Elder Abuse – Awareness for Prevention
“The tragedy of old age is not that one is old, but that one is young.” – Oscar Wilde
The world of seniors is unfortunately plagued by various forms of abuse. Despite the elderly being revered for their wisdom, they are often not treated with dignity and respect in actuality by youngsters around them. Here are some common types of injustices directed towards the elderly.
TYPES OF ABUSE
Physical Abuse: when an elder is hurt or injured physically by hitting, slapping, burning, pushing, kicking etc. It also includes tying the elder to furniture or locking them in a room. Giving inappropriate medication/drugs, or not at all. Incidents of physical abuse are higher among elders with low cognitive ability.
Emotional/Psychological Abuse: being disrespectful or belittling an elder. Humiliating, mocking, name-calling, blaming. Intimidation through yelling and threats. Verbal/non-verbal behavior that causes mental pain, anguish, fear or distress to an elder. Harassment. Not including the elder in social, recreational activities. Isolating them. Being unkind and withholding affection. Preventing the elder from meeting friends or relatives. Withholding or using something that is important to the elder, to make her/him do something specific.
Financial Abuse: financial exploitation, misappropriation of financial resources including property by family members, caregivers, institutions and strangers. Money or other assets are stolen from an elder. It includes forging cheques, taking their retirement and social security benefits. Using their credit cards or bank accounts without consent. Fraudulently changing names on a Will, bank account, life insurance policy or title to a house. Misguiding the elder on financial matters for personal gain. Using financial means to control the person, leading to other types of abuse.
Financial Neglect occurs when an elder’s financial responsibilities, such as paying rent, insurance, property tax, medical expenses or other sundry bills are ignored and not paid by the family/caregiver. Financial Fraud is widespread today. Complete strangers can steal your financial data using mobile phones, apps, internet or e-mail. Healthcare Fraud is sometimes committed by unscrupulous doctors, hospitals or healthcare workers, by overcharging, billing twice, falsifying medi-care claims or charging for services not provided. Single elders are particularly vulnerable.
Sexual Abuse: involves a caregiver forcing an elder to watch pornography or be part of unwanted sexual interaction-often perverted acts, against their will. Verbal innuendos or molestation. Situations where the elder is unable to give consent/dissent, due to various forms of dementia, disabilities or memory problems. Elders who need help with daily activities like bathing, dressing, medication, or are frail, are more vulnerable. Seniors who are alone, without family or friends close by, are more likely to be targeted. Most victims are women, though plenty of men are victims too.
Neglect: when close relatives or caregivers do not respond to the elder’s basic needs – physical, emotional or social. Shelter, adequate and nourishing food, clothing, essential medications and quality healthcare and items necessary for daily living. Indifferent towards social or emotional needs of the elder. Isolating or ignoring them. Leaving a weak or ailing senior unattended. The deprivation can be active neglect-intentional, or passive neglect-unintentional, due to lack of resources or knowledge. Self-neglect by the elder can be a sign of depression or dementia. Or physical impairment and weakness leading to inability to perform essential self-care. It again means poor supervision of the elder, whether at home or in an institution.
Abandonment: when an elder who needs support is left all alone, without any arrangement for their care. Of course, in India especially, many elders are literally abandoned at railway stations and bus stops or thrown out of their homes by heartless and greedy close relatives, without any means of support.
Institutional Abuse: Physical, mental and emotional abuse and denial of rights, is being reported increasingly from institutions meant for the welfare of elders – old-age homes, nursing homes, assisted care living for elders and even hospitals. Sadly, many of the above-mentioned abuse also takes place in these premises.
WARNING SIGNS OF ABUSE
Here are some common red flags of senior abuse:
When the elder looks unkempt and ill-groomed. Becomes withdrawn or gets agitated easily. Displays signs of trauma, like rocking back and forth. Signs of dehydration and frequent infections. Has unexplained bruises, burns or scars. Has broken spectacles and body has signs of being restrained. Lives in unclean, unsafe conditions, has bedsores. Has trouble sleeping and loses weight for no reason. Lacks medical aids like spectacles, dentures, hearing-aid or necessary medication. There are many forms of subtle, emotional abuse that is difficult to recognize. We must learn how to differentiate elder abuse from normal aging process.
LONG-TERM AFFECT AND HEALTH CONSEQUENCES OF ABUSE
The risk of death for elder abuse victims is three times higher than other elders. Apart from physical damage, it seriously harms emotional and psychological health and destroys social and family ties. It leaves the victim feeling apprehensive, fearful and unable to trust others. Embarrassed and afraid of the stigma. They lose their sense of identity and self-esteem. Declining cognitive, functional abilities. Sense of helplessness and increased dependency. Depression and dementia. Malnutrition. Physical and emotional hurts can aggravate existing health conditions and lead to premature death. NIMHS says that the risk of suicide in depressed elders gets doubled.
LIKELY PERPETRATORS OF ELDER ABUSE
Anyone in a position of trust, control or authority. An abuser can be a spouse/partner, adult children (son, daughter-in-law), other relatives, friend, neighbor, paid caretaker, volunteer, healthcare provider, medical practitioner, lawyer; anyone intentionally harming a vulnerable senior to exploit them physically, emotionally and financially. Institutional abuse occurs when some caregivers and staff are maladjusted persons who are willfully cruel and feel superior by hurting or controlling a helpless elder. People addicted to drugs or alcohol. Community abuse occurs because of ageism and contempt for elders.
ELDERS MORE AT RISK
Functionally dependent/disable ie. need help with daily activities, suffer from cognitive impairment, have poor mental health/dementia, are frail and weak, have poor financial condition. Elders living alone without family or friends nearby. Elderly women are more likely to be victims.
HOW TO HELP-PREVENTION
As senior abuse will not stop on its own, concerned people must step in. Check-in on elders who are alone and may not have family members or friends around. If you realize an elderly is being abused, try and talk to the person confidentially-win their trust and offer to help. Seek the help of other family members or friends or senior staff at the institution to protect the victim from the perpetrator. Listen to elders or their caregivers to understand their problems. Appropriate training can guide the healthcare professionals to identify and assist the elder abuse victim. There are many organizations and government agencies that can intervene and help with legal, financial and emotional issues resulting from traumatic abuse. They offer protection, counselling and rehabilitation, if needed. If you think an elder needs help urgently-is in danger-do not hesitate to seek professional emergency support or call the police.
There are professional caregiver interventions by dedicated eldercare organizations like EMOHA – it provides verified services to relieve the burden of caregiving at the elder’s home. With multi-disciplinary teams to deal with issues like physical and mental healthcare, safety and security, social engagement, emergency services, as well as legal and financial advice.
BARRIERS TO INFORMATION
Victims are often reluctant to report or speak about being abused – for fear of not being believed, fear of being institutionalized, fear of retaliation by the abuser. Another reason is they feel ashamed and embarrassed to reveal what they’re going through especially if the abuser is a close relative, like spouse or children. Fear of tarnishing the family name. The victim’s cognitive decline/disability also prevents them from reporting the abuse. Lack of proper training of service providers such as law enforcement officers, social workers, nurses, caregivers etc. to spot abuse, therefore less cases are reported. Financial and emotional abuse is quite often ignored or misinterpreted. Doctors tend to grossly under-report cases, if the abused patient does not want it, or to avoid courtroom hassles.
Only an amalgamation of a sensitive society, appropriate government intervention and individuals willing to fight for the cause of the mistreatment of seniors can help bring a change to the plight of our elderly!
Read Also : How to Stop Elder Abuse