Analysis of the Need for Safe Houses for Victims of Elder Abuse from the Perspective of Police Officers and Social Workers

Abstract

Elder abuse is an increasingly significant public health and human rights issue in aging and long-lived societies. Despite existing intervention strategies, the lack of emergency housing tailored to older victims of abuse remains a critical gap. This study explores professionals’ perceptions of elder abuse, response measures, and challenges in addressing abuse, with a focus on rural regions. A survey was conducted among 100 first responders—social workers and police officers—who intervene in cases of elder abuse. Results indicate significant differences in perceptions of elder abuse severity, with social workers consistently rating all forms of elder abuse as more severe compared to police officers. Both groups highlighted the necessity of multidisciplinary teams, crisis centers, and safe houses as essential responses but recognized a lack of specialized infrastructure and resources as a significant challenge. Respondents emphasized that victims’ reluctance to report abuse due to family dynamics, shame, and isolation further complicates intervention efforts. Good practices identified interinstitutional collaboration, building victim trust, and proactive interventions. The findings underscore the need for age-appropriate safe spaces, improved professional training, and enhanced community awareness to address elder abuse effectively.

1. Introduction

Domestic violence violates fundamental human rights and constitutes a severe misuse of power by one individual over another. It typically targets the most vulnerable members of society (women, children, and older adults) and is regarded as one of the most serious forms of crime. This type of violence occurs within essential social units—families—that also form the core cells of local communities. The effects of domestic violence extend beyond the victims themselves, disrupting community ties between residents, diminishing their sense of safety and security, and negatively impacting the overall atmosphere and quality of life within local communities (Prislan et al. 2016). In recent years, shifting demographic trends have brought new challenges to light, particularly for older adults, who are increasingly recognized as one of the groups most vulnerable to violence and neglect. Europe and the rest of the world are facing significant demographic changes characterized by a rapidly growing elderly population, which has profound implications for society’s development and its inhabitants’ overall quality of life (WHO 2022b). In 2023, over one-fifth (21.3%) of the EU population was 65 and over (Eurostat 2024). Among the many challenges in aging and long-lived societies are violence, neglect, and discrimination towards older persons (UNDESA 2019; UNDP 2016). Elder abuse is now internationally recognized as a widespread, complex, and growing public health and human rights issue (Botngård et al. 2020; Fang and Yan 2021; Luzny and Jurickova 2012; Neuberg et al. 2019). It is defined as a single or repeated act or lack of appropriate action that causes harm or distress to an older person within any relationship where there is an expectation of trust (WHO 2002). Reports from the World Health Organization indicate that around one in six elderly individuals experienced some form of abuse in home settings during the past year. In institutions such as nursing homes and long-term-care facilities, two in three staff reported that they have committed abuse in the past year (WHO 2022a).

Despite efforts to address elder abuse, it remains one of the most neglected forms of violence, both in research and in the implementation of preventive strategies. While international organizations, such as the United Nations and the Council of Europe, have established minimum standards requiring governments and service providers to exercise due diligence in investigating, prosecuting, and preventing domestic violence, enforcement remains inconsistent (IMPRODOVA Consortium 2020). Adult protective services, for example, are a key mechanism for addressing elder abuse, but they are available in only one-third of world regions, making them the least implemented victim-support service globally (WHO 2014). Recognizing these challenges, different approaches have been developed to address elder abuse across different settings, mainly divided into three stages: primary prevention in terms of interventions related to preventing abuse from occurring, secondary intervention in terms of actions aimed to prevent further abuse, and tertiary intervention in terms of actions to manage the consequences after the abuse has occurred (Baker et al. 2016; Gupta and Chaudhuri 2008). In many countries, professionals from various fields (social workers, police officers, healthcare practitioners, NGOs, and other relevant personnel) have come together as effective multidisciplinary teams (MDT) to detect, prevent, and support survivors of elder abuse (IMPRODOVA Consortium 2020). However, despite these collaborative efforts, the research highlights a critical gap in addressing elder abuse: the lack of emergency housing specifically tailored to the needs of older adults who are victims of abuse. Existing domestic violence shelters are primarily established for women and children affected by domestic or intimate partner violence, often lacking the necessary resources to address the unique medical, cognitive, social service, legal, and therapeutic needs of older adults. Furthermore, these shelters typically do not provide services for abused older men (Hightower et al. 2000; Vognar and Gibbs 2014).

While elder abuse is a global concern, its manifestations and responses can be particularly challenging in rural areas, where limited resources, isolation, and demographic factors exacerbate the issue (Knežević Hočevar 2016; Meško 2020). Given the complexity of these challenges and the persistent gaps in support systems, this study focuses on professionals’ perspectives regarding elder abuse in the rural Pomurska region of Slovenia. It examines the prevalence, severity, response measures, challenges, and the need for tailored solutions, such as safe houses1, specifically designed to meet the needs of older adults who are victims of abuse.

1.1. Motivation and Research Question

The motivation for this study arises from a review of existing empirical research, which highlights that violence against older adults encompasses various forms of abuse, including psychological or emotional abuse (e.g., yelling, insults, name-calling), physical abuse (e.g., pushing, grabbing, pinching, physical restraint, punching), economic or financial abuse (e.g., improper or illegal use of older adults’ financial resources, stealing or extorting money, pressuring into changing a will), and sexual abuse (e.g., sexual harassment, forced vaginal penetration), as well as intentional (e.g., ignoring a resident, deliberately delaying care) or unintentional neglect (Alexa et al. 2019; Ben Natan et al. 2010; Botngård et al. 2020; Luzny and Jurickova 2012; Primc and Lobnikar 2019). This mistreatment can manifest in diverse domestic, private, and institutional settings and may be perpetrated by various individuals, such as caregivers, relatives, spouses, or other family members (WHO 2011). Research findings on the prevalence of violence against older adults in various care settings indicate that in nursing homes, there is a high incidence of psychological abuse, neglect, and physical violence (Ben Natan and Lowenstein 2010; Botngård et al. 2020; Bužgová and Ivanová 2011; Moore and Browne 2017; Yon et al. 2019), while in the home environment, self-neglect, neglect, and psychological abuse prevail (Alexa et al. 2019; Bostanci Daştan et al. 2021; Edirisinghe et al. 2014; Nisha et al. 2016; Patel et al. 2018; Primc and Lobnikar 2019).

