I recently attended a seminar on ‘elder abuse’. The severity and pervasiveness of this issue surprised me, and so I am passing along some key points from the seminar which I hope will be enlightening and helpful to all.
A recent U.S. Census reported that over 45 million Americans are 65 or older.[1] As ‘baby boomers’ age, elders become an ever-increasing portion of the U.S. population. No longer do families necessarily live near one another, resulting in a need for non-familial persons and resources to care for aging relatives. These resources may take the form of ‘care givers’, distantly-related ‘care takers’, continuous care facilities, retirement communities, or nursing homes.
All too often, these persons of facilities regard their work as just a ‘tough job’ and have no real interest in those they are caring for. Unfortunately, statistics show that 1 in 10 elder Americans Age 60+ experienced abuse, and many experienced it in multiple forms of physical, mental or financial abuse for as long as a year.[2]
WHAT IS ELDER ABUSE?
Elder abuse refers to intentional or neglectful acts by a caregiver or “trusted” individual that lead to, or may lead to, harm to that vulnerable elder. Physical abuse, neglect, emotional or psychological abuse, verbal abuse and threats, financial abuse and exploitation, sexual abuse, and abandonment are considered forms of elder abuse. In many states, self-neglect is also considered mistreatment.
Who is at Risk?
Elder abuse can occur anywhere – in the home, in nursing homes, or other institutions. It affects seniors across all socio-economic groups, cultures, and races. Based on available information, women and “older” elders are most likely to be victimized. Dementia is a significant risk factor. Mental health and substance abuse issues –of both abusers and victims – are risk factors. Isolation can also contribute to risk.
- 90% of abusers are family members and friends
- 1 in 10 seniors are victims of elder abuse
- 1 in 15 cases are actually reported to authorities
- 50% of adults with Alzheimer’s are victims of elder abuse
- Victims are primarily females, but also older males
- People of ‘non-normal’ ethnicity, orientation, social-economic or religious backgrounds
TYPES OF ELDER ABUSE
- Physical abuse: Use of force to threaten or physically injure an elder
- Emotional abuse: Verbal attacks, threats, rejection, isolation, or belittling acts that cause or could cause mental anguish, pain, or distress to an elder
- Sexual abuse: Sexual contact that is forced, tricked, threatened, or otherwise coerced upon an elder, including anyone who is unable to grant consent
- Exploitation: Theft, fraud, misuse or neglect of authority, and use of undue influence as a lever to gain control over an older person’s money or property
- Neglect: A caregiver’s failure or refusal to provide for a vulnerable elder’s safety, physical, or emotional needs
- Abandonment: Desertion of a frail or vulnerable elder by anyone with a duty of care
- Self-neglect: An inability to understand the consequences of one’s own actions or inaction, which leads to, or may lead to harm or endangerment; excludes a person mentally competent to make and understand consequences of decisions
Warning Signs
- Physical Abuse: Slap marks, unexplained bruises, restraint marks, most pressure marks, and certain types of burns or blisters, such as cigarette burns – – change in physical appearance
- Neglect by caregiver: Pressure ulcers, filth, lack of medical care, isolation, malnutrition or dehydration
- Emotional Abuse: Withdrawal from normal activities, verbal aggression, unexplained changes in alertness, or other unusual behavioral changes – change in personality
- Sexual Abuse: Bruises around the breasts or genital area, genital or anal pain or bleeding, difficulty walking or sitting, torn/stained or bloody underclothing, and unexplained sexually transmitted diseases
- Self-Neglect: refusal or inability to provide for self, filth, hoarding, over or under medicating, isolation
- Financial Abuse/Exploitation: Sudden change in finances and accounts, altered wills and trusts, unusual bank withdrawals, checks written as “loans” or “gifts” and loss of property
- Any changes in home environment
Consent & Capacity
Legally, a person who periodically provides assistance, by law, are termed caretakers. This person has no legal responsibility to provide this care. A caregiver is legally responsible for the care of the elder; normally, this care is given under a contract. Neglect or abuse by the caregiver must be reported to either the police, the facility, Department of Aging or the appropriate ombudsman.
An elder victim can only offer consent when they have:
- Ability to understand and make knowledgeable decisions.
