Theoretical Development in Elder Abuse and Neglect

Simon Biggs & Thomas Goergen

Published online: 14 September 2010# Springer Science+Business Media, LLC 2010

Abstract This paper introduces some key issues in the theoretical and conceptualdevelopment of the study of the elder mistreatment. Five papers are summarized whichcover differing, yet complementary approaches to this growing social problem.

Keywords Elder abuse . Elder mistreatment . Theory . Elder neglect . Gerontology .

Criminology

With a minority of notable exceptions very little has progressed in terms of thetheoretical understanding of elder mistreatment (abuse and neglect) since thepublication of Pillemer and Wolf’s (1986) edited volume ‘Elder Abuse: Conflict inthe Family’. Biggs and Powell (1999) have used a Foucauldian approach to look atthe construction of abuse, while Shemmings (2000) has used attachment theory toexplain conflict in later life. Schiamberg and Gans (2000) have attempted to apply anecological model that places mistreatment in a wider interpersonal and socialcontext, while the National Research Council (NRC) Panel to Review Risk andPrevalence of Elder Abuse & Neglect (Bonnie and Wallace 2003) have developed amodel, which they themselves describe as ‘a first approximation, a theoreticalsketch’ (p 61). Since then, Payne (2005) has applied concepts and theories fromresearch on crime to the field of elder abuse, Hoerl (2007) has begun to explore thesocial construction of violence in old age and Harbison (2008) has reviewed thedifferent professional and policy frameworks that have been used to locate theproblem. However, much of the conceptual energy has been invested in embeddingmistreatment within a particular context rather than engaging with intrinsic meaningand explanatory value arising from the phenomenon itself. It is as if the contents ofmistreatment have been taken as self-evident and while the number of categories,descriptive labels and locations has multiplied, much less attention has been paid tocauses or dynamics that may contain explanatory or preventive value.

Ageing Int (2010) 35:167–170DOI 10.1007/s12126-010-9066-z

S. Biggs (*)School of Social & Political Sciences, University of Melbourne, Melbourne, Australiae-mail: sbiggs@bsl.org.au

T. GoergenDepartment of Criminology and Crime Prevention, German Police University, Muenster, Germany

Theories are needed because they help to make explicit the ways in which eventsare explained. They concern the way we understand the world and the possibility ofunderstanding the world differently. As such they form the basis for consideredaction (Biggs et al. 2004). Without a clear conceptual reason for an intervention,services are likely, as Bonnie and Wallace (2003) have pointed out, to remainreactive and contingent upon local regulatory frameworks.

The papers in this special section on the theoretical development of eldermistreatment attempt to address the question of ‘what is theoretically special to eldermistreatment?’ in related, but distinctive ways. Each of the papers reflects the pointmade by the NRC Panel (Bonnie and Wallace 2003) that mistreatment ‘Conveys twoideas; that some injury, deprivation, or dangerous condition has occurred to the elderperson and that someone else bears responsibility for causing the condition or failingto prevent it’ (p 40). In other words, they take as their focus an interpersonalsituation where some form of harm occurs. In each of the papers, responsibility isexamined, but in quite different ways. Also, each paper has been used to engage withthe issue of what is special about elder mistreatment and to make this complexphenomenon conceptually manageable.

Simon Biggs and Irja Haapala critically assess the spread of awareness ofmistreatment. They observe an upward trajectory of prevalence figures, publicexpectation that the numbers of mistreated elders is greater than scientific evidenceand definitional inflation, and speculate on how this interacts with a lack oftheoretical development. To be able to make sense of mistreatment, and identifywhat is special to the abuse and neglect of older adults, they argue that boundariesmust be set. Limiting mistreatment to interpersonal relations, recognizing adult-adultnegotiations and that age is central to understanding different forms, help to specifyelder mistreatment, which allows a complex socio-emotional context to becomevisible. An ability, both theoretical and practical, to process the emotional dimensionof mistreatment is seen as key to finding sustainable solutions.

Tova Band-Winterstein and Zvi Eisikovits adopt a phenomenological approach.They begin by using a domestic violence paradigm to assess similarities anddifferences between older and younger women’s experience. Central to their paper isan examination of three aspects of intentionality. The body is seen as a centralmedium through which the relationship between violence and ageing takes place.This can lead to confusion between the effects of both and a sense of lostopportunity. This theme is continued through an examination of subjective andobjective elements in the passing of time. Finally, the experience of domestic spaceis looked at as a means of coping with a violent relationship through the creation ofan inner space. The cumulative effect of each medium is seen to create aphenomenology of physical abuse specific to later life.

