Although one might assume elder abuse occurs only in a nursing home setting, as stated earlier, that is simply not true. In fact, the most likely perpetrators of abuse are the spouses or adult children of the elder. Most abusers are male and either have a history of or are currently dealing with a substance abuse issue, have physical or mental health issues themselves, are unemployed, are financially unstable, socially isolated or have a history of run-ins with the police.