Caregiver abuse is typically defined as abuse by someone providing care for the elderly or a person with a disability. Elder abuse is a broad term encompassing all types of abuse and neglect but not always specifically caused by someone in a caretaker role. The term caregiver refers to anyone who routinely helps others who are limited by chronic conditions. While formal caregivers are typically volunteers or paid employees connected to the social service or health care systems, informal caregivers are often family members and friends, who provide nearly 75 percent of the care currently being provided to impaired older adults living in the community.
Caregiver abuse and neglect has remained a relatively understudied problem in the United States with most states only establishing adult protective services units in the mid-1980s. According to the National Institute of Justice, some states have yet to develop mandated reporting laws for caregiver abuse similar to those in place for child abuse. A review of adult protective services and laws for each state shows how widely varied the system really is with regards to protection and investigative capacity of caregiver abuse.
According to the best available estimates, between one and two million Americans aged 65 or older have been injured, exploited, or otherwise mistreated by someone they depend on for care or protection. Yet, elder abuse in all forms has remained an under-reported crime. Data on elder abuse by caregivers suggest that only 1 in 14 incidents, excluding incidents of self-neglect, comes to the attention of authorities. It is estimated that for every one case of elder abuse, neglect, exploitation, or self-neglect reported to authorities, about five more go unreported. The reporting of financial crimes is even less with current estimates putting the overall reporting of financial exploitation at only 1 in 25 cases, suggesting that there may be at least five million financial abuse victims each year.
As our population ages, caregiver abuse will become more of a problem. The United States is an aging society with more people living longer than ever before. This trend is expected to increase. The U.S. Census Bureau projects that more than 62 million Americans will be aged 65 or older in 2025, an increase of 78 percent from 2001, and more than 7.4 million will be aged 85 or older, an increase of nearly 68 percent from 2001. This aging population will require more care and protection than is currently available or possible.
Abuse by caregivers may be physical, sexual, emotional or financial. It may involve intentional or unintentional neglect. These various forms of abuse may be motivated by many factors and unlike most victim-based crime the offenders are just as often female as they are male. A major concern in the criminal justice field is the lack of research on the forensic aspects of elder abuse.
Many families will utilize a private investigator to conduct a wellness check— simply checking in on the health, safety and general welfare of a loved one who is at a distance. Reporting back can do a lot to ease the stress and concern of families or may be the push they need to have someone investigate the situation more closely.
In other circumstances, caregiver abuse investigations can be comprised of background checks, asset checks, reviewing medical and financial reports, conducting alleged victim and offender interviews, taking witness statements and both overt and covert surveillance.
What makes these investigations different and challenging is the often complex dynamics between the victims and their caregivers—particularly if it’s all within the family. Navigating the complex web of the elder services system can also present a challenge to investigators unfamiliar with the government and private entities involved.
While no one factor can explain all incidences of abuse, researchers have found some core fundamental risk factors that are related to the abuse:
- Ongoing domestic violence between intimate partners is one key risk factor for elder abuse. Spouses and domestic partners make up a large percentage of abusers. If there was domestic violence through the course of the relationship there is nothing to indicate that this would stop as the two partners grow old. In fact, it could escalate as the power and control that fuels those who abuse increases, if that partner becomes the caregiver for the other. Alleged incidents of abuse very much mimic what is typically seen in domestic violence cases and should be investigated as such.
- When the caregiver is an adult child there are times when this caregiver becomes dependent on the elder for their financial stability including financial assistance, housing, bill pay and other forms of support. This assistance is needed for any number of reasons related to personal problems such as their own mental health, drug or alcohol abuse.
- If the adult caregiver is living with the elder, the risk is higher and often more difficult to uncover. Living with the elder, an adult child can assert a level of power and control over the victim that is hard to detect, prove and break.
- Often when interviewed, a victim, if able to provide information and details, will not do so simply because he or she believes this family member is their last hope to remain in the home instead of being placed in a nursing home. Some elders would rather suffer the abuse than risk losing their home.
- When the caregiver is a family member, the elder will often protect and take the blame for their own abuse, claiming to be difficult to care for and will make excuses for the caregiver.
- Lastly, researchers have found that in some cases “caregiver stress” has contributed to the abuse and neglect.