Thomas Goergen and Marie Beaulieu’s paper draws on developments incriminological theory and critically assesses their relevance to understanding thegrowing problem of financial abuse. Two conceptual approaches, routine activitytheory and situational action theory are examined in order to explore therelationship between an intention to harm and contexts that give an opportunityfor abuse to take place. It is argued that a criminological paradigm helps to explainthe strategies used by perpetrators and distinguish between why some adults abuseand others do not. The explanatory power of the two theories are tested against two

168 Ageing Int (2010) 35:167–170

scenarios- that of deception by strangers and abuse in family care-giving. It isconcluded that elder mistreatment is in many ways a ‘deviant type of deviance’ inthat it reverses expected criminal profiles. Thus while criminology can enhance ourunderstanding of elder mistreatment, elder studies can throw a new light on deviantbehavior.

Ariela Lowenstein reflects on abuse from the perspective of family caregiving.She compares the theoretical approaches based on intergenerational family solidarityand conflict, ambivalence in family relationships and the role of stress. In theabsence of a consistent conceptual paradigm she attempts an umbrella perspectivethat looks at models of coping in stressful situations.

Francoise Busby draws on the experience of the ALMA helpline, which began asa telephone based service and has now expanded, both geographically and in termsof more sophisticated responses to reports of mistreatment. These new developmentsinclude a multidisciplinary assessment and counseling service, plus training andconsultation initiatives.

Finally Bridget Penhale ties together theoretical approaches to elder mistreatmentand questions of responding to and intervening in cases of abuse and neglect of olderadults. She draws our attention to the diversity within the European region—diversity that begins with an understanding of what constitutes abuse, continues withexplanatory concepts and frameworks and is very pronounced regarding approachesto intervention. Her suggestions for future research in this field emphasize the needto include the voices of older people, to conduct intervention studies and to carefullyevaluate new approaches, such as specialist teams.

It is perhaps interesting to reflect that each of these papers, either through a focuson specific forms of abuse, or by adopting a particular conceptual position,specialize and limit boundaries in order to concentrate theoretical development.Taken together they suggest that mistreatment includes a series of complexphenomena which generate their own particular dynamics. Hopefully each throwsfresh light on elder mistreatment and will help the reader think about it in novel andcontrasting ways.

References

Biggs, S., & Powell, J. (1999). Surveillance & elder abuse: the rationalities and technologies ofcommunity care. Journal of Contemporary Health, 9, 10–18.

Biggs, S., Lowenstein, A., & Hendricks, J. (2004). The need for theory: Critical approaches to socialgerontology. Amityville: Baywood.

Bonnie, R. J., & Wallace, R. B. (2003). Elder mistreatment: Abuse, neglect and exploitation in an agingAmerica. Washington: National Research Council.

Harbison, J. (2008). Conceptual frameworks: Understandings of ‘Elder Abuse and Neglect’ and theirimplications for policy and legislation. Ottawa: HRSDC.

Hoerl, J. (2007). Social construction of violence in old age. Journal of Adult Protection, 9(1), 33–38.Payne, B. K. (2005). Crime and elder abuse: An integrated perspective. Springfield: Charles C Thomas.Pillemer, K. A., & Wolf, R. S. (Eds.). (1986). Elder abuse: Conflict in the family (pp. 167–196). Dover

Mass: Auburn House.Schiamberg, L. B., & Gans, D. (2000). Elder abuse by adult children; an applied ecological framework for

understanding contextual risk factors and the intergenerational character of quality of life.International Journal of Aging & Human Development, 50(4), 329–359.

Shemmings, D. (2000). Adult attachment theory and its contribution to an understanding of conflict andabuse in later life relationships. Journal of Adult Protection, 2(3), 40–49.

Ageing Int (2010) 35:167–170 169169

Simon Biggs is Professor of Gerontology and Social Policy at Melbourne University. His researchinterests include ageing and identity, intergenerational relations and elder abuse. He has written widely ongerontological theory and on practice issues.

Thomas Goergen, Ph.D., psychologist, is a professor at German Police University (Muenster) and head ofthe university’s Department of Criminology and Crime Prevention. His main research interests are in thefields of elder abuse and victimization in older age, domestic violence, juvenile crime, homicide, andcrime and violence prevention. He is currently coordinating a federal action programme on “Secure life inold age” and acts as Germany’s national representative in the International Network for the Prevention ofElder Abuse (INPEA).

170 Ageing Int (2010) 35:167–170