Sexual Elder Abuse

What Is Sexual Elder Abuse?

The National Center on Elder Abuse (NCEA) defines sexual elder abuse as “non-consensual sexual contact of any kind with an elderly person.” This is not limited to clear-cut sexual acts. Sexual elder abuse also includes any unwelcome or non-consensual sexually-related activity.

Unwanted sexual conduct may include:

• Forcing a senior to undress
• Forcing an elderly person to witness sexual acts
• Sharing pornography

Nursing home residents and those living in long-term care facilities or other institutional settings are at higher risk for elder sexual abuse because they are more likely to be living with physical or mental disabilities.

These limitations may prevent them from giving proper consent or defending themselves from unwanted sexual advances.

Studies have found that nursing homes and assisted living facilities often handle sexual elder abuse cases inadequately.

Since nursing home staff may have a hard time believing that sexual elder abuse happens, residents are put at even greater risk. This also makes it more of a challenge for nursing home abuse victims to speak out.

Fortunately, there are options if you or a loved one has suffered sexual abuse while in a nursing home. Elder protective groups, police, and lawyers can all help you start the healing process and hold loved ones accountable.

Quick Facts About Sexual Abuse in Nursing Homes

• Elderly victims of sexual abuse are less likely to report the abuse than younger people.
• Many victims avoid reporting sexual elder abuse, especially when the abuser is someone that victim cares about, as they don’t want to get the abuser in trouble.
• Perpetrators of sexual elder abuse tend to be paid or unpaid male caregivers.
• Victims of sexual elder abuse are most often females over age 70, who are either completely dependent or have some type of impairment.
• Victims of sexual elder abuse suffer more genital trauma than younger victims.

Types of Elder Sexual Abuse

Sexual elder abuse occurs when a perpetrator engages in any form of sexual contact without consent. This includes sexual assault, unwelcome advances, and inadequate consent due to incapacity.

Sexual Assault

Sexual assault is any type of sexual contact or behavior that occurs without consent.

Some types of sexual elder assault are:

• Fondling
• Forcing someone to perform sexual acts, such as oral sex
• Rape or attempted rape
• Unwanted sexual touching

Unfortunately, even though elder sexual assault victims generally need more assistance to hold their abusers accountable, they often receive less support than younger victims.

Unwelcome Advances

Unwelcome sexual advances may include requests for sexual favors and other verbal or physical harassment that is sexual in nature.

Capacity to Consent

Sexual contact with a person who is incapable of giving consent is sexual abuse. Sadly, non-consenting sexual contact is the least reported type of elder sexual abuse.

Conditions such as Alzheimer’s disease or stroke may render a victim unable to provide real consent. Sexual abuse of these victims may include unwanted touching, sexual assault, coerced nudity, and sexually explicit photography.

Signs of Sexual Abuse in the Elderly

Elder sexual abuse can be difficult to detect. This is especially the case when it comes to those affected by Alzheimer’s or other non-verbal nursing home residents, such as stroke victims.

The following may be warning signs of sexual elder abuse:

• Any report of sexual assault, regardless of the mental state of the victim
• Bruises around the genital area, inner thighs, or breasts
• Torn, stained, or bloody clothing or sheets
• Unexplained bleeding in the genital area
• Unexplained sexually transmitted diseases (STDs)

In addition to the physical effects of sexual elder abuse, mental health problems are also very common. Sadly, deaths associated with rape are known to occur, including suicide.

“11 out of 20 nursing home patients died within a year after the sexual assault.”

– National Institutes for Health (NIH)

Since many of the victims who died were frail and elderly, it is not possible to know whether the deaths were a direct result of the sexual elder abuse. However, the mental health of victims should be carefully monitored at all times, especially if sexual elder abuse is suspected.

Some non-physical signs of sexual elder abuse include:

• Being easily startled
• Becoming fearful of the location of the sexual abuse
• Becoming fearful of male caregivers
• Experiencing flashbacks
• Hyperarousal
• Symptoms of traumatic stress (fear, confusion, sleep disturbances, loss of appetite, and social withdrawal)

Due to the physical and emotional frailty of seniors, sexual elder abuse puts them at extremely high risk for severe reactions.

