Help-Seeking Behavior in Victims of Elder Abuse: A Systematic Review

Abstract

Elder abuse has become increasingly relevant for intervention and study in the context of an aging population. One of the major barriers to progress in the field is underreporting of elder abuse by victims. This systematic literature review aimed to synthesize the available findings regarding victims’ help-seeking behavior to inform practice, understand the limits of the evidence, and identify research gaps. A comprehensive search of published and unpublished literature was undertaken, and studies were included if they addressed help-seeking behavior from the perspective of elder abuse victims aged 60 and older. A total of 19 studies met inclusion criteria for review. Findings are presented as a narrative synthesis organized according to help-seeking barriers, facilitators, sources of help, the responses of others, and the characteristics of victims more likely to seek help. Although barriers and sources of help received detailed attention across all studies, findings regarding victim characteristics and facilitators for and responses to help-seeking were limited. The results suggest that there are many barriers to help-seeking and that some victims only seek help when the abuse is perceived as unbearable or they fear for their safety. Results are discussed in relation to implications for intervention, including suggestions to enhance help-seeking behavior. Future research should identify facilitators of help-seeking among victims of elder abuse and victim characteristics associated with early disclosure. Research efforts should frame help-seeking as a continuing process and study ways in which the responses of others may impact future help-seeking or service engagement.

Development and validation of REAGERA-P, a new questionnaire to evaluate health care provider preparedness to identify and manage elder abuse

“…However, many victims of elder abuse are reluctant to share their stories of abuse with health care providers, and health care providers have been reported to be reluctant to ask patients questions about abuse or to report cases to authorities. Hence, many victims go unnoticed by health care providers [12][13][14][15][16][17][18][19].…”

Elder Abuse Detection and Intervention: Challenges for Professionals and Strategies for Engagement From a Canadian Specialist Service

“…While it is essential to have knowledge about possible indicators of EA to enhance detection, relatively little has been written about how health care providers can facilitate disclosure if they suspect abuse, or how to engage victims in intervention efforts (Fraga Dominguez, Storey, & Glorney, 2019). However, victims' rejection of interventions is a critical challenge in this field and research has shown that supportive formal networks, including health care providers, facilitate victim disclosure and engagement (Burnes, Lachs, Burnette, & Pillemer, 2017;Jackson & Hafemeister, 2015).…”

“…Victims of EA are a diverse group. Mental and physical health, as well as factors related to the abuse or perpetrator, such as culture, social support, and formal support, may impact victims' ability or willingness to disclose the abuse (Fraga Dominguez et al, 2019), all of which impact the necessary health care response. Considering some of these factors, EA victims can be classified into one of four presentation types: victims with mental capacity who do or do not disclose abuse, and victims without mental capacity who do or do not disclose abuse.…”

“…Victims with mental capacity who do not disclose. There are several reasons why EA victims with the mental capacity to disclose choose not to do so (Fraga Dominguez et al, 2019). For example, a fear of consequences for themselves or the perpetrator, feelings of shame or embarrassment, and barriers related to a lack of effective access to or support from formal services or their informal network (Fraga Dominguez et al, 2019).…”

“…There are several reasons why EA victims with the mental capacity to disclose choose not to do so (Fraga Dominguez et al, 2019). For example, a fear of consequences for themselves or the perpetrator, feelings of shame or embarrassment, and barriers related to a lack of effective access to or support from formal services or their informal network (Fraga Dominguez et al, 2019). Other factors such as cultural norms and societal expectations may also influence help-seeking behaviors (Dong, 2012;Fraga Dominguez et al, 2019).…”