Hidden victims: the healthcare needs and experiences of older women in abusive relationships

Abstract

Background: Intimate partner violence (IPV) is a problem in older women, but older victims of IPV are often unidentified in the medical setting because providers think of IPV as a problem of younger women. The experiences of older women with IPV are unknown. This study reports on the healthcare experiences and needs of older victims of IPV.

Methods: Interviews were conducted with 38 women > 55 years who responded to an advertisement recruiting "women who had been in an abusive relationship since age 55." Interviews were audiotaped, transcribed, and analyzed for themes.

Results: The median age of participants was 58 years (range 55-90). The majority were Caucasian with annual incomes over dollar 40,000. The median relationship length was 24 years (range 2-67), and 39% remained in their abusive relationships. About half had discussed IPV with a healthcare provider. The themes that were identified included disclosure about IPV and both negative and positive experiences with healthcare providers. Reasons for nondisclosure were similar to those of younger women but were compounded by the generational mores of privacy about domestic affairs and society's lack of understanding and resources for IPV. Some of the women who disclosed IPV to their providers felt discounted and unsupported. Others reported receiving valuable help, including empathy, referrals to resources, assistance in naming the abuse, linking the stress of IPV to health, and respect for their decisions to continue their abusive relationships.

Conclusions: Older women victims have difficulty initiating discussions about IPV with their providers. Providers are encouraged to identify signals of potential abuse and to create privacy with all patients to discuss difficult issues, such as IPV, and to be knowledgeable about appropriate referrals.