Elderly Sexual Abuse: An Examination of the Criminal Event

Victims of sexual abuse aged 60 and older, an observational study from the Department of Forensic Medicine of Paris, France

INTRODUCTION

The global population of individuals aged 60 years and older is projected to nearly double by 2050, highlighting the growing importance of addressing sexual abuse in older patients. These abuses remain poorly understood and underreported, which may be related to factors such as cognitive impairments, social isolation, societal taboos, and ageism. This retrospective study aimed to analyze cases of sexual abuse reported by patients aged 60 years and older at the Department of Forensic Medicine (DFM) in Paris, France, over a six-year period.

METHODS

We conducted a single-center retrospective study and collected medical and forensic data on all patients aged 60 years and older at the time of the assault, who were examined at the DFM between 01/01/2018 and 31/12/2023. The study adhered to ethical standards in accordance with the General Data Protection Regulation and received approval from the Ethics Committee of Cochin University Hospital.

RESULTS

Fifty-eight patients were included, representing 1.5 % of the sexual abuse victims examined in the department during the study period. The majority of victims were female (84.5 %). The average age of the victims was 69.4 years, and many had vulnerabilities, primarily psychological/cognitive (55.2 %) and physical (19.0 %). Assaults mostly occurred in the victim's home (48.1 %) or in public places (13.5 %), with known perpetrators identified in 62.7 % of cases. Associated physical abuse was documented in 44.8 % of cases. Forensic examinations revealed extragenital injuries in 43.1 % of cases and anogenital injuries in 21.6 % of cases.

DISCUSSION

The study confirms the likely underreporting of sexual abuse against older patients, particularly male patients, and highlights the heightened vulnerabilities in this specific population. This study also emphasizes the severity of these abuses and the multifaceted challenges in detecting, reporting, and addressing such crimes. Tackling these challenges is crucial for the development of effective prevention and intervention strategies tailored to protect older patients.

A Scoping Review of Sexual Violence Events Perpetrated Against Older People

Although 9 million older adults are estimated to be victims of sexual violence and abuse (SVA) globally each year, this population is largely overlooked in criminological research. Given the known impacts of SVA, particularly for older victims, enhanced understanding of incident characteristics, and how these events unfold, is crucial to improving prevention and response. Guided by environmental criminology perspectives, a scoping review was conducted to assess the extent to which SVA events against older people have been empirically examined to gain an understanding of the immediate circumstances in which incidents occur and how this can inform early intervention and prevention. Eight databases were searched, with records included if they reported characteristics of SVA events occurring in older adulthood, were original, peer-reviewed, empirical research, and published in English. After screening 1,278 records, 33 studies were included for review. Findings demonstrate that considerable attention has been given to understanding who is involved in SVA events and what typically occurs, however, there is a dearth of information regarding when and how these crimes are perpetrated, and the situational factors influencing offending. Resultingly, prevention recommendations largely focus on actors (e.g., victims, perpetrators, witnesses), rather than the environment in which abuse occurs, emphasizing significant gaps in understanding and response to this growing issue.

A case and intervention for older adult sexual mistreatment

BACKGROUND

The sexual mistreatment of older adults is a significant public health issue; like other forms of sexual violence, it is more prevalent than officially reported. Survivors often hesitate to speak out due to feelings of embarrassment, fear, or potential cognitive impairments. Moreover, the concealment of such mistreatment, coupled with societal stigmas surrounding aging and sexuality, creates challenges in recognizing sexual mistreatment during routine or emergency room visits.

PURPOSE

This paper provides a framework for informing physicians, psychiatrists, and other healthcare providers on best practices screening, detection, and management of sexual mistreatment in older adults.

METHODS

A literature review of older adult sexual mistreatment articles between 2005-2024 was conducted.

RESULTS

Medical professionals and psychiatrists are well-positioned to raise awareness and identify sexual mistreatment in older adults and manage such situations when suspected.

CONCLUSION

Assessing suspected sexual mistreatment can improve detection, responsiveness, and patient safety for older adults through an interprofessional approach.

A Criminological Perspective on the Sexual Victimization of Older Adults

PURPOSE OF REVIEW

This review presents recent research on the sexual abuse of older adults and examines this phenomenon from a criminological perspective. Much of the previous work has neglected to consider the entirety of the crime-commission process. Therefore, the work highlighted in this review showcases important information regarding the individual who committed the crime, the victim, and the criminal event as a whole.

RECENT FINDINGS

Comparative studies suggest that the motivations of people who commit sexually victimize older adults are vast and can include those that are sexually and anger motivated, while the victims present with unique vulnerabilities, such as disabilities and spending most of their time at home, that make them more susceptible to excessive violence. People who commit sexual abuse against older adults are a heterogenous group, and the context of victim vulnerabilities is key to understanding why they are targeted. Specific prevention and investigative practices can be formed to better address this crime and protect older adults from future victimization.

