Table of Contents
Key Takeaways
- Elder abuse takes on many forms, including physical, emotional, sexual, financial, and neglect. While some forms may not have obvious warning signs, many victims experience a wide variety of symptoms.
- By noticing the signs of unexplained or repeated injuries, shifts in emotion and personality, and inconsistencies in their finances, concerned family or friends can intervene sooner rather than later to provide needed assistance to an elderly victim of abuse.
- Keeping education about abuse and exploitation at all levels, building strong and continuous communication channels between family members and elderly loved ones, and conducting regular well-being visits of elderly family members and friends are among the best supports to ensure that our most vulnerable elders are protected.
There is increasing concern regarding the abuse of our older adult population that often takes place behind closed doors or disguised by the normal process of providing care for a loved one. Many times, family caregivers, between friends and family members, are the perpetrators of abuse against the person they trust the most. However, many different forms of elder abuse can remain hidden, making education and awareness necessary to identify these forms of abuse to enable users and caregivers to intervene earlier in the cycle of elder abuse.
According to Claudette Spinelli Schwartz, an elder abuse expert, it is the identification of these silent threats to the elderly population that must occur first if we want to ensure that all elders can maintain their dignity and have their needs met safely.
Understanding the types of abuse that occur is extremely important. Not just the accounts of the obvious physical injuries or high costs of financial loss, but what are the more subtle forms of abuse? These less visible forms of abuse can cause great pain and suffering and may lead to acquiring or maintaining poor health through lack of adequate care, resulting in high costs associated with the physical care of that person. The number of elderly individuals continues to grow, and the level of care they receive is increasing from outside sources, making prevention and detection of such abuse more critical than ever.
What Is Elder Abuse?
Elder abuse refers to acts of intentional or negligent behavior by a person with a position of power resulting in a harmful situation for a senior or older adult, causing personal distress (harm). A nursing facility, or through some form of long-distance scam. However, these are just a few examples of a much larger issue that affects millions of people globally. In the U.S. alone, millions of seniors are abused every year. In fact, according to the National Institute on Aging, about 10% of U.S. adults over age 60 will experience some form of elder abuse.
Both families and professional caregivers need to continually stay alert for both obvious and hidden indicators of elder abuse. An effective response is more likely to occur if regular discussions occur among family members and caregivers regarding elder abuse and there is a reliable method of reporting suspected abuse, so as to create a safe place for elderly individuals living in a community and minimize the effects of many years of abuse on the victim.
The community must establish a cooperative approach toward providing a strong network of support systems and enforcing the many laws that exist to protect the elderly from becoming victims of elder abuse. This is something that both geriatricians and elder abuse advocates recommend.
Physical Elder Abuse
Physical elder abuse includes any act performed on an elderly person that is intended to cause physical injury or harm — for example, hitting, pushing, or improperly using restraints. The majority of the time, when physical elder abuse occurs, those who committed the act use the reasons for their actions to explain away the abuse with words like “accidental falls” or “minor mishaps.” There are also instances of repeated injuries to an individual, such as having bruises in different stages of healing, having broken bones in areas that are not typical locations for a person who has not experienced a fall or injury, and/or being burned while a person is told that they have fallen. In any such case, if a healthcare provider suspects elder abuse, it is imperative to investigate.
Emotional or Psychological Elder Abuse
Elder abuse is not just about abuse that is visible. Emotional elder abuse occurs in a number of ways: verbal intimidation, humiliation, threats of verbal abuse, and/or enforcing complete social isolation. The long-term impact of emotional elder abuse may be a decline in self-esteem and a subsequent increase in mental health issues (including depression and/or anxiety). An older person experiencing this form will suddenly begin to withdraw from social situations, be fearful of being with a caregiver, or show major changes in behaviour.
Families and friends should pay attention to non-verbal signs (flinching, looking away, being hesitant to speak openly about things in front of others) that might indicate that an older person has been abused. These signs are important to pay attention to because victims of abuse are often very scared and ashamed to talk about the abuse they are suffering from their caregiver. You can learn about the psychological effects of hidden abuse at the Centre for Disease Control and Prevention.
Neglect
While less obvious than other forms of elder abuse, neglect is the most common form of abuse of older adults and refers to repeated failures on the part of a caregiver to meet basic needs, including food, hygiene, medication, safety, etc. These failures may occur either as a result of the caregiver having been trained improperly or due to caregiver burnout. Common signs of neglect: Poorly managed medical conditions, extreme weight loss, chronic bedsores, and filthy living conditions.
Unlike other forms of intentional abuse, which consist of the intent to hurt the victim, neglect may be borne of good intentions on the part of a caregiver who is experiencing stress or fatigue. Therefore, regular home visits and regular health assessments are very helpful in preventing neglect of the older individual and in detecting problems before they become dangerous.
Financial Exploitation
As our society has moved from physical threats to electronic/economic threats, so too has the definition of financial exploitation of older adults. As technology has changed, so has the opportunity for stealing from older people; financial exploitation includes theft of personal property through investment fraud, theft by telephone solicitation, use of a credit card by a person without the victim’s permission, and theft of social security numbers. Most often the victim is unaware that the theft has occurred until it has already happened. Therefore, prevention and education are essential components of being proactive in this area. Families should create ways to oversee their elders’ finances, and be alert for changes in their elders’ financial status, or indications of financial hardship, unpaid bills or lack of accounting, or changes in financial spending patterns. The AARP’s resource center for preventing fraud on older adults offers up-to-date, clear guidance.
Indicators of Abuse
The possibility of elder abuse can appear to be small or insignificant along with the other signs of elder abuse. You should look for changes in mood, the inability to express feelings, sudden financial hardship, or unexplained injuries. Sudden changes in the relationship between caregivers and elders, such as missed medical appointments and bills that are not being paid, should raise concern. In addition, you may see changes in the appearance of your elder, such as unkempt clothing, dirty or inadequate hygiene, or chronic lethargy that requires further investigation.
Preventing Abuse
Education and Advocacy
Public awareness is a vital key to preventing elder abuse; to protect our loved ones, caregivers and others must know what to watch for. To foster an awareness of potential abuse, communities must engage family caregivers and professionals to identify abuse risk factors and signs. In addition to educating themselves on the warning signs of elder abuse, participating regularly in community workshops and/or webinars and sharing their knowledge with others will help create a stronger safety net for older adults.
Create an Open Communication Environment
Encouraging older adults to feel comfortable talking about their well-being is essential. Family members, friends, and health providers should check in with older adults on a regular basis, actively listen to their concerns, and provide opportunities for open communication regarding changes in their caregiving situations.
Routinely Monitor Your Elder
One of the most effective means of preventing elder abuse is by performing regular and unannounced visits to the home or other care facilities. These visits enable you to see firsthand your elder’s health, mood, and interaction with caregivers.
Your Community’s Role
Having both an offline and online support system for your elder is an essential part of protecting him or her from abuse. Anonymous reporting options and organized group discussions help provide an avenue for people to speak up about elder abuse.
The protection of aging adults from all types of maltreatment is an ongoing process that calls for constant vigilance, compassion, and a commitment by all of us to continue to learn about and educate others about how to promote and protect the dignity and safety of every single elder in our community through collaboration among families, service providers, and other community members for their benefit.