According to the National Council on Aging, five million individuals over age 65 experience sexual abuse each year, but such trauma remains the least-reported of all sexual violence. In Alaska, where sexual assault remains high (three or four times the national average) and continues to trend upward statewide, it’s still a struggle to make abuse against older Alaskans a visible epidemic requiring attention.
Alaska’s Standing Together Against Rape (STAR), headquartered in Anchorage, is a statewide organization that since 1978 has responded to the physical and emotional needs of those who survive sexual assault. In addition, STAR works to integrate prevention and awareness programs with a goal of reducing harm to all Alaskans.
Defining abuse and consent
The definition of abuse consists of touching, fondling, intercourse, or any other sexual activity with an older adult, when the older adult is unable to understand, unwilling to consent, threatened, or physically forced. In May of 2022, the Alaska legislature went one step further to amplify the term ‘consent’ and passed HB 325, stating:
“’(W)ithout consent’ means that, under the totality of the circumstances surrounding the offense, there was not a freely given, reversible agreement specific to the conduct at issue; in this paragraph, "freely given" means agreement to cooperate in the act was positively expressed by word or action.”
While the bill’s passing is particularly important for vulnerable adults who may experience dementia or aphasia (difficulty communicating verbally, usually due to stroke), victims of sexual abuse and their families still face challenges.
Samantha Mintz-Gentz, director of programs at STAR, says anyone with a caregiver should be aware of the signs of sexual abuse, either against a loved one, or themselves.
“Unfortunately, abusers build trust with people prior to perpetrating harm, and work to maintain it to secure access to victims (known as ‘grooming’),” she said. “Constant communication for people in care is as critical as noticing any physical or emotional changes before something may happen.”
Mintz-Gentz goes on to say that there are a host of emotional signals that may point to sexual trauma, including:
Increased fear/anxiety, with uncharacteristic shyness, outbursts, or an unwillingness to be left alone
isolation
unusual changes in sleep (either more or less sleep)
withdrawal from normal activities
Physical clues may be more obvious, Mintz-Gentz says, with dehydration or unusual weight loss, missing daily living aids or personal items, loss of appetite, unexplained injuries or bleeding, and frequent urinary tract infections or sexually-transmitted diseases.
It’s also a point of note that “Those who abuse vulnerable adults or the elderly are those who care for them,” said Mintz-Gentz. “The relationship creates a power imbalance and reliance that leaves the abused person isolated and vulnerable.”
Finding help
Adults do have the power to be their own best advocate with supportive friends or family who take seriously the risk of sexual trauma. The State of Alaska Long Term Care Ombudsman program is a pathway through which all elders and vulnerable adults have a representative under federal law who will identify and investigate complaints against seniors in residential care facilities, or, if in-home care is being provided, at the senior’s own residence.
Additionally, STAR staff and volunteers provide 24/7 support for both primary (the abused) and secondary (family or friends) victims of sexual assault, including services tailored to each person’s needs.
Mintz-Gentz says this “may be a phone call once a week, and information on what to do, like filling out a report of harm, or trauma counseling, relocation, protective orders, and financial assistance if necessary.”
STAR operates a 24-hour crisis line, and Mintz-Gentz emphasizes that calling can be a good first step.
“The crisis line is a good resource, even just to ask a question,” she said. “A STAR advocate may also be a good connection to make as well, to determine what services may help.”
Warning signs and prevention
But what about prevention? STAR provides educational programs for both the general public and professionals to cast as wide a net as possible across the state. Through online and in-person training sessions and awareness campaigns, STAR is able to share simple, practical strategies for older adults to know about possible red flags and stop abuse before it happens.
For families, this means paying attention to the physical, emotional and social conditions of individuals who live in long-term care or have a caregiver in their own home.
“Keep all interactions observable and interruptible, meaning that caregivers should never be alone with people in their care,” she says, and “all spaces should be visible with windows, open doors, whenever possible.”
She adds that while fingerprinting and background checks are also good tools, the process is not foolproof and is only helpful if an individual has a criminal record. The greatest tool, said Mintz-Gentz, is vigilance.
For seniors who have the capability to hire their own caregivers, there are also several ways to be self-aware:
Designate a living will and power of attorney before health care decisions become urgent
Stay active in the community and connected with friends and family to decrease social isolation, which has been connected to elder abuse
Post and open your own mail
Never give personal information over the phone
Use direct deposit for all checks and never allow someone else to conduct bank business
Have your own phone and know how to use it
Know your rights. If you engage the services of a paid or family caregiver, you have the right to voice your preferences and concerns.
How to report suspected abuse
Adult Protective Services (APS): 1-800-478-9996, or https://health.alaska.gov/dsds/pages/aps/default.aspx
Long Term Care Ombudsman: https://akoltco.org
STAR 24-hour crisis line: 907-276-7279
Anonymous Victim Report: People have this option within seven days to collect evidence, but not meet with law enforcement. A forensic nurse will do exam and interview, and a STAR advocate will be available for support. This evidence, once collected, will be stored until such time as the victim decides to release it to the police.