Among the various forms of elder abuse, intimate partner violence (IPV) in older women remains particularly overlooked. Despite significant overlaps between the two, IPV among older women is often treated as a separate issue rather than being recognized within the broader discourse on elder abuse. This conceptual divide has critical implications for intervention strategies, as current policy frameworks fail to account for the gendered dimensions of elder abuse, frequently misclassifying IPV in older women as generic elder mistreatment (Orte and Sánchez 2012). As a result, older female IPV victims are often overlooked, with their abuse framed as a caregiver burden rather than as domestic violence (Casado Verdejo and Bárcena Calvo 2014). This misclassification has severe consequences, as interventions tend to focus on reducing caregiver stress rather than empowering survivors or removing them from abusive environments (Orte and Sánchez 2012). Additionally, documentation practices in social work, legal systems, and healthcare settings frequently fail to capture the lived experiences of older survivors, reinforcing their invisibility in domestic violence policies and interventions (Isobe et al. 2025). Certain subgroups of older women are particularly at risk. Women over the age of 75 who are unmarried or single, have limited social networks, lower levels of education, and poor health conditions (often suffering from dementia), and who require assistance with daily activities and are economically dependent on the perpetrator constitute the most vulnerable group to elder abuse. Studies indicate that this group faces a heightened risk of experiencing violence in domestic (non-institutionalized) settings, where the most common perpetrators are family members, including daughters-in-law, children, partners, siblings, and other relatives (Alexa et al. 2019; Bužgová and Ivanová 2011; Nisha et al. 2016; Patel et al. 2018; Primc and Lobnikar 2019). The combination of isolation, economic dependence, and physical vulnerability significantly limits their ability to seek help or escape abusive environments, reinforcing their exposure to long-term mistreatment. Research indicates that IPV among older women is severely underreported, as many victims do not perceive themselves as abused due to lifelong gender norms and traditional values that emphasize endurance, self-sacrifice, and marital permanence. Deeply ingrained cultural expectations, religious beliefs, and economic dependency contribute to a culture of silence, preventing many older women from seeking help (Casado Verdejo and Bárcena Calvo 2014). Domestic violence services primarily cater to younger women with children, leaving older victims feeling excluded, invisible, and underserved (Orte and Sánchez 2012). Furthermore, IPV among older women is rarely included in public awareness campaigns, further contributing to low recognition and a lack of targeted interventions (Casado Verdejo and Bárcena Calvo 2014). A review of existing projects reveals the presence of elder abuse prevention programs, as well as specific initiatives aimed at providing secure accommodations for older adults and victims of abuse, along with certain gaps and deficiencies in their implementation and coverage. Notably, a key limitation of current safe house programs for older adults is their narrow development, primarily within select U.S. states and partially in Canada, with few to no such programs identified in Slovenia, Europe, or globally. Furthermore, considering numerous studies (Botngård et al. 2020; Bužgová and Ivanová 2011; Lachs et al. 2016; Ben Natan et al. 2010; Ben Natan and Lowenstein 2010; Primc and Lobnikar 2019; Šmit and Leskovic 2013; WHO 2022b) indicate that elder abuse also occurs within nursing homes and long-term care facilities, the establishment of a safe house within these accommodations is not deemed an optimal solution, a perspective supported by several other authors (Lachs et al. 2021, 2016). In addition, the act of transitioning from one’s residence to a nursing home has been linked to the occurrence of »transfer trauma«, leading to significantly heightened levels in terms of unfavorable outcomes, including health instability, hospitalization, and mortality, particularly within the initial three-month period following admission (Hirdes et al. 2019). Compounding these challenges, the health consequences of IPV in older women are severe and long-lasting. Studies show that older IPV survivors suffer from higher rates of chronic illness, PTSD, depression, and an increased mortality risk. Many victims develop maladaptive coping behaviors, such as substance use, overmedication, and social withdrawal, which further increase their vulnerability. However, traditional shelters and crisis centers are often ill-equipped to accommodate older women, as they may require specialized medical care, accessible housing, and age-appropriate social interventions (Casado Verdejo and Bárcena Calvo 2014). In addition, economic dependency on their abusers remains a significant barrier, as retirement benefits, home ownership, and pension structures are often tied to the perpetrator, making leaving an abusive environment financially unfeasible for many victims. This lack of financial autonomy, combined with insufficient shelter programs and limited policy focus on older IPV victims, leaves many older women trapped in abusive situations with few viable exit strategies (Orte and Sánchez 2012).

Elder abuse in rural environments presents distinct challenges compared to urban settings, largely due to economic instability, lack of healthcare services, limited transportation, and cultural stigma, all of which prevent many victims from seeking or receiving help (Boka 2005; Eastman et al. 2007; Grama 2000; Logan et al. 2003, 2004, 2005a, 2005b; Pruitt 2008; Neill and Hammatt 2015). Older women in rural areas face a heightened risk of IPV, as traditional gender norms, close-knit community surveillance, and distrust of external support services create significant barriers to intervention (Casado Verdejo and Bárcena Calvo 2014). The ideology of self-sufficiency in rural communities discourages victims from seeking outside help, while social proximity inhibits reporting, as victims and perpetrators often belong to the same small social networks (Knežević Hočevar 2016). The scarcity of domestic violence shelters and elder-specific safe houses in rural areas further compounds these challenges, leaving many victims without viable escape options and forcing them to remain in abusive environments (Knežević Hočevar 2016; Meško 2020; Meško et al. 2020). The structural limitations of rural environments that contribute to the poor recognition of domestic violence can be understood through four main explanations. First, domestic violence is often not seen as a crime because it occurs within families, aligning with the rural cultural norm of not questioning family matters. Second, victims in rural areas face a higher likelihood of repeat violence after leaving their abuser, as community values discourage separation and emphasize self-reliance over external intervention. Third, poor awareness of the dynamics of violence and victims’ rights leads to tolerance or normalization of violence as part of everyday life, making it less likely that victims will seek legal or social assistance. Finally, close-knit communities in rural areas hinder reporting. Victims often mistrust support services, as representatives are embedded in the same environment and know both the victim and perpetrator (Knežević Hočevar 2016).

The challenges associated with elder abuse in rural environments are not unique to any one country; rather, they are a pervasive issue across various regions where geographic isolation, cultural norms, and limited services create barriers to intervention. In Slovenia, rural communities face many of the same obstacles observed in other countries, with older victims often struggling to access protection and support due to deeply ingrained social expectations and insufficient institutional resources. Fear of crime and social proximity significantly impact the help-seeking behavior of older adults in rural areas, as many victims avoid reporting abuse due to fear of retaliation or community ostracization, especially when perpetrators are family members or close acquaintances (Meško et al. 2007). Low trust in law enforcement and victim protection services further discourages intervention, as many older victims perceive the police as ineffective in handling abuse cases (Meško et al. 2007). The lack of dedicated elder abuse support services in rural Slovenia means that victims often rely on informal community networks for assistance, which may not always be equipped to handle domestic violence situations (Meško et al. 2020).

Based on this review, we formulated three key research questions to explore the perceptions, response, and challenges of addressing elder abuse. The first research question (RQ1) focused on how the severity of elder abuse is perceived, with a particular emphasis on whether differences exist between police officers and social workers in their assessment of this issue. Understanding these differing perspectives was crucial, as they shape the actions taken by professionals in responding to abuse cases and highlight the importance of collaboration across sectors. The second research question (RQ2) investigated the response to elder abuse, focusing on whether factors such as knowledge, expertise, and professionalism among police officers and social workers influence perceived responses and an understanding of its severity. By uncovering these connections, the study sought to provide insights into how professional competencies and preparedness impact the effectiveness of interventions. The third research question (RQ3) focused on identifying challenges and good practices in addressing elder abuse within this context. This aspect of the research aimed to uncover obstacles that hinder effective responses, such as resource limitations, institutional barriers, or societal attitudes while highlighting successful practices and strategies implemented to protect older adults. Together, these research questions provided a comprehensive understanding of elder abuse, offering guidance for improving responses, fostering collaboration among professionals, and enhancing the overall support system for older adults at risk.

1.2. Understanding Elder Abuse—Theoretical Background

To gain a deeper understanding of the complexities of elder abuse and contextualize the research questions, it is essential to examine theoretical frameworks and perspectives developed to explain causes, dynamics, and consequences. Research on elder abuse draws from disciplines such as sociology, as well as gerontology, social work, psychology, and criminology, each offering distinct perspectives and frameworks to understand and address elder abuse (Goergen and Beaulieu 2010). These theories provide a foundation for analyzing the factors that contribute to elder abuse and inform strategies for its prevention and intervention.

From a criminological perspective, Routine Activity Theory (RAT) has been applied to understand older person victimization, especially in long-term-care facilities, and to develop policies as a guide to preventing elder abuse (Payne and Gainey 2006). RAT posits that criminal opportunities arise when three elements converge: a motivated offender (a person capable of committing a crime), a suitable target, and the absence of capable guardians (who could prevent the crime) (Cox 2008; DeLiema 2018; Goergen and Beaulieu 2017; Setterlund et al. 2007). RAT provides valuable insights into preventing elder abuse by informing older individuals and their relatives about risks, educating professionals to detect early signs of abuse, and, if necessary, removing the elderly from abusive environments (Goergen and Beaulieu 2010, 2017; Setterlund et al. 2007).

In terms of an interpersonal approach, Caregiver Stress Theory suggests that high caregiver stress levels are more likely to lead to elder maltreatment. The elderly victim is typically described as highly dependent on the caregiver, who becomes overwhelmed, frustrated, and resorts to abusive behaviors due to the constant demands of providing care to an older adult (Abolfathi Momtaz et al. 2013; Burnight and Mosqueda 2011; Jackson and Hafemeister 2013). Social Learning Theory proposes that violent behavior is learned through observation. It attempts to explain the intergenerational transmission of violence (Abolfathi Momtaz et al. 2013; Gholipour et al. 2020; Hyde-Nolan and Juliao 2012; Ziminski Pickering and Phillips 2014a). In the context of elder abuse, individuals who engage in abusive behavior have learned to use violence from previous experience, either as a means to resolve conflicts or to achieve desired outcomes (Burnight and Mosqueda 2011; Mosqueda et al. 2016). A third interpersonal approach, Social Exchange Theory, explains interactions between people as a process of negotiated exchange, which may include material resources like money and housing and non-material resources like approval and prestige (Mosqueda et al. 2016). If all involved parties perceive a balance between »profit and costs«, there is a mutually satisfying balanced exchange (Fundinho et al. 2021). As applied to elder abuse, it suggests that abusers perceive themselves as being unjustly treated or not receiving their fair share within their relationship with the older adult. Consequently, they turn to violence to restore or attain what they believe to be a rightful balance (Jackson and Hafemeister 2013). Cycle of Violence Theory highlights the predictable pattern of abusive relationships: the tension-building phase, the acute battering incident, and the honeymoon phase. The trend within each cycle is for the cycle duration to decrease while the intensity of the violence within it increases. Breaking the cycle is crucial to ensure the safety of victims of abuse (Wilson 2019).

