By Carrie Bower, Practice Development Consultant Trainer at the Social Care Institute for Excellence (SCIE)
When I talk about domestic abuse in later life, I often start with a simple observation: ageism creates a petri dish for abuse to thrive.
That may sound uncomfortable, but we need to sit with that discomfort.
Too often, domestic abuse is viewed through the lens of youth. Campaigns, services and public awareness frequently focus on younger women experiencing abuse, often violence, from intimate partners. While that is an essential part of the picture, it is far from the whole story.
What happens when the person is in later life?
What happens when they have a long-term health condition, memory loss, sensory loss or increasing care and support needs?
What happens when the person causing harm is not a partner, but an adult child or grandchild?
For many older adults, the answer is that they become invisible. It’s been a decade since the publication of the report ‘Older people and domestic abuse spotlight’ from Safe Lives, which found that 44% of victim-survivors of domestic abuse aged 61 and above experienced abuse from a family member, compared to 6% of those aged 60 and below. It also found that 48% of victim-survivors aged 61 and above have a disability. A more recent report from Safe Lives, ‘Routes to Safety’, explored inequalities which can significantly affect how long abuse lasts and how quickly people can access specialist support. Notably, disabled victim-survivors experienced longer abuse, higher risk and worse outcomes, whilst victim-survivors aged 51 and above from racially minoritised backgrounds experience the longest form of abuse.
Domestic abuse does not suddenly disappear when adults reach later life. Power and control do not retire when we do; often, the patterns get harder to spot. Disguised in routines and rituals, where we don’t ask about consequences.
Later life can introduce new opportunities for joy, but it can also create opportunities to exert power and control.
Ill health, disability, cognitive decline, a caring role and financial dependency can all be exploited by somebody determined to maintain power over another person. That person can be a partner, a spouse, but in the context of domestic abuse, it can also be a family member, an adult child, a grandchild or a sibling.
What concerns me most is that when older victim-survivors become invisible, those older adults who choose to control, exert power and use harmful behaviours can also become invisible too. This is why The Big Conversation on Care, being led by the Independent Commission on Adult Social Care, matters so much.
Because if we are genuinely asking what kind of care system we want for the future, we must also ask whether that system is equipped to recognise abuse in all its forms, including domestic abuse, and at every stage of life.
When we talk about the future of adult social care, we often focus on funding, workforce pressures and systems reform. All important issues. But I wonder whether we sometimes overlook one of the greatest strengths of those services working with people in their homes and communities, whether that’s the voluntary sector, housing, community health services, care providers and adult social care.
Relationships.
These services see people within the context of their ordinary day-to-day lives. Practitioners understand relationships, changing needs and family dynamics. They see how a person’s life is shaped by experiences accumulated across decades.
Acute health services often see an incident; social care practitioners can see patterns.
Accident and Emergency may see a fracture. A GP may see anxiety. A nurse on a hospital ward may see dehydration.
Those visiting people in their own homes often see the wider picture. They observe family dynamics. They can feel an atmosphere. They can notice interactions, rules and routines that have consequences if not followed.
And when practitioners create safe relational spaces and are curious, they hear stories that may never be told anywhere else. Dewis Choice has created a short film, Power of Asking, to help practitioners start the conversation.
When it comes to domestic abuse, conversation matters.
Domestic abuse in later life remains hidden in shame, fear and isolation. One of the most common misconceptions about domestic abuse is that if somebody is experiencing abuse, they will simply tell someone. The reality is much more complicated.
Older adults may not recognise that what they are experiencing is abusive, and when they do, they may fear losing their independence. They may be well aware of the risks. They may worry about what will happen to family members if professionals become involved. They may fear being moved from their home or losing vital support.
Many may rely on the abusive person for their care and support, whilst some may be caring for an abusive person and feel completely trapped in a caring role.
Others may have lived with abuse for decades. They may not describe their experiences as domestic abuse because controlling behaviour has become normalised over time.
This is why relationship-based practice matters so much.
Disclosure is rarely a single conversation. More often, it develops through trust, consistency and feeling safe enough to speak.
Professional curiosity means asking ourselves:
What is changing?
What am I noticing?
What is this person trying to tell me?
What am I not asking and why?
Older adults do not arrive at later life as blank slates. They bring with them a lifetime of experiences, relationships, strength, resilience and sometimes trauma.
An older person living with chronic pain may also be carrying decades of emotional abuse.
A person with dementia may have survived coercive control throughout an entire marriage.
A family experiencing strain related to caring responsibilities may also be dealing with long-standing patterns of power and control.
Without understanding the wider context, it is easy to focus only on immediate needs.
Social care offers the opportunity to see the whole person. Not a diagnosis, a referral, an assessment or a support plan. A person.
As adult social care enters this period of national reflection, I hope we do not lose sight of what makes it special. Every home visit, every conversation and every relationship creates an opportunity to notice what others might miss and noticing can change a life.
