Revealing Hidden Abuse
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What is hidden abuse and neglect?
Seniors are being abused, and others often do not recognize it.
Senior abuse can usually be divided into two kinds of situations, one is intentional abuse, such as taking the property of the elderly; and the second is unintentional abuse, due to the family or caregiver unable to provide proper care for the elderly. This can be because of lack of time, money and experience.
It is also just as difficult for celebrities to avoid this situation when they are old. For example, Mickey Rooney, a legendary actor who won the Oscar Lifetime Achievement Award, testified at the age of 90 saying that the assets he had was being drained by his stepchildren, and that he often could not get access to food and water.
Senior abuse is very common and not easy to detect, but the consequences are very serious and can even be fatal.
90% of abuses come from the senior’s relatives or care-person. However, a report published last summer showed that one in five seniors living in nursing homes have been attacked or physically attacked by the elderly in the same home. Mark Lachs, director of the Center for Aged Research and Medical Care at Cornell University's College of Wells in New York, states that this kind of abuse is even more hidden: "Health care workers who abuse the senior can be fired, prosecuted, and sentenced. On the contrary, mutual abuse between the senior in the same senior home is unobserved, but it may be more dangerous."
The problem of senior abuse has already received attention. Senior abuse has become more and more serious, but it has not received the attention of the media and the public, and is not easy for medical personnel to detect it. What makes the situation even worse is that the phenomenon of elder abuse is not easy to find. According to experts, about one in every 23 cases of elder abuse was reported by the media. The current public health system is not enough to be concerned of the phenomenon of elder abuse. Although the number of elderly people visiting the emergency has reached an average of 2.3 million per year, the emergency room medical staff will rarely find the elderly that are abused. Studies have shown that among 7700 seniors, doctors will only diagnose one senior that was abused.
The main reason for this phenomenon is that it is very difficult to diagnose whether or not the senior is being abused. Experts have analyzed that the elderly generally have more physical or mental problems, which makes them vulnerable to injury: "It is difficult for doctors to judge whether the bruises on them are caused by accidental falls or abuses from others; An old man who does not take care of his outlook is hard to tell whether it was because of he own will, or that his from the neglect of his families.”
According to estimates by the World Health Organization (WHO), from 2015 to 2050, the number of elderly people aged 60 or older worldwide will increase from 900 million to approximately 2 billion, which is more than double the amount.
(The above information is translated from the webpage of Initium Media, the article "Abusing the Senior: Not Easy Observed Evil")
Elder Abuse
Elder abuse is a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person. This type of violence constitutes a violation of human rights and includes physical, sexual, psychological, and emotional abuse; financial and material abuse; abandonment; neglect; and serious loss of dignity and respect.
Elder abuse is an important public health problem. It is estimated that 1 in 10 people worldwide suffer from abuse every month. Since the elderly are often afraid to report abuse to their families, friends or authorities, only one out of every 24 senior abuses has been notified, so the actual situation of the abuse of the elderly may be worse than estimated. Because of many countries in the world are experiencing rapid population aging, the needs for older people cannot be fully met with limited resources, the number of elder abuse is expected to increase.
(Information from the World Health Organization)
2. Influence of Senior Abuse and Neglect
When elders are abused, they often exhibit unusual behavior, such as
apprehension, withdrawal, low mood, depression, becoming passive or being absent from activities in which they used to participate without cause. If workers encounter the above situations, they should take the initiative to attend to the elders and assess whether the elders have been abused.
The following is a list of indicators of elder abuse. This includes physical and behavioral indicators of the elders, behavioral indicators of the caretakers and environmental indicators. This list is to assist the workers in assessing whether the elders have been abused or not.
Indicators of Physical Abuse
a. Unwilling to receive medical examination
b. Unwilling to disclose information relating to the injury when asked about the cause of injury
c. Repeatedly attributing the injury to own carelessness or making contradictory statements
d. Delaying in receiving medical treatment for the injury
e. Seeking medical service from different doctors in an unusual manner
f. Attempting suicide
Indicators of Psychological Abuse
a. Extremely passive
b. Attempting suicide
c. Depression tendency
d. Often showing extreme apprehension
e. Being afraid of the caretaker
f. Avoiding contacts with others
g. Emotionally disturbed
h. Hysteria
Indicators of Neglect
a. Frequent dirtiness
b. Wandering around frequently or for prolonged period
without being accompanied
c. Obvious irregularity of eating pattern being ignored
d. Obvious loss of appetite being ignored
Indicators of Abandonment
a. Wandering on streets, parks or malls, etc. by himself/herself for a long period of time
b. Often being dirty
(The above information is an excerpt from the Hong Kong Social Welfare Department: Procedural Guidelines for Handling Elder Abuse Cases - Revised August 2006)
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3. How to Prevent Hidden Senior Abuse and Neglect?
