Elderlyabuse can be defined as the infliction of physical,psychological/emotional, financial or sexual harm on an elderly. Inaddition, it can involve intended or unintended neglect of an olderindividual by relatives or caregivers. The issue of elderly abuse inthe United States is alarming given that, the U.S population of theelderly has increased in the last few years. In the U.S 2010 Census13 percent (40.3 million) of the population are 65 and over. It isestimated that, 4 million senior citizens are victims of abuse eachyear. Even though this statistics may not be accurate because mostcases of elderly abuse go undetected or unreported (AmericanPsychological Association, 2012). Women appear to be more abused thanmen. Elderly abuse signs may be missed by professionals workingelderly people due to lack of adequate training on how to detectabuse. Elderly abuse greatly affects the lives of those individualswho are abused since they suffer worsened functional and financialand progressive dependency, feeling of helplessness, poor self ratedhealth, and heightened psychological distress.
Accordingto studies by American Psychological Association (2012), the abusedelderly persons die prematurely as compared to those who do not faceabuse, even without chronic conditions or life threatening ailment.The elderly people may be reluctant to report abuse due to lack ofphysical and/or cognitive ability to report, fear of retaliation, andsimply for not wanting to get the abuser (most of whom are familymembers) in problems. As a result, cases of abuse are rarely reportedwith only 1 out of 14 cases being reported according to AmericanPsychological Association (2012).
Elderlyabuse is a complicated issue just like other forms of abuse whichbrings a mixed perception about it. When people hear of elderlyabuse, they perceive it as something that happens in care homes or toolder relatives living alone without someone looking after them. Thisperception is wrong as elderly abuse happens every day everywhere.
Elderlypeople are usually weak due to age or they may be having a healthcondition that may make them vulnerable for physical abuse. Physicalabuse for the elderly is common and involves actins such as slapping,pinching, kicking, biting, burning or severe beatings and restrainingmovement with chains or ropes. It may also include unwarranted use ofmedication to restrain an older person (American PsychologicalAssociation, 2012). Physical abuse may occur when a caregiver usesreasonable force to inflict unnecessary pain or injury on an elderlyperson. Even when this action is aimed at helping the older person,it is still termed as abuse.
Verbal,Psychological or Emotional Abuse
Thisis the most common form of abuse towards the elderly. It involvesthings such as name calling, threatening or intimidating the person. It is common among family members and caregivers in general. Behavingtowards an elderly person in a manner that causes fear, emotionalpain or distress is a form of abuse. Verbal abuse can involve yellingat the elderly, making insulting comments or swearing to an elderly(Bond & Butler, 2013). Psychological abuse on the other hand caninclude any form of threatening behavior that brings about a powerdifferential between the older person and his or her caregiver or afamily member.
Caregiverscan neglect the elderly person through use of strategies that denyexpected attention from the person and deliberately failing to meetthe physical, social or emotional needs of the elderly person(American Psychological Association, 2012). Usually, neglect entailsfailure to provide basic necessities and services including food,water, medication, clothing, and assistance with routine lifeactivities as well as with personal hygiene.
Olderpeople’s mental and physical abilities decline. This makes themneed help from third parties when transacting, or are taken advantageof by caregivers or relatives, who milk them off their financialresources. Financial exploitation of the elderly involve taking moneyunder false pretences, forgery, fraud, forced transfer of funds,purchasing expensive items with the old persons money without theirauthority or knowledge or preventing them from using their money asthey desire (Gibson, & Greene, 2013). Perpetrators of this formof abuse usually take advantage of legal guardianship,conservatorship or powers of attorney. In the recent years, variousinternet or telephone scams have been in the rise involving salespeople or friends for home repairs, mortgage companies, health orfinancial services. According to National Committee for thePrevention of Elder Abuse, the annual financial loss of the elderlyvictims of financial exploitation was about $2.9 billion in 2009, 12percent higher than the previous year (2011).
Sexualabuse of the elderly can include photographing the elderly person insuggestive poses, inappropriate touching, forcing them to watchpornographic materials, forcing sexual contact with another person,coerced nudity, rape, as well as sodomy. This form of abuse is themost egregious but rarely reported.
Thisis the intentional desertion of an elderly individual by caregiver offamily member or any other responsible individual.
