Violence against the elderly is a social problem that was invisible for many years. Certain sociocultural factors contributed greatly to limiting attention to this age group and, therefore, made it difficult to detect.

The demographic aging of the population may have potential repercussions for the incidence of abuse of the elderly in the family and social spheres. Projections suggest that the proportion of older adults will not only continue to increase, but that the age group of older people over 75 years of age will also grow, with the consequent risk of health problems and demands for care that will also increase.

Currently, families continue to be the ones that provide care first and for the longest time to the elderly. This support allows the latter to remain in their family environment. However, this situation, while on the one hand it benefits the elderly person who can continue to live with their emotional environment, on the other hand, it can be accompanied by an increased risk of perpetrating some type of abuse and/or mistreatment.

Psychological violence in the elderly: some conclusions

One of the myths about violence that frequently appears is linked to the statement “psychological violence is not as serious as physical violence”, however, far from reality, this type of violence generates serious consequences for the physical and emotional health of people. The affectation of self-esteem, depressive or psychosomatic symptoms, stress or anxiety symptoms are only some of the consequences on the health of the elderly. These myths tend to perpetuate the problem and the false belief that only violence that causes visible damage to the body can be reported. As described in this article, current legislation has sufficient grounds for psychological violence to be reported.

A comprehensive approach to the problem of violence against older people requires the need for an interdisciplinary approach, whose interventions are directed towards the multiple determinants of violence. Strengthening intergenerational relationships, actions aimed at promoting a positive image of ageing, as well as the effective coordination of the Organisations involved in addressing the problem to optimise the institutional response, are part of the comprehensive approach and the visibility of the violence perpetrated against older people.

Abandonment: It not only refers to the assumptions contemplated by criminal legislation, but also covers specific situations arising from negligence, consisting of the intentional or unintentional neglect of basic and essential obligations for the life of the person being cared for. This type of abuse not only refers to the special crime of abandonment, but also covers those assumptions specific to the specialty such as when the professionals in charge of care fail to comply with obligations inherent to the care of the person, such as, for example, not providing the prescribed medication or providing it in an inadequate manner.

Harassment: This consists of harassment of an elderly person through mild but continuous actions or attacks, causing them anxiety and distress with the intention of bothering or pressuring them. This type of abuse is also a crime in the field of criminal law, but in this case it is limited to conceptualizing it from a specialized perspective by referring to the continuity of the attack, even if it is mild, and constant suffocation, such as instilling fear, interrupting rest hours, denying them food without medical justification, ordering them to do things using force, etc.

Assumptions of psychological abuse

The reality of abuse of the elderly is very complex; it can manifest itself in different scenarios (social, institutional and intrafamilial), present itself in different ways (physical, psychological, sexual, economic) and with multiple risk factors (characteristics of the aggressor, the victim, the bond between the two, the social and community support networks). In some way, when there is some type of violence, the three areas of development are interrelated. Violence is not exercised in a single place, but institutions and society are also areas of violence; of which the elderly are victims in everyday life. One of the forms that violence takes is psychological abuse, which is one of the most prevalent types in this age group.

However, speaking of psychological abuse implies referring to multiple behaviors, verbal or not, whose intention is to inflict emotional distress, seriously damaging the self-esteem of the elderly person, disturbing their self-determination and violating their rights. Abuse occurs within the framework of an abusive relationship that is defined by an imbalance of power. The intention is to dominate the victim in order to control the relationship, an attempt to subdue the elderly person and includes actions such as:

• Threats of causing physical harm and institutionalisation: often older people do not make the decision to report the abuse for fear that it will become more serious and because of the threats they receive of being placed in a nursing home against their will.
• Insults, shouting, humiliation and disqualification: the use of abusive language, mockery of their person, discredit and the permanent disqualification of their actions damage their self-esteem, often making them feel responsible for the abuse inflicted.
• Threats of abandonment: in situations where the older person depends on the care of the perpetrator because they suffer from a health problem, which increases the fear of asking for help and/or reporting it. In many situations, the older person, in a situation of isolation and lacking social support networks, normalises the abuse suffered, prioritising the link with the perpetrator, who generally belongs to their family environment, thus perpetuating the violence.
• Situations of ridicule: through ironic or hurtful comments about the person, their physical appearance or a health problem, whether or not other people are present.
• Manipulation, blackmail: extorting the elderly person or manipulating their emotions by generating fear or guilt in order to obtain power and dominance.
• Indifference towards the elderly person: acting as if the elderly person were not there, not paying attention to them, not speaking to them or interacting with them.
• Infantilisation in treatment: through treating people as if they were children. This usually occurs in nursing homes.
• Depersonalisation: in institutions, services or care are usually provided without considering personal aspects and needs, which responds to stereotypical conceptions in relation to old age and the myth “older people are all the same”.
• Forced isolation and impediment or limitation of links with family members or people in the social environment: limiting the links of the elderly person to prevent them from asking for help, preventing contact with grandchildren.
• Situations of confinement: forcing the elderly person to remain locked in their room, taking away their keys to their property, hindering the elderly person's communication with their social environment and their ability to ask for help. This action in turn exposes them to risks to their psychophysical integrity in circumstances in which they could present a health problem and would be prevented from requesting medical assistance.
• Demands that exceed the elderly person's real possibilities: forcing them to perform household tasks, paperwork, pressuring them to walk around, clean themselves, get dressed or carry out other activities more quickly, not respecting their time or the physical limitations they may have. Includes the obligation to be the grandchildren's caregivers.
• Control of their actions and constant surveillance: through actions that permanently limit their freedom and increase the fear of reprisals if they are able to make a complaint.
• Lack of respect for their privacy: at the time of hygiene or dressing. Not respecting beliefs, feelings and ways of thinking.
• Blaming: occurs in situations where the person who performs the care function blames the elderly person for the impact on their personal, social and work life due to the task they perform.
• Intimidation: instilling fear through attitudes, looks, gestures or words.
• Defamation of the elderly person: divulging something private about the elderly person, making false accusations, trying to convince others that they are “crazy” in order to undermine the credibility of their statements or complaints.
• Preventing them from making decisions: in relation to their daily development, the use of their economic resources, their health, the choice of activities and the relationship with people.
• Preventing them from using spaces in the home: preventing them from using the kitchen and bathroom, exposing them to degrading situations.
• Obstructing home health care: through refusal to receive medical and/or nursing staff in the home, violating their right to health.
• Obstruction of recreational activities: prohibiting attendance at retirement centres, courses and/or cultural activities, restricting their decisions and the possibility of creating bonds.
• Situations of rejection: limiting all possibilities and initiatives of the elderly person for contact and communication, depriving them of affection and all emotional expression. It refers to the persistence of an omission, the lack of affection, lack of communication and hostility.
• Harassment: subjecting the elderly person to harassment through mild but continuous actions or attacks, causing them anxiety and distress with the intention of bothering them or pressuring them.