By Professor Lee-Ann Fenge, Director of the Centre for Seldom Heard Voices, Department of Health and Social Science, Bournemouth University

The abuse of older people (also referred to as elder abuse) is an issue that all societies and governments across the world need to acknowledge and tackle in a proactive way. Elder abuse is an umbrella term which includes physical, psychological or emotional, sexual and financial abuse. It can also be the result of intentional or unintentional neglect and can occur in institutional settings as well as in the home environment. It is an issue which is often hidden from view and seldom recognised, the voices of victims silenced by ageism and indifference. It results from the wider marginalization, invisibility, and exploitation that older people experience in many societies, and ultimately results in de-humanised care and an absence of human rights for older people. According to the World Health Organisation (WHO,2002) elder abuse is a subject which is often underestimated and ignored by societies globally

https://www.who.int/ageing/projects/elder_abuse/alc_toronto_declaration_en.pdf

The impact of sexual violence on older women is more invisible within society compared to other forms of abuse and little is known about the experiences of older women as victims of sexual violence (Nobels et al. 2020). Several factors influence the lack of awareness around sexual violence in old age:

• Ageism and the assumption of asexuality assumes that older women experience a lack of sexual attraction to others, or low or absent interest in or desire for sexual activity. A societal view of old age which assumes asexuality, also assumes that old age will protect older people from sexual violence when evidence suggests the opposite.
• By subsuming sexual violence within the terminology around ‘elder abuse’ the prevalence and impact of these crimes within society get lost. It is important to acknowledge that sexual violence against older people occurs within both the home and institutional settings where there is an assumption of ‘safety’. Sexual violence is often categorized as physical abuse rather than sexual abuse or sexual violence (Band-Winterstein et al., 2019). The language of ‘elder abuse’ therefore masks sexual violence being seen and reported as a crime. This results in different responses being offered to older and younger women in the UK (SARSAS,2020).
• Older women are less likely to speak openly about past and present sexual and domestic violence including child sexual abuse. It is important to remember that sexual violence is the least frequently reported and substantiated form of elder abuse (Yon et al., 2017), and older women are less likely to access specialist services for their experiences of sexual violence than younger women (SARSAS, 2020).
• Despite a growth in research and literature concerning sexual violence over the last forty years, little research or discussion has taken place concerning sexual violence against older women. In part this is due to limitations in available datasets, which until recently only collected data on intimate partner violence to an upper age limit of 59 years old, resulting in invisibility of any rape occurring over the age of 60. The CSEW (previously the British Crime Survey) collects data on most types of crimes but for the purposes of Police statistics in this area are also impacted by under-reporting of rape to the police (Bows and Westmarland, 2017).

As a result of these challenges our knowledge and understanding of the prevalence, characteristics and impacts is extremely limited and there has been little attention paid to sexual violence against older women by both the academic research and front-line practice (Bows, 2019).Recent research from Belgium suggests that it is important to recognise older adults as a risk group for sexual victimisation and as such this area should be researched as a separate category to other forms of abuse in old age (Nobels et al. 2021).

Going forward there needs to be further research and practice development focused on the experiences and needs of older people who experience sexual violence. This requires:

1. A move away from the terminology around ‘elder abuse’ to use language of sexual violence, rape, sexual assault or sexual abuse (SARSAS,2020). This would help inform understanding of the scale of the issue and help inform the development of specific services for older victims of sexual violence.

2. The inclusion of older people who have experienced sexual violence within policy and practice guidance. This requires the inclusion of images of older women as victims of rape to depict sexual violence as an experience that can occur across the life span the inclusion within literature and publications.

3. Health and social care organisations need to develop improved understanding of the needs of older women disclosing sexual violence.Sexual violence services need to be made more accessible, and practitioners need to be more aware of ‘intersectional stigma’ linked to factors such as age, gender and sexuality (Crockett et al. 2018). Health and social care practitioners need to reflect on their own potential bias that may prevent them from seeing older women as victims of sexual violence.

4. The need to develop understanding of sexual violence against older women within the wider context of lifelong intimate partner violence (IPV) (Band-Winterstein and Avielli, 2022).

References

Band-Winterstein, T., Goldblatt, H., & Lev, S. 2019. Breaking the taboo: Sexual assault in late life as a multifaceted phenomenon—Toward an integrative theoretical framework. Trauma, Violence, & Abuse, 22(1), 112–124

Band-Winterstein, T. and Avieli, H., 2022. The lived experience of older women who are sexually abused in the context of lifelong IPV. Violence Against Women, 28(2) 443–464

Bows, H. and Westmarland, N., 2017. Rape of older people in the United Kingdom: Challenging the ‘real-rape’stereotype. British Journal of Criminology, 57(1), pp.1-17.

Bows, H. 2019. Sexual violence against older women in the UK. In Bows, H. (Ed.), Violence against older women (Vol. 1, pp. 81–96). Palgrave Macmillan.

Crockett, C., Cooper, B. and Brandl, B., 2018. Intersectional stigma and late-life intimate-partner and sexual violence: How social workers can bolster safety and healing for older survivors. British Journal of Social Work, 48(4), pp.1000-1013.

Nobels, A., Vandeviver, C., Beaulieu, M., Cismaru Inescu, A., Nisen, L., Van Den Noortgate, N., Vander Beken, T., Lemmens, G. and Keygnaert, I., 2020. “Too grey to be true?” Sexual violence in older adults: A critical interpretive synthesis of evidence. International journal of environmental research and public health, 17(11), p.4117. https://doi:10.3390/ijerph17114117

Nobels, A., Cismaru Inescu, A., Nisen, L., Hahaut, B., Beaulieu, M., Lemmens, G., Adam, S., Schapansky, E., Vandeviver, C. and Keygnaert, I., 2021. Sexual violence in older adults: a Belgian prevalence study. BMC Geriatrics, 26;21(1):601.

SARSAS, 2020. The Chilling Silence: A briefing paper on sexual violence against older women in the South West of England. Available from: https://www.sarsas.org.uk/wp-content/uploads/2020/01/the-chilling-silence.pdf

United Nations 2002. The Toronto Declaration on the Global Prevention of Elder Abuse, Available from: https://www.who.int/ageing/projects/elder_abuse/alc_toronto_declaration_en.pdf

Yon Y, Mikton CR, Gassoumis ZD, Wilber KH. 2017. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Global Health. 5:147-56.

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