We have clients who are doing their best to help elderly family members, but are inadvertently harming their loved ones by leaving them isolated and alone. There just are not enough hours in a week to do the shopping, preparing meals, visiting, cleaning and the other large and small endless chores required for fragile or demented elders. So many people just do the best they can. But that really may not be enough or right in the big picture. How do you know when there is “Elder Abuse”? This brief article by Dr. Mor highlights the subtle and overt forms of abuse. It is my hope that being aware of even unintentional forms of abuse will help prevent this from happening and move caregivers to seek help in providing care for our seniors.
PREVENTION OF ELDER ABUSE
Eva Mor PhD, Author of “Making the Golden Years Golden“
The numbers reflecting incidents of abuse in the senior population vary depending on the source that is reporting them. Definitions of what constitutes as “abuse” are also diverse: some sources define elder abuse as only physical abuse, while other sources include emotional abuse, sexual abuse and financial abuse. Accurate numbers are also extremely difficult to compile since many incidents of abuse go unreported. Many elderly are afraid or ashamed to report incidents of abuse, especially if the perpetrator is a family member. Seniors at times are emotionally or physically abused by a familiar person, and are often unable to recognize it as abuse or rationalize it.
What can be done to eliminate incidences of abuse? Society should shoulder the responsibility to protect the elderly, but it begins with the family of the senior. Many of the children and other relatives of the elderly feel that once they have a care giver to care for the elderly their work is done. Far from it, they need to remain vigilant in directing and overseeing that good care is in fact what is provided.
When visiting an elder loved one, you should be alert to the warning signs of abuse:
•Emotional or Psychological Abuse:
Are there insults or threats directed at the elder? Are they living in social isolation? The elder may be extremely upset, withdrawn, unresponsive, or exhibiting other unusual behavior. He or she may have a vacant look in their eyes or exhibit fear; they may not always express those verbally, so look for signs in their face or behavior.
• Physical and Sexual Abuse:
Look for suspicious bruises or other injuries. Look for signs of restraints, such as a rope burns. See if he or she shows sudden changes of behavior, such as unexplained anger, fear, withdrawal, or has become very quiet. Note if a worker or caregiver refuses to let you visit the elder, making all kind of excuses.
• Neglect:
Look for signs of malnutrition, if there is noticeable weight loss, dehydration, bed sores, or if personal hygiene is noticeable neglected. Note if the elder is sitting in soiled clothing, unshaven, unkempt, without dentures, or with long or dirty nails, are they walking around at midday still wearing pajamas? Listen to complaints from the senior as to whether or not their aide is listening to them or following their wishes and follow up on them.
• Financial Abuse:
Keep an eye out for unexplained bank withdrawals, unauthorized use of bank and credit cards, reports of stolen or missing checkbooks and bank cards, or if your parent or elder writes checks as a loan or gift to the aide. Be on the lookout for valuables suddenly disappearing. Monitor any sudden changes in the will or banking documents, and be alert if assets are suddenly transferred to a family member or to someone outside the family.
If you discover any of the above warning signals, you should correct them and/or notify the police. The above warning signs should be looked for not only in the home of the elderly, but also if they reside in a nursing home, assisted living facility or a residential care facility. If the elder does not have a family member to protect him or her, the responsibility falls on the society, all of us – doctors, social workers, friends, neighbors and local clergy. For more info: www.goldenyearsgolden.com