Coercive control of older adults in filial relationships: a hybrid concept analysis

Abstract

Purpose

This study aims to synthesise published evidence relating to filial coercive control to generate an understanding of this under-explored concept. This paper identifies its defining characteristics and explores the circumstances under which the phenomenon manifests in the lives of older adults.

Design/methodology/approach

A scoping review methodology was adopted to guide the literature review, while a concept analysis methodology guided data extraction and analysis. Drawing on Rodgers’s (1989) evolutionary concept analysis method, a co-constructed research methodology was developed for this study.

Findings

The concept of filial coercive control was understood in the context of the following antecedents: ageist norms, a parental relationship (both biological and non-biological), physical proximity and the controlling characteristics and tendencies of the abusive adult child. The defining attributes included the exercise of power through control, dependency and entrapment, isolation and confinement and fear and intimidation. Using the dominant themes, models and contrary cases were constructed to illustrate the findings.

Originality/value

Existing bodies of theory fail to adequately describe the phenomenon of filial coercive control adequately; as a consequence, a co-constructed concept analysis was conducted. A tentative operational definition and a conceptual model are proposed providing a starting point for future research and informing professional practice and education.

Citation

Quinlan, F., Donnelly, S. and O’Donnell, D. (2024), "Coercive control of older adults in filial relationships: a hybrid concept analysis", The Journal of Adult Protection, Vol. 26 No. 6, pp. 279-295. https://doi.org/10.1108/JAP-06-2024-0033

Introduction

In the absence of an established definition, the term filial coercive control is adopted for the purposes of this study to denote a relationship between an adult child and their older parent(s) which is characterised by a persistent pattern of controlling and abusive behaviour. There is a deficit of published evidence exploring coercive control in the context of adult child and older parent relationships. Therefore, the parameters for this evidence retrieval were extended to include research on the related concept of psychological elder abuse in the context of adult child to older parent relationships. The knowledge generated from this concept analysis, along with the tacit knowledge of the lead author (FQ1) as a practitioner-researcher, was synthesised to produce a tentative conceptual framework that describes how the phenomenon of filial coercive control may manifest in practice. The specific characteristics that distinguish filial coercive control from psychological elder abuse are explained with the use of models and contrary cases. A model case is presented to illustrate the defining attributes of filial coercive control as identified through this synthesis. To support conceptual clarity, a contrary case is presented that shares some attributes with the model case but is not considered to be filial coercive control as per the hypothesised concept generated through this synthesis. This hypothesised concept will be used to guide semi-structured interviews with safeguarding social workers in a later qualitative study. This study forms part of doctoral research undertaken by the lead author (FQ1) under the supervision and guidance of her academic supervisors and co-authors (SD2, DOD3). The scoping review, inclusive of the design and implementation of the search strategy, was undertaken by all three authors (FQ1, SD2, DOD3). The lead author (FQ1) wrote the manuscript with significant input from co-authors (SD2 and DOD3) with respect to drafting and revisions (Reflexive researcher as a data subject).

Reflexive researcher as a data subject

Braun and Clarke argue for the researcher’s subjectivity to be considered a resource, rather than something to be set aside in pursuit of value-free, unbiased research practices (2022). In situating this research study, I recognise that the insights that I bring as a practitioner are integral to the analysis. I strive to acknowledge my perspectives and bring a “qualitative sensibility” (Braun and Clarke, 2022, p. 11) that sees all research as interpretive (Denzin and Lincoln, 2005) and all knowledge as situated (Harraway, 1988). To explore the extent of this phenomenon in the real-world field of practice, I facilitated a World Café on adult–child to older–parent coercive control with approximately 90 safeguarding social workers from the Republic of Ireland at the HSE National Safeguarding Conference in 2022. For practitioners, the difficulties they encountered when intervening in cases of coercive control were manifold, and the absence of a clearly defined articulation of the concept within a practice, policy and legal context compounded these difficulties. Social workers explained that their capacity to accurately identify and assess situations of filial coercive control would be greatly enhanced by an operational definition of the phenomena which could then help to inform practice interventions. Source: Created by authors.

