Invisible Wounds: Elder Abuse 

About the Author:

Arusa Habib is currently pursuing a part-time Master of Science in Nursing (MScN) degree at the Aga Khan University while serving as the Assistant Head Nurse in the Department of Medicine. With seven years of nursing experience, she has worked in a geriatric care unit, where she observed that elder abuse often goes unrecognized and unreported. This concern inspired her to write a blog on the topic, aiming to raise awareness and provide valuable information to healthcare providers.

With the world’s elderly population projected to double by 2050, elder abuse has become a silent and deeply troubling global issue. Despite its seriousness, it often goes unrecognized, underreported, and misunderstood in clinical and community settings. Elder abuse includes physical, emotional, financial, and even sexual harm, as well as neglect, and disproportionately affects individuals aged 60 and above. As older adults increasingly rely on others for care, they become more vulnerable to mistreatment, especially when dependency, cognitive decline, or social isolation are involved. In many cases, victims are unable or unwilling to report the abuse due to fear, shame, or lack of support. This issue is not only a public health concern but also a matter of justice, dignity, and fundamental human rights.

The Critical Role of Nurses

Nurses, as the first point of contact in many healthcare settings, are in a unique position to identify and advocate for victims of elder abuse. Their close and ongoing interaction with patients provides an opportunity to notice subtle signs of mistreatment, such as unexplained injuries, changes in behavior, or signs of neglect. A study by Estebsari et al. (2023) found that triage nurses in emergency departments often struggle to detect elder abuse due to limited training, unclear reporting protocols, time pressures, and fear of legal consequences. These barriers hinder their ability to intervene effectively and safeguard vulnerable patients. These findings highlight the urgent need for standardized training programs that equip nurses and other frontline staff with the skills and confidence to recognize and report abuse. Clear legal frameworks and institutional support must also be in place to guide healthcare professionals in responding ethically and lawfully when abuse is suspected.

Insights from Community Practice

Building on these challenges, Cronin and Duffy (2025) conducted an audit in Ireland’s mid-west region to assess community nurses’ confidence and knowledge in responding to elder abuse. The findings revealed a concerning gap: while nurses were committed to safeguarding adults, many lacked formal education on identifying abuse and were unsure of appropriate referral pathways. This points to the critical importance of not only providing initial training but also offering ongoing education, reflective practice opportunities, and interdisciplinary collaboration to enhance community responses. Increasing nurses' confidence through education and practical tools is vital to closing this gap between awareness and effective action.

Call to Action: Advocacy, Education, and Reform

Elder abuse will only grow in complexity and prevalence as the global population ages. This issue calls for greater public awareness, multidisciplinary collaboration, and system-wide reform. Future strategies should include:
• Mandatory training for healthcare workers
• Improved screening tools and reporting protocols
• Legal support and protections for reporting abuse
• Community education and public awareness campaigns
• Focus groups to explore local challenges and solutions

We must also foster open public dialogue to reduce stigma, encourage reporting, and promote respect for ageing populations across all cultures and communities.

Conclusion

Protecting older adults is not only a professional responsibility, but also a social and moral imperative. Conducting focus groups, raising awareness, and advocating for a safer, more compassionate future for all generations is vital. Elder abuse is not always visible, but its wounds run deep. As a global community, we must work together to ensure that these wounds are seen, heard, and healed with urgency, empathy, and unwavering commitment.

References

Cronin, T., & Duffy, A. (2025). Recognising and responding to abuse in the community: An audit of community nurses’ knowledge and confidence in Irelands mid-west region. The Journal of Adult Protection, 27(2), 97-107.

Estebsari, F., Ghorbanzadeh, S., Milani, A. S., Saboohi, Z., Latifi, M., Shahsavari, A., & Rahimi Khalifeh Kandi, Z. (2025). Triage nurses’ perspectives about abuse of older people: A study in a hospital setting. BMC nursing, 24(1), 1-8.