Risks factors at the individual level include:^1,4,5

• poor physical health or frailty
• cognitive impairment and dementia
• poor mental health, including psychiatric illness
• behavioural problems
• functional dependency (needing assistance with activities of daily living)
• low income or wealth
• trauma or past abuse
• ethnicity
• social isolation or loneliness and lack of social support
• gender.⁴

Risk factors related to the carer or care relationship include:^1,4,5

• caregiver burden or stress
• mental health problems
• alcohol or substance use
• financial dependency on the older person
• a history of trauma or abuse.

Relationship risk factors include a history of poor family relationships and unrealistic expectations of caring. Being in a shared living situation is a risk factor for the abuse of older people. However, it is not clear whether spouses or adult children of older people are more likely to be the perpetrators of abuse.²

Within residential aged care homes, abuse is more likely to occur where:²

• standards for healthcare, welfare services and care facilities for older people are low
• staff may be poorly trained, poorly remunerated and overworked
• the physical environment is deficient
• policies operate in the interests of the institution rather than the residents.

For possible signs and symptoms of abuse in older people, see table 15.1 in the RACGP’s Abuse and violence: Working with our patients in general practice.

There are no specific recommendations or advice for Aboriginal and Torres Strait Islander peoples.

Abuse and violence: Working with our patients in general practice, 5th edition (The White Book) | RACGP