Literature review

Increasingly, the phenomenon of coercive control has been recognised as a significant social problem experienced by older adults (Policastro and Finn, 2017). Like most forms of elder abuse, filial coercive control often occurs in relationships where there is an expectation of trust. Practitioners and researchers working in the area of intimate partner violence (IPV) have expressed concern that the term elder abuse has been adopted by professionals who do not understand the dynamics of power and control that underpin domestic abuse (Brandl and Horan, 2002). Extensive research studies have examined how coercive control is enacted within intimate relationships (Dutton and Goodman, 2005; Crossman and Hardesty, 2018; Stark and Hester, 2019; Katz, 2022). However, there is limited understanding of the extent to which adult children use strategies of coercive control in their relationships with their older parents. This is a concern echoed by elder abuse theorists who have used a feminist lens to analyse how power relations are enacted within abusive familial and intimate relationships (Whittaker, 1995; Penhale, 2003; Crichton et al, 1999). Stark (2007) describes coercive control as a pattern of behaviour that involves the use of physical violence (threatened or actual) and related tactics, such as isolation, emotional abuse and/or economic abuse, as a means of maintaining control over one’s partner. When coercion and control occur together, the result is a “condition of unfreedom” that is experienced as “entrapment” (Stark, 2007, p. 205).

Benbow et al. (2018) researched how terminology used to describe the domestic abuse experienced by older adults can vary across disciplines (social work, police, etc.). In calling for a multi-agency response that can coalesce differing professional views and nomenclature, they posit that “coercion takes place in relationships between older adults and their adult children, but it is not always understood in those terms” by older adults or professionals (2018 p.188). Policastro and Finn (2017) suggest the concept of coercive control has not been adequately researched with respect to older adults, with little attention paid to how gender and age may complicate the abuse experienced. They propose that the caregiving dimension, rather than the intimate relationship that characterises spousal abuse, could help to describe the type of victimisation experienced (Policastro and Finn, 2017).

Method: concept analysis

Concept analysis methods are used to identify the key attributes of a concept that are critical to distinguishing it from related concepts and serve to clarify its meaning (Walker and Avant, 2005). The method of contextual concept analysis adopted for this study is the evolutionary approach proposed by Rogers (1989), which details the methodological requirements necessary to advance the understanding and development of the concept of interest. From this standpoint, concepts are continually evolving, and as such, efforts to harness their essence present an opportunity for concept advancement rather than seeking to provide a conclusive definition (Figure 1). Through a process of socialisation and enculturation, a concept becomes connected with a specific set of attributes that constitute the definition of the concept (Rogers, 1989; Tofthagen and Fagerstrøm, 2010).

Evolutionary concept analysis

To address the ambiguous and poorly defined representations of filial coercive control, this concept analysis progressed through the following seven phases of analysis (Rogers, 1989, p. 333):

• 1.

  Identify and name the concept of interest

The concept of interest is coercive control and the context in which the phenomenon is being explored is adult–child to older–parent relationships. The wider structural context is the field of social work/social science. Coercive control is defined by the Cambridge Dictionary (2024) online as “control of another person’s behaviour by using force or threats, or by causing fear”. Adult child to older parent coercive control is aligned theoretically with descriptions in the literature of intimate partner terrorism (Johnson, 2008) and coercive control (Stark and Hester, 2019), whereby violent and non-violent strategies are used to dominate another person and deprive them of their agency, gradually eroding their autonomy and self-esteem. Coercion is a goal-orientated behaviour that arrives out of a decision-making process, whereby individuals who engage in coercive actions have a history of positive outcomes from using these strategies (Tedeschi and Felson, 1994). This would suggest that where there is a history of appeasement in response to coercive threats made by adult children, there may be an increased risk of this form of abuse as actors are less likely to engage in coercion if they expect retaliation (Tedeschi and Felson, 1994):

• 2.

  Identify surrogate terms and relevant uses of the concept.

As coercive control is an emerging research topic, standardised terminology has not been well established. Surrogate terms used to describe the concept of filial coercive control, along with population and context are detailed in Appendix 1.

• 3.