Sexual Abuse of Elderly in Nursing Homes

Tragically, nursing home sexual abuse is not often handled appropriately. In a report published by the NIH, in which 60 past elder abuse studies were analyzed, many nursing homes did not even report cases of sexual elder abuse to the authorities. Additionally, proper documentation about the abuse was not made.

What’s worse, some nursing homes in the study did not provide medical assistance to elder sexual abuse victims and even failed to protect victims from future interactions with the perpetrator.

Some appalling findings from the elder abuse study include:

• Nursing home sexual abuse victims were usually only moved to another department in the same nursing home, with many victims continuing to be at risk.
• When other nursing home residents were the abusers, they were simply transferred to other departments or nursing homes.
• When staff members were the perpetrators, they were either fired, placed on leave, or transferred to other jobs, with very few facing criminal charges — despite witnesses.

It is uncommon for there to be witnesses of sexual elder abuse. To further complicate matters, victims are often cognitively challenged, making accurate reporting nearly impossible. Because of these complicating factors, most cases of nursing home sexual abuse are dismissed due to insufficient evidence.

Nursing home sexual abuse is a problem in great need of attention. Since it is often viewed as a taboo topic, many elders are forced to silently endure immense physical and emotional suffering. Properly training staff to recognize the signs and symptoms of sexual elder abuse is critical.

If your loved one was sexually abused in a nursing home, our team can help you take action and start the healing process.

Why Does Elder Sexual Abuse Occur?

Elder sexual abuse occurs because offenders target vulnerability. They are known to seek out victims who they can easily manipulate and overpower.

They also look for victims who are unlikely or unable to report the assault, especially those who would likely not be considered credible if they did report it.

Reasons elderly people are targeted for sexual violence include:

• Believed to be less likely to report the abuse
• Considered easy targets
• Have physical or mental conditions that make them unable to report
• Likely to have reduced physical strength to resist abuse
• May have low self-esteem due to a decline in health
• Tend to be isolated, with few family and friends checking on them

There are many risk factors that are common to the aging process that make older persons likely to be victims of sexual assault. Even for seniors who are physically able, there is a social stigma to aging that makes them more likely to remain silent if they become victims.

Who Are the Perpetrators of Sexual Elder Abuse?

NIH analysis of the elder abuse studies determined that perpetrators of sexual abuse of the elderly were mostly men aged 18-80, but there were some women perpetrators as well.

The most common perpetrators were nursing home staff and other residents. The second most common perpetrators of sexual elder abuse were family members. In some cases, nursing home visitors that were known or unknown to the victims were the sexual abusers.

Common traits many many sexual abusers share are:

• Low-scoring social competence
• Preying on frail and defenseless victims

Because these criminals seek out the most vulnerable of victims who are least likely to be able to report the crime, it is critical to check-in regularly with loved ones living in care facilities.

The Main Locations of Elder Sexual Abuse

Sadly, elder sexual abuse can occur wherever there are frail people, male or female, who are easy targets to predators.

Other than nursing homes, elder sexual abuse could occur in:

• Adult Day Services: Usually provided on a part-time basis at adult day centers in communities
  Attendant Care: Also called Personal Assistance Services, these are in-home services geared toward helping people keep their independence
• Continuing Care Retirement Communities: Housing communities that offer independent, assisted living, and nursing home residency all in one campus
• Domiciliary Care Homes: Family-like facilities for up to 13 people that are certified by the Department of Aging
• Home Health Care: In-home services provided by registered nurses and/or licensed health aides focused on providing skilled nursing care
• Hospice Care: Services provided to the terminally ill and their family by an interdisciplinary team with a focus on peace and comfort

Findings of the elder abuse studies seem to indicate that the location of elder sexual abuse is not as important as the frailty of the victim.

Who Is Most at Risk of Elder Sexual Abuse?

The results of the studies that were analyzed found that both elderly women and men can be nursing home sexual abuse victims.

“Official statistics vastly underrepresent male victims of sexual abuse, and this seems to be the case also for elder abuse.”

– World Health Organization (WHO)

Tragically, yet not surprisingly, most victims of nursing home sexual abuse were cognitively impaired and/or physically frail.

Conditions that put residents at risk of sexual abuse include:

• Alzheimer’s disease and other dementias
• Brain injury survivors
• Stroke survivors
• Those with a psychiatric diagnosis
• Those who are physically frail (wheelchair, bedridden, paralyzed, and reduced mobility)

Appallingly, the oldest nursing home residents (age 79-99 years) were more frequently victims of elder sexual abuse. This reaffirms the belief that sexual offenders are most attracted to vulnerability.