Sexual Assault in Older-Age Adults: Criminal Justice Response in New Zealand

There is growing recognition that older persons, both male and female, may experience sexual assault. One clearly identified gap in the body of scientific literature is examination of the criminal justice response for older adults who have been sexually assaulted. This retrospective age-group comparative data analysis examines publicly available population and police statistics for 2018 to describe rates (per 100,000) of reported sexual assault across adult age categories (young adult, n = 748; adult, n = 1,478; middle age, n = 290; older adult, n = 58) and compare (using Chi-square bivariate analysis) the criminal justice response to sexual assault for these adult age categories in New Zealand (NZ). Sexual assault was perpetrated against victims across all age and sex groups examined. The rate of reported sexual assault against older adults was significantly lower after the age of 65 years (7.90 per 100,000) compared to younger adults aged 20-64 years (87.57 per 100,000). Across age categories no difference was found in the proportion of cases proceeded to court action. This study raises awareness of the topic of sexual assault perpetrated against older persons and shows that a substantial number of older adults experience sexual assault in cases that do not result in court action. It points to the need for policy-makers to consider the reporting of sexual assaults against older persons to justice services.

Forms of sexual assault against older women in the context of acquaintance relationships: An intersectional perspective

This study addresses forms of sexual assault against women in late life (SAWLL) from an intersectional perspective, focusing on acquaintance relationships. Qualitative research was conducted, using in-depth interviews with 18 welfare and healthcare professionals who treated sexual assault survivors. Five forms (themes) emerged, relevant to the identification of SAWLL: (1) Coercive sexual assault in the context of changes brought on by old age, (2) contempt and sexual humiliation based on ageist and sexist social constructions, (3) violation of the older women's dignity in the multigenerational context, (4) life-long incestuous relationships and sexual assault against older women and (5) erotic touching and exhibitionism in caregiving relationships. The revealed forms emphasise the vulnerability of older women who are sexually assaulted in domestic relationships by perpetrators whom they know. These forms can contribute to filling the existing gap in knowledge on SAWLL and promote the visibility of sexually assaulted older women in the justice system. In addition, they can aid law enforcement, health and welfare professionals and policymakers to advance the general understanding of SAWLL as well as improve the response to this phenomenon.

Examining Sexual Crime Severity in China: A General-specific Model on Sex Offending Against Adults

Sexual violence severity has long been viewed as a critical factor of sex offending. However, the criminological viewpoints on sexual violence severity have not received much attention, especially in the Chinese context. By integrating general-criminogenic (inhibitory mechanisms) and specific sex offending (learning mechanisms and contextual factors) perspectives, the current study links the propositions of social control (bonds) theory, self-control theory, differential association theory, and the integrated theory of sex offending, proposing a general-specific model for sexual violence severity. Survey data was collected from 250 Chinese offenders who committed sexual offenses against adults. The mediation analysis found that deviant peer association fully mediates the effects of social control and low self-control on sexual violence severity. The moderation analysis showed that substance abuse exaggerates the impact of deviant peer association on sexual violence severity, while sex purchasing mitigates this relationship. This general-specific model may expand our current understanding of sexual violence severity from both criminological and psychological perspectives.

Is There an "Expert" Stranger Rapist?

The concept of expertise applied to the criminal context assumes that offenders are driven by the abilities to both maximize the payoffs and minimize the risks associated with the crime-commission. This study tested the articulation between these two types of decisions taken by stranger rapists to successfully commit their crime. Specifically, this study aims to identify whether offenders whose modus operandi is indicative of criminal expertise are more likely to use forensic awareness strategies. Multivariate analyses conducted on 1,551 cases showed that stranger rapists who adopted behaviors indicative of expertise were more likely to use forensic awareness strategies to decrease the risk of police detection. Mixed associations were found between the number of forensic awareness strategies and their nature (i.e., protecting identity vs. destroying evidence) and rapists' expertise, thus leading to a four-type theoretical classification of expertise: novice, bold, opportunistic, and expert stranger rapists. Implications for research and practice are discussed.

Sexual Homicide in France and Canada: An International Comparison

Despite a recent increase in the number of studies published on sexual homicide (SH), several of these studies have been based on small and nonrepresentative samples. This study aims to describe and compare two samples of SH from France (n = 412) and Canada (n = 350) where data have been collected and coded with the same tool. The data include variables related to the crime, the offender, and the victim characteristics. The overarching goal is to further the knowledge about French SH and to assess the possibility of merging French and Canadian cases to create a cross-national database of 772 cases of SH. Among the 126 variables included in the comparative analysis, 31 (24.60%) presented significant differences between the two samples. Overall, findings suggest that SH cases between the two countries are more similar than they are different.

