Elderly victims are often unsure whether sexual assault occurred

Astudy into the sexual assault of people over the age of 65 found vulnerable victims can often be unsure if a sexual assault occurred. In these cases, injuries and witness accounts alert authorities to the crime.

Sixty people over the age of 65 attended a Sexual Assault Treatment Unit (SATU) in Ireland from 2017 to the end of last year.

Gardaí accompanied a large number of these people to one of the six national treatment units; some of them had dementia.

“Our study reveals that older people comprise less than 1pc of attendees to the national SATU network, highlighting a potential under-representation influenced by stigma, lack of suitable support, and the specific vulnerabilities of this population,” the authors of the study said.

“The findings underscore the significant proportion of cases where victims are unsure whether a sexual assault occurred, emphasising the impact of cognitive impairment on disclosure.”

While there were 60 attendees nationally, the study carried out a more in-depth analysis of 21 older people who attended the Dublin Sexual Assault Treatment Unit, representing just over a third of the attendees of this age group nationally.

Twenty of these patients were female and one was male, although one female did not proceed with her attendance at the service.

Nine cases occurred in a nursing home and five in a hospital.

In the Dublin cases, the study found cognitive impairment, as well as significant physical impairment, was identified in eight of the patients.

Over half of the people that had a forensic examination had the procedure performed either in a nursing home or hospital.

“This subset analysis revealed that most incidents occurred within healthcare facilities,” said the study carried out by the Rotunda Hospital in collaboration with the Royal College of Surgeons in

Ireland. “Among these cases, the assailant was identified as a staff member in some instances, while in other incidences it was a fellow resident.

“Disturbingly, two instances involved sexual assaults witnessed by staff, both perpetrated by fellow residents.

“The documented prevalence of sexual assaults by fellow nursing home residents emphasises the need for heightened supervision and targeted interventions in these environments.”

Five of the Dublin cases were reported based on concerns about potential sexual assault due to a finding of genital injury.

“In all these instances, patients relied on others for daily activities, had a dementia diagnosis, and could not provide an account of the injury’s cause,” the study noted.

“The fact that genital injuries were identified in older people who had no recollection of an assault again reiterates the need for healthcare providers to be vigilant about this type of elder abuse and to report any concerns they have through well-defined channels.”

One elderly person reported being sexually assaulted by a stranger in a hospital. Another attending the Dublin unit reported being sexually assaulted by a healthcare provider in a hospital.

In the overall study across the six units around Ireland, half of the 60 people were unsure whether a sexual assault occurred.

“This finding highlights a specific vulnerability of this cohort of people, where cognitive impairment could play a significant role in their ability to report an assault,” said the authors, who include Dr Daniel Kane, a forensic examiner with the SATU. “Therefore, it is of vital importance that if a disclosure of a sexual assault is reported by someone with a cognitive impairment that it is thoroughly and promptly investigated.”

Analysis of the Dublin cases showed there were incidents in which a sexual assault had been witnessed by staff, with the victim having no recollection of the event.

Nationally, the majority of the patients were white females and all perpetrators were male, with the majority being single assailant assaults.

The 59 female patients and one male patient ranged in age from 65 to 92, with an average age of around 76 years.

The study, published in the Journal of Forensic and Legal Medicine, found the vast majority were retired and three were still employed.

Just over three-quarters attended the sexual assault units around the country with An Garda Síochána, with two-thirds undergoing a forensic examination with DNA collection and 11pc undergoing a forensic physical examination without DNA collection.

Fewer than half of attendees, 29 out of the 60 victims, could identify an attacker, while injuries, both genital and extra-genital, were noted in 21.7pc of the patients. In cases where there was a recollection of the assault, three were verbally threatened and four were physically restrained, by the limbs and throat.

The research team concluded that the demographic patterns of predominantly white females, and the prevalence of assailants described as strangers or persons in authority, raise concerns about the vulnerability of older people in healthcare settings and the supports needed for staff, residents and patients.

“Continued efforts are crucial to ensure timely and appropriate care for this vulnerable demographic,” they said.