population age 65 and older increased by 188 percent, and the population 85 and older increased by 635 percent (Eberhardt et al., 2001, Hetzel and Smith, 2001). Over this same period, the life expectancy of people at age 65 increased from 13.9 to 17.9 years (Natonal Center for Health Statistics, unpublished data, 2001). These trends will likely be accentuated by the aging of the post-WWII baby boom generation. The U.S. Bureau of the Census predicts that by 2030, the population over age 65 will nearly triple to more than 70 million people, and older people will make up more than 20 percent of the population (up from 12.3 percent in 1990) (Population Projections Program, 2000).
It is heartening that large proportions of the nation’s older people are living without substantial disability. Among people age 75 and older in 1999, 70 percent described their health as good or excellent (Eberhardt et al., 2001). Inevitably, however, the aging of the population is also associated with increases in age-related diseases and disabilities. Of the estimated 12.8 million Americans reporting need for assistance with activities of daily living (ADLs—eating, dressing, bathing, transferring between the bed and a chair, toileting, controlling bladder and bowel) or instrumental activities of daily living (IADLs—preparing meals, performing housework, taking drugs, going on errands, managing finances, using a telephone), 57 percent (7.3 million people) were over the age of 65 (Administration on Aging, 1997). Dementia is present in approximately 5 to 10 percent of persons age 65 and older and 30 to 39 percent of persons age 85 and older (Rice et al., 2001; Henderson, 1998). Among people age 85 and older in 1999, 33 percent reported themselves to be in fair or poor health, 84 percent had disabilities involving mobility (unpublished data Natonal Center for Health Statistics, 2002), and 16 percent had Alzheimer’s disease (Brookmeyer et al., 1998).
Given the projected growth in the elderly population, long-term care for elderly people with disabilities has become an increasingly urgent policy concern (Institute of Medicine, 2001; Stone, 2000). The settings in which long-term care is provided depend on a variety of factors, including the older person’s needs and preferences, the availability of informal support, and the source of reimbursement for care. An increasing number of elderly people reside outside traditional home settings in highly restrictive institutional environments (such as skilled or intermediate nursing facilities) or in less restrictive community-based residential settings, such as assisted living facilities, board and care homes, and adult foster homes. Among the 34 million persons over age 65 in 1995, 5 percent were nursing home residents, and 12 percent lived in the community setting with ADL or IADL limitations. The number of nursing home residents increased between 1973–1974 and 1999 from 961,500 to 1,469,500 among those age 65 and older, and from 413,6000 to 757,100 among those 85 and older (Eberhardt et al., 2001). In 1999, another 500,000 elderly people were living in
Kathryn Patricelli, MA Dec 15, 2005 Updated Nov 2, 2015
Physical and sexual abuse greatly exacerbate the risk of substance use disorders. Abuse has particularly far-reaching effects when it occurs during childhood. Please learn more about treatment here.
Types of Abuse
- Verbal: They may verbally abuse them by calling them names, tell them they are stupid, have no worth or will not amount to anything on their own.
- Physical: They may become physically violent, inflicting pain, bruises, broken bones and other physical wounds (visible and hidden both).
- Sexual: They may rape or sexually assault their victims.
- Negligence: Alternatively they may neglect dependent victims, disavowing any responsibilities they may have towards those victims, and causing damage through lack of action rather than through a harmful, manipulative action itself.
Abuse is a commonplace event in modern times, taking on many different forms, including physical, sexual, emotional, and verbal abuse, occurring in many different contexts, including the home (domestic violence, spouse rape, incest), the workplace (sexual harassment), and in institutional (elder abuse, bullying) and religious and community (hate crime) settings. It touches victims across the lifespan from children through elders. Abuse is a serious social and cultural problem affecting everyone whether as a victim of abuse, a perpetrator, a friend or confidant of an abused person looking for ways to be helpful, or simply as someone who is angered by injustice and wants to work for positive change.
If you are currently being abused, or have been abused in the past, you should know that you do not suffer alone. Right now millions of people around the world struggle to maintain dignity, safety and self-worth in the face of ongoing abuse. Millions more people struggle to recover from wounds they have sustained during past abuse. You should also know that help is available for victims of abuse, although it is not always easy to access. Community abuse resources (such as domestic violence shelters), mental health professionals, law enforcement, and various other organizations, websites and printed resources can provide instruction and assistance for people who need help removing themselves from abusive situations.
Victims of abuse often find themselves dealing with serious psychological and physical consequences of having been abused. There are various forms of counseling, psychotherapy, medical and self-help resources available for people who have been abused and want assistance and support for managing problems and issues they have developed as a result of being abused Such post-abuse issues are sometimes called 'abuse sequela' by health professionals. While no therapy is capable of erasing the effects of abuse, such resources can provide real and meaningful assistance in helping to minimize the negative effects of abuse. Helpful abuse-related resources can be found throughout this document, in the appendix of abuse-related resources provided at the end of this document, and in the lists of other (non-document) resources collected within this abuse topic center.
Some people aren't sure if they are being or have been abused. They may know that they have been harmed, but they may think that they deserved that harm, for instance, or perhaps think instead that some degree of harm is acceptable or reasonable, or just inevitable. Though it is not possible for us to give you a definite answer to any questions you may have about what is abuse and what is not abuse, consider that people who haven't been abused don't tend to spend much time wondering whether they have been abused, while a many people who have been abused (or are being abused) do wonder about it. If you are upset enough to wonder about it, it is likely (although not definite) that you have been abused. We'll explore the definition of abuse in greater detail later in this document.