Abuse of Older Women
For Family & Friends, Female Survivors, Workers
This article is written for women and assumes a male offender, however SECASA acknowledges that both men and women can be survivors of sexual abuse and that offenders can be male and female.
The following information is and excerpt from the a 2006 article by the Australian Institute of Family Studies entitled 'Elder Abuse' and the sexual assault of older women'. It has been reproduced with permission of the author.
Responding to sexual assault in the context of aged care facilities
It is important to consider the particular features of the settings in which sexual assault against older women requiring care takes place. The context of aged care facilities, and the circumstances of residents, can be regarded as quite distinct institutional settings where vulnerability to sexual assault by service providers can be high, particularly in the case of residents with intellectual disability. Counsellors at a Sexual Assault Service based at Royal North Shore Hospital in Sydney developed a project supporting victims of sexual assault who resided at aged care and disability settings. Responding to Sexual Assault in Aged Care and Disability Care Settings – or the “SADA project” aimed to develop a framework for relevant agencies in the local area to respond effectively to sexual assault of disabled and aged care settings (Kelly & Blyth, 2005). Through their consultations with agencies and counselling with victim/survivors, it was found that sexual assault in these settings was characterised by:
- high rates of sexual assault perpetrated by service providers;
- decreased likelihood of assaults being detected and acted upon;
- lack of formal follow up where sexual assault has been detected, either because there were no mechanisms in place to do this, or because the perpetrator is temporarily employed by the facility (for example by providing locums) and can continue offending in different facilities;
- barriers to disclosing incidents of sexual assault (cognitive and communication impairment usually means that victims are unable to communicate what has occurred, or are not believed when they do communicate);
- lack of provision within the criminal justice system to hear and interpret evidence from victims for whom communication or cognition is an issue; and
- delays in police investigation as a result of lack of expertise in this area, or a lack of what is considered to be legal ‘evidence’ (e.g., complaints can result in ‘no further action’ being taken, particularly in the case of more elderly victims, for whom the trauma of sexual assault can result in death).
This recognises that organisational care settings contain elements that could be regarded as ‘situational risk factors’ for sexual assault. In the context of child maltreatment, it is suggested that a “‘situational crime prevention’ model provide[s] a useful framework for extending the prevention of child maltreatment in an organisation setting beyond individual-based risk assessment and risk management strategies” (Beyer, Higgins, & Bromfield, 2005, p. 1). Similarly, the SADA project identifies the situational barriers within aged care settings that make it difficult not only to disclose sexual assault, but also to adequately respond.
It also recognises the way in which the impact of sexual assault and the task of supporting victim/survivors cuts across agencies. An impetus for the SADA project was the difficulty in detecting, investigating and prosecuting sexual assault where victim/survivors were residents of aged care and disability facilities.
It was felt that it was no longer an option to rely on existing structures such as the Police and court systems. What was required was inter-agency development, participation and knowledge-sharing around the key issues in sexual assault in aged care facilities. Two days of workshops were attended by agencies including the NSW Police Service, the NSW Ombudsman’s Office, Department of Ageing, Disability and Home Care (NSW Government), National Disability Abuse and Neglect Hotline and Sexual Assault Services. Three areas of need were identified:
- creating safe environments;
- the investigation of sexual assault as a crime; and
- what to do in complex situations, such as when police investigations cannot proceed.
It is worth noting that that the development of a complaints mechanism, in order to create safe environments was only part of what the SADA project identified as essential to effective responses to incidents of sexual assault. It recognised that responding to the sexual assault of older people as a crime, ensuring that victim/survivors had equitable access to the criminal justice system, and changing the culture of residential care facilities, was a core part of providing support for victim/survivors of sexual assault and ensuring their ongoing safety.
An additional aspect to responding to elder abuse in residential care is awareness of the often gendered nature of elder abuse. Research demonstrates that women are more likely to experience elder abuse in all its forms. Although women live longer than men, and therefore are likely to be slightly overrepresented in any seniors statistics, the over-representation of women in elder abuse statistics is substantial and is consistent with the gender-bias in most abuse statistics throughout the lifespan. The CUT study estimated the prevalence of elder abuse of women in Western Australia to be two and a half times that of men, a finding replicated in other studies (Faye, 2003; Roberts, 1993; Sadler, 1993).
Although sexual assault makes up about 3% of known cases of elder abuse in care facilities, research suggests that women are overwhelmingly the victims in situations of elder sexual abuse. One of the first studies on sexual assault against older women conducted in Massachusetts (US) found that, of the 28 cases examined, all victim/survivors were women, all but one of the offenders was a man, and the majority of offenders were caregivers to the victim/survivors (Ramsey-Klawsnik, 1991). A study conducted in the UK also found that 86% of victim/survivors of elder sexual abuse were women, and in 98% of the cases, the offenders were male (Holt, 1993). The studies are indicative of the fact that while elder abuse may take many forms, sexual assault within aged care facilities resembles the pattern of sexual assault generally: an overwhelming proportion of victims are women who experience violence at the hands of family members or those in position of trust.