Problem of Elderly Abuse

Description of the topic

Elder abuse is a hidden and often ignored issue in society. Elder abuse, also known as elder mistreatment is any form of maltreatment or neglect of an adult age 60 or older that threatens his or her health and safety. Each year, hundreds of thousands of adults are being abused. Perpetrators are often nurses, physicians, home health aides, bankers, and even lawyers. However, the most common perpetrators of elder abuse are family members such as an intimate partner, son, daughter or even a grandchild. This is believed to be because often times family members are the elder’s caretakers. There are many forms in which abuse can take place. A common type of abuse is physical abuse, such as infliction of pain or injury. There is also sexual abuse which includes any nonconsensual sexual contact. Emotional abuse is any infliction of mental anguish. Caregiver neglect refers to refusal or failure to fulfill caregiver obligations to meet basic needs of the elder. This includes deprivation of food, clothing, housing, and medical care. Any unauthorized or improper use of the elders funds or resources is a type of abuse known as financial exploitation.

In elder abuse, neglect, and exploitation, authors Namkee Choi and James Mayer inform “the first nationwide incidence study of domestic elder maltreatment estimated that a total of 450,000 elders aged 60 or older became victims of elder abuse, every year an estimated 2.1 million older Americans are victims of physical, psychological, or other forms of abuse and neglect (Choi & Meyer, 2000, p. 9 ). Elder abuse first gained attention as a medical and social problem about 20 years ago when the term “granny battering” first appeared in a British medical journal. Despite the major issue with elder abuse among the United States population, it still became the most understudied. Adults suffering from memory problems such as dementia or physical dependency from others became victims. Mental illness, depression, loneliness or lack of social support also became high-risk factors for the elderly.
Elder abuse is believed to be widely under-reported, only one of every 14 cases is reported. In the textbook, Violence and Maltreatment in Intimate Relationships by Cindy Miller, Robin Perri, and Claire Renzetti they state, “As “baby boomers” age and the elderly population grows significantly, this situation could change dramatically. The population grew from 12.4 percent in 2000 to 13.7 percent in 2012 and it is expected to exceed 20 percent by 2030” (Miller, Perri, Renzetti, 2018, p. 261). With the elderly population growing tremendously, elderly abuse has become a need for immediate assistance. Awareness towards this issue is necessary but an appropriate measure towards people who care for these elderly individuals is a must.

Literature Review of the Problem

The issue of Elder Abuse is prevalent worldwide, for this section we will be taking a look at various cultures and their views for elders. The World Health Organization(WHO) gives a profound statement on elder abuse as “elder abuse is a violation of human rights and a significant cause of illness, injury, loss of productivity, isolation and despair.” In the journal article Prevalence and Predictors of Elder Abuse in Mahikeng Local Municipality in South Africa, authors Paul Bigala and Natal Ayiga focus on the widespread elder abuse issue in Sub-Saharan Africa and South Africa, specifically on how it is a serious public health problem in their community. Some of the common reports of elder abuse are suicidal ideation, injury and pain, psychological impairments including depression, anxiety, post-traumatic stress disorder, and death due to neglect and loneliness. The article estimates prevalence and identifies the forms and predictors of elder abuse. Statistics prove that 64.3% of men and 60.3% of women often experience elder abuse. Physical abuse is more common among men while emotional, financial, and sexual abuse are more common among women. If the elder had no working children, were currently single, living in rural areas, or had a poor-perception of health and had a disability they were significantly associated with elder abuse. It is likely that elder abuse has harmful impacts at all levels of society, affecting public health, resources, and civic engagement (Bigala, 2014,pg.463)

As previously mentioned, elder abuse is increasingly becoming a matter of global concern in developed and developing countries. The older population is living longer and in many cultures, millennials are having fewer children because they are taking care of their older loved ones. Another population that is being abused in different forms than heterosexual elderly is the LGBT elderly population. According to Choi and Meyer, “It is estimated that there are over 2.4 million LGBT older adult over age 50 in the U.S., with the expectation that this number will double… by year 2030” (2016, pg. 2). The report also shows that the LGBT population is increasing along with the older population. Furthermore, LGBT have a higher risk of becoming mentally ill than heterosexual people. An issue that was discussed in the report is that the Older American Act (OAA) does not recognize the LGBT older population. The OAA is a federal law that helps the well-being of 60 year-olds and above through services and other programs designed for the elderly. Discrimination is a type of abuse that the LGBT older adults face often. In the report we found that 19% were refused a home or even an apartment based on their gender identity or even by their way of expression (2016, pg. 10). The LGBT older population are being left out of long-term care facilities such as nursing homes due to their sexuality. Financial abuse is another form of abuse this population faces.

