Background

1. Professor Catherine So-kum Tang and Miss Elsie Yan of the Department of Psychology had conducted studies on "Elder Abuse in Hong Kong" between 2000 and 2002. The purpose of the studies was: (1) to determine the prevalence rate of elder abuse in Hong Kong and to explore the demographic characteristics and psychological impact of abuse on elderly victims, and (2) to investigate the public's proclivity to elder abuse in Hong Kong. Survey results enhance the understanding of elder abuse to facilitate the design of public education, services, and policies to prevent and reduce elder abuse.

Method

2. Study 1 is on the prevalence of elder abuse in Hong Kong. A total of 355 elderly people (120 men and 235 women) were individually interviewed. Elderly participants' ages ranged from 60 to 92 years old, with the average age being 74 years old. The interview included items on participants' experiences of abuse in the past year and current mental health status.

3. Study 2 is on the proclivity to elder abuse. A total of 464 (225 men and 235 women) individuals were interviewed. Participants' ages ranged from 18 to 70 years old, with the average age being 28 years old. The interview included items on participants' proclivity to elder abuse, childhood experience of abuse, views about traditionality and filial piety, as well as attitudes toward elderly people.

Prevalence of Elder Abuse

4. In the majority of research on elder abuse, a typical breakdown of abuse subtypes includes psychological, physical, and social abuse/neglect. Psychological elder abuse refers to the abused elderly person being frightened, humiliated, or intimated; Physical elder abuse involves an elderly person being hit, having things thrown at him / her, or being burned; Social elder abuse/neglect involves the involuntary isolation or neglect of an elderly person.

5. Table 1 summarizes the prevalence rate of elder abuse as reported by elderly participants in Study 1. About 20% of the elderly participants reported experiencing various types of abuse in the past year. Verbal abuse was the most prevalent form of elder abuse (20.8%), followed by social abuse/neglect (3.9%), and physical abuse (2.0%). In general, more women then men reported abuse experiences.

6. According to reports by the abused elderly participants, a great majority of them were abused by their adult children (75%), followed by their spouses (21%), and grandchildren (4%).

Characteristics of Abused Elderly

7. Table 2 compares the background characteristics of abused and non-abused elderly participants. In general, abused elderly participants were more likely to be older women living with their families. They generally had poor vision and memory, were more likely to have chronic illnesses, and viewed themselves as being dependent on their family members.

8. Table 3 compares the mental health status of abused and non-abused elderly participants. Results indicated that abused participants were more likely to report bodily discomfort, anxiety, depressed mood, and poor social relationship than non-abused participants.

Proclivity to Elder Abuse

9. In assessing proclivity, people indicate their likelihood to commit a socially undesirable behavior given that they can get away with it. For Study 2, participants were asked whether or not they would display abusive behaviors to an elderly person given there was no social constraints and no punishment whatsoever would follow. The depicted abusive behaviors included psychological abuse, physical abuse, and social abuse/neglect.

10. Table 4 shows the rate of proclivity to elder abuse. Among those who were interviewed, about 20% admitted that they would abuse an elderly person if there was no negative consequence. In particular, proclivity to verbal elder abuse was the most prevalent (20.3%), and followed by proclivity to social elder abuse (2.4%) and physical elder abuse/neglect (2.4%).

Factors Related to Elder Abuse Proclivity

11. Table 5 compares the characteristics of respondents who were inclined to commit elder abuse with those who were not. Results indicated that respondents who would abuse an elderly person were in general younger, single, with high educational attainment, and were victims of child abuse.

12. Table 6 compares respondents' views toward traditional values and filial piety. There was no difference between respondents who were inclined to commit elder abuse and those who were not. In general, the public tended to hold negative views toward traditional values but positive views towards filial piety. For example, more than 60% of the participants agreed that "listening to an older person is not necessarily the best way to avoid making mistakes" and more than 70% of the participants endorsed that "children should not do evil thing to preserve their parent's honor."

13. Table 7 compares respondents' attitudes toward elderly people. In general, participants who were inclined to commit elder abuse tended to hold negative attitudes toward elderly people. They were more likely to agree that "elderly people's past experiences are boring", "most elderly people are nosy and like to meddle with others' business", and "most elderly people live in shattered and dirty places."

Suggestions

Based on findings of the present study, the following suggestions are made:

14. Further studies on elder abuse should be conducted and results from local surveys and reported cases of elder abuse should also be complied to provide a more detail understanding of the problem. Information gleaned can facilitate the design of public education, services, and policies to prevent and reduce elder abuse.

15. The existing services for elderly people and their carers should be reviewed and expanded, for example, hotlines for reporting suspected elder abuse cases, counseling services and shelter for victims of elder abuse can be established.

16. The independence of elderly people should also be fostered. Services and activities of community centers for the elders can be strengthened. Regular physical check-up and health seminars should be conducted to promote elderly people's physical well-being. Encouraging elderly people to participate in voluntary work can also enhance their self-confidence and expand their social support networks.

17. Community-wide public education programs should be launched on healthy aging, attitudes toward and relationships with elderly people, and on elder abuse (definition, reporting, prevention, and intervention).

18. Specific training should be provided to professionals, e.g., social workers and clinical psychologists, in relation to early detection, identification, crisis management, and appropriate interventions with elder abuse.

Table 1. Prevalence of Elder Abuse

Note: *Gender differences

Table 2. Characteristics of Abused and Non-abused Elderly Participants

Note: *Group differences

Table 3. Mental Health Status of Abused and Non-abused Elderly Participants

Note: *Group differences

Table 4. Proclivity to Elder Abuse

Note: *Gender differences

Table 5. Characteristics of Participants Inclined to Elder Abuse

Note: *Group differences

Table 6. Views Toward Traditionality and Filial Piety

Table 7. Attitudes Toward Elderly People

Note: *Group differences