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Aging, Disabilities, and Abuse

Jill Hightower and Greta Smith

What is meant by “disability?” According to the World Health Organization, disability is “any restriction or lack (resulting from impairment) of ability to perform an activity in a manner or within a range considered normal for a human being.” Types of disability include: mobility, agility, hearing, vision, speech, and others such as mental disabilities, cognitive disabilities, and learning disabilities. An individual may have more than one disability. (DCS, 2002) Disabilities can increase an individual’s vulnerability to abuse: persons with disabilities are approximately 50 percent more likely to encounter violence and abuse than the population at large. (Roeher Institute, 1995) The prevalence of disability tends to increase systematically as people age, particularly in the case of women. (NACA, 1996)

However, this should not lead us to the misperception that the majority of older people have a disability. Aging is itself a variable process, as each of us ages in a unique way. However, the state of our later life develops from former life patterns, such as socio-economic and health-related variables that may include disabilities and previous exposure to violence and abuse. For example, a respondent in a study on older women reported that her extreme history of abuse had brought on several health challenges, including ulcers, irritable bowel syndrome, and stress. (Hightower et al, 2002) Mental-health difficulties, arthritis, and other health issues can sometimes be traced to violence and abuse in women’s younger lives. It is difficult to obtain the data needed to estimate the incidence of violence in the lives of adults without disabilities; it is even more difficult to do so for those with disabilities given their increased vulnerability due to factors such as dependence on support and assistance from others, and stigma and negative attitudes in the general population.

While adults may acquire disabilities in later life through illness, sensory loss, and accidents, a growing number of individuals are reaching their senior years with a variety of physical and cognitive disabilities already present in their lives. For some, such as those with developmental handicaps, these disabilities may have existed from birth. Others have disabilities that resulted from physical or mental trauma, which can happen at any age. It seems evident from a growing body of literature examining the vulnerability of adults with disabilities to abuse, that abuse may already be a well-established factor in the lives of some individuals as they move into their senior years.

As noted by Nosek, Howland, and Young (1998) the prevalence of abuse among women in general has been fairly well documented, yet only a few North American studies, primarily from Canada, have examined the prevalence of abuse among women with disabilities. These studies have detailed the nature and extent of physical, sexual, and emotional abuse suffered by many women. (Ridington, 1989; Young et al, 1997; Sobsey and Doe, 1991) Growing older increases the likelihood of women becoming disabled, which increases the likelihood of their being abused. (Migus, 1990)

Social attitudes toward persons with disabilities are probably a large factor in individuals’ vulnerability to violence. This is comparable to the influence of ageist attitudes on the way older adults are often perceived and treated. The way society views persons with disabilities puts them at a disadvantage in many ways. For example, there is a view that persons with disabilities are somehow “not perfect,” which devalues them and may be a factor in a diminished sense of self worth. This in itself can contribute to a climate that is conducive to abuse. (DCS, 2002)

Vulnerability to abuse is strongly related to the dependence that someone with disabilities has on caregivers. Caregivers may be partners, other family members, friends, or employees. This dependence creates a power imbalance, thereby increasing the possibility of victimization. In some instances, individuals must depend on a variety of persons to provide basic assistance and care. Research suggests that the large number of persons involved in care along with the very intimate physical and emotional contact that can be involved increases the risk of abuse. (National Clearing House, 1990)

As with many adults who are victims of abuse and violence – and they are mostly women – there is a reluctance to report victimization. Adults of all ages who depend on others for daily life services may fear losing their caregiver services and fear for their personal safety if they report their victimization. People of any age with mobility, cognitive, or communication impairments may be unable to get help or to leave their abusive situations. They may be very isolated. And even if they report their abuse, they may not be believed.

The kinds of violence and abuse that can be experienced by individuals with disabilities include:

· physical abuse such as hitting, shaking, inappropriate handling, giving inappropriate medicine, withholding medicine, confinement, forced feeding, and use of restraints
· sexual abuse, including forced kissing, fondling, or intercourse.
· psychological and emotional abuse involving behavior intended to control the victim and instill fear or diminish the victim’s sense of self worth. This might include intimidation, threats to harm the victim or others, or threats to destroy pets or property.
· financial abuse. This might involve controlling a person’s financial resources, including money, a home, savings, or other assets. Or it might entail a misuse of power of attorney, or withholding money for basics such as food, clothing, medication, or transportation.
· neglect might involve failure to provide the necessities of life such as food, clothing, safe and sanitary shelter, proper medical care, personal hygiene, and general care.
· human rights violations could include isolation, refusal or removal of aides necessary for mobility or communications, withholding mail, or preventing communication with family and friends. (DCS, 2002)

The nature and type of abuse suffered by adults with disabilities is really similar regardless of age. In all cases, it is fair to assume that those who commit this violence and abuse hold some form of economic or social power over their victims. However, it is important to remember that older age greatly increases the risk of disabilities, particularly for women, with concomitant risks of violence and abuse.

Jill Hightower retired as Executive Director of the BC Institute Against Family Violence in 1998. She is the current President of the BC Coalition to Eliminate Abuse of Seniors (BC CEAS) and a member of the BCIFV Board of Directors. Greta Smith retired as Executive Director of the BC/ Yukon Society of Transition Houses (BC/YSTH) in 2001 after 25 years of involvement in the anti-violence and women’s shelter movement in BC. Greta and Jill are partners with Henry Hightower in a small research and consulting group, which focuses on abuse in the lives of older adults and especially older women. They are currently researching violence against older women on behalf of BC/YSTH.

Sources

DCS: Nova Scotia Department of Community Services (2002) Fact Sheet 8: Abuse of Persons with Disabilities, Halifax: Nova Scotia Department of Community Services.
Hightower, J, and Smith, MJ (Greta) and Hightower, H ( 2001) Silent and Invisible: A Report on abuse and violence in the lives of older women in British Columbia and Yukon, Vancouver: BC/ Yukon Society of Transition Houses.
National Advisory Council on Aging (1996) “Age and Disabilities” in Info-Age:-N0. 16 September, Ottawa: National Advisory Council on Aging.
Migus, NI (1990) Elder Abuse Fact Sheet, Ottawa: The National Clearinghouse on Family Violence, Health and Welfare.
Nosek, MA, Howland, CA, and Young, ME (1998) “Abuse of Women with Disabilities: Policy Implications,” in Journal of Disability Policy Studies, 8:1,2, pp. 158-175.
Young, ME, et al (1997) “Prevalence of abuse of women with physical disabilities,” in Archives of Physical Medicine and Rehabilitation Special Issue, 78:12, Suppl. 5, pp. S34-S38.
Ridington, J (1989) Beating the “Odds”: Violence and Women with Disabilities (Position Paper 2), Vancouver: DAWN Canada.
Roeher Institute (1995) Harm’s Way: The Many Faces of Violence and Abuse Against Persons with Disabilities, Ontario: Roeher Institute.
Sobsey, D and Doe, T (1991) “Patterns of Sexual Abuse and Assault,” in Sexuality and Disability, 9:3.