It is important that health care and service providers acknowledge psychological/emotional, control, threat, physical, and sexual abuse against older women and understand their health implications. In addition, it is important for providers to be trained in both aging and domestic violence services and resources.

Older women victims have difficulty initiating discussions about IPV with their providers. Providers are encouraged to identify signals of potential abuse and to create privacy with all patients to discuss difficult issues, such as IPV, and to be knowledgeable about appropriate referrals.

Thirty-eight women who were in abusive relationships since age 55 years were interviewed to understand their abuse stories, ways of coping, and health care experiences. In responding to these questions, women described the nature of the abuse perpetrated by their elderly partners and tried to "make sense" of what they had experienced and to define "who" these men were. This took various forms, from personal theories about aging, to labels (ethnic stereotyping, demonizing, pathologizing) to characterizations of the abuser's private versus public behaviors. The authors explore the implications these findings have for assisting the elderly victim and perpetrator.

Physical and sexual abuse by an intimate partner does occur in women over 55 years, but rates are lower than those of younger women. Health care providers are reminded to think about IPV in older women and to ask about abuse as disclosure is rare.

Little is known about how older women cope in long-term abusive intimate relationships. Understanding their coping strategies may give insight into how to further support their effective coping efforts. Interviews were conducted with 38 women older than age 55 years. Grounded theory analysis demonstrated that women who remained in their abusive relationships employed mainly cognitive (emotion-focused) strategies to find meaning in a situation that was perceived as unchangeable. By reappraising themselves, their spouses, and their relationships they refocused energies in certain roles, set limits with their abusers, and reached out to others (friends, family, and community organizations). Some women appeared to thrive, others merely survived, but all maintained the appearance of conjugal unity.

A clinical sample of 995 community dwelling women aged 55 and older were surveyed by telephone about their experience with psychological/ emotional, control, threat, physical, and sexual abuse. Nearly half of the women experienced at least one type of abuse since turning 55. Sizable proportions were victims of repeated abuse, and many experienced co-occurring abuse. Women who experienced any type of abuse were more likely to self-report negative health effects than those who were not abused. Health care and social service providers should routinely screen older women for psychological/emotional abuse at it often co-occurs with more severe forms of abuse.

Background: Intimate partner violence (IPV) is common in primary care; 11% to 22% of women experienced physical abuse in the past year. Older women experience IPV as well, but it is often undetected. This study examined primary care providers' awareness about IPV in older women, including their screening practices and management.Methods: Interviews and focus groups were conducted with 44 primary care providers. Thematic analysis was used to identify common themes.Results: Providers fell along a continuum of thoroughness for identifying and managing IPV in older women, ranging from suboptimal to thorough identification of IPV and suboptimal to thorough management of the patient. In addition to the barriers commonly reported about IPV screening in younger women, providers described limited understanding of the diagnoses commonly associated with IPV, frustration with older women's unwillingness to disclose problems and ask for help, and limited community services that accommodate older women with IPV. Providers recommended that communities sponsor public awareness campaigns about IPV as a problem for all women and that aging and IPV agencies work together.Conclusions

To understand women’s reasons for continuing long-term abusive relationships, inter-views were conducted with 36 women who were over the age of 55. These women matured during times of sweeping social changes with the feminist, battered women’s, and elder abuse movements. Reasons for remaining were organized into three categories: cohort, period, and aging effects. Cohort effects included reasons similar to those of younger women such as lacking education or job skills. Period effects related to efforts to seek help early in the abusive relationship and receiving little assistance from society’s social institutions. Finally, aging effects dealt with how the health challenges of physical age limited options.