What we know about ourselves and our behavior tells us that any of us might abuse or neglect our children. Many of us have felt at times that life is more than we can handle. What stops us from giving up or lashing out are skills and mechanisms we have learned to control or divert our anger, accept and assume adult responsibility, recognize realistic boundaries of acceptable behavior and expectation, and seek and accept help and support. When adults are faced with a situation that requires the use of coping skills that have not been developed, child abuse or neglect often results.

Clermont County Ohio CPS, 2019

Child Abuse

The cogent statement above hints at the complexity of reasons why child abuse occurs. There is no simple answer because there is almost never one specific clear cause. The many risk and protective factors discussed in the previous module hint at the wide variety of personal, family, and community variables that can affect the occurrence of child abuse and neglect.

Some factors we know help predict increased risk, but there is no guaranteed effect because the straw that breaks the camel’s back for one parent or caregiver may be an addressable challenge for another. In the end the why may be better turned into “what contributed to this situation and how can understanding those factors direct our efforts to bring the abuse or neglect to an end?”

Generally speaking, a perpetrator of child abuse must be someone responsible for the care of a child, and individual state laws define specific terminology. Perpetrators frequently include:

• Parent, guardian, foster parent
• Relative or any other person the child lives with who assumes responsibility for care and/or supervision
• Employee or agent of a public or private facility that provides care to the child and may include:
  • Hospitals
  • Health care facilities
  • Group homes
  • Mental health facilities
  • Residential treatment centers
  • Shelter care facilities
  • Detention centers
  • Child care facilities
• Any person providing care for the child

Perpetrators of child abuse come from all walks of life, races, religions, and nationalities. They come from all professions and represent all levels of intelligence and standards of living. There is no single social stratum free from incidents of child abuse.

Abusive parents may show disregard for the child’s own needs, limited abilities, and feelings. Many abusive parents believe that children exist to satisfy parental needs and that the child’s needs are unimportant. Children who don’t satisfy the parent’s needs may become victims of child abuse.

Sexual abusers may have deviant personality traits and behaviors that can result in sexual contact with a child. Sexual abuse perpetrators sometimes use threats, bribery, coercion, or force to engage a child in sexual activity. They violate the trust that a child inherently places in them for care and protection, and exploit the power and authority of their position as a trusted caretaker in order to misuse a child sexually. Often the child is threatened or warned “not to tell,” creating a conspiracy of silence about the abuse.

State laws vary as to whether educators are caretakers and, if so, under what circumstances. Additionally, other children are sometimes cast in the role of caretakers, although an adult who delegated responsibility to them may still be considered responsible. Individuals who are not responsible for the child’s care yet expose them to maltreatment are generally subject to a state’s criminal statutes. Any questions should be verified in your state’s legislation and usually links to that information will be available from your state or local department of health or child protective services department.

Dependent Adult Abuse

As with child abuse and neglect, dependent adult abuse has no single simple explanation but the two categories of abuse have a somewhat different mix of factors. Among other things, when considering elder abuse the many years in which a family dynamic has evolved can play a role in the abusive behaviors. The literature on family and behavior offers several theories about possible factors that contribute to dependent adult abuse. These include the following:

