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Abusive Relationships

Family care can be among the very best or worst experiences human beings can devise for each other.¹⁰

The vast majority of perpetrators of elder abuse have been identified as close family members, often living with the victim. A recent Aged Care Assessment Team (ACAT) study examined elder abuse on the Central Coast of NSW. The study involved 1,777 people aged over 65 years of age who were referred to the Central Coast ACAT during a one-year period from November 1996 to November 1997. The research focused on clients and carers living in private homes. Clients in hospitals, aged care facilities and boarding house type accommodation were excluded. Of the 1,777 referrals to ACAT, there were 96 cases (five per cent) of elder abuse confirmed. The study found that in these cases, 40 per cent of perpetrators were the adult children of the victim, 35 per cent were spouses and 25 per cent were other and non-relatives.¹¹

Other research conducted by the Aged Rights Advocacy Service (ARAS) in Adelaide examined 100 case records for older people who had reported some form of elder abuse, and for whom the outcome was known (i.e. whether the abuse had stopped, or whether it had not). This represented approximately 20 per cent of total clients over an eighteen-month period from November 1997 to June 1999. The study found that out of the 267 situations of abuse reported, 56 per cent of abusers lived with the victim and that the adult child was the most common perpetrator, with sons making up 29 per cent and daughters 24 per cent overall of abusers. These were followed by:

…multiple family (11 per cent), spouse (eight per cent), and grandchild (seven per cent). Friends comprised six per cent of total abuser relationships, with the remainder being made up of other family relationships (e.g. niece).¹²

The ACAT and ARAS studies are the only available studies on who the perpetrators are. However, given that these studies related to very specific geographic areas (i.e. Central Coast, NSW, and Adelaide, South Australia) the extent to which their results are generalisable to the NSW population is unclear.

Carers and others in relationships characterised by a duty of care are sometimes abusers of older people in their care, but are also sometimes the subject of abuse.

The stressful nature of the caring role, complex family dynamics and a loose and largely unregulated system of support provide an environment in which abusive situations arise. These factors also mean that abuse is not always an uncomplicated or unidirectional interaction of ‘carers’ who abuse dependent people. In some situations, especially where there is a history of family violence or child abuse or where dementia and other psychological disorders are present, the dependent elderly can also be ‘abusive’ towards their carer.¹³

In the ACAT study, 25 per cent of the victims identified were carers.¹⁴

In NSW, approximately 150,000 (19 per cent) carers are aged over 65, and of all older people 20 per cent are carers.¹⁵ Ninety per cent of all primary carers aged over 65 live with the person they care for and 75 per cent care for a spouse.¹⁶ It is reasonable to conclude that at least some of the abused carers will be older people.

One phenomenon that has been noted is that well-established power relationships can shift through ageing and onset of disabilities. This shift can affect abuse patterns. For example, a long-term relationship characterised by domestic violence which continues into old age may result in the victim becoming the perpetrator when the original perpetrator becomes ill.¹⁷ Another example is where a person who was sexually abused in childhood by a parent becomes the parent’s abuser when the parent ages and is dependent upon the grown-up child.