Dimension 1

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Elder abuse occurs more often within the family setting rather than in outside institutions. In relationship to medication adherence, abuse may include withholding medications, overmedicating the older adult, or neglecting to provide access to medical treatment.

The following have been identified as risk factors for elder abuse based on current research (Center for Substance Abuse Prevention):

• Living arrangements, such as cohabitation of family member and older adult or an older adult who is living alone
• Social isolation of abuser and victim
• Presence of Alzheimer's disease or related dementia
• Presence of mental illness or increased levels of hostility in the abuser
• Alcohol abuse on the part of the abuser
• Dependency of the abuser on the victim
• History of marital violence, also known as intimate partner violence.

A 2000 nationwide survey of Adult Protective Service Departments found 13.2% of elder abuse cases involved caregiver neglect or abandonment (Teaster, 2000). Identifying the characteristics of the caregiver may help predict elder abuse. The problems caregivers face and their views of the care recipient may trigger abuse (Anetzberger, 2000).

Social isolation is a risk factor for abuse. Social isolation may be a strategy for keeping the abuse secret, or may result from the stresses of caring for a dependent older family member. Social isolation is problematic because it cuts off family members from the outside help and support they may need to cope with the stresses of caregiving (American Psychological Association).

Caregiver substance abuse is a risk factor associated with elder abuse and neglect. Caregivers may turn to substance abuse as a coping mechanism for the demands required in their role as care provider. For spouses who are care providers, substance abuse increases the likelihood of partner violence. Especially among men, problem drinking increases the chance of partner abuse eightfold (Sharps et al., 2001)

When elder abuse is suspected, interventions should emphasize changing the dynamics of the relationship. Addressing the needs of the victim and the abuser begin to change this dynamic. At the same time, abusers must be held accountable (Center for Substance Abuse Prevention). Reporting abuse to the local or state Adult Protective Services begins the process.