Sexual Abuse of the Elderly - A Problem Still Not Widely Embraced by Society
By Don Drake, Connelly Law Offices, Ltd.
"Sexual abuse is a deplorable crime that targets individuals across all age groups, including older adults," stated professional fiduciary and certified elder law Attorney RJ Connelly III. "Contrary to popular belief, older individuals are not less susceptible to sexual abuse, and may even be at a higher risk due to declining physical and cognitive abilities."
Sexual abuse is often driven by the desire to exert power and control over the victim and to demean and humiliate them. As individuals age, they may become more vulnerable to abuse due to decreased personal power. Consequently, elderly and disabled individuals may be targeted for sexual abuse.
"Elder sexual abuse is a serious issue that has gained some media attention in recent times; however, only the sensational cases tend to dominate the news, while other occurrences fade from the public eye," stated Attorney Connelly. "Elder sexual abuse can happen anywhere, whether in the victim's home, nursing facilities, rehabilitation centers, or hospitals. The abusers could be program staff, visitors, strangers, or even other residents. This problem is persistent and requires continued public attention to address it effectively."
What is Sexual Abuse/Assault
Elderly sexual abuse involves any form of unwanted or non-consensual physical or sexual contact with a senior citizen, including those who are unable to give consent due to confusion, cognitive impairment, or other factors. The abuse can range from subtle and insidious acts of touching to more blatant and severe forms of sexual assault, such as rape.
As stated earlier, elderly sexual abuse often goes unreported due to shame, fear, or lack of awareness. Therefore, it is essential to be vigilant and report any suspicion of elder sexual abuse to the relevant authorities to ensure that the perpetrators are held accountable and the victims receive the necessary support and care. Types of sexual abuse and assault can include:
Unwanted touching, groping, and massaging.
Sexual assault and battery.
Sexual photography.
Rape.
Forced nudity.
"When an elderly person falls victim to abuse, it can have physical and psychological effects that should not be ignored," said Attorney Connelly. "Care providers and family members should be aware of the physical warning signs that may indicate abuse."
These signs include unexplained bruises, cuts, burns, broken bones, sudden weight loss, and poor hygiene. Additionally, psychological warning signs may also be present, such as changes in behavior or mood, social withdrawal, anxiety, or depression. It is crucial to pay attention to these signs in order to identify potential abuse and take the necessary steps to protect the elderly person and prevent further harm.
Who Are the Victims
Sexual predators often target individuals whom they perceive to be vulnerable or easy targets. Unfortunately, seniors often fall into this category due to a variety of factors. For instance, they may be isolated or lack the physical or cognitive ability to defend themselves. In addition, some may be dependent on caregivers or family members for support, which can make them more susceptible to abuse. Abusers often look for:
Physical frailty or diminished ability to defend themselves.
Dependency on assistance from others (e.g., driving, heavy cleaning, health care, etc.).
Predictable routines.
Living alone or in a nursing home.
Dementia or cognitive impairments.
The Department of Health and Human Services Administration for Community Living has reported that there were over 16,000 cases of sexual abuse between 2002 and 2017. However, experts believe that this number is significantly higher due to underreporting.
The underreporting of sexual abuse cases in these settings is a complex issue, often related to factors such as fear of retaliation, lack of awareness, and difficulties in recognizing and reporting sexual abuse. While the actual number of cases may be much higher, the real impact of sexual abuse on vulnerable adults cannot be overstated and underscores the need for stronger measures to prevent and address such abuse.
"It is surprising to note that many individuals unfamiliar with senior care are unaware of this issue," said Attorney Connelly. 'While the prevalence of sexual abuse against children in care is widely recognized, it appears that society has not yet fully embraced the reality that seniors are also vulnerable to such exploitation."
What Drives the Perpetrators
Sexual abuse is not motivated primarily by sexual desire but by a desire to exert power and control over others and to humiliate and belittle the victim. We may become more vulnerable to abuse as we age since impairments decrease personal power, increasing the risk of abuse. Consequently, elderly and disabled individuals are sexual abuse targets. Seniors may be abused both inside and outside the home.
The stories of elder sexual abuse can be found in newspapers across the nation. These assaults occur in homes, nursing facilities, rehabilitation centers, and hospitals. The acts can be perpetrated by program staff, visitors, strangers off the street, and even other residents.
Let’s look at some of these reports from the recent past:
In Rhode Island, a 74-year-old nursing home resident was charged with first-degree assault on an 80-year-old female resident after a program staff member witnessed it. The person arrested was out on bail for first and second-degree child molestation stemming from an incident in 2012.
In Connecticut, a 26-year-old man was arrested after at least one sexual assault at a nursing home there. The perpetrator was charged with second-degree sexual assault on a physically helpless victim.
A Fall River, Massachusetts man was accused of raping two residents at a New Bedford nursing home where he was a licensed practical nurse. The perpetrator stated that he “never forced" himself on the victims, but at least one of the victims reported being assaulted in the bathroom.
In California, a 77-year-old cancer survivor with a colostomy bag stated that while sleeping in a chair, she was awakened by someone grabbing her head and raping her. During the assault, the victim stated that the man whispered to her that she should “relax and enjoy it” and even offered her a glass of water. She did not report the first rape out of shame, but the perpetrator returned two weeks later to rape her again. The perpetrator was caught and convicted of raping fourteen women over a five-year period.
In Florence, Alabama, a 21-year-old nursing assistant was arrested and charged with sodomizing a male patient.
