Forensic Biomarkers of Elder Abuse: What Clinicians Need to Know

Catherine Pearsall


J Foren Nurs. 2005;1(4):182-186. 

In This Article


Elder abuse is one of the most under-diagnosed and under-reported problems in the United States. Official prevalence and incidence national statistics do not exist as state statistics vary widely and there is no uniform reporting system (National Center on Elder Abuse, 2005). It is estimated that approximately 2 million Americans aged 65 and older have been the victims of abuse or mistreatment by someone on whom they depend for their care or protection (Bonnie & Wallace, 2003). The problem of elder abuse will most likely increase in magnitude over the coming decades, as the elderly population increases.

Unfortunately, the characteristics, causes, consequences, and effective means of management and prevention continue to elude clinicians (Bonnie & Wallace, 2003). A contributing factor may be the lack of a standard for elder abuse screening and diagnosis.

The true extent of elder abuse is limited and as many as 84% of cases are not reported (National Center on Elder Abuse, 2004). Victims are often reluctant to reveal abuse due to shame, self-blame, denial, fear of reprisal, or desire for privacy (Hirsch, Strattan, & Loewy, 1999). For clinicians to be instrumental in prevention and early intervention of elder abuse, it is vital for them to be knowledgeable about its prevalence and potential markers.

Elder abuse results in unnecessary suffering, pain, injury, violation of human rights and an overall decreased quality of life. Elders who have been abused, neglected, or neglect themselves tend to die earlier than those who have not been abused (Lachs, Williams, O'Brien, Pillemer, & Charlson, 1998). In general, family violence costs society up to $5 billion annually in medical, police, and court costs (Fisher & Dyer, 2003). The impact of abuse and mistreatment are magnified in the elderly population due to decreasing physical, psychological and economic support systems (Bonnie & Wallace, 2003). Identification of elder abuse has serious implications for nursing practice.