Term
| The APA defines elder abuse as: |
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Definition
| • The infliction of physical, emotional/psychological, sexual, or financial harm on an older adult or the intentional or unintentional neglect of an older adult by a caregiver |
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Term
Defining Elder Abuse
• Physicalabuse: |
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Definition
• Any use of enough force to cause unnecessary pain or injury
• Includes any inappropriate use of medications, physical restraints, or physical punishment |
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Term
Defining Elder Abuse
• Verbal, emotional, or psychological abuse: |
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Definition
• Behavior by an individual that causes fear, mental anguish, or emotional pain or distress
• Also includes coercive and threatening behavior, “silent treatment,” isolation, and manipulation |
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Term
Defining Elder Abuse
• Sexual abuse: |
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Definition
• Any inappropriate touching, photographing, or sexual contact or behavior that is unwanted
• Most underreported type of elder abuse |
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Term
Defining Elder Abuse
• Financial abuse and exploitation: |
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Definition
• Ranges from misuse of funds to embezzlement
• Includes misuse of legal guardianship arrangements, power of attorney, or conservatorships
• Frequently reported as telephone or Internet scams, coercive salesmen |
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Term
Defining Elder Abuse
• Caregiver neglect: |
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Definition
| • Ranges from withholding appropriate attention to intentionally failing to meet the physical, social, or emotional needs of the individual |
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Term
Defining Elder Abuse
• Some individuals harm themselves through self- neglect |
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Definition
| • Family members must balance respecting autonomy and intervening before neglect is dangerous |
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Term
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Definition
• No clear explanation as to why elder abuse or neglect occur
• Complex problem often stemming from multiple causes
• Appears across all ranges of health status, living arrangements, and cognitive status |
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Term
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Definition
- WHO reports the following estimates of number of older adults affected by abuse:
• 11.6% psychological abuse
• 6.8% financial abuse
• 4.2% neglect
• 2.6% physical abuse
• 0.9% sexual abuse
- Approximately 50% of patients with dementia admit to being mistreated by caregivers
• 88% psychological abuse
• 20% physical abuse
• 30% neglect
-Perpetrators:
• 2/3 are family members
• 60% men (primarily 30–59 years of age)
• Higher rates among those who abuse substances |
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Term
Elder Abuse
What Do We Look For? |
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Definition
• Differentiate signs and symptoms of disease or medication use from abuse and neglect
• Cues that do not have a clear medical explanation should be further investigated |
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Term
What Do We Look For?
Physical abuse |
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Definition
• Bruises or grip marks around the arms or neck
• Rope marks or welts on the wrists and/or ankles
• Repeated unexplained injuries
• Dismissive attitude or statements about injuries
• Refusal to go same emergency department for repeated injuries |
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Term
What Do We Look For?
Verbal/emotional/psychological abuse |
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Definition
• Uncommunicative and unresponsive
• Unreasonably fearful or suspicious
• Lack of interest in social contacts
• Evasive or isolated
• Unexplained or uncharacteristic changes in behavior |
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Term
What Do We Look For?
Sexual abuse |
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Definition
• Unexplained vaginal or anal bleeding
• Torn or bloody underwear
• Bruised breasts or buttocks
• Venereal diseases or vaginal infections |
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Term
What Do We Look For?
Financial abuse or exploitation |
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Definition
• Life circumstances don't match what is known about the individual's financial assets
• Large withdrawals from bank accounts, accounts that have been switched, unusual ATM activity
• Signatures on checks don't match the older person's signature |
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Term
What Do We Look For?
Caregiver neglect |
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Definition
• Lack of basic hygiene, adequate food and water, or clean and appropriate clothing
• Sunken eyes or loss of weight
• Person with dementia left unsupervised
• Untreated pressure bedsores
• Lack of medical aids (glasses, walker, teeth, hearing aid, medications) |
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Term
Elder abuse
Questions to Ask |
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Definition
• Always ask in a private, safe area
• Do you feel safe? Is anyone hurting you or
scaring you?
• Isanyoneaskingyoutodothingsthatyoudo not understand or that make you uncomfortable?
• Has anyone taken things that belong to you without asking or without your approval?
• Do you rely on anyone else for help? What kind help? Does that person ever fail to help you meet your needs?
• Do you regularly see friends and family? When is the last time you saw them?
• Do friends and family visit you? How long has it been since they visited?
• Are you concerned about your finances?
• Are you afraid of anyone in your life? |
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Term
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Definition
• Patternorhistoryofviolenceinthefamily
• Multigenerational household
• Social isolation
• Elder abuse may be a continuation of marital abuse that has been occurring for may years
• Previously abused children taking advantage of parents in later years
• Financialstressofcaringforparents,maynot know where to turn for resources unintentional neglect |
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Term
| Caregiving Stress and Abuse |
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Definition
• Often times family members assume the role of caregivers
- Often times this is out of necessity, not will
- Inexperienced, feel trapped, hopeless
• Take personal life stress out on elder
• May retaliate if elder is abusive towards caregiver (Alzheimer’s disease)
• Feel like discussing outside help or residential care is a betrayal of parent
• Financial stress when living together |
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Term
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Definition
| James is a financially secure 85-year-old man who has been healthy and active until the last year. He has finally agreed to allow his oldest son, Tom, to help him manage his daily affairs. Tom now believes his father "owes him" more of his money than his brother and two sisters are entitled to. He talks his father into giving him power of attorney for his bank accounts "as a convenience" and then writes himself large checks that he tells himself are for "expenses." Soon Tom has come up with excuses to transfer a significant portion of his father's investment holdings into his name. James has no energy to oversee his finances and is totally trusting that his son has his best interests at heart. |
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Term
| Societal and Cultural Norms and elder abuse |
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Definition
• Devaluationandlackofrespectofelders
• Behind closed doors, private family matters failure to seek help and failure for outsiders to intervene
• Shame or embarrassment
• Dependence on younger generation impacts ability or willingness to report abuse
- More common with ethnic minorities, recent immigrants, non-English speakers
- Do not attribute cues to cultural differences |
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Term
What Can We Do?
• Education |
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Definition
-For caregivers:
• You are not alone
• Abuse is common, reasons why
• It’s okay to ask for help
• Need for “you time”
- For elders:
• Your voice matters
• Encourage living wills, advanced directives, limited powers of attorney for health care and finances
• Helping to find purpose in life
• Resources, who to contact
• Do not confront the abuser without permission of patient and without adequate resources to help protect safety of self or patient at that moment.
• Connect with resources. |
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Term
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Definition
• National Center on Elder Abuse (NCEA) • Adult Protective Services
• Area Agencies on Aging
• Eldercare Locator
• Medicaid Fraud Control Units
• National Domestic Violence Hotline
• National Eldercare Locator:
• eldercare.acl.gov or 800-677-1116
• National Center on Elder Abuse (NCEA) State Resources page: https://ncea.acl.gov/resources/state.html |
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