1
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
Ma ília San os Sil a1
1Facul y o Medicine o he Uni e si y o Po o, Po ugal
Au ho No e: Co espondence conce ning his a icle should be add essed o Ma ília
San os Sil a, Facul y o Medicine o Po o Uni e si y, Al. P o . He nani Mon ei o,
4200-319 Po o, Po ugal. Phone numbe : +351 912035658. E-mail:
[email p o ec ed].
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
2
Abs ac
Abuse agains elde s wi h disabili y is a p oblem wi h endency o g ow as he wo ld
popula ion is aging. Though o obliga o y epo ing, cases o abuse a e mos equen ly
igno ed by heal h p o essionals, o a a ie y o easons, one o which is he di icul y o
making he co ec diagnosis, e en hough hey a e on a p i ileged posi ion by he
p oximi y o bo h ic ims and abuse s. By making a e ision o alleged domes ic
iolence cases agains elde s wi h mode a e o se e e disabili y we aimed o p omo e a
be e knowledge abou his heme o encou age he de ec ion and p e en ion o u u e
cases, namely by heal h p o essionals.
In ou sample, he mos equen ly epo ed ype o abuse was physical (86%),
pe pe a ed by male abuse s (63%) li ing wi h hei ic ims (90%), mos commonly
hei child en (47%) o hei pa ne s (when ic ims a e ma ied; 49%). Vic ims we e
mos equen ly emale (63%), wi h mo o disabili ies (49%), and p esen ed a his o y o
p e ious episodes o abuse in 74% o cases, hough only 28% we e epo ed.
Consequences o abuse we e mos equen ly mino inju ies (95%) wi h o wi hou
associa ed pain, wi h pe manen consequences (sca s) esul ing in only 6.8% o cases.
Lesions we e mul iple in he majo i y o cases (64%), he p e e en ial loca ions being
he head and neck (75%).
Keywo ds
Domes ic Violence; Elde ; Disabili y
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
3
In oduc ion
The mos consensual de ini ion, adop ed by he Wo ld Heal h O ganiza ion, desc ibes
elde abuse as a single o epea ed ac o lack o app op ia e ac ion, occu ing wi hin
any ela ionship in which he e is an expec a ion o us o dependence, ha causes
ha m o dis ess o olde people, hus con ibu ing o dec eased quali y o li e, inc eased
mo bidi y, educed su i al and possibly dea h[1, 2].
The use o di e en de ini ions, as well as sampling and su ey me hods, applied o
di e en popula ions makes i di icul o compa e s udies, desc ibe elde abuse and
es ima e i s p e alence[2-5], wi h alues anging om 3.2% o 27.5% in gene al
popula ion s udies om di e en coun ies[5].
Some expe s belie e ha he incidence and p e alence o elde abuse may be
inc easing, bu i is no known i his g ow h is due o be e ecogni ion and epo o o
an ac ual escala ion in he numbe o cases. Wha is ce ain is ha elde abuse cases will
become mo e equen wi h he aging o he wo ld popula ion. In Po ugal, om 2001 o
2011, he popula ion unde he age o 15 dec eased om 16% o 15% o he o al
popula ion, wi h a simul aneous inc ease in he popula ion o e he age o 65 om 16%
o 19%[6], ma king a shi in he age py amid which had al eady been p edic ed and is
expec ed o wo sen conside ing he highe longe i y and dec eased bi h a e.
Al hough mos elde s a e au onomous and independen , i is known ha olde
popula ions ha e highe p e alence o heal h diso de s and added consequences o
acciden s. Acco ding o elde abuse li e a u e, men al illness[7-11], poo physical
heal h[12-14] o poo heal h in gene al[15] cons i u e isk ac o s o abuse. Elde s wi h
physical and/o men al disabili y a e a e en highe isk as hey ha e inhe en
limi a ions in daily li ing ac i i ies[12, 16, 17] ha make hem comple ely o pa ially
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
4
dependen [5], and in many cases isola ed om socie y. Lowe physical esis ance o
iolence, lowe capaci y o escape om i and/o highe di icul y o unde s and and
epo he abuse[2, 13, 18] a e also possible explana ions o he inc eased isk o abuse in
elde s wi h disabili ies. Abuse agains hese elde s is, hus, an expec ed e en in he
aging popula ion, wi h 50% o people 65 yea s o age o olde , in Po ugal, decla ing o
ha e much di icul y in pe o ming a leas one o six ac i i ies o daily li ing (seeing,
hea ing, walking, memo y/concen a ion, ba hing/d essing up, unde s anding/making
hemsel es unde s ood)[6].