  Identify and select an appropriate realm for data collection:

• Scoping review

Searches of the professional literature revealed that filial coercive control was not addressed; therefore, the broader concept of psychological elder abuse was reviewed and placed within the general context of adult–child to older–parent relationships. The review was conducted by the lead author (FQ1) and co-authors (SD2 and DOD3) using the framework proposed by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR) guided the reporting (Tricco et al., 2018). A systematic literature search was conducted of PsycINFO, cumulative index to nursing and allied health literature, Scopus, Applied Social Sciences Index & Abstracts, Violence and Abuse Abstracts (EBSCO), International Bibliography of Social Science (IBSS), ProQuest databases. Appropriate truncation symbols and MESH terms were used to account for search term variations and maximise searches. Searches were conducted up to 30 April 2023 with no limitations to the start date. Inclusion and exclusion criteria were designed to be highly inclusive (Appendix 1). All identified studies were uploaded to Covidence™ software, where duplicates were automatically removed at the time of upload (Appendix 2). The search identified 488 titles. Abstracts were then screened by FQ1 with 15% double screened by co-authors SD2 and DOD3. Inclusion criteria included older adults experiencing psychological abuse from their adult children. In total, 18 articles were used to inform this concept analysis; FQ1 carried out a full-text review with any conflicts arising resolved with SD2 and DOD3 in regular research meetings.

• 4.

  Identify the attributes of the concept

Defining attributes are those characteristics of a concept that appear consistently in the literature. A total of 18 documents were read and re-read by the author to identify the characteristics described. The overarching theme of power through control emerged as the core attribute, underpinned by the three sub-themes of dependency and entrapment, fear and intimidation and isolation and deprivation. A descriptive and reflective thematic concept analysis approach was applied. In the retrieved texts, power through control described an intentional and sustained pattern of psychological abuse that resonates with the author’s “pathic knowledge” and experience of engaging with the phenomena in practice:

When practitioners find themselves, as they often do, faced with the everyday unpredictable and contingent conditions of practice, they turn to pre-theoretical or to situated knowledge, where they engage in pathic practice and use language to convey pathic understandings and to communicate directly to the lived experience of their client relationship (Longhofer and Floersch, 2012, p. 511).

All 4 themes were identified in 11 of the papers, however, not all of the clustered characteristics were included in each study. Some of the identified themes were descriptive and illustrative, whereas others, such as the attribute of power through control, were more analytical, requiring a more nuanced and inquisitive engagement with the texts (see Appendix 3).

• Power through control

The attribute of power through control was an overarching theme identified in 16 of the retrieved articles, the clustered characteristics in Figure 2 have been coded under this theme. Sprangler and Brandl (2007) state that power and control dynamics used to gain and maintain compliance in IPV can also be perpetrated on older adults by their family members. This involved denying the older person’s complaints (Conrad et al., 2011a, 2011b), convincing others they are incapable (Brandl, 2000; Sprangler and Brand, 2007), turning family members against them (Roberto, 2016) and dehumanising and subjecting the older adult to degrading treatment (Brandl, 2000; Sprangler and Brand, 2007; Anand et al., 2013; Conrad et al., 2011a, 2011b; Roberto, 2016). Jackson and Hafemeister’s theorisation of “hybrid financial exploitation (HFE)” focuses primarily on the enduring and dynamic nature of the interactions between the abusive individual and the older victim. While dynamics of power and control are not specifically referenced in this theorisation, the behavioural strategies described, such as the abuser’s sense of entitlement, their history of extortion and past or current threats of violence (Jackson and Hafemeister, 2016) are also illustrative of how power and control dynamics can be enacted within filial relationships.

• Isolation and deprivation

Isolation was a defining attribute in 13 articles analysed, along with other key empirical markers such as deprivation, confinement and exclusion. Isolation manifests as psychological abuse and includes tactics such as intentional confinement of the older parent (Conrad et al., 2011a, 2011b; Roberto, 2016), restricting contact with family and friends (Brandl, 2000; Conrad et al., 2011a, 2011b; Jackson and Hafemeister, 2016; Roberto, 2016; Sprangler and Brandl, 2007) and social isolation (Brandl, 2000; Conrad et al., 2011a, 2011b; Jackson and Hafemeister, 2016; Roberto, 2016; Schiamberg and Gans, 1999, 2000; Sprangler and Brandl, 2007; Roberto, 2016; Wydall and Zerk, 2017). In a conceptual analysis carried out by Conrad et al. (2011a, 2011b), isolation, inclusive of confinement and deprivation, was clearly identified as the most severe form of psychological abuse. Isolation that develops because of the increasingly controlling and bizarre behaviour of the adult child (Jackson and Hafemeister, 2016; Roberto, 2016) has the effect of reducing the social world of the older parent, thereby leaving them even more reliant on their abusive adult–child. Other adult children perceive the apparent loyalty that their parent shows towards their abusive sibling as indicative of a choice that they have made to prioritise the abusive relationship (Jackson and Hafemeister, 2016), and this can further compound their isolation and deprivation of social experiences.

