Managing abusive experiences: a qualitative study among older adults in Sweden

Abstract

Background Elder abuse is prevalent, and is associated with poor health outcomes. How an older adult is affected by abusive experiences is dependent on myriad factors, including aspects of the abuse itself, other life circumstances, coping strategies, and what kind of help the older adults receive to manage the experience. In this study, we sought to investigate how older adults themselves describe how they manage abusive experiences. An increased understanding of this could help to tailor society’s response to older adults suffering from abuse. Method Participants (n = 30) were recruited from patients admitted to one acute geriatric and one acute internal medicine ward at a university hospital in Sweden. Patients over the age of 65 who reported experiences of elder abuse or who reported that they were still suffering from abuse that had occurred earlier in life were included. In-depth qualitative interviews were conducted, transcribed verbatim, and analyzed using qualitative content analysis. Results The analysis resulted in five themes, three pertaining to strategies used to manage abusive experiences (self-reliant coping, restoring dignity in relation to others, and needing formal and informal help) and two pertaining to the disclosure process (inner resistance to disclosure, and external barriers and facilitators for disclosure). Conclusion Older adults were found to use a combination of different strategies to manage abusive experiences. Some were self-reliant, but older adults often managed their experiences with the help of others. Health care professionals were generally in a position to facilitate disclosure, but some participants reported poor encounters with health care. The findings indicate a need to facilitate disclosure by, for example, training professionals on issues related to elder abuse and developing more easily navigated response systems that can respond to the complex needs of older adults trying to manage abusive experiences.

Social Representations of Violence among Brazilian Older People with Functional Dependence

“…The results found in studies in this field demonstrate the condition of chronicity of violence, which is in line with the social representations evoked by older people in this category [8,36]. These results demonstrate the occurrence of repeat violence or polyvictimization, that is, the co-occurrence of two or more types of violence over a one-year period, with these events being perpetrated by family members, friends, neighbors, or even formal caregivers [7,9,37].…”

Elder abuse and life-course victimization in hospitalized older adults in Sweden: prevalence and associations with mental ill-health

“…The difference in mental ill-health may also be attributed to the fact that all cases in that category were polyvictims, i.e., were victimized on several occasions or by several perpetrators. Polyvictimization has previously been reported to be associated with greater ill-health than any single victimization among older adults [37], and in this particular sample previous experiences of abuse were found to influence both the experience of elder abuse and how it was managed [39,40]. It is therefore unfortunate that many studies on elder abuse focus on past-year exposure, and that polyvictimization is not further explored.…”

“…Thereafter, a semi-structured interview was conducted with the help of an interview guide to evaluate exposure to abuse (supplementary file 1). Whenever experiences of abuse were revealed, qualitative interviews were conducted covering both the experiences of elder abuse [39] and how abusive experiences were managed by the older adults [40].…”

“…In the case of uncertainty about whether to classify an experience as abusive, the ambiguity was discussed among the interviewers before classification. The interviews with victims of elder abuse were also recorded and transcribed for the purpose of subsequent qualitative studies about experiences of abuse [39,40]. Hence, when necessary, the transcripts could be used to reach a consensus agreement on abuse classification.…”

Testing an educational intervention to improve health care providers’ preparedness to care for victims of elder abuse: a mixed method pilot study

“…To date, however, there are no evidence-based programmes that can be generally applied to victims of elder abuse [41,42]. This is in part due to a paucity of studies on the subject, but also a reflection on the complexity of the issue, where all victims have individual needs [43,44]. Hence, the sought-after clearcut way of managing the response is perhaps not possible to achieve.…”