Elder Abuse Among Older Adults With Chronic Illness in Northern Thailand: Causes, Consequences, and Coping Strategies
Main Article Content
Abstract
Older adults with chronic illnesses are vulnerable to experiencing abuse due to their reliance on others for their care. A sequential explanatory mixed-method approach encompassing a survey involving 462 older adults with chronic illnesses to examine the nature of elder abuse and predictive factors, and conducting in-depth interviews with a cohort of 30 older adult victims to gain insights into the causes and consequences of elder abuse and their strategies for coping with it. Descriptive statistics and logistic regression were used to analyze the quantitative data, while the qualitative data were analyzed through content analysis. The most prevalent form of elder abuse was psychological abuse at 58.4%. Elder abuse results from a combination of factors specific to both the victims and perpetrators. The outcomes of elder abuse encompass physical pain, emotional pain, diminished self-worth, and a lack of desire to live. Strategies employed to address abuse encompassed running away from home, confiding in trusted individuals, and increased self-reliance. Elder abuse has negative consequences on the physical and psychological well-being of older adult victims. Healthcare professionals, including nurses, play an essential role in prevention by identifying potential abuse, enhancing caregiver skills, promoting healthy family relationships, and working with communities to establish surveillance systems for at-risk older adults. These efforts should be supported by interdisciplinary collaboration with local leaders and government agencies to address issues such as substance abuse.
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
• Acob, J. R. U. (2018). Lived experiences of the abused elderly. Public Health of Indonesia, 4(1), 1–8. https://doi.org/10.36685/phi.v4i1.172
• Atim, L. M., Kaggwa, M.M., Mamum, M.A., Kule, M., Ashaba, S., & Maling S. (2023). Factors associated with elder abuse and neglect in rural Uganda: A cross-sectional study of community older adults attending an outpatient clinic. PLOS ONE,18(2), Article e0280826. https://doi.org/10.1371/journal.pone.0280826
• Austin, P. C., & Steyerberg, E. W. (2017). Events per variable (EPV) and the relative performance of different strategies for estimating the out-of-sample validity of logistic regression models. Statistical Methods in Medical Research, 26(2),796–808. https://doi.org/10.1177/0962280214558972
• Burnes, D., Acierno, R., & Hernandez-Tejada, M. (2019). Help-seeking among victims of elder abuse: Findings from the National Elder Mistreatment Study. The Journals of Gerontology: Series B, 74(5), 891–896. https://doi.org/10.1093/geronb/gby122
• Centers for Disease Control and Prevention (CDC). (2024, October 4). About chronic diseases. https://www.cdc.gov/chronic-disease/about/index.html
• Centers for Disease Control and Prevention (CDC). (2025, April 2). Disability and health overview. https://www.cdc.gov/disability-and-health/about/index.html
• Conrad, K. J., Liu, P.-J., & Iris, M. (2019). Examining the role of substance abuse in elder mistreatment: Results from mistreatment investigations. Journal of Interpersonal Violence, 34(2), 366–391. https://doi.org/ 10.1177/0886260516640782
• Creswell, J. W., & Plano Clark, V. L. (2017). Designing and conducting mixed methods research (3rd ed.). Sage Publications.
• Dow, B., Gahan, L., Gaffy, E., Joosten, M., Vrantsidis, F., & Jarred, M. (2020). Barriers to disclosing elder abuse and taking action in Australia. Journal of Family Violence, 35(8), 853–861. https://doi.org/10.1007/s10896-019-00084-w
• Du, P. & Chen, Y. (2021). Prevalence of elder abuse and victim related risk factors during the COVID-19 pandemic in China. BMC Public Health, 21, Article 1096. https://doi.org/10.1186/s12889-021-11175-z
• Fong, J. H. (2019). Disability incidence and functional decline among older adults with major chronic diseases. BMC Geriatrics, 19, Article 323. https://doi.org/10.1186/s12877-019-1348-z
• Fraga Dominguez, S., Storey, J. E., & Glorney, E. (2021). Help-seeking behavior in victims of elder abuse: A systematic review. Trauma, Violence & Abuse, 22(3), 466–480. https://doi.org/10.1177/1524838019860616
• Ho, C. S., Wong, S. Y., Chiu, M. M., & Ho, R. C. (2017). Global prevalence of elder abuse: A meta-analysis and meta-regression. East Asian Archives of Psychiatry, 27(2), 43–55. https://pubmed.ncbi.nlm.nih.gov/28652497/