• Fear and intimidation

Fear and intimidation were defining attributes of filial coercive control and are referenced in 15 articles. This fear can manifest in concerns for personal safety because of current or past incidents of violence or threats of future violence (Anand et al., 2013; Brandl, 2000; Conrad et al., 2011a, 2011b; Jackson and Hafemeister, 2016; Roberto, 2016; Sprangler and Brandl, 2007; Schiamberg and Gans, 1999; 2000; Dow et al., 2020; Lin and Giles, 2013), the threat and perceived fear that abusive adult child could effect their institutionalisation (Conrad et al., 2011a, 2011b; Dow et al., 2020; Wydall and Zerk, 2017). Living in fear of the abusive individual was a dominant theme throughout, specifically verbal abuse (Anand et al, 2013; Brandl, 2000, Brandl and Horan, 2002; Conrad et al., 2011a, 2011b; Jackson and Hafemeister, 2016; Lin and Giles, 2013; Roberto, 2016; Schiamberg and Gans, 1999) and a fear the abuse will escalate if the older adults disclose or seek support (Dow et al, 2020; Smith, 2025).

Schiamberg and Gans (1999) apply an ecological approach to their analysis of the risk factors of psychological abuse, which they define as “an act carried out with the intention of causing psychological distress” along with a failure to allow an older person, “who is otherwise able, the ability to make his or her own decisions” (p. 333, 1999). For Smith (2015), using a feminist lens recognises that the indissoluble bond of mothers towards their abusive adult–children is underpinned by a feeling of self-blame that their abusive behaviour is reflective of poor parenting. This fear can also manifest on a macro-level, with mothers failing to attend to their victimisation as they fear the stigma and social censure that could be attributed to them because of the actions of their abusive adult children (Smith, 2015; Dow et al., 2020). Older parents also fear that their abusive child will be made homeless if their behaviour becomes known, or that severing the kinship bonds will restrict contact or cause harm to their grandchildren (Sprangler and Brandl, 2007; Dow et al., 2020). The level of intimidation experienced by older adults can leave them hyper-vigilant, feeling like they are walking on eggshells due to the adult–child’s volatile behaviour (Jackson and Hafemeister, 2016); this in turn leads to increased physical health symptoms and behaviours indicative of anxiety and depression (Conrad et al., 2011a, 2011b; Roberto, 2016).

• Dependency and entrapment

Dependency can serve as a predicate for filial coercive control in several ways; for instance, the abusive adult–child’s transition to adulthood may have been stymied, leaving them financially and emotionally dependent on their older parent (Jackson and Hafemeister, 2016). Alternatively, attempts at sustaining an independent home life may have failed with the adult child returning to the family home following a relationship breakdown, often leaving the older parent with the difficult choice of taking them in or seeing them homeless (Smith, 2015; Dow et al., 2020). For the adult child, this dependency can induce resentment or leave them feeling emasculated because of their reliance on their older parent (Jackson and Hafemeister, 2016) and coveting their financial resources (Ziminski Pickering and Phillips (2014). Hybrid financial exploitation (HFE), the model developed by Jackson and Hafemesiter is identified as the “most devasting form of elder abuse” (p. 307, 2016). Within this conceptualisation, it is proposed that a mutually co-dependent relationship can develop that does not serve either party well, as the adult child is not equipped to deal with the increased demands of an ageing parent and especially not a parent who has provided for them financially and emotionally. For the adult–child, their dependency on their older parent can trigger anger and resentment leading them to reconceptualise their role as care recipient to one of caregiver, and with this transition, an increased sense of entitlement to their parent’s emotional and financial resources may be engendered.

The older parent with increasing care and support needs may perceive their abusive adult–child as their sole means of support, as contact with other family and friends has been intentionally restricted, leading them to feel a heightened sense of confinement and entrapment (Roberto, 2016; Brandl, 2007; Conrad et al., 2011a, 2011b). The abusive adult–child cultivates this reliance, reminding the parent of their dependency and using this to exert increasing levels of control in a concerted effort to diminish their autonomy and reduce their self-esteem (Conrad et al., 2011a, 2011b; Brandl, 2000).

• 5.

  Identify the references, antecedents and consequences of the concept.