Elde abuse is mos equen ly pe pe a ed by amily membe s[2], which may cons i u e
domes ic iolence cases. This may be pa ly explained by highe le els o iolence,
s ess, bu nou and inancial p oblems a ec ing he ca egi e s[1, 3, 4], ha may e en lead
o deadly consequences[19].
No wi hs anding he ac ha elde s wi h heal h p oblems equen ly isi hei
physicians, hese being in a p i ileged posi ion o de ec and epo cases o elde abuse,
only 2% o suspec ed cases a e epo ed by physicians[20]. In Po ugal, domes ic
iolence cons i u es a “public c ime”, so he Public P osecu o O ice may ins i u e
c iminal p oceedings e en hough he ic im does no exp ess will o p ess cha ge; in
hese cases, public employees ha e he legal obliga ion o epo e e y suspec ed case
ha hey come o acknowledge du ing hei p o essional ac i i y. Mo eo e , acco ding
o he 53 d a icle o he E hics’ Code o he Po uguese Medical Associa ion, physicians
ha e he obliga ion o epo hese si ua ions o he au ho i ies. Howe e , in addi ion o
he di icul y o dis inguishing symp oms and signs o abuse om hose age- ela ed o
o o he diso de s, physicians ail o epo due o a a ie y o easons ha migh
include, among o he s[2, 3, 21]: (a) unawa eness o he obliga ion o epo ; (b)
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
5
unawa eness o a ailable ic im suppo associa ions, hus conside ing ha he ic im
may be mo e endange ed i he abuse is epo ed; (c) ime limi a ions ha make hem
choose sol ing o he o he pa ien ’s p oblems; (d) p e e ence o keep he pa ien -
physician ela ionship, when he pa ien does no wan o epo he abuse; and (e) ea
o implica ion in a legal p ocess. Among cases in ol ing a mode a e o se e e
disabili y, hese pa ien s being aile and a inc eased isk, he e may be g ea e
di icul y in making he co ec diagnosis and, consequen ly, he epo . Due o hei
cha ac e is ics, hese cases dese e special a en ion o he de ec ion o abuse.
The aim o his s udy is o p omo e a be e knowledge abou domes ic iolence
pe pe a ed agains elde ly people p esen ing physical and/o men al disabili ies ha
make hem dependen and/o wi hou au onomy, in o de o p omo e he de ec ion and
p e en ion o hese cases, namely by heal h p o essionals.
Me hods
A e ospec i e analysis o clinical o ensic medical epo s was pe o med. Cases’
inclusion c i e ia we e: (a) alleged ic im 65 yea s o age o olde p esen ing, p io o
he suspec ed episode o abuse, a mode a e o se e e physical and/o men al disabili y,
co esponding o a a e disabili y supe io o 60% (de e mined acco ding o he
Po uguese Na ional Table o Disabili ies – annex 1 o he Dec ee-Law 352/2007, o
23 d o Oc obe ) o o a disabili y ha condi ioned dependency o loss o au onomy o
daily li ing ac i i ies; (b) allegedly abused by a amily membe (wi h o wi hou
cohabi a ion); (c) ha ing been submi ed o a o ensic medical e alua ion in he scope o
c iminal law; (d) a he no h b anch o he Na ional Ins i u e o Legal Medicine and
Fo ensic Sciences o Po ugal, in Po o; (e) be ween 2005 and 2013.

DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
6
Da a ex ac ed om epo s included cha ac e iza ion o : (a) he alleged ic im’s and
abuse ’s socio-demog aphics; (b) he ela ionship be ween alleged ic im and abuse ;
(c) he ype o disabili y p esen ed by he ic im; (d) p e ious episodes o iolence
pe pe a ed by he same alleged abuse ; and (e) he episode o abuse ha mo i a ed he
epo and consequen o ensic medical examina ion, namely i s ype, he esul an
lesions, he need o medical ea men and he exis ence o pe manen physical
consequences.
I was conside ed ha o all ypes o abuse, psychological abuse exis s simul aneously,
so his ype o abuse is only e e ed when i occu ed in isola ion.
Vic ims we e di ided in 2 g oups depending on hei disabili y deg ee: (a) mode a e
(when hey had au onomy wi h some dependencies, excluding hi d pe son
dependence); (b) se e e (when hey we e dependen on a hi d pe son). Vic ims’
disabili ies we e ca ego ized in 5 g oups, co esponding o: (a) men al; (b) mo o ; (c)
senso ial; (d) o he disabili ies; and (e) mul iple disabili ies (when mo e han one ype o
disabili y was p esen ).
Findings we e eco ded in a da abase and s udied using SPSS (S a is ical Package o
Social Science - SPPS INC, Chicago, Illinois, USA) e sion 21.0, o Windows.
Desc ip i e s a is ics was pe o med using equency analysis o ca ego ical a iables
and desc ip i e analysis o con inuous a iables. Con ingency ables we e c ea ed o
s udy he ela ionship be ween ca ego ical a iables and Chi-Squa e o Fishe ’s es
we e used o e i y he independence and non-exis en ela ionship be ween a iable
ca ego ies. Va iables we e conside ed o be ela ed when p<0.05.
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
7
Resul s
A o al o 1278 o ensic medical epo s ela ed o alleged in a amilial elde abuse we e
analyzed, o which 70 (5.5%) we e selec ed acco ding o he abo e c i e ia.
Vic im’s and abuse s socio-demog aphic cha ac e iza ion
Vic ims’ and abuse s’ socio-demog aphic cha ac e iza ion is p esen ed in able 1.
Vic ims we e mos ly emale (n= 26, 62.9%), ma ied (52.9%) and e i ed (94.3%), he
majo i y p esen ing mode a e disabili y (55.7%). Mean age was 76.94 yea s old
(SD=7.689; median=76; Min.=65; Max.=95), and male and emale ic ims had
app oxima ely he same mean age (mean=75, SD=8 s. mean=78, SD=8). The
p opo ion o se e e disabili y was highe among emale ic ims (56.8% s. 23.1%;
p=0.006), and ic ims olde han 74 yea s o age (57.5% s. 26.7%; p=0.010).
Abuse s we e male in 62.9% (n=44). The e was no signi ican ela ion be ween abuse ’s
and ic im’s sex (p=0.087). Thei mean age was 52.53 yea s old (SD=16.626;
median=50; Min.=20; Max.=88). In he 28 cases wi h a ailable in o ma ion, none o he
abuse s had a p o essional ac i i y. In o ma ion abou subs ance abuse was included in
24 epo s, o which 75% e e ed o i s p esence, alcohol being he mos equen
(n=13). In o ma ion abou psychia ic diso de s was included in 11 epo s, wi h 72.7%
ic ims e e ing hei abuse s as ha ing some so o his ype o pa hology.
Table 2 p esen s he ela ionship be ween alleged ic ims and abuse s in he o al
sample and in ma ied ic ims (n=37). Though when conside ing he o ali y o cases
he majo i y had been allegedly pe pe a ed by ic im’s child en (47.1% s. 32.4% o
pa ne s), wi hin ma ied ic ims, pa ne s co esponded o 48.6% o cases ( s. 28.6%
o child en). In 46 cases o which he e was in o ma ion, 89.7% (n=52) o abuse s
we e li ing wi h he ic ims.
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
8
Vic ims’ disabili y cha ac e iza ion
P opo ion and desc ip ion o he di e en ypes o disabili ies is p esen ed in Table 3.
Mo o disabili y was he mos equen disabili y p esen ed by he ic ims,
co esponding o 48.6% o cases, ollowed by mul iple disabili ies (30%), senso ial
disabili y (8.6%), men al disabili y (7.1%) and o he ypes (5.7%). O e all, he
p opo ion o ic ims wi h mo o disabili ies was 77.1% (n=54), wi h men al disabili ies
was 24.3% (n=17), wi h senso ial disabili ies was 22.9% (n=16) and wi h o he ypes
was 11.4% (n=8).
Desc ip ion o p e ious episodes o abuse by he same alleged abuse
In o ma ion abou p e ious episodes o abuse by he same alleged abuse was p esen in
74.3% (n=52) o o ensic medical epo s. I was no desc ibed whe he he e was a
backg ound o abuse in 15 (21.4%) cases. Table 4 p esen s desc ip i e s a is ics o he
p e ious episodes o abuse. The pe iodici y o abuse was speci ied in 29 o ensic
medical epo s, wi h 93.1% o ic ims e e ing o ha e been equen ly abused, 25
speci ied i s du a ion, wi h 40% men ioning i was supe io o 10 yea s, and 42 s a ed
he occu ence o p e ious epo s wi h 69% (n=29) denying i s occu ence. O hose
which had his o y o p e ious epo s (n=13), in 8 he epo had been made by he
ic im. The e was no signi ican ela ion be ween he ic ims’ backg ound o iolence
and he ic ims’ sex (p=1.000) o he disabili y deg ee (p=0.611).
In 51 cases o which i was possible o de e mine he ca ego y o abuse and conside ing
he associa ion be ween mul iple ypes o abuse, he mos equen ype was physical
abuse (n=41), ollowed by inancial (n=11), psychological (when isola ed; n=8) and
sexual (n=1). Among hese cases, neglec was obse ed simul aneously wi h 9 cases o
physical abuse, 4 o physical plus inancial abuse and 1 o inancial abuse,
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
9
co esponding mos ly o nu i ional and hygiene neglec , ollowed by medica ion, heal h
ca e, es , a ec ion and housing/sa e y neglec .
Desc ip ion o he episode o abuse ha mo i a ed he epo
The ypes o abuse ha mo i a ed he epo we e physical abuse in 85.7% (n=60) o
cases, physical and inancial abuse in 8.6% (n=6), and psychological abuse in 5.7%
(n=4). Simila ly, in hese cases, neglec was iden i ied in 6 cases o physical abuse and
4 cases o physical plus inancial abuse, in ol ing nu i ional, hygiene, es , heal h ca e,
medica ion and a ec ion neglec .
Physical abuse co esponded o an agg ession only by means o body s eng h
(excluding a emp ed asphyxia ion) in 72.9% (n=43) o cases, o agg ession h ough use
o blun objec s in 8.5% (n=5), o agg ession wi h esou ce o body s eng h (excluding
a emp ed asphyxia ion) and o a blun objec in 13.6% (n=8), o a emp o s angle in
3.4% (n=2) and o p i a ion o basic needs in 1.7% (n=1) o cases. Among cases o
agg ession only by means o body s eng h he mos equen ly in ol ed ypes (no
always occu ing in isola ion) we e: pushing (n=27, 51.9%), pounding (n=25, 48.1%),
g asping (n=8, 15.4%), slapping (n=8, 15.4%), kicking (n=8, 15.4%), sc a ching (n=6,
11.5%), hai pushing (n=1, 1.9%) and bi ing (n=1, 1.9%). The e was no signi ican
ela ion be ween he occu ence o physical abuse and he ic ims’ (p=0.800) o
abuse s’ (0.800) sex, o he ic ims’ disabili y deg ee (p=1.000).
Physical abuse esul ed in pain in 5.6% (n=3) o cases, mino inju ies in 24.1% (n=13)
and mino inju ies wi h pain in 70.4% (n=38). In only 6.8% (n=4) an o ganic pe manen
consequence was ound (sca ). Consequences o physical abuse we e no desc ibed in
12 o ensic medical epo s, ei he because hey had e ol ed o cu e a he ime o he
o ensic e alua ion o because no physical consequences esul ed. Inju y dis ibu ion is
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
16
psychological abuse as a signi ican o se ious o m o abuse by many people,
especially when compa ed o physical abuse. I is also possible ha psychological abuse
is no as p edominan o e physical abuse as sel - epo ed by ca egi e s, since people
may end o hide beha io s conside ed mos ep ehensible, hus disclosing
psychological abuse mo e easily han physical abuse.
Li e a u e men ions inancial abuse as mo e p e alen han physical abuse among
elde s[1]. Howe e , i was p esen in only 8.6% o ou cases. I is possible ha hese
cases a e no e e ed as he ic im may eel ha he o ensic expe is no he
app op ia e pe son o whom hey should denounce his ype o abuse as i is no di ec ly
associa ed wi h hei heal h. Ano he explana ion may be ha he police migh no di ec
inancial abuse o a o ensic medical examina ion.
Sexual abuse was epo ed in only one o he cases o ou sample, and as an e en
occu ing in he dis an pas . This ype o abuse may be hidden as sex is s ill seen as a
aboo opic in he eldes g oups o ou socie y. Howe e , he epo ed p e alence o his
ype o abuse is also low among Eu opean coun ies (0.7%)[1], hus being di icul o
ep esen in a sample such small as ou s’[28].
Among cases in which a p elimina y epo was w i en, less han hal we e concluded.
Tha may e lec wi hd awal om complain (when he public p osecu o does no see
he case as a domes ic iolence one), denial o cha ges (when he ic im is blackmailed
by he abuse o do so, o when he epo is p esen ed agains he ic im’s will) o dea h
o he ic im.

DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
17
Conclusions
F om his s udy, we can conclude:
a) The p opo ion o 5.5% o ic ims wi h disabili y obse ed among all cases o
elde s allegedly abused by amily membe s p esen ed o o ensic medical
e alua ion a he no h b anch o he Na ional Ins i u e o Legal Medicine and
Fo ensic Sciences o Po ugal, in Po o, seems clea ly unde es ima ed;
b) The ic ims a e p edominan ly emale (63%);
c) Mo o disabili y (49%) appea s o be much mo e equen han men al disabili y
(7%) in ou sample o abused elde s; howe e , he e may be mo e signi ican
unde epo ing in he las g oup;
d) Elde s wi h se e e disabili y ha e epo s p esen ed by a hi d pe son mo e
equen ly han elde s wi h mode a e disabili y; he same happens when
compa ing elde s wi h and wi hou men al disabili y;
e) The abuse s a e p edominan ly male (63%) and li ing wi h he ic ims (90%);
) Al hough mos abuse s a e ic ims’ child en (47%), ma ied ic ims a e mos
equen ly abused by hei pa ne s (49%);
g) Mos ic ims ha e p e ious his o y o abuse by he same abuse (74%), in
mul iple cases o many yea s and wi h equen episodes (93%);
h) Physical abuse is he mos equen ly epo ed ype o abuse (86%);
i) Abused elde s equen ly p esen wi h mul iple supe icial inju ies (64%),
mos ly in he head and neck (75%).
Since his was a e ospec i e s udy o o ensic medical epo s, cau ion mus be aken
in he gene aliza ion o ou esul s o he gene al popula ion o elde s wi h mode a e o
se e e disabili y.
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
18
Decla a ion o Con lic ing In e es s
The e we e no po en ial con lic s o in e es wi h espec o he esea ch, au ho ship,
and/o publica ion o his a icle.
Funding
The au ho s ecei ed no inancial suppo o he esea ch o p epa a ion o his a icle.
E hical app o al
This s udy was ca ied ou in acco dance wi h e hical ules. I has no been submi ed o
E hical App o al since i was a e ospec i e e iew in which no in asi e s udies we e
ca ied ou no iden i ica ion o he indi iduals was gi en.
Re e ences
1. Se hi, D., e al., Eu opean epo on p e en ing elde mal ea men , 2011, Wo ld
Heal h O ganiza ion: Denma k.
2. Bond, M.C. and K.H. Bu le , Elde abuse and neglec : de ini ions,
epidemiology, and app oaches o eme gency depa men sc eening. Clin Ge ia
Med, 2013. 29(1): p. 257-73.
3. Ya e, M.J. and B. Tazka ji, Unde s anding elde abuse in amily p ac ice. Can
Fam Physician, 2012. 58(12): p. 1336-40, e695-8.
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
19
4. K iene , J.L., J.A. Walsh, and M. Tu ne , Elde ly in Ame ica: a desc ip i e
s udy o elde abuse examining Na ional Inciden -Based Repo ing Sys em
(NIBRS) da a, 2000-2005. J Elde Abuse Negl, 2009. 21(4): p. 325-45.
5. Coope , C., A. Selwood, and G. Li ings on, The p e alence o elde abuse and
neglec : a sys ema ic e iew. Age Ageing, 2008. 37(2): p. 151-60.
6. Ins i u o Nacional de Es a ís ica, I.P., Censos 2011 Resul ados De ini i os -
Po ugal, 2012, Ins i u o Nacional de Es a ís ica, I.P.
7. Ane zbe ge , G.J., e al., A model in e en ion o elde abuse and demen ia.
Ge on ologis , 2000. 40(4): p. 492-7.
8. Coope , C., e al., Abuse o people wi h demen ia by amily ca e s:
ep esen a i e c oss sec ional su ey. BMJ, 2009. 338: p. b155.
9. Lee, M. and S.R. Kolome , Ca egi e bu den, demen ia, and elde abuse in
Sou h Ko ea. J Elde Abuse Negl, 2005. 17(1): p. 61-74.
10. Hughes, K., e al., P e alence and isk o iolence agains adul s wi h
disabili ies: a sys ema ic e iew and me a-analysis o obse a ional s udies.
Lance , 2012. 379(9826): p. 1621-9.
11. Comp on, S.A., P. Flanagan, and W. G egg, Elde abuse in people wi h
demen ia in No he n I eland: P e alence and p edic o s in cases e e ed o a
psychia y o old age se ice. In J Ge ia Psychia y, 1997. 12(6): p. 632-5.
12. Johannesen, M. and D. LoGiudice, Elde abuse: a sys ema ic e iew o isk
ac o s in communi y-dwelling elde s. Age Ageing, 2013. 42(3): p. 292-8.
13. Laumann, E.O., S.A. Lei sch, and L.J. Wai e, Elde mis ea men in he Uni ed
S a es: p e alence es ima es om a na ionally ep esen a i e s udy. J Ge on ol
B Psychol Sci Soc Sci, 2008. 63(4): p. S248-S254.
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
20
14. Fe ei a-Al es, J. and A.J. San os P e alence S udy o Abuse and Violence
agains Olde Women - Po ugal Repo (AVOW P ojec ). 2011.
15. Biggs, S., e al., Mis ea men o olde people in he Uni ed Kingdom: indings
om he i s Na ional P e alence S udy. J Elde Abuse Negl, 2009. 21(1): p. 1-
14.
16. Lachs, M.S., e al., Risk ac o s o epo ed elde abuse and neglec : a nine-
yea obse a ional coho s udy. Ge on ologis , 1997. 37(4): p. 469-74.
17. Pe ez-Ca celes, M.D., e al., Suspicion o elde abuse in Sou h Eas e n Spain:
he ex en and isk ac o s. A ch Ge on ol Ge ia , 2009. 49(1): p. 132-7.
18. Walsh, C.A., e al., Elde abuse and opp ession: oices o ma ginalized elde s. J
Elde Abuse Negl, 2011. 23(1): p. 17-42.
19. Dan as, S., e al., Pa icide: A o ensic app oach. J Fo ensic Leg Med, 2014. 22:
p. 1-6.
20. Mu phy, K., e al., A li e a u e e iew o indings in physical elde abuse. Can
Assoc Radiol J, 2013. 64(1): p. 10-4.
21. Ro i, S., e al., Mapping he elde mis ea men icebe g: U.S. hospi aliza ions
wi h elde abuse and neglec diagnoses. J Elde Abuse Negl, 2009. 21(4): p.
346-59.
22. Anme, T., M. McCall, and T. Ta a a, An explo a o y s udy o abuse among ail
elde s using se ices in a small illage in Japan. J Elde Abuse Negl, 2005.
17(2): p. 1-20.
23. Kishimo o, Y., e al., Abuse o people wi h cogni i e impai men by amily
ca egi e s in Japan (a c oss-sec ional s udy). Psychia y Res, 2013. 209(3): p.
699-704.
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
21
24. Wigleswo h, A., e al., Sc eening o abuse and neglec o people wi h
demen ia. J Am Ge ia Soc, 2010. 58(3): p. 493-500.
25. Walsh, C.A. and Y. Yon, De eloping an empi ical p o ile o elde abuse
esea ch in Canada. J Elde Abuse Negl, 2012. 24(2): p. 104-19.
26. Vandewee d, C., e al., Physical mis ea men in pe sons wi h Alzheime 's
disease. J Aging Res, 2013. 2013: p. 920324.
27. Cooney, C., R. Howa d, and B. Lawlo , Abuse o ulne able people wi h
demen ia by hei ca e s: can we iden i y hose mos a isk? In J Ge ia
Psychia y, 2006. 21(6): p. 564-71.
28. Nob ega Pin o, A., e al., Sexual o enses agains elde ly people: o ensic
e alua ion and judicial ou come. J Elde Abuse Negl, 2014. 26(2): p. 189-204.
29. Coope , C., e al., The de e minan s o amily ca e s' abusi e beha iou o
people wi h demen ia: esul s o he CARD s udy. J A ec Diso d, 2010. 121(1-
2): p. 136-42.
30. Yan, E. and T. Kwok, Abuse o olde Chinese wi h demen ia by amily
ca egi e s: an inqui y in o he ole o ca egi e bu den. In J Ge ia Psychia y,
2011. 26(5): p. 527-35.

DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
22
Tables
Table 1: Vic ims’ and abuse s’ socio-demog aphic da a (n=70)
Vic ims
n (%)
Abuse s
n (%)
Ma i al s a us
Ma ied
37 (52.9)
-
Widowed
25 (35.7)
-
Di o ced
5 (7.1)
-
Single
3 (4.3)
-
P o essional ac i i y
Re i ed
66 (94.3)
9 (32.1)*
Wi hou ac i i y
4 (5.7)
1 (3.6)*
Unemployed
0
18 (64.3)*
Wi hou in o ma ion
0
42 (60)
Deg ee o disabili y
Mode a e
39 (55.7)
-
Se e e
31 (44.3)
-
Subs ance abuse
Yes
-
18 (75.0)*
No
-
6 (25.0)*
Wi hou in o ma ion
-
46 (65.7)
Psychia ic diso de s
Yes
-
8 (72.7)*
No
-
3 (27.3)*
Wi hou in o ma ion
-
59 (84.3)
*Valid pe cen
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
23
Table 2: Rela ionship be ween ic im and abuse .
Rela ionship
To al (n=70)
n (%)
Ma ied ic ims (n=37)
n (%)
Pa ne
20 (28.6)
18 (48.6)
Child en
33 (47.1)
12 (32.4)
Child en-in-law
10 (14.3)
3 (8.1)
G andchild en
5 (7.1)
3 (8.1)
O he
2 (2.9)
1 (2.7)
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
24
Table 3: Vic ims’ disabili y cha ac e iza ion (n=70)
n (%)
Type o disabili y
Men al
5 (7.1)
NSD (3); Alzheime ’s disease (1); Aphasia (1)
Mo o
34 (48.6)
MSP (18); MSP and hemipa esis (3); MSP and monopa esis (1);
MSP and a axia (1); Hemipa esis (4); Monopa esis (3);
Pa kinson’s disease (3); Hemipa esis and dysa h ia (1)
Senso ial
6 (8.6)
Dec eased isual acui y (3); Dec eased hea ing acui y (1);
Amau osis (1); Bila e al dea ness (1)
O he
4 (5.7)
Renal ailu e (2); Respi a o y ailu e (2)
Mul iple
21 (30)
NSD and MSP (4); NSD wi h aphasia and a axia (1);
Alzheime ’s disease and MSP (1); Pa kinson’s disease wi h
demen ia and MSP (1); Alzheime ’s disease and dec eased
hea ing acui y (1); Hemipa esis and dec eased isual acui y (2);
MSP wi h dec eased hea ing acui y (2); MSP wi h bila e al
blindness (1); MSP wi h dec eased hea ing and isual acui y (1);
MSP, loss o sphinc e con inence and neoplas ic pa hology (1);
Pa kinson’s disease wi h MSP and pneumonia (1); MSP and
enal ailu e (1) NSD wi h MSP, hemipa esis, loss o sphinc e
con inence and dec eased hea ing acui y (1); Cogni i e
impai men wi h aphasia, MSP, loss o sphinc e con inence and
dec eased hea ing and isual acui y (1); Pa kinson’s disease wi h
demen ia, MSP and dec eased isual acui y (1); NSD, MSP and
epilepsy (1)
MSP: Musculoskele al pa hology; NSD: Non-speci ied demen ia
DOMESTIC VIOLENCE AGAINST ELDERLY WITH HANDICAP
25
Table 4: Backg ound o abuse (n=52)
n
%
Pe iodici y
F equen ly
27
93.1*
Spo adically
2
6.9*
Wi hou in o ma ion
23
44.2
Du a ion
< 1 mon h
3
12.0*
1 mon h-1 yea
8
32.0*
1-5 yea s
4
16.0*
>10 yea s
10
40.0*
Wi hou in o ma ion
27
51.9
Type o abuse
Psychological
8
15.7*
Physical
31
60.8*
Financial
2
3.9*
Physical + Financial
9
17.6*
Physical + Sexual
1
2.0*
Wi hou in o ma ion
1
1.9
Repo
Yes
13
31.0*
No
29
69.0*
Wi hou in o ma ion
10
19.2
*Valid pe cen