Elder Abuse : Violence Prevention East

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Elder Abuse

Any act or behaviour towards an elder person which results in; the intentional or reckless infliction of pain or injury; the use of threatened violence to force participation in sexual conduct or other conduct contrary to the wishes of the elder; the intentional imposition of unreasonable confinement; or the intentional or deliberate deprivation of food, shelter, or health care - when this deprivation constitutes a threat to life or physical well being.

Prevalence

Approximately 4% of elders (98,000) in Canadian private dwellings reported being abused.
Financial abuse is the most prevalent type of abuse affecting 60,000 Canadian elders.
Chronic verbal aggression affects approximately 34,000 elderly Canadians.
More than 18,000 elderly persons in Canada are subjected to more than one type of abuse.
Approximately 12,000 seniors in Canada experience physical abuse.
Female victims of abuse outnumber male victims by approximately 5:3.

Types of Elder Abuse

Physical Abuse: the use of, or threatened use of force against an elder. This includes: physical assaults, sexual assaults, unnecessary physical restraint, physical coercion and medical maltreatment.

Indicators:

frequent unexplained injuries (cuts, grip marks, welts, broken limbs and bruises)
reluctance to seek medical treatment for injuries or denial of there existence
injuries in various stages of healing
the refusal of community contact
sudden introversion in the presence of specific persons
injuries to scalp
disorientation or grogginess may indicate the misuse of medication

Neglect: the intentional or accidental withholding of the physical or psychological necessities.

There are three categories of neglect:

Active Neglect - when an elder requires assistance but is abandoned in spite of knowledge of this need.
Passive Neglect - when an elder person, under the care of a care giver, does not receive the assistance to enable them to complete tasks necessary to allow normal life standard.
Self Neglect - when the elder person neglects his/her self because they wish to be that way.

Indicators:

poor personal hygiene
malnutrition
dehydration
clothing / living quarters dirty and unkempt
unchanged bandages in the case of previously obtained medical treatment

Psychological Abuse: the wilful intimidation and/or humiliation of an elder. This form of abuse also includes the removal of the decision making power from the elder, verbal and non-verbal abuse, isolating and name calling, emotional deprivation, mental cruelty and the use of threats or instilling fear.

Indicators:

social isolation
verbal assaults (shouting, degrading, etc)
depression
withdrawal
contact between abuser and victim lacking emotion
unexplained nervousness

Financial Abuse: any situation involving the dishonest use of an elder's resources such as money or property. This includes: criminal financial behaviour, stopping mail with intent and the forced selling of property, stealing money or personal possession, forgery and misuse of power of attorney.

Indicators:

disappearance of possessions and financial assets
bills and expenses continuously unpaid
sudden revision of elder's will, naming a new beneficiary
granting power of attorney under suspicious condition
disclosure of situation by elder
elder having to resort to other means to attain necessities

Why does Elder Abuse Happen?

The burden of responsibility on caregivers, which is growing heavier as older people live longer, can lead to elder abuse. This is especially true in cases where caregivers have to take care of physical needs, such as bathing and toileting.
Economic problems, such as high unemployment, can increase the stress experienced by caregivers and also increase the potential for financial abuse. In addition, economic recessions often mean that fewer resources are available to assist relatives in caring for the elderly.
Cultural changes that lower the status of the elderly and lead to less respect from younger people can increase the likelihood of abuse.
Personal problems on the part of relatives or caregivers, such as substance abuse or mental or emotional impairments, can cause neglect of elders and sometimes abuse.
An increasing number of socially isolated elderly means that more older people are lonely and vulnerable to abuse.
Elderly women are more likely to be abused, simply because they outnumber men. Women may also be more economically dependent on others.
A lack of adequate housing can contribute to abuse, especially if family members feel forced to co-habit with elders.
The extent to which society tolerates aggression and crime is thought to be related to the incidence of elder abuse.
Within families, a history of violence can mean that violence is used to respond to stress.
Within institutions, elderly residents may be powerless and vulnerable, and staff may be underpaid, underqualified and overworked. These factors create a climate which can contribute to elder abuse.

What can be done about Elder Abuse as a Social Problem?

Public education is extremely important. Both elders themselves, and the public at large, need to understand more clearly what elder abuse is, why it happens, how to recognize it and what can be done.
Elder need to retain as much power and control over their own lives as possible, since this reduces the risk of abuse. Knowledge is empowering, so it is important that older people know their rights. In addition, we need to ensure that the elderly have the power to make everyday life choices, as much as is possible. For example, organizations and institutions who work with or house the elderly need policies that promote this empowerment.
There are some systemic issues that need to be addressed. Agism, for example, creates a social environment which makes it easier for elder abuse to occur. Abusers with stereotyped views of the elderly as frail or senile, or who feel that the old have less inherent worth than younger people, may be able to rationalize abusive behaviours. We all need to make it clear that agism is unacceptable.