• References

The empirical referents “consist of the observable phenomena by which the defining attributes can be recognised” (Lam Wai Shun et al., 2022, p. 822), they are essentially the measurement tools that evidence the occurrence of the concept (Walker and Avant, 2005). Identifying the empirical referents of filial coercive control was challenging because it is such an underexplored concept in the literature and the concept is rarely explicit in the published evidence. Therefore, empirical referents were not sufficiently evident to allow for full exploration of this element.

• Antecedents

An antecedent is a behaviour or condition that must be apparent before the concept can occur (Rogers, 1989; Avant and Walker, 2005). The antecedents of filial coercive control are ageist norms, a parental relationship (both biological and non-biological), physical proximity, along with the controlling characteristics/tendencies of the abusive adult–child. Anand et al. (2013) found that older adults identified ageist norms within Western society as laying the groundwork for elder abuse to flourish more broadly; this was characterised as a loss of voice, becoming invisible socially and a loss of status and power within intergenerational relationships. Physical proximity features as an antecedent, and while co-residency is often a feature of coercive control, it is not a prerequisite as power and control tactics can be used by abusive adult children while their parents are in alternative care arrangements such as hospital. Indeed, abusive children can circumvent physical barriers such as hospital admission by deploying control tactics such as identifying themselves as their parent’s primary support person, thus excluding other concerned relatives from performing this role (Sprangler and Brandl, 2007; Schiamberg and Gans, 1999; Conrad et al., 2011a, 2011b). The final antecedent of this concept is the abusive adult–child’s controlling and manipulative characteristics which become evident in their wilful intention to inflict pain and anguish on the older parent (Brandl and Horan, 2002; Conrad et al., 2011a).

• Consequences

The consequences of filial coercive control are the events or situations that are observed to emerge when the concept has become actualised in the lives of older parents. For older parents, the impact of the phenomena is multifaceted, it can lead to a decline in mental and physical health (Conrad et al., 2011a, 2011b; Sprangler and Brandl, 2007; Roberto, 2016), an increased sense of dependency and reliance on the abusive child (Jackson and Hafemeister, 2013; Wydall and Zerk, 2017), loss of autonomy and self-esteem (Conrad et al., 2011a, 2011b; Schiamberg and Gans, 1999).

• 6.

  Related concepts

Related concepts are those that have some relationship with the concept of interest but do not share the same attributes (Rodgers and Knafl, 2000). The concepts related to filial coercive control include elder abuse, intimate terrorism (Johnson, 2008), elder mistreatment, family violence, domestic abuse, intimate partner coercive control (Stark, 2007), non-intimate coercive control and severe psychological elder abuse.

• 7.

  Identify a model case of the concept.

In keeping with Rogers’s (1989) evolutionary method, the model case or exemplar of filial coercive control should be identified from existing literature. Through a process of reflective thematic analysis (RTA) model and contrary cases that best illustrate the key themes/attributes of the concept have been developed (Braun and Clarke, 2022). The use of RTA in this context fully acknowledges the position of the author as a social worker with practice experience in supporting older adults living with this form of abuse. A contrary case has been constructed to clarify the concept being analysed, as sometimes it is easier to say what something is not, rather than succinctly describe what it is (Conrad et al., 2011a).

• Model case:

Mary is 82 years old and lives with her adult son Tom aged 49 years. Mary has three older adult children, and her husband died approximately 5 years ago, at which point Tom returned to live with his mother. Prior to her husband’s death, Mary’s adult children and grandchildren were frequent visitors to the family home. Tom has always had a difficult relationship with his siblings; he is the youngest of four children and had a troubled adolescence. Tom has not been able to sustain employment or an intimate partnership and has few social supports. During the Covid pandemic, Tom instituted restrictions on visits to Mary, preventing access to family and neighbours under the guise of infection control and safety. While life has returned to normal for most people, Mary’s family visits remain restricted. Mary has had several falls at home, and her mobility is now limited; she can no longer get to the phone, and Tom has told her she cannot use a mobile phone. Tom does not work and identifies himself as his mother’s primary carer, he manages her finances, health appointments, and activities of daily life. On the rare occasions that Mary’s other adult children gain access, Tom does not permit them to see Mary alone. He does not allow them to bring gifts for Mary and his increasingly aggressive behaviour means that Mary’s grandchildren can no longer accompany their parents on these infrequent visits. Family members are concerned that Mary is completely controlled by Tom, she no longer leaves the home and declines opportunities to stay with her other adult children. She appears fearful and nervous in Tom’s presence. Tom has encouraged Mary to amend her will and to institute a power of attorney and decision-making arrangement that favours him to the exclusion of other siblings. When Mary speaks with concerned family members, she reports that “Tom is very good to me, where would I be without him” she acknowledges that he can be a “bit bossy” but he is doing it for her own good. She becomes upset when she cannot provide gifts for her grandchildren as Tom controls her finances. The local nurse and GP rarely get to see Mary on her own, her increase in falls is a concern, but Mary reports that is down to “her own stupidity”; she declines referral to occupational therapy and physiotherapy as Tom says “they’re useless”.