[Sexual abuse in elderly]

Seniors at home and in institutions can be victims of sexual abuse. Older women are more often victims than men. Sexual violence is often accompanied by physical violence and theft of property. More often than among the youngest, the crime is passed over in silence with the authorities. The consequences of the assault are serious, especially when there is cognitive impairment in the victim.

Sexual homicide in Australia and New Zealand: a description of offenders, offences and victims

The field of sexual homicide research is relatively recent, with many existing studies limited by small sample sizes and sampling bias. In Australia and New Zealand specifically, only one study to date addresses this phenomenon but there is a lack of comprehensive descriptive data. This study aims to fill this research gap using a representative sample gathered from public legal databases. A total of 118 cases of sexual homicide offenders are described to create a portrait of this type of offender, their victims and their offence behaviour. Findings are similar to those found in other large samples from the UK, Canada and Germany. Because this crime is rare and practitioners tend to have limited experience of them, the findings of this research have the potential to inform investigative, criminal justice and clinical practice.

Determination of the knowledge and awareness of nursing students about elder neglect and abuse: The case in Turkey

PURPOSE

This study determined the level of knowledge and awareness of elder neglect and abuse among nursing students in Turkey.

DESIGN AND METHODS

This cross-sectional, descriptive study surveyed 2128 nursing students across seven Turkish universities.

FINDINGS

Results indicated that 31.1% of students had received training on elder neglect and abuse; 77.5% considered their knowledge of the topic to be sufficient; 18.7% had encountered elder neglect and abuse during their education; 58.7% did nothing for the situation; 95.2% thought that people living alone were exposed to elder neglect and abuse more frequently; and 94.8% of students thought that elders who could not meet their own needs were exposed to more neglect and abuse.

PRACTICE IMPLICATIONS

Future nurses need to increase their level of knowledge about abuse and neglect of the elderly.

Making sense of senseless murders: The who, what, when, and where?

The phenomenon of "senseless" or "motiveless" homicide refers to homicides that lack an objective external motivation. Despite the unique challenges these homicides pose to police, few empirical studies have been conducted on the topic and existing studies are limited to clinical studies using small samples. To overcome existing empirical shortcomings, the current study used a sample of 319 homicide cases where no motive was established during the investigation to describe the "who" (offender and victim characteristics), "what" (modus operandi, crime characteristics), "where" (encounter, crime, and body recovery associated locations), and "when" (time of the crime) of the entire criminal event. Findings provide insight into the entire crime-commission process and suggest a different dynamic to "senseless" homicide from what has been described in previous literature. Implications for police investigative practice are discussed.

Sexual Homicide: a Criminological Perspective

PURPOSE OF REVIEW

This review presents recent findings of research focusing on sexual homicide. Firstly, we examine international comparative studies of victim, offender, and crime characteristics. Secondly, we review an important body of literature that compares developmental and psychological as well as the decision-making process of sexual murderers with other violent offenders. Thirdly, recent and major findings on links between sexual homicide and psychopathy as well as sadism are presented. Fourthly, findings on spatial behavior and factors that can explain it are discussed. Finally, the last section reviews characteristics of sexual homicide involving children and elderly victims.

RECENT FINDINGS

International comparisons suggest that sexual homicide presents more similarities than differences across countries implying that most of knowledge can be generalized and applied to other countries. Comparisons with other types of violent offenders highlight that sexual murderers are a specific type of offenders with particular characteristics (criminal careers, developmental factors, personality disorders, lifestyle characteristics) and crime commission process (modus operandi, spatial behavior). As to the etiological factors of sexual homicide, psychopathy and sadism are important characteristics of sexual murderers leading their criminal life as well as their everyday life. Finally, studies focusing on specific types of vulnerable victims showed a high level of heterogeneity within the population of sexual murderers. Sexual murderers are specific offenders with peculiar characteristics and further research should develop proper knowledge on it. Creation of new international databases allows research to confirm and increase knowledge by considering sexual homicides as a complex heterogenous crime.

Lethal combinations: A conjunctive analysis of crime scene behavior associated with sexual homicide

This research investigates violent stranger rapes and the factors leading these cases to sexual homicides. Variables relating to modus operandi characteristics on one part and offender behavior on the other part are examined using conjunctive analysis of cases configuration to identify the different combinations leading to a lethal outcome. Using a French sample of 1263 cases of violent rapes and 303 cases of sexual homicides involving female adult victims, we find that blows given by offenders and information about physical resistance of victims are strongly associated intentional and non-intentional sexual homicides. Psychoactive substance consumption by offenders as well associal isolation are in a lesser extend also associated with the lethal outcome.