Elder abuse has become a major issue in the world we live today. As a result, every state has passed legislative bills on elder abuse to protect elderly people from abuse. International Network for Prevention of Elder Abuse (INPEA) was formed in 1997 to advocate for the prevention of elder abuse and promote the human rights of older people in the society (Laumann et al, 2008). The organization has designated June 15 of every year as a World Elder Abuse Awareness Day. Several events are held on this day around the globe to raise awareness about elder abuse and suggest mechanisms to prevent and fight this vice. Community based organizations, government agencies and other institutions have now recognized elder abuse as a social problem that needs immediate intervention from a wide range of stakeholders. In USA alone, there are more than five hundred thousand reported cases on elder abuse every year (Laumann et al, 2008).
The primary culprits of elder abuse are caregivers who spend most of their time with the elderly people. Instead of given them physical and emotional support, such caregivers may abuse them for their own pleasure or benefits. In my learning process, I have learned quite a number of issues related to elder abuse including: definition, types of elder abuse, signs and symptoms, risk factors, and ways of reporting or helping the elderly.
Center for Disease Control and Prevention (CDC) defines elder abuse as any form of abuse on people aged 60 years and above by a caregiver or any other person related to the older person in a way that generates an expectation of trust (Center for Disease Control and Prevention, 2014). Elder abuse therefore includes harm by those people known by the older person or those related to them in one way or another. Administration on Community Living (ACL) also defines elderly abuse as an intentional or negligent act by a caregiver or any other person that causes harm to an adult who is vulnerable (Administration on Community Living, 2015). According to Elder Abuse Prevention Unit (EAPU), elder abuse is a repeated or single act or lack of proper action, occurring in a relationship with trust expectations, and causes distress or harm to older people (Elder Abuse and Prevention Unit, 2014). This definition was developed by Action on Elder Abuse in 1993 in the UK, and was adopted by the world Health Organization.
Types or forms of Elder Abuse
Elder abuse can occur in form of physical, sexual, psychological, neglect, abandonment or financial abuse. These are explained below:
- A physical abuse takes place when an older person is physically injured intentionally by a caregiver or any other related person (Administration on Community Living, 2015). Physical injuries may include biting, pushing, hitting, scratching, burning, etc. older people may also be abused physically through assault or threats, and inappropriate restrains.
- Sexual abuse refers to any sexual contact made with an older person against their will. It may occur when the older person does not understand the act or not able to communicate (Laumann et al, 2008). It may also include intentional touching of genitals, anus or breast of an older person against their own will.
- Emotional/psychological abuse is a traumatic experience of an older person after being threatened or coerced (Center for Disease Control and Prevention, 2014). This may occur due to social isolation, limited access to amenities, property destruction, etc.
- Neglect occurs when a caregiver or someone expected to be trusted refuses to provide basic needs or emotional needs to the older person (Center for Disease Control and Prevention, 2014). This includes lack of proper hygiene, lack of clothing or shelter, and poor healthcare.
- Abandonment refers to caregiver’s act of leaving or deserting an older person intentionally.
- Financial abuse takes place when a caregiver uses the older person’s financial resources without proper authority for their own interests, e.g. forgery, theft, coercive or deceptive acquisition of finances, and inappropriate use of power of attorney.
Signs of Elder abuse
An abused older person is likely to exhibit certain signs and symptoms that distinguish them from normal adults. First, an older person who has experienced physical abuse is likely to have signs of injury, including scars and bruises (Administration on Community Living, 2015). If the adult cannot be able to explain the causes of the injuries, then he or she is likely to be suffering from elder abuse. Physical abuse can also be identified through sprains and broken bones, and drug overdose of improper medication. Rope marks may also indicate signs of restrain.
Emotional abuse can be noted through belittling, controlling and threatening behaviour of the caregiver. Behavioral changes in the adult can also indicate dementia, e.g. mumbling. Bruises around genitals and breasts may also be signs of sexual abuse. Furthermore, elder sexual abuse may be identified through genital infections, stained undergarments and unexplained bleeding in the vagina. Malnutrition or dehydration may also be a sign of neglect from the caregiver. Other signs of neglect include: poor living conditions, dirtiness, improper attire, and abandonment in public places. Signs of financial abuse can also be noted through regular and significant cash withdrawal from the adult’s account, loss of cash or items, changes in wills and powers of attorney, and rising bills.