Sociocultural theories consider larger societal and cultural factors. Power and Control Theory highlights the abuser’s use of coercive tactics to gain and maintain power and control in the relationship (Brandl 2000; Burnight and Mosqueda 2011; Mosqueda et al. 2016). It emphasizes that the abuser relies on the victim, such as adult children living at home and depending on their parent’s resources. The abuser’s dependence can be financial, emotional, or based on practical needs, like having meals prepared (Brandl 2000). Ecological Theory considers a wide range of factors that may contribute to abuse, including characteristics of the vulnerable elder, the trusted other, characteristics of the relationship between the vulnerable elder and trusted other (Mosqueda et al. 2016), and external influences on the relationship, such as the timing of caregiving, employment status, availability of formal or informal support, and cultural norms (Ziminski Pickering and Rempusheski 2014b).

All these theories, by highlighting key factors and each explaining one part of the phenomenon, collectively point to the need to break the cycle of violence by removing victims from abusive environments, which interrupts the pattern of abuse and creates opportunities for safety and healing. The theories support the fundamental understanding that providing a safe place for victims is critical in addressing elder abuse and supporting victims’ well-being and recovery. The need to help victims of abuse is not only based on theories but also on our shared humanity and a recognition of the importance of assisting those in distress.

2. Responding to Elder Abuse

2.1. National Projects and Programs

Addressing elder abuse requires multidimensional and multisystem actions, such as policy formulation, raising awareness, social response, and diverse services to stop or reduce elder abuse (Alon and Berg-Warman 2014; Moore and Browne 2017). In some countries (e.g., USA and Canada), adult protective services (APS) is the primary public agency responsible for investigating potential abusive situations involving elderly individuals within communities through legal, medical, and social services (Roberto 2016). Many elder abuse prevention programs now incorporate multidisciplinary teams (MDTs), which provide the combined knowledge of various professionals such as police officers, social workers, attorneys, and doctors. These teams effectively address cases of elder abuse, showcasing strength in their ability to meet multiple needs through collaborative efforts (Alon and Berg-Warman 2014; Lachs et al. 2021; Lachs and Pillemer 2015; Pillemer et al. 2016). Several studies examining the outcomes and impact of interventions with respect to victims of abuse found that victims experienced a decrease in the amount and severity of abuse and neglect, a decrease in victims’ dependence on their abusers or family members, an improvement in their self-esteem, treatment for medical problems that were previously unaddressed because of the isolation, and a reduction in abusers’ economic dependence on victims (Alon and Berg-Warman 2014; Lachs et al. 2021; Rizzo et al. 2015). Strategies like legal restrictions on perpetrators (e.g., arrest, restraining order, removal from home) (Storey et al. 2022) and removing victims from unsafe environments or removing abusers from their homes significantly reduced instances of neglect and abuse (Alon and Berg-Warman 2014; Lachs et al. 2021; Rizzo et al. 2015). Overall, these interventions led to the cessation of abuse by supporting victims, empowering their decision-making abilities, providing information, and referring them for further treatment (Alon and Berg-Warman 2014). Telephone helplines are widely used globally for advice and assistance in elder abuse cases, facilitating early intervention to prevent or forestall mistreatment (Moore and Browne 2017; Pillemer et al. 2016). Caregiver interventions also hold significant promise as an effective approach to elder abuse prevention, alleviating the burdens of caregiving by helping with housekeeping and meal preparation, offering respite care, conducting educational programs, facilitating support groups, and providing daycare services (Livingston et al. 2013; Pillemer et al. 2016). Compelling case studies show that money management programs are carefully designed to assist vulnerable individuals with daily financial tasks (such as bill payments and bank deposits), effectively preventing financial exploitation (Pillemer et al. 2016). Hospitals and emergency departments (EDs) also have a vital role in identifying and intervening in various forms of family violence, including elder abuse. Innovative approaches like Vulnerable Elder Protection Teams (VEPTs) and emergency department elder abuse screening programs are being developed to enhance elder abuse identification and intervention (Elman et al. 2020; Lachs et al. 2021; Platts-Mills et al. 2018).

2.2. Community Projects and Programs

The use of nursing home beds to shelter community elder abuse victims is an idea that has recently gained attention (Lachs et al. 2021). Some communities have added alternative accommodations, such as foster homes, apartments, and even motels (The Weinberg Center for Elder Justice 2018; Vognar and Gibbs 2014). Within these shelters, a multidisciplinary team collaborates with each client to develop and execute a comprehensive, trauma-informed strategy focused on addressing the abuse, promoting healing, and, whenever possible, returning the client safely to the community. The services include case management, intensive therapeutic support, and comprehensive legal support (The Weinberg Center for Elder Justice 2018).

Specialized shelter programs operated by various non-profit organizations (Kootenai Community Centre Society n.d.; Sage n.d.; Saint Elizabeth Community n.d.; Smith Life Communities n.d.; Wyoming Safehouse n.d.) have emerged as concrete solutions to address the pressing needs of victims of elder abuse. Through a multifaceted approach, these programs provide essential services, such as support groups and advocacy programs, financial and housing assistance, emotional support, and counseling. Their primary purpose is to provide victims of elder abuse a temporary refuge and protection from their abusive environments, acting as a critical stepping stone for a safe return to the community or a potential transition into a more sustainable long-term-care setting. Victims receive personalized care and support, empowering them to develop safety plans and explore suitable long-term housing options, ensuring permanent escape from the cycle of abuse. Similarly, transitional houses provide temporary accommodation and support to older individuals transitioning from one living situation to another (Atira Women’s Resource Society n.d.; Victoria Women’s Transition House Society n.d.). With individual or group counseling sessions and life skills training, the shelter environment focuses on empowering survivors to regain control of their lives, break the cycle of abuse, and work toward healing and recovery. Their commitment also increases public awareness and education about elder abuse. Descriptive studies of shelter programs have shown positive results (Heck and Gillespie 2013), such as providing a medically appropriate environment, preventing permanent relocation to a nursing home, and providing security while allowing a plan for safety at home to be put in place, indicating that this is a promising program option (Pillemer et al. 2016).

In Slovenia, there are 11 counseling centers for victims of violence, 13 safe houses for victims of domestic violence, and a network of seven programs specifically for older adults at risk of social exclusion or in need of support and assistance in everyday life, including other support programs for older individuals in distress, their relatives, and intergenerational centers. Of these, one counseling center for victims of violence, one safe house, and one support program for people with dementia and their relatives are in the Pomurska region. There are no safe houses at the national level specifically for victims of elder abuse (Ministry of Labour, Family, Social Affairs, and Equal Opportunities n.d.a, n.d.b.).