However, it’s important to remember that any elder can suffer sexual abuse — and our team is standing by to help those affected.

Preventing Nursing Home Sexual Abuse

The most important step in preventing nursing home sexual abuse is to believe survivors.

To many people, the thought of frail and defenseless seniors being sexually victimized is so sickening that they refuse to believe it happens. Perpetrators know this, and this is why elderly individuals become targets.

Other ways to prevent sexual elder abuse in nursing homes include:

• Choosing nursing homes that are sufficiently staffed for loved ones
• Ensuring that your loved one’s nursing home checks/documents staff references
• Staying vigilant — remember that there is increased potential for abuse wherever there are dependent people
• Verifying that the facility does not hire employees with criminal histories

Nursing homes should have supervisors who are strongly present on unit floors. They should foster a comfortable environment that encourages “whistle-blowing” by staff and residents alike.

It bears repeating: Believing that elder sexual abuse does happen is the biggest defense in preventing it.

Statistics on Elder Sexual Abuse

Accurate statistics on elder sexual abuse are difficult to obtain. The main reasons for this are that many cases of nursing home sexual abuse get categorized as physical abuse. Additionally, many other cases are not documented at all.

That said, accepted statistics on elder sexual abuse include:

• 0.7% of nursing home staff members reported sexually abusing residents.
• 1.9% of nursing home residents (or their guardians/loved ones) reported sexual abuse.
• More than 20,000 complaints of sexual abuse in nursing homes were made over the last 20 years, according to the Administration for Community Living (ACL).
• Sexual elder abuse is the least common type of elder abuse.

Further, A CNN report found that from 2013-2016, over 1,000 nursing homes in the U.S. were cited for sexual abuse. 100 of the facilities were cited for multiple citations. Over 500 of the facilities were also cited for failing to investigate and report allegations of sexual abuse — or for not screening employees for past sex crimes.

Although there are nursing homes that take sexual elder abuse cases seriously, far too many try to sweep cases under the rug. To compound the problem, nursing home sexual abuse victims are unlikely to report their abuse.

There is a great need for improved statistics on nursing home sexual abuse. Without accurate data, it is nearly impossible to put an end to these horrifying crimes.

“It’s impossible to know just how many victims are out there. But through an exclusive analysis of state and federal data and interviews with experts, regulators and the families of victims, CNN has found that this little-discussed issue is more widespread than anyone would imagine.”

– CNN

Other Types of Elder Abuse

The World Health Organization (WHO) uses five categories for elder abuse: psychological, physical, financial, neglect, and sexual. It is important to note that abuse of any elder is often not limited to one type. Sadly, many seniors are victims of multiple forms of abuse.

The following chart shows a break out of the types of abuse by incidence.

Physical Abuse

This is bodily harm caused by hitting, slapping, or pushing. Physical elder abuse can also include restraining an elder against their will.

Financial Abuse

Financial elder abuse is the theft of money or belongings of an elderly person. It can include forging checks, using a person’s credit card without authorization, or changing names on a will or insurance policy without permission.

Emotional Abuse

Using hurtful words, threatening, yelling, or ignoring an elderly person. Emotional elder abuse can also include keeping them from friends or family.

Nursing Home Neglect

Failing to respond to a nursing home resident’s physical, emotional, or social needs. Nursing home neglect can include not providing food, medications, or health care.

If your loved one has suffered sexual elder abuse, nursing home neglect, or another type of elder mistreatment, our team may be able to help you pursue justice.

Report Sexual Abuse in Elderly

If an elderly person is in immediate danger, call 911. If there is no life-threatening danger, there are several ways to report nursing home abuse.

The local police, Adult Protective Services (APS), and the Long-Term Care (LTC) Ombudsman should be contacted. For more information on properly reporting abuse, call the Eldercare Locator at 1-800-677-1116.

If you wish to address the problem directly with the nursing home, talking to the staff may be helpful.

However, you may also need to talk with:

• A supervisor
• A nursing home abuse lawyer
• The facility’s director of nursing
• The nursing home’s social worker
• The nursing home administrator
• Your loved one’s doctor

To see if you can take legal action for the abuse your loved one has suffered, get a free case review from our team without delay.