• Contrary case

Sean is 65 years old is lives with his wife Julia 68, and their adult daughter Olivia 32. Olivia has had mental health and addiction issues over many years. Sean has two adult sons living in the city with their own partners and children. His son Peter contacts the safeguarding social worker to report that Olivia “takes advantage of my father’s good nature and is bleeding him dry”. Peter reports that his father has helped Olivia financially over the years and has now provided her with a deposit for a flat. Olivia has a child in foster care, and she is hoping that she will be able to care for her once she has addressed her addiction and housing issues. Peter states that his mother Julia is unhappy with the level of support that Sean provides to Olivia, she thinks that Olivia is taking advantage of Sean. Sean takes Olivia to all her appointments, and it appears that he “does everything that she asks him to”. Peter has seen Olivia making demands of their father and “having outbursts”. Sean and Julia are financially comfortable, they both drive and enjoy regular trips abroad. Sean is active in his local community and has recently told his close friend that he regrets his granddaughter’s admission to foster care. He reports that at the time Olivia had pleaded with him and his wife to look after her, but that Julia was not willing to parent a grandchild in her retirement. Sean states that he will do what is required to support Olivia to have her child returned to her care. Sean feels that Olivia’s traumatic adolescence and poor attachment to her mother have been a factor in her mental health and addiction issues. Sean states that Olivia does become angry on occasion, but that she is always remorseful and contrite after the event. Sean states that he knows “how to manage Olivia”; he has informed her that if she resumes using drugs, he will withdraw his support; he refers to her as a “kind but troubled young woman”.

Discussion

Straka and Montminy (2006) state that elder abuse and elder mistreatment are frequently considered synonymous; to conceptually distinguish the two terms, they propose that elder abuse should be used for situations with power and control dynamics and elder mistreatment for situations without. However, elder abuse can occur when power and control dynamics are not clearly evidenced, for example, the contrary case details how “outbursts” constitutive of psychological abuse, along with requests for financial support, have the potential to adversely affect Sean. While Olivia’s vulnerabilities can provide some mitigation for this behaviour, it does not lessen the hurt or worry that Sean may be experiencing. While the disclosures concerning Olivia’s interactions with her father are a potential concern, it is evident that Sean does not appear coerced, socially isolated or controlled. Therefore, this case is not considered to be an example of filial coercive control as the pattern of behaviour exhibited by Olivia is not underpinned by a desire to exercise power and control over her father. Rather, Sean is making informed decisions about the level of support that he is willing and able to provide to his troubled daughter. He is not reliant on Olivia to meet his care or support needs, and his role is one of caregiver to Olivia’s role of care recipient. This dynamic could change were Sean to become reliant on Olivia to meet his care and support needs in the future; then the model of HFE proposed by Jackson and Hafemeister (2016) could assist in making sense of this role reversal and the attendant concerns of elder abuse that may emerge.

The model case clearly illustrates how Tom has reinterpreted his inability to sustain independence into adulthood as an act of benevolence and altruism towards his recently bereaved mother. Tom’s return home comes at a time of emotional vulnerability for Mary; however, it also provides Tom with the opportunity to assume the role of caregiver not previously available because of his father’s presence. As a dutiful son returning home following his father’s death, Tom is now well-placed to inculcate in Mary a dependency and reliance that positions him as her primary source of support. For Mary, it can be difficult to identify when Tom’s behaviour crosses the line from caring to coercive and controlling. Equally, for practitioners, evidencing when this threshold has been reached can be very problematic, as it is often only when other family members or services are able to provide corroborative information that a clearer picture of the relationship dynamics emerges.