• Hou, C., Ping, Z., Yang, K., Chen, S., Liu, X., Li, H., Liu, M., Ma, Y., van Halm-Lutterodt, N., Tao, L., Luo, Y., Yang, X., Wang, W., Li, X., & Guo, X. (2018). Trends of activities of daily living disability situation and association with chronic conditions among elderly aged 80 years and over in China. The Journal of Nutrition, Health and Aging, 22, 439–445. https://doi.org/10.1007/s12603-017-0947-7
• Hsieh, H. F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9),1277–1288. https://doi.org/10.1177/1049732305276687
• Isac, C., Lee, P., & Arulappan J. (2021). Older adults with chronic illness-caregiver burden in the Asian context: A systematic review. Patient Education and Counseling, 104(12), 2912–2921. https://doi.org/10.1016/j.pec.2021.04.021
• Jika, B. M., Khan, H. T. A., & Lawal, M. (2021). Exploring experiences of family caregivers for older adults with chronic illness: A scoping review. Geriatric Nursing, 42(6), 1525–1532. https://doi.org/10.1016/j.gerinurse.2021.10.010
• Kohn, R., & Verhoek-Oftedahl, W. (2011). Caregiving and elder abuse. Medicine & Health Rhode Island, 94(2), 47–49. https://pmc.ncbi.nlm.nih.gov/articles/PMC4961478/
• Kulachai, W. (2018). Elder abuse in Thailand: Prevalence, causes, consequences, and public support. International Journal of Management and Applied Science, 4(10), 52–56. https://www.iraj.in/journal/journal_file/journal_pdf/14-506-154755184852-56.pdf
• Kumar, P., & Patra. S. (2019). A study on elder abuse in an urban resettlement colony of Delhi. Journal of Family Medicine Primary Care, 8(2), 621–625. https://doi:10.4103/jfmpc.jfmpc_323_17
• Ludvigsson, M., Wiklund, N., Swahnberg, K., & Simmons, J. (2022). Experiences of elder abuse: A qualitative study among victims in Sweden. BMC Geriatrics, 22, Article 256. https://doi.org/10.1186/s12877-022-02933-8
• Ong, A. D., Uchino, B. N., & Wethington, E. (2016). Loneliness and health in older adults: A mini-review and synthesis. Gerontology, 62(4),443–449. https://doi.org/10.1159/000441651
• Orfila, F., Coma-Sole, M., Cabanas, M., Cegri-Lombardo, F., Moleras-Serra, A., & Pujol-Ribera, E. (2018). Family caregiver mistreatment of the elderly: Prevalence of risk and associated factors. BMC Public Health, 18, Article 167. https://doi.org/10.1186/s12889-018-5067-8
• Pinyopornpanish, K., Wajatieng, W., Niruttisai, N., Buawangpong, N., Nantsupawat, N., Angkurawaranon, C., & Jiraporncharoen, W. (2022). Violence against caregivers of older adults with chronic diseases is associated with caregiver burden and depression: A cross-sectional study. BMC Geriatric, 22, Article 264. https://doi.org/10.1186/s12877-022-02950-7
• Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative project on early detection of persons with harmful alcohol consumption—II. Addiction, 88(6), 791–804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x
• Schroeder, M. A. (1990). Diagnosis and dealing with multicollinearity. Western Journal of Nursing Research, 12(2), 175–187. https://doi.org/10.1177/019394599001200204
• Schulz, R., Beach, S. R., Czaja, S. J., Martire, L. M., & Monin, J. K. (2020). Family caregiving for older adults. Annual Review of Psychology, 71, 635–659. https://doi.org/10.1146/annurev-psych-010419-050754
• Simmons, J., Wiklund, N., & Ludvigsson, M. (2022). Managing abusive experience: A qualitative study among older adults in Sweden. BMC Geriatrics, 22, Article 456. https://doi.org/10.1186/s12877-022-03143-y
• Timalsina, K. P. (2023). Prevalence and patterns of elderly abuse in family environment: A cross-sectional study of Hetauda Sub-Metropolitan City. International Research Journal of MMC, 4(2), 51–59. https://doi.org/10.3126/irjmmc.v4i2.56013
• Van Royen, K., Van Royen, P., De Donder, L., & Gobbens, R.J. (2020). Elder abuse assessment tools and interventions for use in the home environment: A scoping review. Clinical Intervention in Aging, 28(15), 1793–1807. https://doi.org/10.2147/CIA.S261877
• Whangmahaporn, P. (2019). Thai elder abuse problems and prevention. Asian Crime and Society Review, 6(2), 46–56. https://so02.tci-thaijo.org/index.php/IJCLSI/article/view/242597
• Yon, Y., Mikton, C. R., Gassoumis, Z. D., & Wilber, K. H. (2017). Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Global Health, 5(2), 147–156. https://doi.org/10.1016/S2214-109X(17)30006-2
• Yunus, R. M., Hairi, N. N., & Choo, W. Y. (2019). Consequences of elder abuse and neglect: A systematic review of observational studies. Trauma, Violence, & Abuse, 20(2), 197–213. https://doi.org/10.1177/1524838017692798.
• World Health Organization (WHO). (2024, June 15). Abuse of older people. https://www.who.int/news-room/fact-sheets/detail/abuse-of-older-people