Elder abuse in domestic settings is a serious problem. Every year an estimated 2 – 5 million older Americans (depending on the study you read) are victims of physical abuse, emotional or psychological abuse, intentional or unintentional neglect, financial or material exploitation, abandonment or sexual abuse. June 15th is World Elder Abuse Awareness Day. The day aims to focus global attention on the problem of physical, emotional, and financial abuse of elders. It also seeks to understand the challenges and opportunities presented by an aging population, and brings together senior citizens, and their caregivers, national and local government, academics, and the private sector to exchange ideas about how best to reduce incidents of violence towards elders, increase reporting of such abuse, and to develop elder friendly policies.
Before you decide not to read this article because you don’t believe it to be in our community, please read on.
Elder abuse is extremely complex. Because it is largely hidden under the shroud of family secrecy, elder abuse is grossly under-reported. Experts estimate that for every incident of elder abuse authorities are aware of, as many as five to fourteen more are not reported.
Elder abuse is largely a women’s issue. Female elders are abused at a higher rate than males. While making up 58% of the total national elderly population in 1996, women were victims in 76.3% of emotional/psychological abuse, 71.4% of physical abuse, 63% of financial/material exploitation, and 60% of neglect.
Intergenerational and marital violence can persist into old age and become factors in elder abuse. In some instances, elder abuse is simply a continuation of abuse that has been occurring in the family over many years. If a woman has been abused during a 50 year marriage, she is not likely to report abuse when she is very old and in poor health.
Our oldest elders (80 years and over) are abused and neglected at two to three times their proportion of the elderly population.
Almost half of substantiated abused elderly people were not physically able to care for themselves.
Most elder abuse takes place at home. In almost 90% of the cases the perpetrator is a family member, with adult children or spouse inflicting the abuse most often (67% of the time).
What is Elder Abuse?
Physical Abuse: hitting, kicking, pushing, beating, slapping, choking, punching, burning or restraining.
Sexual Abuse: forcing the victim to perform unwanted sexual activities or degrading treatment.
Emotional Abuse: making humiliating remarks, name-calling, yelling, mocking, blaming, swearing, interrupting, threatening, harming pets, withholding affection and/or not respecting the victim’s feelings, rights and opinions.
Financial Abuse: stealing money or property as a way to maintain control.
Neglect: withholding or failing to provide food, water, assistive devices, shelter, clothing, medical treatment or personal care. Can be self imposed or imposed by others.
Signs and Symptoms of Elder Abuse
Physical Indicators
Injuries not consistent with lifestyle, or various stages of healing
Pain from touching
Cuts, puncture wounds, burns, bruises, welts
Dehydration or malnutrition without illness related cause
Poor coloration
Sunken eyes or cheeks
Inappropriate administration of medication
Soiled clothing or bed
Frequent use of hospital or health care/ doctor shopping
Lack of necessities such as food, water or utilities
Lack of personal effects, pleasant living environment, personal items
Forced isolation
Behavioral Indicators
Fear
Anxiety or agitation
Anger
Isolation or withdrawal
Depression
Non-responsiveness, resignation or ambivalence
Hesitation to talk openly
Confusion or disorientation, wandering
Change in social activities
Homelessness
Environmental Indicators
Lack of utilities (heat, water, electric)
Fecal matter about living space
Extremely cluttered to point of unsafe
Inappropriate or unsafe use of appliances
No food
Spoiled food in refrigerator, expired perishables
Malodorous
Unkempt exterior
Physical deterioration of property
Accumulated mail
What are some preventative measures that can be taken?
Take care of your health; see a doctor regularly, exercise, eat healthy and follow doctor’s instructions.
Seek professional help if there are any concerns (substance abuse, depression, urge family members to get help)
Plan for your future. Seek advice about Power of Attorney, living will and health care proxy from someone you trust.
Stay active in community. Avoid social isolation.
Know your rights.
Watch for symptoms above.
Be involved. Volunteer with older adults in the community and support initiatives that help prevention and intervention of elder abuse.
Get mad when you are scammed, not embarrassed.
Use “Do Not Call” registry.
Sometimes, older adults harm themselves through self-neglect. Of all of the types of abuse, self-neglect is the most controversial and sometimes the hardest to deal with once identified. The question that we face concerning self-neglect is a question of competency. If a person is competent and chooses to neglect their needs, do we have the right and responsibility to take action. Many families and health providers face this question on a regular basis. Self-neglect according to Linda M. Woolf of Webster University
Potential factors to be considered when evaluating the situation are:
Is the person repeating a pattern that has existed all of his/her life? As we age and face increased impairments, the lifelong pattern of neglect increases. This type of individual may be most resilient to services.
Early stages of dementia that is undiagnosed can lead to self-neglect. The first step is obtain a diagnosis and treatment. Families sometimes dismiss the early signs of dementia as normal aging. Normal aging is not a time of life in which we forget to eat or forget what we did last night. Repeated evidence of this type of behavior should be taken seriously and medical opinion should be sought.
Illness, malnutrition and over medication are also problems that lead to self-neglect. These problems can look like early dementia and need medical attention also.
Depression is a serious issue in older adults and often leads to self-neglect. The good news about depression is that it is treatable. Rapid diagnosis and treatment is very important so the risk of suicide can be reduced. This is particularly true for older white males. Their suicidal rate is as much as 12 times higher than any other group. Two signs of depression are self-neglect and dementia like symptoms.
Substance abuse is self-neglect regardless of age. Intervention is important because some people can overcome their addiction with appropriate treatment.
Poverty causes older adults to have to make choices such as, food, housing, medications, regular doctor visits, etc. In this situation the older person is forced into self-neglect behaviors as a survival mechanism. Obviously connecting the older person with appropriate resources such as food stamps, rental subsidies, etc. can modify this problem.
Isolation is also a factor that can lead to self-neglect. Assisting the older person find social outlets such as senior centers, travel groups, church activities can be the real solution to isolation. Sometimes a family member or friend needs to accompany the person on the first trip, or the first visit to the center. Walking in alone and not knowing anyone can be overwhelming for anyone of any age.
Self-neglect can be treated if we are willing to offer help and support to the older person in a non-judgmental way.
As the population of older Americans grows, so does the hidden problem of elder abuse, exploitation and neglect. One out of five residents in Niagara County
No comments:
Post a Comment