3. Methods

3.1. Study Background—Administrative and Social Context of Pomurska Region

The Republic of Slovenia is a country in Central Europe that covers 20.271 square kilometers and has a population of 2.1 million. The nation’s capital and largest city is Ljubljana. Administratively, Slovenia is divided into 12 statistical regions: Pomurska, Podravska, Koroška, Savinjska, Zasavska, Posavska, Jugovzhodna Slovenija, Osrednjeslovenska, Gorenjska, Primorsko-notranjska, Goriška, and Obalno-kraška. The Pomurska region (where the research was conducted), located in northeastern Slovenia, is characterized by its predominately rural landscape. It is the seventh largest statistical region, encompassing four administrative units—Murska Sobota, Gornja Radgona, Lendava, and Ljutomer—along with 27 municipalities. It is one of the country’s most demographically and economically distinct areas, characterized by a predominantly agricultural landscape, with fertile soil, a continental climate, and vast arable land that accounts for more than 80% of all agricultural land in use—twice the national average. Despite gradual economic improvements, the Pomurska region continues to face persistent challenges, such as high unemployment, low disposable income, and an aging population. In 2023, the average net salary (EUR 1335.89) remained below the national average (EUR 1445.12), and the region had the highest registered unemployment rate in Slovenia, ranging from 4.7% to 6.8% across subregions. A particularly vulnerable group includes persons with disabilities and persons older than 50 years, who make up 25% of the unemployed, significantly above the national average of 15.5%. Additionally, the Pomurska region has experienced negative population growth for over a decade, and its average age of 46.3 years is the highest in Slovenia (Statistical Office of the Republic of Slovenia 2025a). With approximately 113.551 residents (5.8% of Slovenia’s population), the Pomurska region is also one of the most rapidly aging regions in the country. The aging index, which reflects the number of people aged 65 and older per 100 children under 15, is among the highest in Slovenia (Regional Development Agency Sinergija n.d.). Older adults, 65 years and older, represent 25.4% of the regional population, reinforcing concerns about age-related vulnerabilities and the demand for specialized elder care services (Statistical Office of the Republic of Slovenia 2025b). The region is also ethnically diverse, with indigenous Hungarian and Roma communities residing along the Hungarian border, though they represent less than one percent of the population. As a crossroads of cultures, religions, languages, and ethnic groups, the Pomurska region has a rich cultural heritage that distinguishes it within Slovenia (Statistical Office of the Republic of Slovenia 2025a).

Law enforcement in the Pomurska region is managed by the Murska Sobota Police Directorate, which oversees five regional police stations in Murska Sobota, Lendava, Gornja Radgona, Ljutomer, and Gornji Petrovci, along with three specialized police stations. The directorate’s jurisdiction covers the northeastern part of Slovenia, spanning an area of 1336 square kilometers, which represents 6.6% of the country’s total territory (Policija n.d.).

In Slovenia, social work centers (SWCs) are organized as public social welfare institutions responsible for implementing state-mandated social services. They operate regionally, covering designated administrative units, and are further divided into organizational units within larger regions. SWC Pomurje covers four administrative units—Gornja Radgona, Lendava, Ljutomer, and Murska Sobota. It provides various social welfare programs, including child and family care, adult care, financial and social assistance, and parental protection insurance. Its services also extend to first social aid, personal assistance, family home support, social prevention, and the coordination of local networks for social welfare programs (Center za socialno delo Pomurje n.d.). Recognized for its innovative and collaborative approach, SWC Pomurje was awarded the European Social Services Award 2022 by the European Social Network (ESN) for its integrated and multidisciplinary support system. The center has been acknowledged for bringing together social workers, healthcare providers, educators, and law enforcement to ensure comprehensive assistance to vulnerable groups, particularly older adults, families in crisis, and children in need. This award highlights Slovenia’s progress in modernizing social work practices and positions SWC Pomurje as a case of good practice in collaborative social welfare services at the European level (Bakos 2022).

All 16 social work centers in Slovenia are included in the Association of Centers for Social Work of Slovenia, within which the Regional Service for Coordination and Victim Support operates. These services ensure a standardized and coordinated approach to assisting victims of violence, implementing intervention measures, and monitoring violence-related issues in the region. The services also include intervention units, crisis centers, and regional coordinators for violence prevention (Association of Centres for Social Work of Slovenia n.d.).

3.2. Questionnaire Description

Following a focused literature review, a questionnaire was developed for self-administration to gather information and opinions from professionals working in various fields regarding the issue of violence against older adults and the need to establish a safe house specifically dedicated to victims of elder abuse in the community in which they work. It consisted of a combination of multiple-choice questions, rating scales, and open-ended questions to capture both quantitative and qualitative insights. The main domains of the questionnaire included assessing respondents’ (1) general perceptions of the seriousness of different forms of violence against older adults (also in comparison with intimate partner violence, family violence, and violence among youth in the school environment and outside); (2) evaluation of the severity of various specific forms of violence against older adults; (3) rating of the effectiveness of formal institutions and other organizations in responding to violence against older adults, both in comparison to responding to other forms of violence and across different living situations (private vs. institutional); (4) opinion on the necessity of different response measures when violence against older adults occurs (e.g., informal assistance, counseling, operation of MDTs, operation of crisis centers, and establishment of a safe house); and (5) self-perceived knowledge and competencies in recognizing signs of violence against older adults and conducting interviews with victims of violence.

Regarding the general perception of the severity of different forms of elder abuse in the Pomurska region, respondents evaluated the perceived severity of physical, psychological, sexual, economic/material abuse, and neglect of older adults. The domains for individual forms of abusive behavior were based on the definitions provided by the World Health Organization (WHO 2011). Respondents rated the severity on a scale of 1 to 5, where 1 meant that a particular form of violence is not a problem at all and 5 indicated it is a severe problem.

When evaluating the quality of responses from formal institutions and other organizations to elder abuse cases in private and institutional settings, respondents chose between the following options: very poor, poor, neither poor nor good, good, very good, or do not know. When asked to assess their competencies in recognizing external signs of abuse and conducting interviews with older adults who are victims of abuse, respondents chose from four possible answers: not at all, mostly not, somewhat sufficient but needs improvement, and sufficient for good work.

Finally, we asked participants how necessary they perceived specific responses to elder abuse in their environment, including informal assistance, counseling, operation of MDTs, operation of crisis centers, and the establishment of a safe house specifically dedicated to victims of elder abuse. Respondents rated their opinions on a scale of 1 to 5, where 1 meant not necessary at all and 5 indicated very necessary.

Open-ended questions allowed respondents to provide examples of good practice from their work with victims of elder abuse and to describe the main challenges they face in this field. Responses to open-ended questions were analyzed using qualitative content analysis to identify recurring themes and patterns. First, responses were coded inductively, allowing for the systematic identification and construction of themes based on the data. Thematic analysis was then conducted to categorize responses into major themes. To enhance reliability and consistency, two researchers were involved in coding a subset of the qualitative responses.

In the last part of the questionnaire, we also collected data on the demographic characteristics of the respondents, such as age, gender, education level, profession, and geographic location of their work. These variables were included to provide a sample profile and ensure a well-rounded understanding of the professional backgrounds of those responding to the survey. Close-ended questions were primarily analyzed using descriptive and inferential statistical methods in SPSS version 29.0 (Statistical Package for the Social Sciences). Descriptive statistics (e.g., mean, standard deviation, and frequency distributions) were used to summarize responses. Cronbach’s alpha was computed in SPSS to assess the internal consistency and reliability of rating scales, yielding values of 0.91 and 0.92 for the sections on severity perception and response necessity, respectively. Comparative analyses were conducted using t-tests, ANOVA, and Cohen’s d test to examine potential differences between respondent groups.

The questionnaire was piloted with an expert in the field of elder abuse and the violence prevention coordinator in the Pomurska region to obtain feedback on wording and suggestions for additional questions. Their feedback led to refinements in the wording of certain items and the addition of relevant questions. The final version of the questionnaire ensured clarity, validity, and comprehensiveness in assessing the perceptions and experiences of professionals working in this field.

3.3. Data Collection

Approval to conduct the survey was obtained from the Ethics Commission of the Faculty of Criminal Justice and Security, University of Maribor, in May 2023. The target population consisted of social workers and police officers, who serve as first responders to violence in Slovenia and play a crucial role in defining further actions taken by other institutions, such as NGOs and courts, in addressing violence. The questionnaire was available in both paper and online formats, allowing respondents to select their preferred method of participation. Respondents could select either format but were restricted to completing the questionnaire only once, on paper or online. The paper questionnaires were distributed at a roundtable discussion on elder abuse organized by SWC Pomurje in Murska Sobota in June 2023. All first responders involved in addressing elder abuse in the Pomurska region were invited to the roundtable. We disseminated the questionnaires through internal communication channels to social workers and police officers. The invitation explained that participation in the survey was voluntary and anonymous. We surveyed between June 2023 and March 2024 because we first had to obtain formal approval from the police administration before distributing the electronic version of the questionnaire to police officers. This approval process was necessary to ensure compliance with institutional protocols and ethical guidelines regarding data collection within law enforcement. Once the official authorization was granted, we proceeded with the survey administration.