The model case demonstrates the various strategies that the adult child may use to achieve control and dominion over their parent, such as assuming control of finances or restricting visitors. The incremental exercise of power through control requires intent on the part of the adult child. It is a campaign of gradual but escalating abuse, which can engender in the older adult a state of fear, anxiety and dependency, along with the loss of autonomous decision-making and personhood. Brandl (2000) suggests that the dynamics of abuse are rooted in the abuser’s need to dominate and control the victim; moreover, practitioners who fail to address the imbalance of power by attributing instances of abuse to caregiver burden only serve to blame the victim and collude with the abuser. Exerting power through control can be understood as the failure of the adult child to induce their parent to comply with their demands in a socially acceptable way; thus they resort to tactics of coercion to achieve their goals (Tedeschi and Felson, 1994). Coercive power is deployed by adult children who attempt to make their older parent an extension of their own will by restricting or opposing their parent’s freedom to make their own choices (Turner, 2005). It is the exercise of power through control in adult child older parent relationships that distinguishes coercive control from distinct episodes of psychological abuse committed unintentionally, or when the desire to control and manipulate the older parent is absent, as exemplified in the contrary case. When adult children acknowledge the psychological harm inflicted on their older parents and express remorse for their actions, the exercise of power through control is less likely to be a sustained feature of this relationship dynamic.

Conclusion

The processes of coercive control may be far more complex and nuanced for older parents, particularly where interdependency has become a critical feature of the relationship dynamic (Wydall and Zerk, 2017). For the adult child who has not sustained independence, their ongoing reliance on their older parent, coupled with their self-identification as their parent’s primary support, could prove the catalyst for the development of coercive and controlling filial relationships. Unlike intimate partnerships, the bond that parents have with their adult children is life-long and as such it is rarely severed permanently (Sprangler and Brandl, 2007; Smith, 2015). Older parents may tolerate the coercive and controlling behaviour of their adult child for a myriad of reasons, and indeed the denial of their victimisation may be a well-considered safety strategy (Stark, 2007) adopted to protect both themselves and their abusive adult child. Wydall and Zerk, (2017) call for more research to investigate how coercive control perpetrated on older adults by their children can further complicate their help-seeking behaviour on both personal and structural levels. Assessing cases of filial coercive control remains a challenging and complex area of practice, particularly when the line between care and control has become blurred for the older parent and their adult child. Moreover, evidencing the impact of filial coercive control on the older parent can be further complicated by the onset/progression of a cognitive impairment, or when the older parent has become habituated to the controlled and restrictive environment in which they live.

Relevance to practice and further research

The elements identified in this concept development for filial coercive control were generated inductively from the retrieved literature, they were not explicit and therefore remain theoretical. Empirical exploration and verification of this theoretical concept is planned through semi-structured interviews with safeguarding practitioners in Ireland, which will explore the lived experience of practitioners responding to this phenomenon. This will generate an empirical understanding of how practitioners integrate their experiential knowledge of this type of abuse into their decision-making processes in a way that provides positive outcomes for older adults. It will explore the interventions that have been developed to promote healing for older adults experiencing this type of abuse. Furthermore, it will generate empirical knowledge on how abusive adult children have responded to safeguarding interventions. We encourage researchers to empirically explore and evaluate this phenomenon in other contexts and with a wide range of safeguarding and non-safeguarding professionals who may encounter these phenomena to deepen global understandings of filial coercive control.

Limitations

A comprehensive and systematic approach to retrieving evidence was adopted for this synthesis and analysis, however, it is acknowledged that it may not have been exhaustive and any manuscripts published after April 2023 have not been included The search strategy did not include studies in languages other than English. The evidence reflects the inclusion and exclusion criteria developed by the authors. The authors of the original publications that formed the basis of this review may not agree with the inclusion of their work in a concept analysis of filial coercive control; their feedback has not been sought. It is authors’ subjective assessment of the dominant themes used to describe the phenomena of filial coercive control that have been represented in this study.

Acknowledgements

The lead author (FQ1) would like to acknowledge the essential support the Health Service Executive has provided to enable her to undertake this research paper and her Phd studies more broadly.