Thereare various signs which a person, a health care worker, a socialworker or authorities can use to tell if an elderly is being abusedor not. However, they depend on the type of abuse the victim isundergoing. Whereas a single sign may not necessarily exhibit abuse,the following signs are common in abused elderly people (NationalCommittee for the Prevention of Elder Abuse, 2011).
PhysicalAbuse: Bruises, broken bones, pressure marks, abrasions and burns aresigns of physical abuse.
EmotionalAbuse: this can be characterized by withdrawal from routineactivities, an unordinary depression, and an unexpected change inalertness.
SexualAbuse this can be identified by bruises on the genitals or aroundthe breasts.
Emotionalabuse can be identified by behavior like threats, belittling, andother use of control by partners.
Neglectcan be identified by signs like bedsores poor hygiene, unattendedmedical needs, and or an unusual weight loss.
Financialexploitation can be identified through an unexpected change infinancial status.
WhatCauses Elder Abuse
Abuseof elder people is an ancient phenomena and it cannot be said to becaused by a specific or one single factor. Bond & Butler (2013)establishes three major causes of elderly abuse including familystressors, care giver stress and social and cultural issues relatedto elderly abuse.
Familystressors are elements that relate to family relations that canresult to elderly abuse. Family stressors which may result to elderlyabuse include dispute established through a pattern of history ofabusive relations in the family, lifestyle change and adjustments toliving in multigenerational household and social division.Intergenerational and marital conflict can spill into old age andtrigger elderly abuse. In some cases, it is basically a continuationof abuse which has been happening throughout the family’s history.A spouse who had been abused during marriage may take advantage of ahealth condition of his or her partner to revenge. Children can alsotake the opportunity to retaliate abusive parents by withholdingnourishment or by overmedicating the parent, misusing the parents’money (Bond & Butler, 2013). However, this is not a fact as somechildren from abusive parents end up being very caring of theirparents during difficult times in old age.
Anelderly person living in a multigenerational environment can beabused as a result of adjusting and being accommodated in the family.Besides, the financial burden added to the family can push the familyto stress that may lead to abuse of the elderly. In instances wherethe supporting family is incapable and is dependent on the elderlyparent’s resources, abuse can be indefinite. In addition, when thecare of the elderly surpasses the family resources, such as aterminal illness, they can become victims of abuse.
Consequentlysocial isolation is usually a risk factor for abuse of the elderly,it can be used as a strategy to keep conceal abuse or can be a stressindicator for caring for a dependent elderly member of the family.Isolation is risky as it cuts off the entire family from externalsupport that helps in caring for an elderly or a sick elderly person(Bond & Butler, 2013).
Eventhough most family caregivers do their best to provide care and asupportive environment for their loved ones, providing care bringsabout stress that takes toll on both the caregiver and the carerecipient. This kind of stress can provoke potentially harmfulcaregiver behaviors which puts the dependent elderly individual atrisk of abuse.
Caregiver’spersonal problems such as financial difficulties, stress related toschool work, workplace stress, relationship problems, drug andalcohol abuse, as well as abusive dependent elderly personparticularly those having mental problems like Alzheimer’s diseaseof dementia can trigger abusive behavior towards the elderly person(Bond & Butler, 2013). There is no difficult task like caregiving, hence without patience or proper support or training on howto balance between the needs of the dependent elderly person andone’s own needs can lead to serious risk for abuse.
Dependencyof the elderly person on the caregiver can also push the caregiver toheightened stress that can lead to abuse. On the other hand, when thecaregiver is dependent on the elderly for financial support, he orshe may be tempted to financially exploit the elderly person (Gibson,& Greene, 2013).
Insome instances, the caregiver may be compelled by responsibility asthe dutiful child to care for his or her relative, particularly aparent. It may be difficult for him to look for a professionalcaregiver such as a nurse or take the elderly person to nursing homeas it may appear as betrayal of their trust. This may take a toll onthem and lead them to develop abusive behavior towards the elderlyrelative.
Inaddition, caregivers’ emotional and psychological issues can placethem at risk of being abusive to the elderly person. They may turninto drugs or alcohol to manage their stress, which also is a riskfactor for abuse of the elderly.
