A comparison of the nature and characteristics of elder abuse and community violence: a medico-legal analysis

Introduction
In Sri Lanka, violence against the elderly (VAE) has emerged as a subject of public discussion in recent years. This study compares the nature and characteristics of elder abuse, reported to selected medico-legal units, with community violence involving elderly victims.

Methods
Patients 65 years and older were considered as elderly. A descriptive cross-sectional study was conducted during the period 01 January 2009 to 31 December 2013 in a few identified tertiary care hospitals. A total of 17,330 medico-legal examination forms (MLEF) of five Forensic Medical Officers were perused to identify victims of VAE. Violence committed by someone trusted by victims was classified as elder abuse (EA), while violence in general situations was classified as community violence (CV). The study aimed at comparing the nature and characteristics of EA with CV.

Results
Of 17,330 MLEFs, 127(0.7%) cases were VAE. Among victims of VAE, 91(71.7%) were men and 68(53.5%) were 65-69 years. A total of 125(98.4%) reported physical violence, 51(40.2%) occurred in the afternoons, 83(65.4%) occurred at home and 116(91.3%) were committed by persons known to the elder. Common alleged reasons for violence were financial 18(14.2%) and property issues 14(11.0%).

Of 127 victims, 51(40.2%) experienced EA and 76(59.8%) CV. When comparing EA and CV, 12(23.5%) EA and 59(77.6%) CV occurred outside the home. (χ² =8.512, df=1, p=0.004). Following CV, 62(81.6%) victims complained to the police or hospital staff by themselves while the corresponding figure in EA was only 20(39.2%). (χ² =27.677, df=1, p<0.001).

Conclusions
CV against elders, occurring outside the home, is more likely to be reported by victims. Many similarities exist between EA and CV indicating that both groups are based in a society breeding violence. Abuse of elders in Sri Lanka is an area that needs further investigation to develop evidence based interventions.

DOI: http://dx.doi.org/10.4038/jpgim.7331

Journal of the Postgraduate Institute of Medicine 2014; 1: E1:1-6