Addressing Elder Sexual Abuse: The Critical Role for Integrated Care

• Published in: Translational issues in psychological science 2017-12, Vol.3 (4), p.410-422
• Main Authors: Shamaskin-Garroway, Andrea M., Giordano, Nicole, Blakley, Laura
• Format: Article
• Language: English
• Subjects: Criminal Offenders; Elder Abuse; Health Care Psychology; Human; Integrated Services; Primary Health Care; Protective Factors; Risk Factors; Sexual Abuse; Survivors
• ISSN: 2332-2136; 2332-2179
• DOI: 10.1037/tps0000145

Elder abuse is a significant public health issue encompassing neglect, financial exploitation, physical and sexual abuse, and affecting about 10% of adults over age 60 (Acierno et al., 2010). While elder sexual abuse (ESA) is the least common form of elder abuse, its impact can be devastating (Dong, 2015). Though the American Medical Association has long held for the routine screening of elder abuse (Aravanis et al., 1993), there are substantial barriers and challenges in identifying and addressing maltreatment among ESA survivors (Burgess, 2006). This brief commentary provides an overview of the risk factors for ESA, survivors and offender characteristics, as well as signs of abuse health care providers should be aware of in the older population. Given that older adults frequently interface with health care professionals, these providers are in a unique position to screen and address this underrecognized issue. The introduction of the integrated behavioral health model provides additional resources for this domain. We discuss how components of other interprofessional and integrated care programs, which have successfully targeted unique psychosocial needs of the elderly, can be used to address ESA. Primary care psychologists can be a valuable resource providing direct clinical services and training medical providers to sensitively and appropriately assess abuse and intervene when necessary. To highlight this, we discuss the model of trauma-informed primary care and the need for education and communication training for medical providers to address ESA. What is the significance of this article for the general public? Health care providers are in a unique position to address the historically underemphasized public health concern of elder sexual abuse. The capitalization of mental health providers integrated into health care settings provides a novel approach to targeting this problem. Through interprofessional collaboration within an integrated health care system, mental health providers can help train and empower medical providers to appropriately screen, identify, and address sexual abuse in the older population.