Elder abuse: evaluating the potentials and problems of diagnosis in the archaeological record

Abstract

The elderly are the most neglected demographic in archaeology. In today's youth-obsessed society, the elderly are consistently denigrated, particularly those perceived to be physically or mentally frail. A related and growing concern in contemporary populations is the physical abuse of the elderly, believed to be an escalating phenomenon. This study is the first to examine the risk factors, social context and patterns of trauma associated with elder abuse in the present, with the aim of providing diagnostic criteria to apply to past societies. The utility of skeletal evidence in the identification of violent trauma has been detailed in cases of child and intimate partner abuse, both modern and archaeological. Investigating the skeletal evidence for elder abuse is potentially more complex because of the confounding physiological effects of the ageing process, lack of clinical research and contemporary ageist attitudes towards older people. Within the clinical and bioarchaeological literature, there has been a tendency to dismiss injuries in older individuals as the product of accident or opportunistic violence. A proportion of elder members of past societies is likely to have been victims of abuse and family violence. While there are no pathognomonic skeletal features of elder abuse, multiple injuries to the bones of the following are indicative: cranium, maxilla-facial region, dentition, cervical vertebrae, clavicles, ribs and spiral fractures to the humeri. Attention is also drawn to decubiti as indirect skeletal indicators of immobility and possibly neglect. Archaeological context is important to consider, including non-normative burials or those indicating social marginalisation. Bioarchaeological evidence has the potential to provide a long-term perspective on the care and treatment of past elders.