The elderly are a growing population that is subject to domestic violence. The term “elder abuse” can be defined as actions that cause harm or create a serious risk of harm (whether or not harm is intended) to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder. This includes failure by a caregiver to satisfy the elder’s basic needs or to protect the elder from harm.
Types of abuse include: physical, emotional/psychological, economic, sexual, and neglect. While many believe that abuse is more likely to occur at the hands of strangers, in nursing homes or other assisted living facilities, the opposite is true. Most reports of abuse occur in the elder’s own home, and a study by the National Center on Elder Abuse found that approximately 90% of abusers were family members.
Most often, the abuser is the adult child of the elder, followed by spouses and extended family members. Elders who are abused are more likely to lose their independence, finances, security, dignity, and have shorter life expectancy than those who are not.
We have already learned about different types of abuse, but in this lesson we will learn how each specifically affect elders, the prevalence of elder abuse, common warning signs of abuse, and what makes elders more vulnerable.
Types of Abuse
Physical: Physical abuse is any action that results in pain, injury, or impairment. This includes both assaults, such as hitting and slapping, as well as any inappropriate use of restraint or confinement.
Sexual: Sexual abuse is any non-consensual act or contact with an elder. This includes behaviors such as showing an elder pornographic material without his or her consent, or forcing the elder to undress.
Emotional: Emotional abuse is the infliction of emotional distress or anguish through such means as threats, intimidation, humiliation, insults, isolation, or ignoring the elder.
Economic: Economic abuse is the taking, misuse, or concealment of an elder’s monies or assets. This includes stealing money, misusing an elder’s credit cards or other accounts, forging an elder’s signature in order to gain access to his or her monies or assets, and/or identity theft. This type of abuse is often perpetrated by scam artists, but can also be done at the hands of family members.
Neglect: Neglect is the refusal or failure to fulfill one’s obligations of care for an elder. This may include failing to ensure that his or her living conditions are safe and sanitary, or failing to ensure that he or she receives prompt and appropriate medical attention whenever necessary. The term “abandonment” refers to the physical desertion of an elder by a person, whether family member or other caretaker, who has custody of or the responsibility to care for an elder.
In researching the prevalence of elder abuse, researchers encounter difficulties in collecting results. There are a few different reasons for this. First of all, there is no uniform reporting system of elder abuse in the United States, and, therefore, it can be difficult to maintain contact with this age group. Secondly, estimates of prevalence vary from one study to another due as a result of differing research methods and sample sizes. Despite these roadblocks, we can still draw surmise some estimates. According to recent estimates, between 1 and 2 million elders have been injured, exploited, or otherwise mistreated by a caregiver. Unfortunately, only 1 in 14 incidences are reported to the police. Furthermore, it is estimated that for every reported case of elder abuse, another five cases go unreported.
Often, it is more difficult to recognize warning signs of abuse among the elderly population, as opposed to other age groups. Sometimes, warning signs may be falsely attributed to health issues that are common among the elderly, such as general frailty and dementia. For this reason, it is all the more important to know what the common warning signs are, and to take them seriously. General signs of abuse that could result from any type of abuse include noticeable tension between an elder and his or her caretaker, or family members, and/or sudden changes in either the personality or behavior of an elder. Below are some of the common warning signs for specific types of abuse:
- Unexplained bruises, welts, or scars
- Broken or sprained bones
- Burns from cigarettes, appliances, or hot water
- Abrasions or other physical signs of being restrained
- Implausible or inconsistent explanations for injuries from the elder, or his or her caretaker
- Delay between injury and seeking medical care
- Exhibition of behaviors attributed to dementia, such as rocking back and forth and/or mumbling to oneself
- Significant weight loss or gain
- Elevated blood pressure
- Trouble sleeping
- Increased confusion
- Suddenly becoming withdrawn or non-responsive
- More easily agitated and upset
- Bruises around inner thighs, genitals, and/or breasts
- Unexplained sexually transmitted diseases
- Difficulty walking or sitting
- Genital pain, irritation, and/or bleeding
- Large withdrawals from elder’s accounts
- Unexplained activity on bank statements
- Missing monies, assets, or other items from an elder’s home
- Unpaid bills
- Suspicious changes in will, power of attorney, titles, and/or other policies
- Weight loss, malnutrition, and/or dehydration
- Untreated illnesses or injuries
- Unsanitary or unsafe living conditions
- Poor personal hygiene, such failure to bathe regularly or brush one’s teeth
- Bedsores and/or other skin rashes
- The absence of necessary medical assistance such as glasses, hearing aids, walkers, etc.
What Makes Elders More Vulnerable?
Physical Impairments: As we age, we lose muscle mass, our bones become more frail, and our hearing and/or eyesight capabilities tend to decrease. These natural consequences of aging cause the elderly to be less equipped to fight back, or protect themselves, from abuse.
Elders with dementia and other cognitive impairments are at a heightened risk of experiencing domestic abuse. Sometimes, as a result of their impairment, they act out in aggressive or even violent ways, and, as a result of this behavior, caretakers are sometimes likely to respond with violent and abusive behavior. For a caretaker, whether a family member or professional, the added stress of caring for an impaired person can lead to abuse.
Recurring Domestic Violence: Abuse of an elder by his or her spouse may be a pattern that began many years before, perhaps even early in their marriage. If this is the case, the abuse is unlikely to stop when, or just because, one or both partners reaches a certain age.
Problems With the Abuser: Sometimes, when adult children are dependent on their parent(s) for financial assistance or housing, their dependence can become abusive as their parent(s) age – especially if the adult child struggles with alcohol or drug addiction or a mental illness. Abuse is even more likely if the child and elder live together.