Socialand Cultural Issues
Certaincultural believes, values and traditions influence family dynamics,relationships, and the way families perceive their roles andresponsibilities and deal with life challenges. These disparitiesmake it difficult to pinpoint abuse or neglect.
Societalattitudes may result to violence against the elderly, making iteasier for abuse to persist without being exposed or intervened.These may include disregard for the elderly in the society. Thesociety sometimes perceives the elderly as insignificant due to theirinability or unproductiveness. Through this notion, the elderly donot receive dignified, supportive and non-abusive treatment (AmericanPsychological Association, 2012). Consequently, the abused elderlypeople may not avail help or support from outside as members of thesociety conceal abuse, in view that, what happens at home is a familyaffair. As a ripple effect of societal attitude, the abused elderlypeople do not report abuse as they feel embarrassed or shame. In somecultures, women have no regard and are liable to mistreatment hencethey may not know when they are being abuse. This further exuberatethe problem of elderly abuse in cultural and societal stressors’context.
Accordingto Dong et al. (2009), elderly persons from ethnic minorities,especially new-coming immigrants may experience language barrier orfinancial or emotional financial dependence which determine the waythey are treated and their willingness to report abuse.
Theimpacts of elderly abuse are degrading. Elders who have experiencedsome form of abuse are at a 300 percent increased risk of deathcompared to those who have never been abused (Dong et al., 2009). Inaddition, elderly people who have been abused have high degree ofpsychological distress and low superficial self efficacy as comparedto older adults who have not been abused. Abused older personsexhibit an additional health problem (such as joint problems,digestive problems, anxiety, depression, high blood pressure, bone orjoint problems and cardiovascular problems) when compared with thosewho have not been abused. Besides, abuse and neglect of the elderlyhas intense fiscal cost. According to (Dong et al., 2009) the directmedical costs related with violent injuries inflicted on older adultsamount to over $5.3 billion annually, adding to the annual healthbudget. Ultimately, elderly abuse result to serious effects. Itcreates potentially harmful situations and feelings of triviality,leading to isolation of the elderly person from people who canprovide care.
Elderlyabuse should be stopped at all costs as there is no person whodeserves to be mistreated regardless of the age, gender, religion orany other social parameter. Having a positive attitude towards theelderly is an important step in preventing elder abuse. Cases ofabuse against the elderly are a clear indicator that, the peopleinvolved whether family of care givers need immediate help. Ways thatcan help prevent this shameful act include educating the caregiversand the community at large on the importance of caring for theelderly (Cooper, Huzzey, & Livingston, 2012). The media plays asignificant role educating the public. In addition, to minimizecaregiver related stress, respite care can help (Chen, Twomey, &Whittier Eliason, 2012). Respite care is finding someone else to helpwith care giving whether family or a professional. Counseling isanother way that can greatly help improve the lives of the elderly.This is meant to teach caregivers how to be patient avoid drugs andalso guide the elderly to be cooperative with caregivers.
Roleof Nurses in Preventing
Asprimary caregivers in various nursing domains, nurses are the primaryhealth professionals in identifying and providing preventive measuresto elderly abuse. Nurses must be attentive to any signs of abuse inthe elderly such as unexplained injuries (Bond & Butler, 2013).They can achieve this through performing oral interviews to theelderly seeking health attention as well as a head to toe assessment.Empowering the elderly is the basis of preventing abuse. Nurses takethe responsibility of encouraging the elderly to speak out, besidesoffering emotional support and making medical appointment to otherhealth care providers. When a nurse recognizes the cause of abuse,they can make oral report to the unit manager followed by a detailedofficial report with proper supporting documents. In addition, nursesmust always be willing and ready to give testimonies or evidence in acourt of law. If the abused elder person is in need of immediateintervention, the nurse must seek emergency services to help theabused before taking the necessary action on abuse.
Inconclusion, elderly abuse is a beastly act that should be condemnedin all manners. The elderly are vulnerable and should be given utmostcare to appreciate their contribution in life. Like any other person,they have human rights that should be protected. The various forms ofabuse include physical, sexual, emotional/verbal/psychological,neglect, among other forms of abuse. The underlying causes of elderlyabuse include caregivers’ stress, societal and family stressors.With understanding of the issue and help from support groupsincluding counseling can help reduce elderly abuse.
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