3.4. Sample

There are many responders to domestic violence and elder abuse in Slovenia, including healthcare providers, NGOs, and state agencies. However, the police and SWC are the primary frontline responders. The police respond to incidents by issuing restraining orders, conducting investigations, and protecting victims while closely cooperating with other agencies, particularly SWCs. Rules on the cooperation of authorities and the operation of social work centers, multidisciplinary teams, and regional services in addressing domestic violence (Rules on the Cooperation of Authorities 2009) designate the SWC as the local authority for handling domestic violence cases, coordinating multidisciplinary teams, organizing intervention services, and implementing urgent protective measures. Thus, the police and SWC are the leading institutions for detecting and addressing violence, as they are the only authorities with the power to act, operate 24/7, and monitor the victim throughout the entire process. Therefore, in our research sample, we focused on these two populations.

A total of 100 first responders from police and the SWC (51 social care workers and 49 police officers) from the Pomurska region participated in the survey. The Slovenian police force employs over 8000 police officers, with approximately 480 officers working within the Police Directorate Murska Sobota. There is no official specialization within the Slovenian police specifically focused on responding to intimate partner violence and domestic violence. As a result, Slovenian police officers are considered generalists in policing. However, within individual police stations, internal specialization by area of work is implemented. Therefore, for this research, we invited all police officers who serve as first responders to incidents of violence. An invitation to participate in the survey was sent to 191 officers in five local police stations (Murska Sobota, Gornja Radgona, Ljutomer, Lendava, Gornji Petrovci), and 75 of them clicked on the survey link, while 48 completed the questionnaire. Additionally, one police officer completed the survey on paper, bringing the total number of completed responses to 49. This results in a response rate of 25.65% among police officers. The response rate among social workers was higher, as the survey was conducted during a seminar attended by nearly all social workers from the Pomurska region who are involved in responding to violence. Consequently, the sample size for social workers in the study is highly representative of the total population of social workers in the Pomurska region who deal with interpersonal violence. The respondents included 44 men (44.4%) and 54 women (54.4%), while two did not indicate their gender. The average age was 45; the youngest respondent was 22 and the oldest was 68. Most of the respondents had university degrees (56.1%).

4. Results

This section presents the study’s findings, which explore professionals’ perceptions, responses, and challenges related to elder abuse in the rural Pomurska region of Slovenia. To effectively respond to elder abuse, it is first necessary to understand whether it is even recognized as a problem that requires intervention. First, we examined how social workers and police officers perceive the severity of elder abuse overall, as well as its different forms—physical, psychological, economic/material, sexual abuse, and neglect.

As described, the first research question examined perceptions of the severity of elder abuse, with a particular focus on whether police officers and social workers differ in their assessments of this issue. The results of our analysis are presented in the following tables. The results in

Table 1. How seriously do social workers and police officers perceive elder abuse in their community?

Field of Work	N	M	SD	Not a Serious Problem (1 + 2) in %	Serious Problem (4 + 5) in %	t-Test/ p	Cohen’s d *
Social work	50	4.30	0.86	20.00%	78.00	4.49/0.001	0.983
Police	47	3.40	1.10	15.9%	44.60

* Cohen’s d is a measure of effect size in statistics that quantifies the difference between two group means in terms of standard deviation. It is used in hypothesis testing and meta-analyses to evaluate the practical significance of a result. Cohen’s d indicates the magnitude of the difference between groups, independent of sample size. Its interpretation is as follows: small effect (d = 0.2), medium effect (d = 0.5), and significant effect (d = 0.8).

show significant differences in how social workers and police officers perceive the seriousness of elder abuse. Social workers gave a higher average rating (M = 4.30, SD = 0.86) than police officers (M = 3.40, SD = 1.10). A t-test analysis confirmed that this difference is statistically significant (t = 4.49, p = 0.001). Cohen’s d (d = 0.983) demonstrated a large effect size, suggesting a meaningful, practical difference between the groups.

Descriptive statistics further revealed that 78% of social workers consider elder abuse a serious problem (ratings of 4 or 5), whereas this percentage drops significantly to 44.6% among police officers. The findings suggest that social workers perceive elder abuse as a more serious issue, likely due to their closer work with vulnerable populations. These differences may also stem from the two groups’ varying professional experiences, priorities, or training.

The results in

Table 2. How severely do social workers and police officers perceive different forms of elder abuse in their community?

Form of Abuse	N	M	SD	M	SD	M	SD	t-Test/p	Cohen’s d
	Valid	Total		Social Work		Police
Physical abuse	98	3.74	1.11	4.14	0.91	3.35	1.16	3.76/0.001	1.05
Sexual abuse	91	2.98	1.29	4.47	1.28	2.54	1.15	3.63/0.001	1.21
Psychological abuse	100	4.25	0.96	4.71	0.58	3.78	1.05	5.48/0.001	0.84
Economic and material abuse	100	4.10	1.09	4.71	0.57	3.47	1.14	6.81/0.001	0.89
Neglect	98	4.02	1.03	4.55	0.73	3.45	1.02	6.11/0.001	1.13

indicate that psychological abuse is perceived as the most serious form of elder abuse (M = 4.25), followed by economic and material abuse (M = 4.10), neglect (M = 4.02), physical abuse (M = 3.74), and lastly, sexual abuse (M = 2.98). The standard deviations revealed some variation in opinions, with the highest variability observed for sexual abuse (SD = 1.29) and the lowest for psychological abuse (SD = 0.96).

A comparison between social workers and police officers revealed significant differences in how seriously they perceive these forms of abuse. Social workers consistently rated all forms of elder abuse as more serious than police officers. For example, physical abuse was rated 4.14 by social workers and 3.35 by police officers (p = 0.001, d = 1.05). Similarly, sexual abuse was perceived as significantly more serious by social workers (M = 4.47) compared to police officers (M = 2.54), with a considerable effect size (Cohen’s d = 1.21).

Similarly, psychological abuse, economic abuse, and neglect were all rated significantly higher by social workers. Psychological abuse, although recognized as serious by both groups, was scored 4.71 by social workers and 3.78 by police officers (p = 0.001, d = 0.84). Economic and material abuse was also perceived as much more serious by social workers (M = 4.71) compared to police officers (M = 3.47; p = 0.001, d = 0.89). Neglect followed a similar pattern, with social workers rating it at 4.55 and police officers at 3.45 (p = 0.001, d = 1.13). Overall, the findings show that social workers perceive all forms of elder abuse as significantly more serious compared to police officers. These differences are statistically significant and practically meaningful, indicating notable disparities in perspectives and perceptions of the problem between the two groups.

Recognizing the significant differences in perceptions between the two groups, we proceeded to assess how respondents evaluated their competencies in identifying external signs of violence and conducting interviews with older adults who are victims of violence. The second research question investigated the response to elder abuse, focusing on whether knowledge, expertise, and professionalism among police officers and social workers influence perceived responses and the understanding of its severity. For knowledge related to recognizing external signs of violence, the average score among respondents from social services was 3.24 (SD = 0.687), while among respondents from security institutions, the average was 3.23 (SD = 0.692). The difference between the averages is minimal, and the t-test results showed that it is not statistically significant. For self-assessment of knowledge regarding conducting interviews with older adults who are victims of violence, the average score for social services employees was 3.16 (SD = 0.650), while for respondents from security institutions, it was 3.17 (SD = 0.630). Again, the difference between the averages is minimal and not statistically significant.

We further analyzed the correlation between self-assessed competencies and the perception of the severity of violence against older adults. The correlation analysis results for respondents from social services revealed significant relationships between the variables. The most pronounced was a strong positive correlation between knowledge related to recognizing signs of violence and knowledge related to conducting interviews (r = 0.598; p < 0.001). This indicates that better competencies for recognizing external signs of violence are associated with greater confidence in conducting interviews with older adult victims.

Significant correlations emerged between assessments of the severity of violence and various forms of violence, specifically psychological violence (r = 0.550; p < 0.01), economic/material violence (r = 0.672; p < 0.01), and neglect (r = 0.609; p < 0.01). This means that respondents who perceive violence against older adults as a more serious problem are also more likely to recognize other forms of violence, such as psychological abuse, economic/material violence, and neglect. Notable correlations are also observed between specific types of violence: physical violence and sexual violence (r = 0.736; p < 0.01), psychological violence and neglect (r = 0.582; p < 0.01), and economic/material violence and neglect (r = 0.725; p < 0.01). These correlations suggest that different forms of violence often co-occur and are perceived as interconnected by respondents.

