The experience of domestic violence is a major threat to the safety and quality of life of elders, either by family, friends or caretakers. Domestic abuse of the elderly is manifested in subtle ways including the following: physical or sexual abuse, financial abuse or exploitation, neglect, and emotional or psychological abuse. More subtle and difficult to detect, such abuse may also involve withholding medications or treatments.

Domestic violence experienced by older people fall into one of three common categories:

1. Domestic Violence Grown Old – This form of domestic violence often begins in the early stages of a relationship and continues into old age. Basically the cycle is only broken when the abuser is too old or infirmed to continue the abuse.
2. Late Onset Domestic Violence – This form of domestic violence is where the relationship has grown stressful and strained through the years and the abuse doesn’t being until after the age of 65. This type of abuse is linked to retirement, becoming a caretaker of a spouse, changing roles in the relationships, sexual dysfunction and a decrease in sex.
3. Entering into an Abusive Relationship – This form of domestic violence occurs when older people enter into an abusive relationship later in life. Normally, the person entering into the abusive relationship has no idea that that the new individual in their lives has an abusive background and has had normal happy relationships in the past. This is the easiest of the three to get out of since the victim understand that healthy relationships with non-violent individuals are possible for him or her.

According to a case study performed by Arizona State University, in all of these types of domestic violence, the perpetrators are spouses or intimate partners, the majority are men, and oftentimes drugs or alcohol are abused by one or both partners.

At risk victims are usually women whose relationships with their spouses or partners were abusive or strained when they were younger. Also at risk are older women who enter into intimate relationships late in life.
Intervention by healthcare providers can make the difference between safety and increasing risk of harm to elder victims of domestic abuse.

Mandatory reporting of suspected abuse to Adult Protective Services and/or local law enforcement enhances protection for the victim. Contributing to violence against elder victims are dependency needs, failing health, isolation, and stressed caregivers.

Therefore, discharge planning for elder victims of violence should involve linking and networking with appropriate home care or residential treatment facilities and resources. If caregiver stress is a factor, services for the caretaker, including respite services, support groups, and ongoing monitoring may be required to decrease the potential for further abuse. Relocation of the victim may be necessary to protect him/her from harm.

Awareness of domestic violence in the older population and education of those who come into contact with potential victims of domestic violence is imperative to halting the cycle of abuse. Risk assessment and screening for domestic violence can save lives. Partnerships with community services contribute to holistic care and empowerment for victims of all ages.