Abstract
Sexual violence (SV) is an important public health issue with a major impact on victims and their peers, offspring and community. However, SV in older adults is under-researched. This paper aims to establish the prevalence and nature of SV in older adults in Europe, link this with existing policies and health care workers’ response to sexual health needs in older age, and critically revise the currently used frameworks in public health research. To fill this gap in the literature, we applied a Critical Interpretative Synthesis (CIS) approach. The CIS approach uses techniques from grounded theory and processes from systematic review. It allows to critically interpret key findings from both academic as well as grey literature, engendering theory refining. In the first phase of purposive sampling, we conducted a systematic review of academic sources and included 14 references. The cut-off age used to define old age varied between 60 and 70 years old among the included studies. Subsequently we added another 14 references in the second phase of theoretical sampling. We ultimately included 16 peer-reviewed articles and 12 documents from the grey literature. The CIS results demonstrate that knowledge of SV in older adults is still limited. The current research suggests that SV in older adults rarely occurs, however, prevalence rates are likely to be underestimated because of methodological shortcomings. The complexity of SV in older adults is not acknowledged in ongoing research due to the conflation of SV with other types of violence. Information on specific risk factors and about assailants committing SV in old age is absent. Policy documents dealing with sexual and reproductive health, rights and ageing make no mention of SV in older adults. In clinical practice, the sexual health needs of older adults often remain unmet. In conclusion, our findings suggest that older adults are forgotten in prevention and response to SV. Greater awareness about this topic could contribute to a revision of current policies and health care practices, leading to more tailored care for older victims of SV.
Highlights
Since the 1990s, sexual violence (SV) [1] has increasingly been considered a public health problem of major societal and judicial concern [2,3,4]
SV in older adults is studied in the broader context of elder abuse and neglect, which is considered as “A single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person” [4]
Twelve studies reported on community-dwelling older adults [37,39,40,41,43,44,45,46,47,48,49,50], one on older adults living in nursing homes [38] and one study comprised a mixed sample [42]
Summary
Since the 1990s, sexual violence (SV) [1] has increasingly been considered a public health problem of major societal and judicial concern [2,3,4]. Of women and 10–27% of men experienced at least one incident of SV between 16 and 25 years of age [5,6,7,8,9,10,11], so we assume that for older adults at least a similar life time prevalence is to be expected. SV in older adults is studied in the broader context of elder abuse and neglect, which is considered as “A single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person” [4]. The prevalence of SV in the preceding year was
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