Among social workers, a weaker but statistically significant positive correlation was found between the perceived severity of violence and sexual violence (r = 0.314; p = 0.043), indicating a somewhat lower but still noticeable relationship between the seriousness of the problem and recognition of sexual violence. Overall, the correlation analysis results for social services demonstrated strong positive relationships between perceived competencies and various forms of elder abuse. The connection between competencies for recognizing signs of violence and conducting interviews is particularly notable. Moreover, respondents who assessed violence as a serious problem were more likely to identify different forms of violence, reflecting a comprehensive understanding of the issue.

For police officers, the strongest correlation observed was the firm positive relationship between knowledge related to recognizing signs of violence and knowledge related to conducting interviews (r = 0.838; p < 0.001), indicating a high level of association between these competencies. This suggests that a better understanding in terms of recognizing external signs of violence positively influences confidence in conducting interviews with older adult victims. Statistically significant correlations were also found between the perceived severity of violence and various forms of violence: physical violence (r = 0.683; p < 0.001), psychological violence (r = 0.700; p < 0.001), economic/material violence (r = 0.701; p < 0.001), and neglect (r = 0.668; p < 0.001). Additionally, there was a strong correlation between physical violence and sexual violence (r = 0.690; p < 0.001) and between psychological violence and neglect (r = 0.779; p < 0.001). These correlations emphasize that different forms of elder abuse often overlap and are perceived as interconnected by respondents. However, among police officers, statistically significant negative correlations were observed between perceived competencies and assessments of the severity of violence, specifically between knowledge related to conducting interviews and the evaluation of the severity of violence (r = −0.308; p = 0.038), the occurrence of sexual violence (r = −0.297; p = 0.043), and the perception of the severity of psychological violence (r = −0.324; p = 0.025). These negative correlations suggest that those who perceive violence as a more serious issue express lower confidence in their competencies with respect to conducting interviews with older adult victims. The correlation analysis results for police officers highlight a strong relationship between competencies while also revealing a degree of uncertainty in confidence in terms of when they perceive elder abuse as a serious problem. Notably, the findings underscore that different forms of elder abuse are not isolated but interconnected in the perceptions of respondents.

The findings indicate that social workers who perceive elder abuse as a serious problem tend to recognize a broader range of abuse forms. Their competencies in recognizing signs of violence are closely linked to their ability to conduct interviews, reflecting a comprehensive understanding of the issue and high confidence in these skills. Among police officers, the most substantial connection lies between competencies related to recognizing signs of violence and conducting interviews. However, negative correlations indicate that perceiving violence as a serious problem may reduce their confidence in their competencies. These differences between police officers and social workers highlight varying approaches and perceptions of elder abuse, emphasizing the need for enhanced, targeted training for police officers to improve their confidence and effectiveness in addressing elder abuse.

While understanding respondents’ competencies provides insights into their ability to address elder abuse, it is also important to consider how institutions respond to such cases. The third research question focused on identifying challenges and good practices in addressing elder abuse within this context. In

Table 3. Assessment of institutional response quality.

How Well Institutional Responses Are Organized When Elder Abuse Occurs:	N	M	SD	Poor (1 + 2) in %	Neutral (3) in %	Good (4 + 5) in %
When victims of abuse (older adults) reside in private settings (at home, with relatives)	97	3.30	1.06	23.7	28.9	47.4
When victims of abuse (older adults) reside in institutions (nursing homes)	96	3.42	1.11	21.9	22.9	55.2

, assessments of the quality of institutional responses with respect to two elder abuse scenarios are presented: when victims reside in private settings (at home or with relatives) and when they live in institutions (nursing homes). The average response quality score is 3.30 in the first case and slightly higher at 3.42 in the second. The percentage of respondents rating the response as poor (scores of 1 or 2) is 23.7% for private settings and slightly lower at 21.9% for institutions. Conversely, the percentage of respondents who rated the response as good (scores of 4 or 5) is higher for institutions (55.2%) compared to private settings (47.4%).

A t-test revealed no statistically significant differences between the two scenarios when comparing the responses of social workers and police officers. The average scores among the two groups were similar, suggesting a slightly positive to moderate satisfaction with how formal institutions respond to elder abuse in both contexts. We used the paired sample statistics to compare the perceived adequacy of responses to elder abuse based on the location of the abuse. The perceived adequacy of institutional responses to elder abuse was slightly higher when victims reside in institutions (Mean = 3.42) compared to private settings (Mean = 3.27). The results of the paired t-test analysis indicated no statistically significant difference in respondents’ perceptions of the adequacy of institutional responses to elder abuse between private settings and institutional care settings. The correlation (r = 0.650, p < 0.001) demonstrated consistency in individual ratings across both scenarios, while the practical significance of the observed mean difference remains small (Cohen’s d = −0.162).

Recognizing the limitations in existing institutional responses, we further examined the types of interventions professionals perceive as essential for strengthening support systems and improving outcomes for older adults who are victims of abuse. The results in

Table 4. Assessment of necessary activities in cases of elder abuse.

How Necessary Are the Following Responses in Addressing Elder Abuse?:	N	M	SD	M	SD	Necessary (4 + 5) %	M	SD	Necessary (4 + 5) %	t-Test/p	Cohen’s d Test
		All Respondents		Social Work			Police
Informal support for older adults provided by NGOs.	99	4.00	1.06	4.47	0.78	86.2	3.50	1.09	43.8	5.05/0.001	0.94
Professional counseling by trained experts at the SWC.	98	4.23	0.92	4.50	0.76	88.0	3.96	0.99	66.7	3.04/0.003	0.88
Operations of MDTs dedicated exclusively to victims of elder abuse.	99	4.11	1.07	4.57	0.78	90.2	3.63	1.12	52.1	4.82/0.001	0.96
Establishment of crisis centers specifically for victims of elder abuse.	98	4.08	1.14	4.66	0.74	88.0	3.48	1.17	50.0	5.94/0.001	0.97
Establishment of safe houses exclusively for victims of elder abuse.	99	4.13	1.09	4.69	0.73	82.2	3.54	1.11	56.2	6.01/0.001	0.93

indicate that informal support provided to older victims of abuse by NGOs was rated highly. The overall mean score was 4.00, with social workers rating this support form at 4.47 and police officers at 3.50. A total of 86.2% of social workers considered this support necessary. Statistical analysis of differences between the two groups (measured using a t-test) revealed a significant difference between the two groups, with Cohen’s d = 0.94, indicating a strong effect. Professional counseling provided by trained experts at the SWC was one of the most highly rated forms of assistance. Social workers gave it an average score of 4.50, while police officers rated it somewhat lower at 3.96. Statistical analysis again confirmed a significant difference between the two groups, with Cohen’s d = 0.88, reflecting a strong effect.

The highest-rated intervention was the operation of MDTs dedicated exclusively to older victims of abuse. The overall mean score was 4.11, with social workers rating it 4.57 and police officers 3.63. As many as 90.2% of social workers considered such teams necessary. The difference between the two groups was statistically significant, with Cohen’s d = 0.96. Crisis centers specifically for older victims of abuse were also highly rated. The overall mean score was 4.08, with social workers scoring 4.66 and police officers 3.48. The statistically significant difference between the two groups and Cohen’s d = 0.97 points to a strong effect and divergence in perception between the two groups. The respondents also recognized the establishment of safe houses exclusively for older victims of abuse as very important. The overall mean score was 4.13, with social workers rating it at 4.69 and police officers at 3.54. As with the other interventions, the comparison between the two groups revealed a significant difference, with Cohen’s d = 0.93, indicating a strong effect.

The analysis revealed that social workers consistently rated all assistance forms as more necessary than police officers. Interventions such as MDTs, crisis centers, and professional counseling received exceptionally high ratings. Statistically significant differences highlight the varying perceptions between the two groups, emphasizing the need for greater social work involvement and improved coordination with the police. These findings underscore the importance of developing specialized services for older victims of abuse and stress the value of a multidisciplinary approach that integrates both social work and police efforts. Furthermore, investment in infrastructure, such as crisis centers and safe houses, as well as raising awareness and providing training for recognizing and addressing elder abuse, is strongly recommended.

