With the steady increase in the elderly population in our country, there are also mounting new challenges, not just how to meet the needs of the elderly, but also for the families of these people. One such area, is the abuse that happens in the elderly population. The word abuse congers up a mind’s eye image of bruises, but in fact, there are more ways in which the elderly are left vulnerable to different forms of abuse. This paper will help to define the types of abuse and mistreatment, what may possibly ignite the path of abuse and how we can combat it. This is an important part of helping the Social Working field to maintain the safety and well being of the elderly in our country as well as lending some understanding to the issue, and perhaps bringing light to some areas that are not as easily seen.
According to Kohl, Sanders and Blumenthal (2012) a United States Government study shows that elder abuse is on the rise and a widespread problem. With the baby boomer generation entering retirement age, the problem will continue to grow. According to Colby and Ortman (2014), the baby-boomer population began to turn 65 in 2011, and will continue to turn 65 until 2029, at which time the population of 65 and older adults will be 20% of the general population of the United States. It was also found that the population of those 65 and older will be larger than the population of those 18 and older (p.1). The cases of elder abuse and neglect will undoubtedly become more prevalent with the expected rate of aging as predicted by the U.S. Census. Giving seniors a safe and dignified environment to live and thrive in, should be no less a concern than it is for anyone else. The protective services for this population will most assuredly become a greater area of concern for the case workers that will be assigned to ensure that this generation of adults is treated with respect. Quality of life in older age is important.
Types of abuse have been defined by the WHO(World Health Organization) (2008). They were described as being categorized by acts of deliberate harm, either physical or psychological, sexual, financial and neglect. (as cited by Day, Boni. Evert and Knight, 2016 p. 1533). Another common definition of abuse given by the Who includes the following: ” A single, or repeated act, or lack of appropriate action, occuring within any relationship where there is an expectation of trust which causes harm or distrust to an older person. (p.126) NASW, Alabama Chapter, also has a website dedicated to these same forms of abuse with explanation. According to Felton and Polowy (2015), the types of abuse that are a concern for social workers are physical, sexual, neglect, exploitation, emotional abuse, abandonment and self neglect. “Unresolved elder maltreatment is associated with major consequences, including increased risk of pre-mature death, hospitalization, emergency service use, nursing home placement, disability, chronic pain, financial ruin, psychological disturbance, and poor physical health” (Begle et al. 2014)
Physical abuse is considered to be any type of physical injury. It can be a bruise, a burn, a broken bone or fracture, abrasions or signs of restraint. It can be an act of deliberate intent to do harm to and individual. It is also described in the NASW website, as “inflicting physical pain, injury or impairment on an elderly person”. (p.1)
Sexual abuse is defined as “non consensual sexual contact of any kind with an elderly adult” (NASW, 2015) (p.1). It isn’t uncommon to hear of sexual abuse occurring in nursing homes as some of the elderly are cognitively impaired or physically incapable. It is not to say that it does not happen in their own homes by way of caregivers. NASW also give examples of sexual abuse signs to elders are as follows: “STD’s , bruising to genital area and breast as well as blood on undergarments” (p.1).
Neglect is defined as “the failure by those responsible to provide food, shelter , health care or protection for an elderly person” (NASW, 2015) (P. 1) his could be by a care giver, a facility that the elderly is living in or by a family member who has accepted responsibility. There also is another concept of neglect, called self neglect which usually results from the aging adults mental or physical impairments (Moody & Sasser, 2018). One of the worst reports of neglect found while researching this paper was reported in an article that happened in 2011. A woman in a Southern Michigan nursing home had been coughing though out the night and when checked on in the morning, it was discovered that her tracheotomy was infested with maggots and caused her airway to become obstructed. There was no proof that her caregivers in the nursing home were ever charged for this atrocity (Kohl, Sanders & Blumenthal, 2011). Neglect can also have signs like dehydration, malnutrition, bed sores, weight loss and unsanitary conditions according to NASW (2105, p.1).
Exploitation, as defined by NASW (2015), involves the misuse or theft of property or funds that belong to an elderly person. As having experienced this first hand, it is hard to prove, especially if the victim has signed over power of attorney is unwilling to cooperate with Adult Protective Services. The fear of being abandoned and unable to care for one’s self becomes a deterrent to cooperating as well as not wanting anyone to interfere in their lives (Moody & Sassuer, 2018) Warning signs given by NASW (2015) include: ” a sudden change in finances, unpaid bills, large withdrawals from accounts and changes in one’s will” (p.1).
Abandonment, as defined by NASW (2015) is the desertion of the elderly person by their caregiver of whom ever has accepted responsibility. They have also noted that it can be at a “hospital, public location or nursing home” (p.1) The worst type of abuse is most likely the mental abuse of elderly adults. Defined burns, Rizzo and Courtney, (2014) they found that emotional abuse, and” the negative views about older adults” was “the most hurtful ” to them. Warning signs given by NASW (2015) included withdrawal, and changes in behavior of a caregiver that are threatening or controlling p.1).
After reading many articles on this subject, it seems to be that most are in agreement that quite often these types of abuse happen due to caregiver stress and burnout. The family members who care for these individuals, usually adult children or a spouse, are trying to balance their own lives, while looking out for the person in their care. There also was reference made by Moody & Sasser (2018) that it may be in relation to alcohol and substance abuse, a history of family violence, dependence on financial support as well as social isolation (p. 240)
NASW (2018) has noted that there are currently no Federal laws against elder abuse to protect them, but that all 50 states have laws that deal with maltreatment in regards to neglect, exploitation and abuse. One of the best ways that reporting of elder abuse is found is through mandated reporting from physicians, social workers, and emergency rooms. Adult Protective Services also offer a way to report incidents and assign a case worker to an individual that may be experiencing abuse in any form.
As stated earlier, every elderly adult deserves the same respect and life full of well being, and social workers are there to help insure that these needs are being met for the growing population of aging adults. Abuse of our elderly population is not as simple as we think, there is a spectrum of threats that they face that can mean the difference between life, and premature death.
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