• Retaliation. Someone who was abused as a child may harbor anger and resentment toward the abusive parent. When roles are reversed, the once-abused child sees an opportunity for retaliation.
• Violence as a way of life. We live in a violent society. The media are filled with violence, both real and imagined. Violence saturates TV, movies, and video games. Domestic violence is increasingly common, particularly in tough economic times. Family violence often creates generational patterns.
• Unresolved conflict. Conflict from childhood, from marital or other relationships, creates patterns of abuse that continue without resolution.
• Lack of close family ties. Lack of closeness in the relationship between adult children and their parents can create stress and frustration when the parent suddenly or gradually becomes dependent. This can lead to abuse.
• Lack of financial resources. Families who must juggle work and caregiving responsibilities may resent the addition of a dependent adult to the household. Increasing costs for medical care and other services can add to financial stress. Public assistance programs such as SSI and Medicaid may also decrease the dependent person’s stipend if he or she is living with family members.
• Resentment of dependency. Caring for a frail older person who requires attention and assistance can be physically and emotionally exhausting. Stress and frustration can occur even when there is a close family tie.
• Increased life expectancy. The dependency period of old age has expanded, leaving caretakers to provide extensive home care for a longer period of time. Smaller families mean fewer children to care for elderly parents and grandparents.
• History of mental or emotional problems. Someone who is mentally or emotionally unstable may be unable to cope with the demands of caregiving. This can threaten the well-being of both caretaker and dependent adult.
• Unemployment. Financial and emotional stress raises the level of frustration and weakens self-control.
• History of alcohol and drug abuse. Substance abuse is often a factor in family violence. Alcohol suppresses inhibitions, making aggressive behavior more likely. This can be a factor for the caretaker as well as for the dependent adult.
• Long distance caregiver. Today’s mobile population increases the likelihood that adult children may be living far from their parents, increasing the risk of neglect and additional stress.

Abusers of older adults are both men and women, and almost 60% of elder abuse and neglect is perpetrated by a family member, with two-thirds of perpetrators being adult children or spouses (NCOA, n.d.). After family members, the most frequent perpetrators are friends and neighbors (17%) and home care aides (15%) (NCEA, 2019).

Perpetrators are more likely to be male, have a history of past or current substance abuse, have mental or physical health problems, have a history of trouble with law enforcement, be socially isolated, be unemployed or have financial problems, and be experiencing major stress (NCEA, 2019).

Types of Perpetrators

Abusers can be categorized across a spectrum of types from well-intentioned to sadistic. The categories include:

• Well-intentioned but overwhelmed, stressed by the demands of caregiving and lashes out at the victim (means well but tries to do too much)
• Well-intentioned but ignorant and incompetent, doesn’t understand how to take care of someone (leaves an Alzheimer’s patient tied to a chair and goes grocery shopping)
• Lacks interest and concern, just needs a job (takes no pride in work, just wants an easy paycheck)
• Abusive, motivated by self-interest, power, and control (gains trust of dependent person, manipulates into signing over money or property)
• Sadistic, enjoys hurting, extreme power and control (looks for jobs with position and authority to gain control for the purpose of hurting others)

A recent study based on data collected from victims breaks perpetrators down in a slightly different way with four profiles—caregiver, temperamental, dependent caregiver, and dangerous—each presenting different risk factors (USC, 2017).

The first group made up 37% of the sample and provided high levels of both functional and emotional support, with about 90% of them assisting elders with personal care tasks. The smallest category at 7% was “dependent caregivers,” who provided emotional support but were generally irresponsible, couldn’t keep a job, and were financially dependent on the victim (USC, 2017).

Temperamental abusers were described as emotionally draining with volatile tempers. And dangerous abusers, who were nearly 25% of the sample, reflected a group of perpetrators the majority of whom had a history of trouble with the law and drinking problems. Victims described virtually all of them as emotionally draining (USC, 2017).

This study found that dangerous abusers were the most likely to inflict physical and emotional abuse, while those who did provide some emotional support were mainly perpetrating financial exploitation and neglect. Researchers hope that information from this study will be used to design more nuanced interventions that distinguish between types of abuser. When an abuser is providing help and is not likely to physically harm the victim, more training in appropriate care and personal support may address the problem. Situations involving dangerous abusers likely need an entirely different response (USC, 2017).

Expected Responses from Perpetrators

Depending on the type of perpetrator involved, responses to being confronted about the abuse vary among the following:

• Admission of guilt, embarrassment, desire to do better
• Admission, but believes abusive action was justified
• Varies with intelligence and sophistication
• Denial, outrage, rationalizations, attempts to “turn the tables” on the victim, reporter and/or investigator