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Risk and Protective Factors for Elder Abuse

A combination of individual, relational, community and societal factors contribute to the risk of becoming a perpetrator of elder abuse, however these factors may or may not be direct causes of abuse. Understanding these factors can help us better identify ways to prevent abuse.

If a member has any of these risk factors, it would be prudent to investigate further. Please call WellCare at 1-888-453-2534, and ask for the Care Management Department to coordinate efforts with a Care Manager. See also the WellCare Policy and Procedure for Abuse and Neglect in the Aged (NJ23 CM-MD-13.1 and NJ23 CM-MD-13.1-PR-001).

Risk Factors for Perpetration

Individual Level

  • Current diagnosis of mental illness
  • Current abuse of alcohol
  • High levels of hostility 
  • Poor or inadequate preparation or training for caregiving responsibilities
  • Assumption of caregiving responsibilities at an early age
  • Inadequate coping skills
  • Exposure to abuse as a child

Relationship Level 

  • High financial and emotional dependence on a vulnerable elder
  • Past experience of disruptive behavior
  • Lack of social support
  • Lack of formal support

Community Level

  • Formal services, such as respite care for those providing care to elders, are limited, inaccessible, or unavailable

Societal Level

A culture where:

  • There is a high tolerance and acceptance of aggressive behavior;
  • Health care personnel, guardians and other agents are given greater freedom in routine care provision and decision making;
  • Family members are expected to care for elders without seeking help from others;
  • Persons are encouraged to endure suffering or remain silent regarding their pains; and/or
  • There are negative beliefs about aging and elders

In addition to the above factors, there are also specific characteristics of institutional settings that may increase the risk for perpetration of vulnerable elders, including: unsympathetic or negative attitudes toward residents, chronic staffing problems, lack of administrative oversight, staff burnout and stressful working conditions.

Protective Factors for Elder Abuse

Protective factors reduce risk for perpetrating abuse and neglect. Protective factors have not been studied as extensively or rigorously as risk factors. However, identifying and understanding protective factors are equally as important as researching risk factors.

Several potential protective factors are identified below. Research is needed to determine whether these factors do, indeed, buffer elders from abuse.

Protective Factors for Perpetration

Relationship Level

  • Having numerous, strong relationships with people of varying social status

Community Level

  • Coordination of resources and services among community agencies and organizations that serve the elderly population and their caregivers
  • Higher levels of community cohesion and a strong sense of community or community identity
  • Higher levels of community functionality and greater collective efficacy

Factors within institutional settings that may be protective include: effective monitoring systems in place; solid institutional policies and procedures regarding patient care; regular training on elder abuse and neglect for employees; education about and clear guidance on how durable power of attorney is to be used; and regular visits by family members, volunteers and social workers.

Reference: CDC