- Knowledge of the true facts/situation
- Ability to act freely and voluntarily
Consent is not valid if obtained by force, lies, coercion, manipulation; any condition that illustrates the elder does not have the mental capacity to make decisions.
Who Are Abusers?
- Intimate partners
- Adult children or other family members
- Caregivers (paid or non-paid)
- Others in position of authority over the elder person
How big is the problem?
Research indicates that more than one in ten elders may experience some type of abuse, but only one in 23 cases are reported. This means that very few elders who have been abused get the help they need. One thing is for certain: elder abuse can happen to any older individual – your neighbor, your loved one – it can even happen to you.
WHAT SHOULD I DO IF I SUSPECT ELDER ABUSE?
- Report Your Concerns – Remember: Most cases of elder abuse go undetected. Don’t assume that someone has already reported a suspicious situation. To report suspected abuse in the community, contact your local Adult Protective Services agency. For state reporting numbers, visit the NCEA website at http://www.ncea.aoa.gov or call the Eldercare Locator at 1-800-677-1116.
- If You or Someone You Know Is in a Life-Threatening Situation or Immediate Danger, contact 911 or the local police or sheriff.
- To Report Suspected Abuse in a Nursing Home or Long-Term Care Facility contact the Attorney General’s Adult Protective Services or the Long Term Care Ombudsman at http://www.ltc.ohio.gov
Remember: You do not need to prove that abuse is occurring; it is up to the professionals to make a determination.
HOW TO PREVENT ELDER ABUSE
The New York State Elder Abuse Prevalence Study found that for every elder abuse case known to programs and agencies, 23.5 were unknown. In the same study, they examined different types of abuse and found for each case of financial exploitation that reached authorities, 44 cases went unreported. The National Elder Abuse Incidence Study estimated that only 1 in 14 cases of elder abuse comes to the attention of the authorities.[4]
- Report Suspected Mistreatment to your local Adult Protective Services agency or law enforcement. Although a situation may have already been investigated, if you believe circumstances are getting worse, continue to speak out.
- Keep in Contact – Talk with your older friends, neighbors, and relatives. Maintaining communication will help decrease isolation, a risk factor for mistreatment. It will also give the elder a chance to talk about any problems they may be experiencing.
- Be Aware of the Possibility of Abuse – Look around and take note of what may be happening with your older neighbors and acquaintances. Do they seem lately to be withdrawn, nervous, fearful, sad, or anxious, especially around certain people, when they have not seemed so in the past?
- Contact the Ohio Adult Protective Services to identify local programs and sources of support, such as Meals on Wheels. These programs help elders to maintain health, well-being, and independence – a good defense against abuse.
- Volunteer – There are many local opportunities to become involved in programs that provide assistance and support for elders.
- Observe World Elder Abuse Awareness Day – Elder abuse is a global issue. Contact your local aging services organizations to find out how your community will observe World Elder Abuse Awareness Day (commemorated on June 15 every year). Help to raise awareness by talking about the issue.
- Learn More About the Issue – Visit the National Center on Elder Abuse website, www/ncea.aoa.gov.
More research is needed, but it is clear that elder abuse is a major public health problem with significant impact on millions of people. The National Center on Elder Abuse (NCEA) is at the forefront of the national fight against elder abuse.
Note: this article was adapted from a presentation delivered by Sylvia Pla-Raith, Director of the Elder Justice Unit of the Department of Consumer Protection, Ohio Attorney General’s Office, at the Giving Voice to LGTBTQ Older Adults Conference, held at North Congregational Church, Columbus, OH.
The Rev deniray mueller
[1] U.S. Census Facts for Features: Older Americans Month: 2013
[2] Acierno R, Hernandez MA, Amstadter AB, Resnick HS, Steve K, Muzzy W, et al. (2010). Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: The national elder mistreatment study. American Journal of Public Health, 100(2), 292-297
[3] National Clearinghouse on Abuse in Late Life, Abuse in Late Life Wheel, 2006
[4] Lifespan of Greater Rochester, Inc., Weill Cornell Medical Center of Cornell University. New York City Department for the Aging. (2011) Under the Radar: New York State Elder Abuse Prevalence Study. New York: Author. National Center on Elder Abuse, Westat, Inc. (1998). The national elder abuse incidence study: Final
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