“Elder Abuse,” Revisited

Coming to terms with the term “elder abuse”

“Stop elder abuse,” and other campaigns focusing on negative messages are shortsighted. Such messaging may not be effective in changing people’s behavior and typically create fear and anxiety. Such messaging may inadvertently perpetuate stigmas and stereotypes leading to ageism and discrimination.

The term elder abuse does little to address this social harm, which demands human-ecological (Cornell, Karl Pillemer) and humanitarian solutions that extend far beyond an individual case of elder abuse.

We must come together to stop elder abuse. But first we must consider the term and how it hinders our cause. Society’s view of elder abuse creates a contradiction, which puts our future in jeopardy. Consider the words elder and abuse.

• Elder — America’s public-health triumph of the 20th century gained Americans almost thirty years (Max Roser, 2019). Twenty-first-century citizens have three added decades, which we neglect to protect faithfully and fully.

• Abuse — While citizens’ explicit cognitive salience of elder abuse is low, the incidence of abuse is high. Yongjie Yon and colleagues estimate one in six people 60 years and older experience some form of abuse in community settings annually. (2017).

The term elder abuse can re-victimize people through negative associations that come with being labeled a victim of abuse. Being called a victim can elicit archaic guilt-by-association and blame-the-victim responses. For persons who have been victimized, this leads to feelings of guilt, shame, stigmatization, and isolation. Such conditions can make it difficult for people to get the help they need and for society to advance.

The term elder abuse may be redundant for persons — young and old — with an ageist ambivalence (Lindsey A. Cary and colleagues, 2016). Abuse (or abuti, in Italian) means “used up,” and persons who are ageist feel elders are already used up. For other persons, “elder abuse” is not what they think consciously: it’s subliminal, it’s implicit (Harvard).

Elder-abuser dyad

The word pair “elder-abuser” starts to address the dynamic, dyadic (two-person), and non-reciprocal relationship between an elder victim and their criminal abuser. However, this dualistic approach typically focuses on the vulnerabilities of a victim or the motives of a perpetrator, often in isolation from a broader context. This focus on the anti-social dyad “elder-abuser” neglects a pro-social approach to our human ecology and flourishing.

Social scientists have long observed similarities between people who commit crimes and persons who are “victims” of crime, a phenomenon known as the victim-offender overlap. Yet, “it remains unclear as to whether the victim–offender overlap even exists among older population segments” observe Michael D. Reisig and Kristy Holtfreter (2018, 145).

Focusing on the elder-abuser dyad is a major disservice.

As expressed by Julie Schoen (The Justice Clearinghouse; May 17, 2017),

“We tend to construct elder abuse as a relationship between a ‘perpetrator and a victim’ and typically cast older people as powerless and vulnerable reinforcing stereotypes of older people as passive, vulnerable beings.”

This dualistic approach fails to address contextual support and risk factors adequately. It fails to strengthen our safety networks, which start with caregivers and concerned persons (NYC Elder Abuse Center Helpline) who, in their personal and professional roles, try to fulfill their social responsibility to prevent and respond to elder abuse.

A dualistic approach also fails to place society on center stage to embrace and engage all players: older adults who wish to maintain a lead role in their own lives, their supporting actors, and even bad actors who have temporarily assumed the role of an antagonist.

Elder justice for all of us

In contrast, a campaign to “advance elder justice” emphasizes positive messages that promote respect and understanding for older adults and persons in their circles of support. These messages help create a culture of compassion, capacity, and care that prevents elder abuse in the first place. These messages embrace and empower citizens society-wide. These messages don’t ignore the debilitating nature of “elder abuse” — instead, they point to a higher level on the horizon.

Elder justice is gaining ground as an enlightened and forward-looking framework and plan of action for protecting our elders and our future.

The 2010 Elder Justice Act (ALC) was conceived of by M.T. Connolly and colleagues, who sought to establish a proactive, preventive approach to the issue. Connolly, in The Measure of Our Age: Navigating Care, Safety, Money, and Meaning Later in Life (2023), chronicles its inception eight years before enactment:

“In early 2002, Lauren [Fuller] called to say that [Senator John] Breaux [Chair, Special Committee on Aging] wanted to introduce landmark legislation, and over lunch on Capitol Hill, she asked, “What should this law look like?” I pulled a scrap of paper from my bag and jotted down an outline of the ideas simmering in my head, under the heading: “ELDER JUSTICE ACT OF 2002.”

The Elder Abuse Prevention and Prosecution Act of 2017 (S. 178), while starting with “elder abuse” in its title, declares its intentions by leading with a proactive, purposeful, expansive, forward-looking approach in “prevention,” followed by backward-looking “prosecution.”

Prior to the 2020, the annual New York City conference, at which participants learn about new trends and developments in elder abuse prevention and intervention, was called the NYC Elder Abuse Conference. Organizers (led by JASA) opted to rename the event, which is now called the NYC Elder Justice Conference.

Elder justice is in its infancy compared to other realms that define our legal and moral obligations. For humanity, elder justice can complete, not compete, with other causes. We must be mindful of Hegel’s words (EB, 1999), paraphrased:

“…the conflict is not between good and evil but between goods that are each making too exclusive a claim.”

Justice is not about one cause or another. Justice is inclusive. It embraces coming full circle to become whole for society and ourselves, including our future selves.

Our social compact, one-to-one

“Neither the life of an individual nor the history of a society can be understood without understanding both.”

— C. Wright Mills. (2000, original work published 1959). The Sociological Imagination. Oxford University Press. p. 3

Traditionally, our “social compact” is an implicit agreement between society and individuals in which people give up some of their freedom in exchange for the protection and benefits society provides.

But when our social compact is viewed as a partnership between society and individuals in equal measure, we recognize that both parties have obligations to each other, that a power imbalance is righted, and that individuals are more empowered.

Psychologist Albert Bandura (1995, 34) observed,

“Personal efficacy is valued not because of reverence for individualism, but because a strong sense of personal efficacy is vital for successful adaptation and change regardless of whether it is achieved individually or by group members working together.”

Considering our social compact in this way can empower us to realize our rights and responsibilities as citizens, make our own choices, and foster trust and cooperation.

Our social compact traditionally favors society, at its expense. Justice, which represents individuals’ rights, corrects this social imbalance to achieve one-to-one equipoise between society and ourselves.

Equal consideration for society and self is at the heart of the equity and trust, which is comprised in guardianship.

On guard, en garde

Above all other relationships between society and self — and far, far beyond any informal “expectation of trust” (WHO) — guardianship embodies our most demanding legal, social, and moral obligation. Arguably, guardianship manifests society’s greatest responsibility held in trust, given courts’ and guardians’ broad-scope fiduciary duties and the profound, asymmetric power imbalance (Niklas Luhmann and colleagues 2017) imposed on persons subject to guardianship in the absence of beneficiary control. “Fiduciary” or “trust” relationships, in which “one party is at the mercy of the other’s discretion” (Weinrib 1975), must be subject to our strictest legal rules, pro-social norms, and moral obligations.

Guardianship abuse and exploitation is a betrayal of trust, a violation of our social compact and constitutional rights, a systemic social harm that undermines democracy, and — all too often — a state-sponsored white-collar crime. As a social harm, “…white-collar crime has the capacity to undermine the trust in the entire sociopolitical system,” expresses Sally S. Simpson (2013, 310).

Our social compact is cradled in trust. The way we provide or deny trust in guardianship can test our social compact between society and self, making us stronger while protecting our future selves.