National Center on Elder Abuse Blog: Diversity and Inclusion

by Mary Twomey

A few months ago, I was asked to give a talk about elder abuse at a local conference. It was at the height of the demonstrations in Ferguson, MO and, for that reason, I was thinking a lot about racism. As I prepared for the talk, my mind also turned to two of the other "isms", ageism and sexism. When I started to look at the research about elder abuse and race and gender, I was saddened to see that the rates of mistreatment are higher for racial minorities and women.


I freely admit that I am far from culturally competent. I’m working on adopting a stance of cultural humility, however, and towards that end, I'm finding that being curious is key. I think it is important that we recognize that the country of our birth, our race, our gender, our abilities, our age, our sexual orientation, and more, all influence how we perceive older people and how older people themselves perceive elder abuse and how they seek help (or don’t) when they become victims. But, and here is where curiosity comes in, how do they affect our views and the views of our clients?

Several years ago, I received a call at work from an older Chinese woman. She told me that she was being abused. Of course, I was concerned and asked her about the situation. She disclosed that she was being cared for by her second son because her first son refused to provide that care. This, to her, was elder abuse. She was otherwise receiving the care she needed, just not from the person she needed. I doubt that I was very helpful to the caller that day because, to me, what she was describing didn't fit into my picture of abuse. Writing this today, I feel her sadness and shame and I wish I had chosen to be more helpful to her. This story is validated by research conducted by Dr. Aileen Moon at UCLA. When Dr. Moon asked older Asians which type of maltreatment hurt the most, they stated strongly that emotional abuse was the most damaging of all abuse types. In California, to cite just one state’s law, emotional abuse is not a mandatory report.

In some communities, older adults use their financial resources to support many generations of relatives who are not themselves contributing to the upkeep of the household. To many, this looks and feels like financial exploitation, and, in some cases it is. However, in other cases, many older minority elders would disagree. Even when different racial groups of elders agree in their perceptions of a particular scenario, others disagree. In a study that tracked different perceptions of abuse, older Korean-American women were substantially less likely to perceive a given situation as abusive, than were Whites or African Americans.

We all know that for every case of abuse that is reported to APS, 23 cases go unreported. Some abuse victims don’t report because the act of disclosing the abuse is just too risky. Here’s an example: Two lesbian friends were visiting one's father at an Assisted Living facility last year. At his suggestion, they visited a new resident whom he feared was lonely. When they arrived to welcome her, the older woman burst into tears. Until then, she hadn’t known it could be safe to reveal to anyone at the facility that she, too, was a lesbian. If she wasn’t safe disclosing who she really was, how could she have ever disclosed that she was the victim of mistreatment?

Marguerite DeLiema, et al. from USC found that when Spanish-speaking promotores (people from the community trained to be community health workers) went door to door in Los Angeles asking older Latinos about mistreatment, people opened up and disclosed much higher rates than other studies conducted by non-community member researchers. People who have had bad experiences with “the authorities” (i.e., police or other representatives of the state) may be more reluctant to admit when they are being hurt. This may be true of older immigrants without documentation, older gays and lesbians who remember police raids of bars, and older African Americans with memories of past and recent violent racial incidents.

Those of us who work in elder justice often have the difficult job of asking people who already feel vulnerable to tell us about their secrets. How do we make it safe for people to seek our help when they need it? It isn't always possible to send a culturally and linguistically matched person to work with an abuse victim. What can the rest of us do?

Learn! Let your curiosity lead you to learn about the experiences of people different from you. The National Center on Elder Abuse has fact sheets on elder abuse in different communities.

Listen! Let your curiosity root a deep listening to the stories that are being shared.

Be humble! Each of us has many things to teach and many things to learn. Humility sets the foundation for the mutual exchange of these gifts.

Remember! It was Ram Dass who wrote, "When all is said and done, we're all just walking each other home." #oldlivesmatter

-Mary Twomey, MSW

About the Author: Mary Twomey is the project manager for the Aging Initiative at the California Social Work Education Center at UC Berkeley. Ms. Twomey most recently co-directed the National Center on Elder Abuse, a federal Administration on Community Living-funded resource center on best practices, research, training, policy, and public awareness related to elder abuse, neglect, and exploitation. She also co-directed the Center of Excellence on Elder Abuse and Neglect, part of UC, Irvine’s School of Medicine Division of Geriatric Medicine and Gerontology, which provides medical, forensic, and victim services to abused and neglected seniors living in the community or in long-term care facilities.