Domestic abuse of older people

Louise Shepperd

Image shows an elderly woman holding a young woman's hand.

On Wednesday 14 July 2021, Baroness Gale (Labour) is due to ask the Government “what plans they have to investigate the nature of domestic abuse of older people; and what support they offer to older victims of such abuse”.

How is elder abuse defined?

The abuse of older people, often referred to as ‘elder abuse’, is a global public health problem. On 15 June 2021, the World Health Organisation (WHO) published a factsheet on elder abuse to mark World Elder Abuse Awareness Day. It provided the following definition, which includes abuse in both community and institutional settings:

Elder abuse is a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person. This type of violence constitutes a violation of human rights and includes physical, sexual, psychological, and emotional abuse; financial and material abuse; abandonment; neglect; and serious loss of dignity and respect.

The age of an ‘older person’ is not explicitly defined. However, statistics offered by the WHO and the United Nations (UN) typically refer to people aged 60 years and older.

The Domestic Abuse Act 2021, which received royal assent in April, introduced a statutory definition of domestic abuse in UK law for the first time. This sets out that a person’s behaviour towards another is defined as domestic abuse if both people are aged 16 or over and are personally connected to each other, and the behaviour is abusive. In addition:

The definition encompasses people who have been in a relationship or are relatives.
Abuse is defined as “physical or sexual abuse, violence or threatening behaviour, controlling or coercive behaviour, economic abuse or psychological, emotional or other abuse”.

The Government has confirmed the new statutory definition does not contain an upper age limit.

What are the main risk factors?

The WHO’s factsheet identified risk factors that may increase the potential for abuse of an older person at individual, relationship, community and socio-cultural levels. Examples included:

Individual: poor physical and mental health of the victim; mental disorders and alcohol and substance abuse in the abuser; and gender.
Relationship: shared living situation; spouse; adult children; abuser dependency on the older person; history of poor family relationships; increase in women entering the workforce meaning caring for older relatives becomes a greater burden.
Community: social isolation of caregivers and older persons, due to loss of physical or mental capacity, or loss of friends and family members.
Socio-cultural: ageist stereotypes; erosion of generational bonds in a family; systems of inheritance and land rights; migration of young couples; lack of funds to pay for care.

The WHO highlighted that the consequences of abuse can be especially serious for older people. Abuse can lead to long-term psychological problems; convalescence is likely to take longer; and even minor injuries can cause permanent damage or death.

In 2016, the domestic abuse charity Safe Lives published a report on elder abuse in the UK. It noted that many problems facing older victims, also referred to as victim-survivors, are common to anyone experiencing domestic abuse. However, like the WHO, it said older victim-survivors may face additional social, cultural and physical challenges. Key findings included that older victim-survivors can experience:

systematic invisibility;
long-term abuse and dependency issues;
generational attitudes about abuse making domestic abuse hard to identify;
increased risk of adult family abuse;
services not being targeted at older victims, and not always meeting their needs; and
the need for more coordination between services.

The scale of the problem

Data on the extent of elder abuse is limited and reported rates are likely to be an underestimation. The WHO noted the findings of a study published in 2017 that estimated almost 1 in 6 people 60 years and older experienced abuse in community settings that year. However, it said this was likely to be an underestimation as it also noted only 1 in 24 cases is reported, often due to older people’s fears around reporting abuse to family, friends, or the authorities.

Reports by UK charities have also contended that attitudes to elder abuse and data collection impact reporting and estimates of the problem. The charity Hourglass, formerly Action on Elder Abuse, said attitudes around what counts as abuse are “fuelling the crisis”. It reported that nearly a third of UK residents surveyed did not see acts of domestic violence directed at an older person as abuse, including inappropriate sexual acts, as well as pushing, hitting, or beating an older person.

The 2016 Safe Lives report referred to above further detailed how older victim-survivors are a “hidden group”. It found the low numbers of older victim-survivors accessing domestic abuse services meant “professionals tend to believe that domestic abuse does not occur amongst older people”. The report highlighted a number of complex reasons why self-referral rates to domestic abuse services may be lower amongst older women. These included prolonged periods of abuse, care dependencies, lack of awareness of services and generational attitudes encouraging people to remain silent. In addition, the Safe Lives report said the invisibility of this group was exacerbated by age limits found in the Crime Survey for England and Wales (CSEW), as well as other surveys and studies, which excluded consideration of older victim-survivors.

