of the assault – Seniors seem to struggle more with such an assault than do younger people. This is due to the fact that they have accumulated multiple losses which may include their family, status in the community because of aging, lack of support due to lack of access to friends and family, deaths and retirement. If a senior was dealing with a recent loss, a sexual assault could be extremely debilitating for the victim.

  3. The type of assault – This is a difficult subject again because each person does react differently to such a crime. However, research does indicate that how violent the assault and the duration of the assaults can play into negative outcomes.

  4. The senior’s perception of their own recovery – It is horrible enough that a senior was violated by the perpetrator, but because of their age, many suffer bruises, tears and other injuries that may never heal. Expecting them to respond well to counseling when every day they feel the pain from the assault does not bode well for a positive outcome.

Other problems that may be present:


  1. The age of the counselor – seniors are very aware of age differences and even

label themselves as “old”. For many, discussing a sexual assault with someone half their age or even the age of their grandchild can be a massive block when seeking a therapeutic bond. Assigning an older counselor may be a way to increase the rapport and lead to better outcomes.

  1. The victim recanting – because many victims are embarrassed, fear retaliation (this is especially true of those in healthcare facilities) or fear not being believed when a family member is the perpetrator, they may decide that staying quiet is the safest thing for them to do. Unfortunately, even if they are never touched again, they live in silence about the trauma they endured and suffer daily.

  2. Being stoic – Many seniors feel that be stoic is what is expected of them, so they may stay quiet. However, in most cases, an observant caregiver may notice subtle changes in behaviors such as withdrawal, changes in sleeping habits and even out of character emotional outbursts.

So to sum it up, when working with a senior who has been abused, patience and persistence is the key. Keep in mind that your first several contacts may result in nary a mention of the abuse but just being there is the beginning of building the all-important rapport. It may take weeks or even months for progress to occur. But, what is most important about building the relationship with a senior is consistency. Be there when you say you will be there and give them your undivided attention. This builds trust and does set the stage for therapeutic progress.

In the end, don’t expect miracles but rest assured that just by being there, you have provided a level of comfort and safety at a time when the senior needs it most.

To report Elder Abuse in your state, go to the State’s website and look up Adult Protective Services. Many states now have 24-hour hotlines to take such complaints and some have reporting forms online that can be completed and sent to the proper authorities.

The United States Department of Human Services also has a site called Eldercare Locator can assist you in locating services. Please click on the picture below.


If you suspect that a family member or loved one is the victim of sexual abuse or assault, Connelly Law has the experience to represent an elderly individual if they have been a victim of any form of exploitation. Remember, it is not safe to assume that a person is incapable of exploiting an elderly person because they are a family member, financial planner, mortgage broker, caretaker, etc. Anyone can abuse an elderly person, and if found to be factual, criminal charges may be brought against them.

If you wish to discover what our elder law firm can do for you and your elderly loved one, please call our office at 1-855-724-9400.

Attorney RJ Connelly III practices in the area of elder law and is a Certified Elder Law Attorney. This area of law involves Medicaid planning and asset protection advice for those individuals entering nursing homes, planning for the possibility of disability through the use of powers of attorney for the both health care and finances, guardianship, estate planning, probate and estate administration, preparation of wills, living trusts and special or supplemental needs trusts. He represents clients primarily in the states of Rhode Island, Connecticut and the Commonwealth of Massachusetts. He was certified as an Elder Law Attorney (CELA) by the National Elder Law Foundation (NELF) in 2008. Attorney Connelly is licensed to practice before the Rhode Island, Massachusetts, Connecticut, and Federal Bars.


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