Even with the recognition of necessary interventions and cooperation, addressing elder abuse remains a complex issue, particularly in rural settings, where unique obstacles persist. The challenges faced by first responders when dealing with elder abuse in rural environments are numerous and multifaceted. The first significant barrier is the inability of victims to report abuse due to physical isolation, limited access to institutions like SWCs, or complete dependency on others for assistance. Fear and mistrust of institutions are also prevalent, especially among victims who often hesitate to speak up about their experiences. This reluctance becomes even more pronounced when the perpetrators are close family members, such as their children, leading many victims to conceal or deny the abuse out of shame, emotional attachment, or fear of stigma.

A lack of resources and systemic shortcomings further exacerbate the issue. There is a notable absence of crisis accommodations, safe houses, and systemic solutions for immediate relocation or support for victims. For instance, when caregivers are unable to continue caring for immobile older adults, such as in cases of hospitalization, there are no adequate alternatives in place. Limited support services, including counseling, financial assistance, and other structured help, leave victims and their families without essential resources. Furthermore, recognizing and responding to elder abuse presents its own set of challenges. Poor awareness and limited recognition of abuse—both among victims and professionals—are compounded by cognitive limitations in some older adults, preventing them from fully understanding or acknowledging the situation. Abuse occurring in private home settings often remains invisible and unmonitored, making intervention even more difficult.

Trust and communication are critical issues that further complicate the response to elder abuse. Gaining victims’ trust is often a slow and delicate process, as many older adults are hesitant to share their experiences, mainly when abuse happens within their homes, among loved ones they still care for. Conducting compelling interviews with victims requires building a strong foundation of trust, which can be time-consuming and challenging for first responders. Cultural and social barriers also contribute to the difficulty of the resolution of elder abuse cases. In many instances, abuse is seen as a taboo subject and may even be normalized as part of everyday life. This cultural silence discourages victims from seeking help or leaving abusive situations. The emotional and cultural ties victims have to their families and homes make it difficult for them to embrace change, even when relocating to a safe environment is a necessary step for their protection.

The respondents also identified good practices in addressing elder abuse, emphasizing the importance of collaboration, safe spaces, trust-building, and proactive intervention. They pointed out that a key strength lies in cooperation between various institutions, including MDTs, interinstitutional working groups, and joint efforts by the police, healthcare providers, SWCs, and retirement homes. This coordinated approach has resulted in successful removals of older adults from harmful environments through the collective action of police, healthcare professionals, and SWCs.

Providing victims with safe spaces and relocation options has also emerged as a critical practice. Responders described instances where older adults were successfully removed from abusive environments and placed in crisis centers, nursing homes, or other protective settings. These interventions ensured immediate safety and protection for victims. In some cases, financial abuse was addressed by restricting access to funds by perpetrators, safeguarding the older adult’s resources, and providing economic stability. Such measures demonstrate the importance of timely and decisive action in ensuring victims’ well-being.

Equally significant is the focus on building trust and offering individualized support to victims. First responders highlighted the need to develop a confidential and supportive rapport with older adults, many of whom initially do not recognize themselves as victims of abuse. Building trust allows victims to share their experiences and receive the help they need. Emotional and motivational support plays a central role in this process, reassuring that victims are not alone and that someone stands by them. Successful examples include cases where older individuals were removed from decades-long abusive environments, offering them safety, dignity, and a renewed sense of hope.

Finally, good practices include proactive prevention measures and timely intervention. Anonymous reporting mechanisms allow for the early detection of abuse, enabling timely and effective responses. Thorough assessments of elder abuse cases, followed by appropriate follow-up actions, ensure victims receive the necessary support. Respondents stressed the importance of remaining vigilant and persistent in their efforts, as captured in the sentiment “do not rest”, underscoring the critical need for ongoing dedication and attention in addressing elder abuse.

5. Discussion

Elder abuse, a global concern, varies in manifestations across cultures, with disparities in prevention and intervention resources (Pillemer et al. 2016). Mechanisms addressing elder abuse primarily include legislative regulations, education, and awareness initiatives, involving healthcare and social workers, promoting support networks and helplines, and working towards shifting societal perceptions of aging and older adults (Alon and Berg-Warman 2014; Baker et al. 2016; Gupta and Chaudhuri 2008). The findings of this study provide important insights into elder abuse in rural Slovenia, with a focus on the Pomurska region. The study aimed to address three key research questions: How is the severity of elder abuse and its specific forms perceived by professionals (RQ1); what responses are considered adequate for addressing elder abuse, considering whether the knowledge and expertise of the professionals influence their perceived responses (RQ2); and what are the key challenges and good practices in terms of addressing elder abuse (RQ3)?

The study revealed that social workers perceive elder abuse as significantly more severe than police officers. Psychological abuse was rated as the most serious form of abuse, recognizing it is often linked to economic abuse, aligning with findings from other studies (Alexa et al. 2019; Botngård et al. 2020; Primc and Lobnikar 2019). Although recognized as serious by both groups, social workers rated psychological abuse as a severe problem (M = 4.71) compared to police officers (M = 3.78). The lower severity assigned to sexual abuse by respondents mirrors global findings, where sexual violence is frequently underreported or unrecognized among older populations (Ben Natan et al. 2010; WHO 2022a). Their professional roles can explain the differences in perception between police officers and social workers: social workers have direct and prolonged contact with victims, providing deeper insight into abuse dynamics. In contrast, police officers may focus on immediate, visible forms of violence, as observed in studies on professional response disparities (Lachs et al. 2021). The differences also likely reflect these professionals’ varying roles and training, emphasizing the need for improved awareness and education, particularly among police officers.

In responding to elder abuse, the study highlights the critical need for specialized services to address elder abuse, particularly the establishment of safe houses and crisis centers. Social workers rated these interventions as highly necessary, which aligns with the findings in the literature emphasizing the importance of the removal of the victims from abusive environments to a safe space (Alon and Berg-Warman 2014; Goergen and Beaulieu 2010, 2017; Setterlund et al. 2007; Wilson 2019). The study and the literature review highlight a significant gap in providing such facilities for older adults (Hightower et al. 2000; IMPRODOVA Consortium 2020). The literature further points out that existing safe houses often focus primarily on women and children, thereby failing to address the specific and complex needs of older victims of abuse. This gap underscores the urgent need for age-appropriate interventions and infrastructure that can adequately respond to the unique vulnerabilities of older adults. In Slovenia, restraining orders are a legally regulated measure to protect victims of domestic violence, governed by the Police Tasks and Powers Act and the Domestic Violence Prevention Act (Filipčič and Bertok 2024). These laws enable the police to impose restraining orders for 48 h, which can be extended by a judge for up to 15 days, while courts can further prolong the measure for an additional 60 days. Additionally, restraining orders may be issued for up to 12 months with the possibility of further extensions (Filipčič and Bertok 2024). This measure, introduced in Slovenia in 2004, was intended to allow victims to remain in their homes while ensuring perpetrators are removed, reducing the psychosocial and financial burden of forced relocation.

Although research shows that most victims perceive restraining orders as beneficial, they remain an imperfect solution (Filipčič and Bertok 2024). While the measure effectively prevents more severe forms of physical violence, it has significant shortcomings, including high violation rates (around 40% annually), victims’ fear of retaliation, and inconsistent enforcement. Furthermore, 20% of victims reported an escalation of violence after a restraining order was issued, particularly in cases where perpetrators had a long history of domestic violence convictions (Filipčič and Bertok 2024). Studies also suggest that former partners violate restraining orders more frequently than current partners, emphasizing the importance of monitoring perpetrators even after separation.

Despite the legal intent to remove the perpetrator from the violent environment, many victims still relocate to safe houses due to immediate safety concerns, lack of trust in legal protections, and fear that law enforcement does not adequately monitor compliance (Filipčič and Bertok 2024; Lobnikar et al. 2021). Vulnerable populations, such as older women experiencing IPV, are particularly affected by these systemic weaknesses, as they often lack financial independence and fear social stigma if they remain in their communities. Research highlights that well-equipped safe houses could empower these victims, helping them transition safely back to independent living, while expanding programs for perpetrators could contribute to long-term violence prevention (Horvat 2015). However, such programs remain limited and less accessible, particularly in rural areas like Pomurje.

