New tool to gauge risk of elder abuse

Abuse of older people can be hard to pick up - that's why Dr Kathy Peri has created a new elder abuse assessment tool.

A senior lecturer in nursing, Peri led a team that created the tool with a $95,000 grant from the Ministry of Social Development (MSD).

“This tool is for all health providers to use with older people who have been identified as possibly showing signs of being abused,” says Peri.

The World Health Organization estimated in 2017 that one in six people over the age of 60 experiences abuse or neglect each year.

In New Zealand, Elder Abuse Response Services received 2852 reports of abuse from Age Concern in 2022 to 2023, with an average of 11 new cases reported every workday.

However, Peri says the statistics may not reflect the real size of the problem, because many older people are reluctant to report abuse or neglect by a loved one.

“They can be dependent on people who both care for them and cause them harm.

“Some people fear being put in an aged care facility if they disclose that a carer isn’t doing a good job and there’s shame and stigma about what’s happening to them,” says Peri.

Older people often don’t want to report that a son or daughter has a drug problem, has physically harmed them, or has stolen from them, because they don’t want their child to face criminal charges, she says.

Psychological abuse is the most common form of abuse of older people, followed by financial abuse, physical abuse, and sexual abuse.

Peri, who has worked as a gerontology nurse specialist for many years, says neglect is also a major concern.

“There’s an expectation that family members can pick up the caregiving job, but sometimes they’re stressed, unwell themselves, or lack the knowledge to do the job well, so that can result in neglect.”

Since the project launched in April 2025, the research team has held focus groups with people working in the field in the North and South islands, and conducted two surveys to refine the assessment tool.

The assessment includes risk severity ratings and a traffic light system to guide further actions. Red is for those at highest risk, where police intervention is required. Orange indicates more support and monitoring at home is needed. Green covers situations where a person appears safe and health professionals will continue to monitor.

The assessment tool has a section to assess the risk posed by a person suspected of causing harm, as well as a section focused on the older person who may be suffering abuse or neglect.

Family members, such as the older person’s children, children’s partners, friends, paid caregivers, and scammers are among those typically responsible for harming older people - and the dynamics can be complex, says Peri.

“The risk factors we’ve identified for a person using harm are current financial struggles, attitude and relationship problems, aggression, history of drug and alcohol abuse or violence, or a past history of experiencing abuse themselves,” she says.

Calls for a tool to help detect abuse have been made by MSD’s Elder Abuse response services and Te Whatu Ora - Ministry of Health’s services for older people.

“I hope the tool will be used in a timely manner and with empathy, so the older person feels empowered.

“Hopefully, it will pick up abuse and help to keep older people safer.

“The tool could also be used to collect data, so we can see what’s happening with people who are being neglected or abused across the whole motu.”

Globally, most risk assessment tools for older people have been developed without consulting older people, says Peri.

Her team worked with Professor Ngaire Kerse, a GP and director of the University’s Centre for Co-created Ageing Research, which held a focus group to gather older people’s views on the tool.

James Henare Research Centre Director Tia Dawes led the development of the cultural section of the risk assessment tool.

Further funding is being sought to validate the tool. To take part in validating the assessment, contact k.peri@auckland.ac.nz

Confidential support for elder abuse is available on 0800 32 668 65.