Sexual Violence in Later Life: A technical assistance guide for health care providers

The U.S. Census Bureau estimates that by the year 2050, adults age 65 or older will account for 25% of the population (U.S. Census Bureau, 2008). National data suggests that three to five million older adults experience some form of abuse annually (Connolly, 2011). The National Center on Elder Abuse found that between one and two million Americans age 65 and older have been injured, exploited, or otherwise mistreated by someone on whom they depend (National Center on Elder Abuse, 2012).

Sexual violence in later life (a subcategory of older adult abuse) is neither well understood nor well identified in health care communities. Despite this, the potential for physical and emotional sequelae or aftereffects of sexual violence against older adults is significant.

Because it is more common for older adults to seek regular health care services, providers are in a unique position regarding effective identification and response to abuse (National Center on Elder Abuse, 2012). The short- and long-term health implications for patients, in combination with increased mortality rates, make recognizing and effectively responding to sexual violence against older adults an important responsibility of all health care professionals. Collaboration with community-based sexual assault organizations and advocates is helpful in ensuring that health care professionals have the tools they need to identify and respond to sexual violence and to connect victims with supportive services.

The purpose of this technical assistance guide is to assist physicians, nurses, and other clinical health care providers in meeting their professional obligations in identifying and providing intervention and treatment to older victims of sexual violence. It includes introductory information, including definitions and a problem statement, as well as case scenarios. Additionally, it discusses issues relevant to healthcare providers, such as practice recommendations, provider responsibilities, gathering the patient history, examination, and evidence collection. Patient safety and reporting, documentation, and treatment considerations — including sample questions and discussions to have with patients — also are in the guide, as is an introduction to forming meaningful collaborations with professionals in the community.