Note: I contacted an advocate with a Domestic Violence/Sexual Assault program in Vermont who has worked with elderly victims and survivors. Although I would love to publicly acknowledge the valuable work that she is doing and the wisdom she has gained, we decided that readers could benefit more from knowing actual experiences of survivors and how programs adapt to their needs. Therefore, all identifying information about her or her clients has been omitted.

The movement to end violence against women started when women came together to help other women who were being hurt. Most of these women were young mothers. So much work was necessary just to help these young, healthy women that programs and services were tailored to their needs. The anti-violence movement has made invaluable strides in its services and impact on policies that affect younger women, and much has been accomplished with little financial or societal support. However, often the needs of older women do not match the needs of younger women, and as a result, they do not use these services. National statistics show that most women accessing support services are between 25 and 40, and there is a sharp decrease in the numbers of women using domestic violence and sexual violence programs after the age of 50.

It is important to consider how the needs of younger women, particularly women with children, differ from those of older women when examining this fall-off. Young women's concerns can span a broad continuum, including child safety, parenting and job placement, whereas older women's concerns are more likely to include losing pensions and benefits if they leave their partner, access to medical treatment, and living as independently as possible. These differences can bewilder victim service providers and older women alike. A service provider may have difficulty creating a safety plan for an older woman who wishes to stay at home to either care or be cared for by her abuser. An older woman may have difficulty coming to a shelter filled with children or attending support groups with women much younger than she.

Moreover, an older battered woman may not associate the term "domestic violence" with her experience. Many older women may associate domestic violence with the experience of the mother in the movie The Burning Bed. (The movie is about a young woman who experiences egregious violence and assault from her husband and is accused of killing him by setting fire to the house.) This may not be how their abuse manifested itself. Some women who have been in the same abusive relationship for years are not physically abused later in life. The batterer may have used physical abuse to control her early in their relationship, but he may no longer need to resort to those tactics because of years of practiced control. Other older women may be experiencing physical violence for the first time because they are finding it more and more difficult to meet the demands of their partner due to the effects of aging.

With these barriers and thoughts in mind, I phoned Beth (not her real name), an advocate at a Vermont Domestic Violence/Sexual Assault program, to ask about how older women have reached out to her and benefited from her program's resources.

More often than not, women have contacted our program through a referral. Most often family members have contacted us, but also court staff, the local Area Agency on Aging, and Home Health.

First, we will talk to the referring source and assess why the victim is not calling for herself. Then, I only call the victim if the referring source is able to clearly articulate why the victim has a barrier to calling directly.

That is true, but frequently when family members call on behalf of their older relative, they are doing so because the elder is unable to call our program herself. If the older person actually doesn't want to call me, then I won't contact her. I take every measure to make sure that she wants this contact before I call her. After I identify myself to her, I explain that someone had referred her to our program and that I need to make sure that she wishes to talk to me and that it is her choice to talk to me. I also ask if it is safe for her to talk to me. Frequently, because a lot of older women may have difficulty hearing on the phone, I ask if we can meet in person. This option is good because it also helps to ensure that the woman can speak to me confidentially.

The primary reason the women I have served have not directly contacted us is loss of hearing. The elder may not have learned how to use a TTY and so needs support in making phone calls. Also, many nursing home residents do not have access to a private phone, which can make it unsafe for them to call us and disclose personal information within earshot of other residents and staff. Typically, when an elder is referred to our program through a family member, they do not call directly. However, if a woman calls the local Area Agency on Aging helpline, they will have received our phone number and call us directly.

As is true of all victims of crime, it is very unique for each person. A lot of the older women who I have worked with have been victims of sexual assault; many also have called because they are experiencing domestic violence at the hands of their adult children living at home.

A lot of older women I have worked with are not from the traditional domestic violence scenario. There is more sexual violence, more abusive adult kids. Only one woman I have served has experienced domestic violence at the hands of an intimate partner.

In these situations there is more guilt and shame [than with younger women] around getting a Relief from Abuse order (RFA) and calling police to enforce the order. One victim was afraid to call the police because she thought that the police would respond brutally to her son's mental illness. Her son also provided her personal assistance. Some of these women have also been trying to get help for their children/caregivers, with varying responses from the authorities and other agencies.

I work with an older woman now who was raped by a stranger. Before she was sexually assaulted, she lived with her family. She was very happy with this arrangement. She was able to get the care that she needed and felt fairly independent.

A stranger broke into her house one night and raped her. She pressed the panic button on her med-alert bracelet and authorities responded immediately. She was unable to see her attacker very well because she has experienced vision loss; however, she thought she had seen him in passing in the town where she lived. In the end, the authorities could not find him, and as a result, she no longer felt comfortable living at home. She moved into a nursing home.

This woman has lost a huge amount as the result of her trauma and victimization. She used to see her family all the time; and now she sees them once every month or two. This was the first time that she experienced an assault, and her life has drastically changed as a result.

The first meeting with her was very awkward. I went to the nursing home to see her. It was difficult to find private space. Women who call our program are usually in a private space, or we can go to a private space at our program. So, this was a challenge I had not experienced before.

She calls me when she would like to see me and talk. Sometimes I will see her twice a month if she calls me, sometimes less than that. When I visit her, I reassure her and listen to her. She is very lonely; she says that it is helpful when we talk, and I think that she feels emotionally validated. It is interesting that she completely understands that what happened to her was not her fault. I emphasize the strength and courage she showed in her situation. Particularly, I acknowledge her presence of mind to press the med-alert bracelet.

I think that a real fear for older women is that leaving a painful or scary situation will involve moving to a nursing home. The question that they have to ask themselves is, "How many losses do I have to experience to feel safe?" In this woman's case, she had to lose connection to her family and friends in order to feel that she was not in imminent danger. The cost to her was enormous.

Another woman I work with lived with her abusive husband for more than twenty years until he passed away. Her son, who has a mental illness, lived with her for quite a while and was assaulting her.

She moved into her own apartment and set her son up with his own housing, too. For a while, this arrangement worked really well and was a great plan. But her son's living arrangement fell through and he came to live with her. Because she had a Section Eight voucher, she was forced to leave because Section Eight rules dictate that she live by herself. She moved on to other places, but was forced to leave those places as well because her son continued to follow her. She is in a homeless shelter right now.

She felt that she could not call the police, because the police in the state where she lived had previously killed a person labeled mentally ill. She was afraid that something like that might happen to her son.

If she could get him housing or bar him from her apartment, she would like to make it work. He is very violent, not just with her.

Most of what we are providing is hotline support. I connected her with a few different shelters. It has been a lot of hotline advocacy. I have also spoken to APS about her son. She was considering coming to a support group, but never did. We have talked a lot about RFAs, but that won't work because of her reluctance to call the police. We provide the little things like getting her information and phone numbers, connecting her to resources, helping her make phone calls... A lot of what I am doing is emotional support, which happens on the hotline.

Beth's experience with elderly survivors can teach us important lessons. She has been able to adapt her advocacy and services to fit what these older women needed. Her program was willing to relax its policy about victims making the first contact, and she has been willing to meet people at nursing homes.

The types of abuse that Beth has seen are not surprising. Statistically, adult children are the most frequent abusers of elders, followed by other family members and spouses. It is helpful to consider that dynamic when examining how accessible a program or service might be to an elder.

As with all victims, our ability to be with the person, both physically and emotionally, goes a long way to help elderly victims see that domestic and sexual violence programs are there to serve them.