What Do You Know About Elder Abuse?

Today is World Elder Abuse Awareness Day. This was not something I knew until this morning.  I am the first to admit that when it comes to family and personal experience I am a little smug in this area and have little personal, family experience.  My parents died in their sixties, but one of their four children were always nearby, and we have no doubt that during their illnesses they were treated well by their providers.  Certainly their were strides to make then (as now) in terms of communication between doctors and seniors.  But abuse? No. 

The same is true of the other side of our family. I've talked about my in-laws on more than one occasion. The only bruises or harm that ever came to my father in law were in the month before my sister in law realized that she could not lift him herself. There were a couple times there where they were both (dad and daughter) black and blue from the thighs down as they both tried to manipulate him into and out of the wheel chair multiple times. Fortunately, reality set in on both ends, and now Dad lives in assisted living a mile from his daughter and son in law-the best of both worlds for both parties considering. So what I know about elder abuse comes from some limited reading and working with my homeless women.

Even so, I know that elder abuse is often one of those things that not only exists in larger numbers than we know, it also still sits in the shadows.Partly, I suspect because there are elders that no longer can communicate properly. Partly because as we get older we become less graceful or balanced and it's easy to write bruises off as a simple fall or bad skin.  And partly, I am sure because of basic security. If daughter, son or even doctor are committing abuse, reporting them may mean a loss of home or care. Scary at any age, but certainly for seniors, who often rely on family for a great deal.  

I'm certainly the first to admit how very little I know in terms of real facts and statistics when it comes to this topic. A quck visit to the National Council on Aging and an article on Next Avenue were eye opening. Misconceptions about elder abuse apparently abound, while at the same time there are not alot of readily available facts, or publicity about how rampant abuse is among the elderly.  Did you know that seniors who are abused have a 300 percent greater risk of dying in the next year?

After I threw together this blog post this morning, I went home and watched the news this month.  And found out that just now are the Denver Police and District attourny launching an elder abuse unit. Apparantly they never had one before. And Denver is, well, generally enlightened on these kinds of issues.

In spite of the bad "rep" nursing homes get, a full 60% of abuse is committed at home, by family members and other loved ones.   Just as with spouse and child abuse, the huge majority of elder abuse is committed by the people we are supposed to trust.

There are all kinds of elder abuse, beyond the visible bruises. Certainly seniors are physically abused. But as difficult as it is to talk about, there is also sexual abuse, emotional abuse (yelling and screaming and insulting), confinement (confining seniors to a room or tying them to a chair), and financial abuse or misconduct.  These kinds of situations can happen through passive neglect-simply failing to visit or provide food or necessities. However, there is also willful neglect-deliberately putting a senior or his or her finances or home or well being at risk, for whatever reason.

Elder abuse is very often not obvious. Because we change as we age, it's easy to miss symptoms.  Doctors write off weight loss as part of normal "aging" when it could be denial of food.  As I mentioned above, bruises and skin tears get short shrift. The elder or family member may say the parent has "bad skin" or has fallen here and there.

Elder abuse is just as prevalent as child abuse-one in ten adults experience some kind of abuse at some time-and yet there are almost no resources. Rarely are abusers arrested and prosecuted on the level of child abuse, or even spouse abuse. And frankly, we are not trained to observe or even report elder abuse in the same way.  We're reminded regularly that we can anonymously report spouse or child abuse, and that in those cases there will be an investigation even if the abused refuses to testify or file charges. Nothing similar is true when it comes to seniors, at least that I know of.

While things are improving, there is often a lack of communication between providers and caregivers and those they are serving.  Sometimes, this is  simple ageism and sometimes it is something more.  When my daughter recently graduated, one of the nurses receiving her masters did her capstone and thesis on loss of hearing and how it affects communication between patient and doctors.  Aside from the issue of abuse, doctors too easily write off symptoms that could be dangerous as "getting old".  

And finally, we often make excuses for caregivers. It's easy to say "stress made her do it". Being a caregiver is stressful. We need to support those who care for the elderly. And, just as with  us parents I expect, there are those rare occasions when we overreact and want to kick ourselves afterward. That's one thing. But from where I stand, writing off abuse as stress is an easy out and frankly, seems to put the responsibility back on the senior rather on the abuser-no matter what the reason.

So, how to recognize abuse?  I suspect it's not that different from other kinds of abuse. Unusual depression or withdrawal from activities are always a red flag. If your senior friend suddenly stops coming to lunch and bridge, take note. Obvious bruises, tears or abrasions are also a warning sign. Thinking of myself, I'm one of those gals who bruises easily. I just looked at a little mark on my wrist, and I have no idea where it came from. But if my children saw me with twenty of those bruises they would be on high alert.

This post is mainly about physical and mental abuse because senior scams are such a fraught topic and so common even among educated seniors that I figure they deserve their own column. Having said that, when a senior friend or family member has a major change in financial circumstances, that should also be a warning of things to come!!!!  Poor hygiene and sores are also warning signs, especially in health care facilities. And of course always pay attention to language and body language between the family/caregiver and the senior.

So, what can you do to help prevent senior abuse-of yourself or someone else?  According to the National Council on Aging, there are things you can do. Do everything you can to stay physically and mentally healthy and seek professional advice as needed. Plan for your physical and financial situations now, and talk about them with your family if you are comfortable. Even if you are an introvert, involve yourself in some kind of semi-regular community activity (for me it's church) that keeps you involved and socially active (abuse is more likely with isolated seniors). If I miss church once, it's normal. Were I to miss regularly, someone from my church would come and see me. And finally, know your rights.  For more ideas on preventing senior abuse, check out the graphic below!  

And how else can you help when it comes to elder abuse? I would say, befriend seniors you know may be isolated and observe and report.  Such a difficult topic, and easier to say than to do perhaps.  What about you. Are you fearful of abuse as you age?  Do you know folks who have been abused or you suspect may have been abused?  If so, how did you deal with that?