Elder abuse is always encouraged by the needs of the older person which intersects with old age dependence and care giving demands (Cooper et al, 2008). Some of the common risk factors in this situation include: risk factors of the caregivers and the conditions and history of the elder.
Elder people are likely to be abused by stressed or depressed caregivers. Elder Abuse and Prevention Unit (2014) suggests that caring for an elderly person is stressful. Some factors that contribute to caregiver’s stress include: financial problems, lack of external support, costs of care giving, and personal distress.
An elderly person is not able to do things on their own to earn income. Instead, they solely depend on young people to meet their needs. This makes them vulnerable to the people they depend on. Older people usually experience impairments such as physical disability, cognitive disabilities or dementia (Elder Abuse and Prevention Unit, 2014). These conditions prevent the victims of elder abuse from getting out of the abusive relationship with the caregiver.
The caring situation of a family may lead to domestic violence that translates to elder abuse at old age. Furthermore, a child who was abused by his or her parents may become the primary caregiver at old age, continuing the cycle of abuse. Intergenerational conflicts may also arise within a family, leading to elder abuse.
An isolated care giving environment may lead to elder abuse in form of restrains, financial forgery and misuse, sexual abuse and physical abuse (Elder Abuse and Prevention Unit, 2014). It is easy for the caregiver to remove money from the elder’s wallet if they are in an isolated location where the elder may not scream or raise alarm. The elders may also be forced to change their will and restrained in isolated areas where they may not be able to report the abuse.
Prevention of Elder Abuse
The most important approach to elder abuse prevention is to create collaborations and partnerships between medical personnel, caregivers, relatives, community based organizations and government agencies (Anetzberger et al, 2000). Elder Abuse and Prevention Unit (2014) proposes that older people should actively participate in community projects and develop a network of friends, relatives and neighbors. This enables them to secure help and assistance when they experience abuse. They should also work closely with community health workers to improve their health, and participate in church activities.
Government agencies and community based organizations should also create awareness among the older people so that they can detect any abusive behavior of caregivers and avoid it before it happens (Laumann et al, 2008). For instance, they may be trained on financial issues and encouraged to seek financial advice from their banks before making any financial decision, especially changes in power of attorney and will. Community involvement may also be enhanced through programs that are designed to meet the needs of older people (Elder Abuse and Prevention Unit, 2014). For example, Financial Abuse Specialist Teams have been formed in United States to provide advice to caregivers, older people, attorneys, and law enforcement authorities regarding the mechanisms of financial abuse and how to prevent them.
Administration for Community Living (2015). Administration on Aging (AoA): What is Elder Abuse? Accessed August 7, 2015 from http://www.aoa.gov/AoA_programs/elder_rights/EA_prevention/whatisEA.aspx.
Anetzberger, G., Palmisano, B.R., Eckert, S., Schimer, M.R. (2000). A model intervention for elder abuse and dementia. Gerontologist, 40(4), 492–497.
Center for Disease Control and Prevention (2014). Elder Abuse: Definitions. Accessed August 7, 2015 from http://www.cdc.gov/violenceprevention/elderabuse/definitions.html.
Cooper, C., Selwood, A. and Livingston, G. (2008). The prevalence of elder abuse and neglect: a systematic review. Age Ageing, 37 (2), 151–160.
Elder Abuse and Prevention Unit (2014). Elder Abuse: What is Elder Abuse? Accessed August 7, 2015 from http://www.eapu.com.au/elder-abuse.
Laumann, E.O., Leitsch, S.A., Waite, L.J. (2008). Elder mistreatment in the United States: Prevalence estimate from a nationally representative study. Journals of Gerontology: Series B, Psychological Sciences and Social Sciences, 63 (4), 248–254.