Elder abuse

What is elder abuse

Elder abuse is a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person. This type of violence constitutes a violation of human rights and includes physical, sexual, psychological, and emotional abuse; financial and material abuse; abandonment; neglect; and serious loss of dignity and respect.

Forms of abuse

The common forms of abuse of elderly persons are as follows.

• Physical abuse
• Hitting, pushing, kicking
• Inappropriate use of drugs or restraints
• Psychological or emotional abuse - Insults, threats, humiliation, controlling behavior, confinement and isolation.
• Financial abuse - Misusing or stealing a person’s money or assets
• Neglect or abandonment - Not providing food, housing, or medical care
• Sexual abuse - Sexual contact without consent
• Abusive acts in institutions - physically restraining patients, depriving them of dignity (for instance, by leaving them in soiled clothes) and choice over daily affairs; intentionally providing insufficient care (such as allowing them to develop pressure sores); over- and under-medicating and withholding medication from patients; and emotional neglect and abuse.

People responsible for elder abuse

People who commit elder abuse are often in a position of trust.

• At Home : Family members - mostly adult children, spouses and partners.
• Health care workers : Nursing homes, Long-term care facilities

Risk factors

Risk factors that may increase the potential for abuse of an older person

Individual

Risks at the individual level include poor physical and mental health of the victim, and mental disorders and alcohol and substance abuse in the abuser. Other individual-level factors which may increase the risk of abuse include the gender of the victim and a shared living situation. While older men have the same risk of abuse as women, in some cultures where women have inferior social status, elderly women are at higher risk of neglect and financial abuse (such as seizing their property) when they are widowed. Women may also be at higher risk of more persistent and severe forms of abuse and injury.

Relationship

A shared living situation is a risk factor for elder abuse. It is not yet clear whether spouses or adult children of older people are more likely to perpetrate abuse. An abuser's dependency on the older person (often financial) also increases the risk of abuse. In some cases, a long history of poor family relationships may worsen as a result of stress when the older person becomes more care dependent. Finally, as more women enter the workforce and have less spare time, caring for older relatives becomes a greater burden, increasing the risk of abuse.

Community

Social isolation of caregivers and older persons, and the ensuing lack of social support, is a significant risk factor for elder abuse by caregivers. Many elderly people are isolated because of loss of physical or mental capacity, or through the loss of friends and family members.

Socio-cultural

Socio-cultural factors that may affect the risk of elder abuse include:

• depiction of older people as frail, weak and dependent;
• erosion of the bonds between generations of a family;
• systems of inheritance and land rights, affecting the distribution of power and material goods within families;
• migration of young couples, leaving elderly parents alone in societies where older people were traditionally cared for by their offspring; and
• lack of funds to pay for care.

Within institutions, abuse is more likely to occur where:

• standards for health care, welfare services, and care facilities for elder persons are low;
• where staff are poorly trained, remunerated, and overworked;
• where the physical environment is deficient; and
• where policies operate in the interests of the institution rather than the residents.

Risk factors for committing elder abuse

• Using or abusing drugs or alcohol
• High stress levels
• Depression
• ack of social support
• Lack of training in how to care for older people
• Emotional or financial dependence on the older person

Prevention

Many strategies have been implemented to prevent elder abuse and to take action against it and mitigate its consequences. Interventions that have been implemented – mainly in high-income countries – to prevent abuse include:

• public and professional awareness campaigns
• screening (of potential victims and abusers)
• school-based intergenerational programmes
• caregiver support interventions (including stress management and respite care)
• residential care policies to define and improve standards of care
• caregiver training on dementia.

Efforts to respond to and prevent further abuse include interventions such as:

• mandatory reporting of abuse to authorities
• self-help groups
• safe-houses and emergency shelters
• psychological programmes for abusers
• helplines to provide information and referrals
• caregiver support interventions.

Source : WHO