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This article explores the issue of sexual abuse of vulnerable younger and older adults living in long-term care facilities. Clinical findings regarding the sexual abuse of adults who are elderly or have disabilities are presented, and practice implications for psychiatric nurses are discussed. A review of relevant existing literature and previous research is provided. A research study presently under way is then described. This is the first national study of sexual abuse in long-term care. This study seeks to fill current knowledge gaps and inform the practice of nursing and other professionals who are responsible for the care of vulnerable adults.

There is little professional literature, research, or training regarding edler sexual abuse, despite the fact that cases are being identified in many locales. This article presents guidelines and techniques for identifying and interviewing possible elder victims of sexual abuse. Specific techniques are illustrated for working with non-verbal elders. Intervention strategies are suggested for cases in which sexual abuse has been substantiated.

Thorough investigation of reported cases of elder maltreatment is necessary to determine the validity of the allegations and to identify victims to whom protective services should be offered. This paper dicusses the process of a comprehensive investigation, including the goals and steps involved. Information which should be elicited from reporters, collaterals, and existing documents is identified. Guidelines are provided for interviewing suspected victims and offenders. Specialized diagnostic evaluations may aid in determining the validity of allegation and assessing the impact of maltreatment on the victim. Clear, detailed documentation of findings is necessary, as is careful decision-making concerning whether or not to substantiate the allegations. Guidance is provided for completing these inventory tasks.

Twenty-eight cases of suspected elder abuse were identified and described by elder protective service workers. All the victims were female, and 71% experienced significant limitations in capacity for independent functioning and self-protection. Indicators of sexual abuse included victim self-report and third party observation of assault, physical injury, and psychosocial symptoms. All but one of the suspected offenders were male. Eighty-one percent were caregivers for the women they allegedly assaulted, and 78% were family members, predominantly sons and husbands. Repeated vaginal rape was the most prevalent type of reported assault. Findings of the study are presented, and issues relative to the sexual victimization of elders are discussed.