Another prominent finding was the significance of MDTs. The study and literature underscore that MDTs improve outcomes for elder abuse victims by combining expertise across fields (Lachs et al. 2021; Pillemer et al. 2016; Rizzo et al. 2015). The findings also align with the global recommendations for professional collaboration to ensure holistic responses to elder abuse (Alon and Berg-Warman 2014; Moore and Browne 2017). While the literature review points out the general inadequacy of institutional responses worldwide (Pillemer et al. 2016; WHO 2022b), the Pomurje study observes a slightly better perception of responses in institutional settings (M = 3.42) compared to private settings (M = 3.30). However, the differences are not statistically significant. This reflects findings from Botngård et al. (2020), who noted that institutional settings allow for better monitoring but remain prone to neglect psychological abuse. Private settings, particularly in rural areas, present unique challenges due to their isolation, limited resources, and social norms that complicate the reporting and handling of abuse, as observed in our study and in studies by other authors (Knežević Hočevar 2016; Meško 2020). These comparisons indicate that regional studies, such as the one conducted in the Pomurska region, complement broader findings from the literature while enabling the development of specific approaches that integrate global knowledge with local needs.

In addressing RQ3, the study revealed several significant barriers that hinder effective interventions for elder abuse, especially in rural settings. One of the key barriers is victims’ reluctance to report abuse. Family dynamics, shame, and fear of stigma play a central role in deterring victims from seeking help. This aligns with findings from other studies (Alexa et al. 2019; Knežević Hočevar 2016), which highlight how emotional attachments to family members and cultural norms often normalize abuse and silence victims. The dependency of older adults on their abusers, mainly when the perpetrators are close family members, exacerbates the situation, making victims more likely to conceal their experiences (Mosqueda et al. 2016; Ziminski Pickering and Rempusheski 2014b). Another significant challenge is the lack of resources and systematic shortcomings. The absence of specialized infrastructure, such as safe houses and crisis centers specifically designed for older adults, limits opportunities for victims to escape abusive environments. These findings resonate with global studies emphasizing similar gaps in rural and resource-limited settings (Hightower et al. 2000; IMPRODOVA Consortium 2020).

Despite these challenges, the study identified several good practices that effectively address elder abuse. Along with collaboration through MDTs, building trust with victims was established as another critical practice. The respondents highlighted that older adults are often hesitant to share their experiences, mainly when abuse occurs in private settings. Establishing trust through empathy and personalized support has proven essential in helping victims acknowledge abuse and seek assistance. This approach reflects global recommendations on trauma-informed care, as observed in Burnight and Mosqueda (2011). Proactive interventions, such as anonymous reporting mechanisms and safeguarding victims’ finances, were also identified as effective strategies. These measures not only ensure early detection of abuse but also address specific forms of mistreatment, such as financial exploitation, which is often linked to psychological abuse. Similarly, Heck and Gillespie (2013) emphasize the value of timely interventions and protective measures in preventing further harm.

Altogether, challenges in addressing elder abuse reflect a complex interplay of systemic, cultural, and individual factors, all of which influence how abuse is identified, reported, and addressed. Structural barriers such as limited specialized services, inconsistent law enforcement responses, and a lack of age-specific interventions hinder the protection of older victims. Cultural norms, social stigma, and victim dependency on abusers further discourage reporting and intervention, particularly in rural areas, where isolation and limited resources exacerbate the issue. Additionally, individual psychological factors, including fear of retaliation and emotional attachment to perpetrators, make it difficult for victims to seek help, even when legal protections like restraining orders are available. While existing frameworks in Slovenia, such as multidisciplinary teams (MDTs), social work centers, and crisis intervention units, provide valuable services, gaps remain in ensuring sustained and accessible support for elder abuse victims. Effective intervention requires a coordinated, trust-building approach, supported by enhanced financial and housing resources, the development of crisis accommodations tailored to older adults, and widespread public awareness initiatives that reduce stigma and empower victims to report abuse without fear of societal or institutional neglect.

The identified good practices in this study reinforce the importance of a multidisciplinary approach in mitigating elder abuse. The integration of social services, law enforcement, healthcare professionals, and NGOs ensures that victims receive holistic support rather than fragmented assistance. The award-winning approach of SWC Pomurje serves as an example of how integrating various stakeholders can lead to better intervention outcomes and holistic support for victims. Safe spaces, such as crisis centers and specialized shelters, play a pivotal role in offering temporary refuge, psychological counseling, and long-term support, particularly for vulnerable groups such as older women experiencing IPV. Additionally, proactive intervention strategies, such as enhanced monitoring of restraining orders, specialized training for law enforcement officers, and expanded support programs for perpetrators of violence, are critical to breaking cycles of abuse and preventing re-victimization. By strengthening institutional collaboration, ensuring timely responses, and providing individualized support, first responders and policymakers can significantly enhance the protection of older adults, empowering them to live free from violence and restoring their sense of safety, dignity, and autonomy.

5.1. Key Implications

The findings of this study emphasize several critical implications for addressing elder abuse, particularly in rural settings. First, establishing safe houses and crisis centers tailored to older adults is essential to provide victims with immediate safety and long-term recovery options. These spaces can break the cycle of abuse and offer victims the necessary support. Second, the study highlights the importance of multidisciplinary cooperation among professionals such as social workers and police officers (along with other MDT members) as a holistic response to elder abuse, combining expertise from various fields to address victims’ complex needs effectively. The results also underscore the need for targeted training programs to improve police officers’ confidence and competencies in recognizing and addressing elder abuse. While social workers demonstrated a higher awareness of the issue’s severity, police officers’ lower ratings suggest gaps in knowledge and preparedness, which must be addressed through specialized education and training initiatives. Furthermore, raising public awareness is vital to combat cultural stigmas and normalization of abuse within rural communities. Encouraging open discussions and promoting a better understanding of elder abuse can help reduce victims’ reluctance to report abuse and foster a supportive environment for intervention.

The likelihood of establishing safe houses for victims of elder abuse in the Pomurska region—and more broadly in Slovenia—remains uncertain in the near future. However, the study highlights the evident need for such facilities, raising critical questions about their implementation. Key considerations include identifying the responsible actors—whether municipalities, which oversee local welfare institutions, the government, or even private initiatives—and securing sustainable funding sources. Moreover, while the introduction of safe houses, along with comprehensive programs and facilities, remains unclear, the area of training for professionals is relatively well developed. Various stakeholders, including academia, NGOs, and governmental institutions, already provide relevant training programs. In addition to the issues raised in our study, the challenge now is to extend these efforts beyond an individualized approach and ensure that inclusion in an MDT is not dependent solely on the personal engagement of each professional. Instead, a structured and institutionalized framework should be established to guarantee consistent collaboration among key actors. Ensuring clear protocols, cross-sectoral coordination, and sustainable funding will help maintain interventions’ long-term effectiveness and resilience.

Although there are currently no concrete plans for safe houses, Slovenia’s Ministry for a Solidary Future has launched strategic projects aimed at developing a new systemic approach to social protection for older adults. This includes a shift towards deinstitutionalization and a more structured response to victimization among older adults. The evolving framework, which increasingly relies on local community involvement, signals a potential policy transformation that could lead to the formal recognition and implementation of safe housing solutions as part of a more comprehensive strategy to address the needs of a longevity society. Research findings, including those from this study, are expected to play a crucial role in shaping these future policies and interventions, ultimately contributing to a more effective and sustainable response to elder abuse in Slovenia.

5.2. Limitations and Future Work

The study has some limitations that must be considered when interpreting its results. Its focus on the rural Pomurska region of Slovenia limits the generalizability of findings to other contexts (e.g., urban environments where resources, infrastructure, and social dynamics may differ). By including primarily first responders from social work centers and police departments, the study may overlook insights from different stakeholders like healthcare professionals, NGOs, caregivers, or legal representatives. These groups often play significant roles in identifying, reporting, and addressing elder abuse but were not sufficiently represented in this research. The cross-sectional design offers a snapshot of perceptions and challenges at a specific point in time but fails to capture changes over time or the long-term impact of interventions. Future research should broaden participant diversity, adopt longitudinal approaches, and incorporate victim-centered perspectives to provide more comprehensive insights. Further work could also include comparative studies between rural and urban settings to identify context-specific differences in elder abuse prevalence and responses. Research could also explore cultural and societal influences on elder abuse reporting, particularly in close-knit communities, and examine strategies for overcoming these barriers. By broadening the scope of participants, methodologies, and areas of focus, future research can provide more comprehensive and actionable insights in terms of addressing elder abuse.