In Queens, New York, a male patient admitted to a narcotics unit escaped and dressed in hospital scrubs, sexually assaulted a 79-year-old woman in her hospital bed. The woman’s daughter stated that her mother “was never the same after that” and wondered if the senility, which seemed to come on “quickly” was the result of the rape. She added, “I live with the guilt because I put her in the hospital originally.” She also bemoaned the lack of support groups and organizations to address the problem
Can't Adults Protect Themselves?
It is a widely held belief in society that elderly patients are not likely to fall victim to sexual assault. This notion stems from the assumption that seniors are asexual and incapable of committing such acts. However, this perspective is overly simplistic and fails to account for the complexity of human sexuality. As a result, research on this subject is still in its early stages, with ongoing data collection and analysis.
There are, however, several signs that have been identified in relation to the issue, highlighting the need for greater awareness and understanding of the risks faced by elderly individuals in need of care. These include:
Perpetrators of such abuse tend to be male and volunteer or paid caregivers.
Studies have shown that a staggering 70% of reported cases of elder abuse occur in nursing homes. While this may seem like a shocking statistic, it's important to note that nursing homes have a higher number of mandated reporters who are trained to identify and report any acts of abuse or neglect. This means that the high number of reported cases is actually a reflection of a stronger reporting system in place in nursing homes and senior care facilities. On the other hand, it's very likely that the number of assault cases among seniors living at home is not adequately represented due to a lack of oversight.
The abuser is the primary caregiver 80% of the time.
Sixty-seven percent of elder sexual perpetrators were family members.
Seventy-six percent of elder sexual abuse victims have had the incident witnessed by another.
Elderly women are 600% more likely to be victims of abuse than elderly men.
Underreporting the Crime
Although mandatory reporting laws exist in most states, authorities concur that the incidence of sexual abuse and assault of the elderly is significantly underreported for assorted reasons. Some of the reasons include:
The inability to report due to physical or cognitive functioning levels.
Many are so dependent upon the caregiver that they fear losing the person who provides them with care and basic needs.
They may fear retaliation from the abuser.
If they are living in their home, they fear being placed in an institutional setting if they report the abuse.
Although we mentioned shame earlier, shame is magnified when the abuser is a family member. They also fear alienation from other family members because of reporting the abuse.
Sometimes, abuse reports are made but not taken seriously by the facility or the authorities, and the elder refuses to cooperate, which allows the perpetrator to continue with the abuse.
Given this, addressing this issue requires a multi-faceted approach that involves empowering the elderly and educating caregivers and healthcare workers about the signs of abuse.
It's a Difficult Problem for Providers
It is imperative that facilities establish and implement policies and procedures for monitoring, hiring, and supervising staff, as well as responding to incidents that may arise. While it would be ideal for such incidents to never occur, the reality is that even with the best policies and supervision, the human element can introduce the possibility of negative occurrences.
According to Attorney Connelly, it is possible for individuals to pass every background check and still be a predator. "Despite thorough background checks, employers may end up hiring someone with a history of predatory behavior who has never been caught or prosecuted," he said.
Facilities that provide treatment programs for addiction or mental health care face similar challenges. For instance, drug treatment programs may have patients who smuggle in drugs and overdose on the premises. While in theory, such incidents should not happen, even with tight supervision practices and oversight in place, they may still occur due to the nature of the program. Suicide is another unfortunate reality in mental health facilities, and even with the strictest supervision, it is possible for someone to successfully complete the act. In such cases, the press often sensationalizes the story, creating an illusion of mismanagement and neglect, which may or may not reflect the reality of the situation.
Attorney Connelly suggests that people should not be discouraged from considering a facility that has received attention for prosecuting an employee who abused a patient. He advises that it could be an indication that the agency has effective policies and procedures in place, which enabled them to catch and prosecute the perpetrator. However, the negative publicity that follows such incidents may put the facility in a bad light, which could ultimately lead to predators continuing their abusive behaviors elsewhere.
He explains that if an employee is caught engaging in abusive activities, some directors of care facilities may choose to fire them without filing criminal charges to avoid the negative publicity that comes with such incidents. Unfortunately, this could allow the perpetrator to leave and get a job in another facility, where they could continue their abuse undetected. So, we should all support nursing facilities in bringing these perpetrators to justice.
What Should You Do?
When considering a care facility for your loved one, it's essential to do your due diligence and check their policies and procedures. You should inquire about their supervision and hiring practices. However, it's important to remember that even with the finest policies in place, things can happen, as it's impossible to eliminate all risks.
Therefore, the next question you should ask is how the facility responds to such a situation. You need to ensure that the staff reacts firmly and decisively, with the well-being of the patient being paramount. This information should help you make an informed decision about the care facility.
"It's alarming to think that a family member, institutional care provider, home healthcare aide or caretaker could exploit an elderly person, but it happens all too often," stated Attorney Connelly. "Therefore, if you suspect that your loved one has been a victim of sexual abuse or assault, you need to take immediate action. To date, there is no 'ideal profile' of a person likely to abuse an elderly person, but if the allegations are found to be factual against an individual, criminal charges should be brought and they should be prosecuted to the full extent of the law."
In our next blog post, we will delve into the specific challenges that elderly victims of sexual abuse and assault face, including the emotional impact of such traumatic experiences. Further, we will explore the various support systems and counseling options available for elderly victims, detailing the benefits of each and what they entail. We will also discuss the role of caregivers and family members in helping victims cope with the aftermath of this egregious act.
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