Prevalence in the UK

There is no widely accepted prevalence rate for all older victim-survivors of domestic abuse in the UK. However, the CSEW estimated that 210,000 adults aged 60 to 74 experienced domestic abuse in the year ending March 2018. In the survey, domestic abuse included “partner or family non-physical abuse, threats, force, sexual assault or stalking”. The age limit was capped at 74 because the UK Statistics Authority (UKSA) was “not able to produce reliable estimates for those aged 75 and over”. However, in January 2021, UKSA said the upper age limit will be removed when face-to-face surveying restrictions are lifted in light of Covid-19.

In 2020 a report by Age UK estimated around 180,000 women and 98,000 men aged 60 to 74 were victim-survivors of domestic abuse in England and Wales in 2018/19, based on CSEW data. It went on to note that these statistics were collected before the Covid-19 pandemic, “which will have exacerbated the problems facing older victims”.

The impact of the coronavirus pandemic

Age UK’s report noted “Covid-19’s impact on older people has focused on health risks, treatment in care homes, and isolation, not risk of abuse”. However, it highlighted that:

Many older victims will have faced an impossibly cruel situation in which they were afraid to go out for fear of contracting a life-threatening illness, and afraid of staying in for fear of being abused at home.

Age UK went on to report statistics, including:

93% of deaths in England have been of people aged 60+, meaning older people in need of care and support have been rendered “acutely vulnerable”.
Enforced isolation had exacerbated many of the existing challenges older people face in accessing essential goods, healthcare and other services.
Lockdown had increased the risk of older people experiencing domestic abuse, especially in relation to financial or care dependencies and barriers to reporting abuse.
The Women’s Aid Foundation reported 61% of women living with their abuser in lockdown said the abuse had worsened and 67% said that Covid-19 had been used as part of the abuse.

In addition, Hourglass commissioned surveys in January and June 2020 of over 2,500 adults. It found that 1 in 5 UK residents surveyed (22%) had personal experience of abuse as an older person aged 65+ or knew an older person who had been abused. Hourglass suggested this indicated almost 2.7 million older people may have been affected by domestic abuse across the country in 2020. It also found 53% of those surveyed believed that the abuse and neglect of older people had increased as a result of lockdown and noted a “marked increase in calls to [their] helpline since the first national lockdown”.

How has the Government responded?

The Government has acknowledged the need to protect and support all victim-survivors who are abused. The Domestic Abuse Bill passed into law on 29 April 2021. Changes for England and Wales included a new statutory definition for domestic abuse, outlined above. The act also expanded the definition of those “personally connected” to the victim to include relatives, as well as intimate or ex-partners. In addition, it introduced a duty on local authorities in England to provide support to victims of domestic abuse in refuges and other safe accommodation. A consultation on statutory guidance to assist local authorities with these new duties is currently open and will close on 27 July. These changes have been welcomed by Hourglass and other groups. However, Hourglass noted that certain areas could have better protected older people but were not included in the legislation.

In May 2021, Helen Whately MP, Minister of State at the Department of Health and Social Care, responded to a written question on what protections existed for victim-survivors of elder abuse. She noted that:

Local authorities must safeguard people with care and support needs who are at risk, in cooperation with the police and the National Health Service. Specific offences can be used to prosecute perpetrators. These duties have remained throughout the pandemic and we have supported the sector with guidance, training and increased funding for local authorities.

The Domestic Abuse Act 2021 provides protection and support for all victims who are abused or controlled by a relative. We have also committed to review the protections and support in place for adults abused at home by someone caring for them. The Law Commission is running a consultation on its programme of reform. Government officials are also engaged with this work.

Targeted action during the pandemic

The Government has said it has put a number of measures in place to support domestic abuse victim-survivors during the pandemic. In April 2020, the Home Office launched a communications campaign to raise awareness that those at risk of abuse could still leave home during lockdown to get support. It also announced up to £2 million for online support services and helplines. Additional government measures included awarding funding for research. In October 2020, the Centre for Age, Gender and Social Justice received funding from the Ministry of Justice and other funding bodies to explore the experiences of older victim-survivors of domestic abuse in the context of Covid¬-19.

However, the Government’s communications campaign was subject to criticism from Hourglass. In an open letter to Priti Patel in November 2020, it noted “the Home Office’s #YouAreNotAlone initiative failed to respond to the different needs of older victims of abuse”. In particular, they argued that guidance to “leave home and seek refuge despite the lockdown rules” did not account for the complexity of leaving home for older people and conflicted with the public health shielding directive for over-70s.