Figures

Figure 1

An adaptation of Rogers’s (1989) evolutionary concept analysis

Figure 2

Attributes of filial coercive control

Figure A1

Prisma screen (courtesy of covidence systematic review software, veritas health innovation, Melbourne, Australia. available at www.covidence.org)

Table A1

Example of search strategy

Date of Search: 20 April 2023		Database: ASSIA
	Population	Concept	Context
	MS Elderly fathers	MS Coercion	MS Family relationships
	MS Elderly men	MS Elder ABUSE	MS Filial responsibility
	MS Elderly women	MS Emotional abuse	MS Family conflict
	MS Elderly married couples	MS Bullying	MS Parent-adult child relationship
	MS Elderly mothers	MS Verbal aggression	MS Home environment
	MS Elderly husbands	MS Aggression	MS Intergenerational Relationship
	MS Elderly people	MS Chronic victimization	Filial relationship
	MS Older people	MS Victimization	Family relationship
	MS Elderly parents	MS Intimidation	Parent adult child relationship
	MS Older married couple	MS Power relationships	Domestic relationship
	MS Older women	MS Manipulation	Family home
	MS Older people	MS Psychological abuse	Home environment
	MS Older men	MS Locus of control beliefs	Perpetrator victim relationship
	Older adults	MS interpersonal conflict	Adult offspring relationship
	Senior	MS Abusive relationships	Parental relationship
	Elder*	MS Cruelty	Familial relationship
	Old age	Psychological elder abuse	Intergenerational relationship
	Aged	Non-intimate coercive control	Caregiver relationship
	Ageing/aging	Coercive behaviour
	Geriatric	Emotional abuse
	Older women	Coercion
	Older men	Relational aggression
		Cruelty
		Interpersonal control
		Elder abuse
		Coercive control
		Power and control
		Psychological abuse
Sub-total articles retrieved	523,505	76,797	36,655
Total articles (strings combined)			3,446

Source: Table authors’ own

Table A2

The attributes of filial coercive control mapped against retrieved papers

Reference	Country of origin	Sample/literature review	Concept	Isolation and confinement	Fear and intimidation	Power through control	Dependency and entrapment
Anand et al. (2013)	Island of Ireland (North and South)	Sample	Conceptualising elder abuse: implications for policy and professional practice on the island of Ireland	✓	✓	✓	✓
Brandl and Horan (2002)	USA	Guidance paper	Domestic violence in later life: an overview for health-care providers	✓	✓	✓	✓
Brandl (2000)	USA	Guidance paper	Power and control: understanding domestic abuse in later life:	✓	✓	✓	✓
Conrad et al. (2011a, 2011b)	USA	Sample	Self-report measure of psychological abuse of older adults	✓	✓	✓	✓
Conrad et al. (2011a, 2011b)	USA	Sample	Conceptual model and map of psychological abuse of older adults		✓	✓	✓
Dow et al. (2020)	Australia	Sample	Barriers to disclosing abuse and taking action Australia	✓		✓
Jackson and Hafemeister (2013)	USA	Guidance paper	Risk factors with elder abuse: the importance of differentiating with types of elder mistreatment	✓		✓	✓
Jackson and Hafemeister (2013)	USA	Guidance paper	Theory-based models for enhancing the understanding of four types of elder mistreatment	✓	✓	✓	✓
Lee et al. (2022)	Korea	Sample	Psychological mistreatment of aging parents and parents-in-law				✓
Lin and Giles (2013)	USA	Sample	A communication approach to explain dyadic influences between the family caregiver and the elderly care receiver that give rise to the abuse		✓	✓
Roberto (2016)	USA	Guidance paper	The complexities of elder abuse	✓	✓	✓
Roberto and Teaster (2017)	USA	Book chapter	Contextual theory of elder abuse	✓			✓
Schiamberg and Gans (2000)	USA		Elder abuse by adult children: an applied ecological framework for understanding contextual risk factors and intergeneration character of quality of life	✓	✓	✓	✓
Schiamberg and Gans (1999)	USA		An ecological and intergenerational model of risk factors associated with elder abuse by adult children	✓	✓	✓	✓
Smith (2015)	USA	Sample	Expanding constructions of elder abuse and neglect: older mother’s subjective experiences		✓	✓	✓
Sprangler and Brandl (2007)	USA	Guidance paper	Abuse in later life: power and control dynamics and a victim-centred response	✓	✓	✓	✓
Wydall and Zerk (2017)	Wales, UK	Sample	Explores professionals’ perceptions of the barriers to help-seeking for victim-survivors of domestic abuse aged 60 years and over	✓	✓	✓	✓
Ziminski Pickering and Phillips (2014)	USA	Literature review	Development of a causal model for elder mistreatment			✓	✓

Source: Table authors’ own