Characteristics of Elderly and Other Vulnerable Adult Victims of Homicide by a Caregiver: National Violent Death Reporting System - 17 U.S. States, 2003-2007

Homicides of dependent elderly and non-elderly adults by their caregivers violate trust and have long term consequences for families. A better understanding of the characteristics of homicide by caregivers may provide insights that can inform prevention efforts. Data collected in the National Violent Death Reporting System (NVDRS) between 2003 and 2007 were used to characterize victims, perpetrators, caregiver roles and circumstances that precipitated homicides by a caregiver. Sixty-eight incidents were categorized into either homicide by neglect (n=17), intentional injury of the victim only (n=21), or homicide followed by suicide of the perpetrator (n=30). Demographic, mechanism of injury, location of injury and victim to suspect relationship variables are supplemented by narrative accounts of incidents. In general, homicide victims of a caregiver were widowed (42.6%) non-Hispanic (97.1%) white (88.2%) females (63.2%) killed in their homes (92.6%) with a firearm (35.3%) or by intentional neglect (25.0%) by a husband (30.9%) or a son (22.1%). The majority were aged 80 years and older (48.5%), 42.6% were aged 50 to 79 years and 0.9% were aged 20-49. Those below age 50 were primarily persons with disabilities requiring care and those 50 years old and older constitute elder abuse and neglect. Many homicide by caregiver incidents were precipitated by physical illness of the victim and caregiver, opportunity for perpetrator financial gain, mental illness or substance use, or an impending crisis in the life of the caregiver not related to illness. The mechanisms of deaths, demographics and precipitating circumstances suggest multiple types of prevention efforts are required.