Even though having same-sex marriage legal in most states; many spouses still might not be able to access benefits from some federal programs such as social security and Medicaid.
According to the Article “A Cognitive-Ecological Approach To Elder Abuse In Five Cultures : Human Rights And Education,” Marcus Patterson and Kathleen Mallery-Morrison (2006 pg 74), explain how culture and gender affect the way elders are abused in America and in Israel and other countries. The article states how abuse conceptions and practices of elder abuse are influenced by economic strain and social oppression. According to Patterson and Mallery-Morrison(2005 pg 74), in cases where family were going through poverty elders were more susceptible to elder abuse. Moreover, the article states gender also plays a big factor in elder abuse as women are more likely to report the neglect they endure and report economic abuse as abuse than men. In a national survey Eisikovitz & Wintersein (2005, pg 75) found older Arab Woman are the most vulnerable to maltreatment, but also in countries like Germany, elders living independently experience about 2% of abuse while those with dementia experience elder abuse up to 68% (Koenig and Leembruggen-Kallberg, pg.75).

With this being said there are many cultures with high regards to the elderly. Taking a look at different caretaking views, in a 12 year review on ethnicity, culture, and acculturation among asian caregivers of older adults, author Christina E. Miyawaki found many similarities and differences between the Chinese, Japanese, Filipino, Vietnamese, and Korean cultures. Something to acknowledge about the Asian culture as stated by Dai and Dimond (1998) is that asian “adult children are traditionally expected to sacrifice their physical, financial, and social needs for the benefit of their aging parents. They take a family-centered approach to fulfil their filial responsibility” in contrast, according to Chappell and Funk (2011), to an individualistic approach characteristic of Western cultures (Miyawaki, C. E, 2015, pg. 12). Therefore, it was found amongst all five cultures that “regardless of ethnic subgroups and their immigrant generations, all caregivers expressed their deep commitment to caring for their loved ones and a strong sense of filial responsibility” (Miyawaki, C. E, 2015, pg. 14).

However, it is important to note that depending on the immigrant generations, for example Japan consisted of 3rd generation immigrants, “their needs and approaches to caregiving differed, which may be a reflection of acculturation to the Western way of caregiving” (Miyawaki, C. E, 2015, pg. 14). We think this is an important point to touch on because through the review we were able to learn about how Asian cultures hold their elders with high respect but how the aspect of acculturation brings confliction with their Asian culture and the new culture they adapted coming into the U.S. An example of the confliction was with 3rd generation Japanese immigrants who were born in the U.S and were more aware and exposed to the Western way of caregiving but still held their Japanese values close. The way the participants in the review dealt with this was by using family caregiving along with the help of paid caregivers which they referred to as “fictive kin.” This was done in order to preserve familism with a modified approach to filial responsibility (Miyawaki, C. E, 2015 pg. 13). Therefore, we learned that although different cultures might adapt to Western ways of caregiving they still hold onto their cultural values in order to maintain high regards for their elders. We can see there are cultural differences among many different people globally and based on if the individual felt high filial responsibility or not determined whether their caretaking experience was positive or negative.

Literature Review of an Intervention

As previously mentioned, elder abuse is a global health issue and it is a form of violence that often gets overlooked. Over the decades, abuse in general has been a topic that hasn’t been getting the attention that it should. In many cultures, elder abuse, among other kinds of abuse are kept a private matter, something that is only discussed among family (Patterson, M., & Malley-Morrison, K. (2006) . Given that the matter is kept private, this might explain why it is often underestimated and underreported. In order to shine some light on this issue, our group has proposed an intervention that has been supported by the Oxford University press and could help alleviate the issue. The focus of our intervention is prevention (Baker, Fancis, Hairi, Othman, Choo, 2017, pg 347). As social workers, our role is to prevent, advocate and vouch for our clients. In this case, the best way to address the issue is by implementing preventative measures and making sure that those who work or deal with the elderly have the proper education and patience to be working with them. In order for people to be able to work with them and not abuse them in any form, they must have some proper education(Baker, Fancis, Hairi, Othman, Choo, 2017, pg 347).

Educational workshops should especially be provided for family members who are caretakers as well as those who work in elder or retirement homes. Family members and workers need to be provided with educational workshops that teach them how to handle difficult situations that can come up while working with them and they need to be taught how to be especially patient with elders. The elderly population requires more attention and understanding. Those working or living with older people are the recommended population to have these educational workshops for because they have to be understanding of the needs that an older person requires. These interventions should not only apply to those working in homes, but also to those who are family members of an older person as we’ve learned family members are the number 1 perpetrators of elder abuse. The people living at home with an older person are the ones that seem to need a lot more help when dealing with elders. For these individuals, the recommendation would be coping skills. This is so that they learn how to communicate with their family members and to learn to listen to their needs instead of automatically deciding what is best for them without first asking them. These preventative measures are important to establish because before a solution can be created, the solution must start from the root of the problem. We believe by focusing on intervention as prevention the amount of elderly who are abused each year will go down as caretakers become more educated.

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