Elder Abuse and Neglect - An Ever Present Danger
Abuse and neglect of elders is one of those topics that everyone knows about but hardly any one talks about. It is somewhat like art in that you can't define precisely but you know it when you see it. One definition is that is elder abuse is doing something or failing to do something that results in harm to an elderly person or puts a helpless older person at risk of harm. This includes:
- physical, sexual and emotional abuse
- neglecting or deserting an older person you are responsible for
- taking or misusing an elderly person's money or property
While it's true that many family/friend caregivers find deep satisfaction in the care they provide, it's also true that many care giving situations are not systematically planned for and carried out, but backed into by default. Typically someone will realize that if they don't provide the care for the dependent elder in question, no one else will. It also is a common scenario that the elder could receive care in a facility but the elder herself or family/friends find that to be an unacceptable solution. Even though a caregiver may be going into a situation willingly, they may find themselves unprepared for the unrelenting demands of having someone physically and/or emotionally dependent on them. Quite often, in family caregiving settings, there is ongoing, unfinished business from the past that sets the tone for the relationship between the elder and his/her relative. This can also be true of in-laws who are expected to step up to the plate and provide care for someone they may or may not feel close to. Even when elders are placed in care facilities, there is usually still someone in the family or a friend who shoulders the responsibility of overseeing their care. You see many variations of family dynamics in all care settings that involve dependent elders and they're not always pretty.
In addition to outright physical abuse and neglect by caregivers, there is also the aspect of self-neglect or unwillingness on the part of the care recipient to accept help from anyone else. Very often, family and friends are doing everything they can including using social service agencies to put services in place for the elder, only to have them not allow anyone in their home or to run off the helpers that do come in.
Research on elder abuse and neglect is scant and inconclusive regarding the best methods to identify it or intervene to stop or prevent it. One study in the Journal of the American Medical Association in 2009 concluded that there is an increased risk of mortality within one year of reported abuse and the risk was not restricted to those with the lowest levels of cognitive or physical disabilities. Under-reporting is a significant problem due to abusers fearing prosecution and recipients fearing abandonment or retribution. Most of the research studies in the medical literature have been done in Britain or Canada and generally draw the conclusions that because issues can be so complex, there is no standard approach that can be considered effective. A research study in Geriatrics out of the University of Texas Medical School at Houston found barriers to reporting abuse and neglect by health professionals because of a lack of clinical education in medical school about how and when to report elder abuse.
Fortunately, there is a treasure trove of resources on the internet and in printed material. While there is still no standardized approach to preventing, detecting or stopping elder abuse and neglect there is a lot to be learned from the experience of agencies and individuals who work with the problem on a daily basis. Here are a few references you may find useful:
