Review Article

Sexual Abuse of Older Nursing Home Residents: A Literature Review

Table 1

Description of articles included in the review.

ArticleAimMethodParticipantsMain findings

Teaster and Roberto [21]To investigate the characteristics and outcomes of sexual abuse against elderly women in nursing homes.Data collection from APS case files1 of sexually abused elderly women in nursing homes collected over a four-year period.50 female nursing home residents aged 70–89 years who have been victims of sexual abuse.The most common form of sexual abuse was sexual kissing, fondling, and unwelcome sexual interest in the women’s body. 90% of the perpetrators were male nursing home residents over 70 years. Three of the cases ended up in court and one perpetrator was convicted.

Teaster et al. [34]To analyze the reported cases of sexual abuse against men in nursing homes and to understand the characteristics of sexual abuse, who victim and perpetrator are, and how cases are handled.Data collection from APS case files and other regulatory agencies. Reporting from five states in the U.S., over a 6-month period.242 male nursing home residents from 50 to 93 years who have been sexually abused in nursing homes.Over 80% of the victims had cognitive and physical deficits that limited their ability for self-care. Type of abuse: fondling 35%, unwanted sexual attention 27%, finger penetration of the anus 12%, and rape 9%. Of the suspected perpetrators were 75%3 staff and 25% other nursing home residents. Of 26% of the reported cases were 6 substantiated.

Ramsey-Klawsnik et al. [35]To better understand the sexual abuse of the elderly in institutions. Furthermore, to examine the characteristics of the victim and the perpetrator and also the factors related with abuse situations.Randomized selection of the reported cases of abuse by APS and other reporting agencies, from five U.S. states. Information from the MDS5 was used to examine the consequences for the victims over time.96 female and 27 male nursing home residents aged 60–101 years, who had been sexually abused. 119 perpetrators.The victims suffered from a number of cognitive and physical illnesses. Of the suspected perpetrators were most employees4 ( = 51) and other nursing home residents ( = 48). In 32 of the cases it was proved that the assault had taken place. No perpetrators were given legal punishment.

Burgess et al. [36]To explore the characteristics of perpetrators.Review of relevant documents retrieved from the courts. Of the 20 case files that were reviewed, the perpetrators were identified in 18.18 perpetrators who had committed sexual abuse of nursing homes residents.The perpetrators were from 16 to 83 years and either employees6 ( = 15) or nursing home residents ( = 3). Two common denominators for the perpetrators were that (1) they scored low on social competence; (2) they hunted victims who were frail and defenseless.

Ramsey-Klawsnik and Teaster [37]To focus on sexual abuse of the elderly in institutions. Collect data about experiences and handling of specific cases and further recommendations to help the victims and prevent abuse.Randomized selection of reported cases. Participants were interviewed by telephone.46 employees working in the APS and other regulatory agencies in five states in the U.S., receiving reports of sexual abuse against elderly in institutions.Participants had examined a total of 300 reported cases.
Interviewees indicated that they had a lack of training in handling these types of cases and called for guidance, knowledge, and education in the area.

Burgess et al. [38]Drawing attention to sexual abuse of the elderly and to focus on victim impact.Review of relevant documents retrieved from the court system, including records from nursing homes, interview, and video interview with victims.18 female and 2 male nursing home residents subjected to sexual abuse.11 of the victims died within 12 months after the assault. Most of the victims were cognitively or neurologically impaired. Half of the victims were examined medically. The victims suffered from anxiety, fear, and withdrawal and refused help with personal hygiene.

Adult Protective Services (APS) is a state agency and its function is to assist the elderly who are prone to or have been victims of various types of abuse. They start preliminary investigation and assist the elderly in abuse cases.
2Started with 26, two fell out, no explanation.
3One woman was confirmed as the perpetrator.
4Three women were confirmed as the perpetrator
5Minimum Data Set, a public reporting system for cases of suspected sexual abuse. Medical database.
6One woman was confirmed as the perpetrator.