Prevention and intervention strategies for elder abuse
The problem would not disappear by itself if it is just tolerated.
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Suggestions for self and mutual help for elders
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Crisis intervention
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Stay calm, do not argue with the abuser
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Dial 911 for immediate help, especially if there is physical injury
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Seek help from neighbours
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Bring documentation of identity, some money and needed medication to a relative's home for temporary stay
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Share feelings with a trusted person
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Seek help from social services/organizations for temporary shelter, if necessary
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Understand personal rights and increase awareness for elder abusive behaviors
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Strengthen problem-solving abilities to life events (e.g., learn how to manage own funds and properties)
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Enlarge social network
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Seek help from community resources and share with a trusted person when problems are encountered
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Family members and caregivers
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Establish good communication with the elders; avoid unrealistic expectation of one's or the elder's mental and physical abilities
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Show acceptance to the elder's feelings and provide emotional support
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Maintain and enhance optimal physical health
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Use positive coping strategies for mood management (e.g., maintain appropriate level of physical activities, listen to music), and share feelings with family and friends for emotional ventilation
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Learn caregiving skills in order to alleviate the caring burden
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Share the caregiving work with others and seek community resources for support
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Proper staff training, supervision and monitoring
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Promote public education on respect and care for elders
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Community Resources
To provide the best support to those being abused and in crisis, we should promote and develop the mutual-support service and seek help from professionals when necessary.
(The above information is an excerpt from the Hong Kong Department of Health Elderly Health Service website, from an article called "Prevention of Elder Abuse")
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4. Responsibilities and actions of the community, the senior and the caregiver
Everyone should be aware that seniors also have their rights and respect the individual's personal rights. There must be no mentality of "old people equal to weakness” and show that they are the ones who are strong and are exploiting or abusing the elderly. The thoughts and lives between the two generations might be different. If there are conflicts in the relationship, we should bear in mind that elder abuse will inevitably trigger greater conflicts and escalate the problem. Why not communicate openly with the seniors, understand their actual situation and ability, and avoid excessive demands on the elderly? At the same time, they should also pay attention to the emotions of the seniors, accept their feelings, and give specific support. We hope that everyone can care for the elderly, protect them, respect the old and not abuse the old.
On the other hand, we also encourage older people to know more about their rights and interests, if they are capable, they should tried to broaden their social circles, and to participate more in community activities. If senior can courageously have more contact with the ever-changing society, they could enhance their recognition of how the new generation thinks, and can also improve their ability to handle and respond to their life events. Even if they encounter abuse, they should take the initiative to tell the person they trust that if you are hurt, you should ask for help. We hope that everyone can raise the awareness of caring for the senior. It will be good that if everyone say "no" to elder abuse and join hands to build the harmony, and to build a caring society that cares for the elderly and respects the senior.
Senior, Caregiver and Community responsibilities and actions:
a. Encourage them to ask for help:
Assisting the abused or suspected abused elders to break through their worries and psychological barriers
b. Maintaining relationships:
Assisting the elderly and the abusers to discuss a mutually respectful and harmonious way of getting along, and developing their relationship
c. "Win-win" solution:
Use a non-hostile attitude to solve the problem, so that the resentment of both sides is no longer intensified, and even released and resolved in the process
d. Emotional response
May include anger, anxiety, worry, or resistance, etc.
(The above information is an excerpt from the The Nethersole School of Nursing of The Chinese University of Hong Kong CADENZA Training Programme: Understanding elder abuse training materials)
5. Community Resources
Ontario Network for the Prevention of Elder Abuse: 416-640-7784
Senior Safety Line: 1-866-299-1011
(7 days a week, 24 hours, services available in 150 languages)
Carefirst
Elder Abuse Helpline
INFORMATION & INQUIRY
Tel: 416–502–2323
Soft Power Inc.
Senior Hotline: (647) 700-7319
This brochure is published by Canal 360 Community Services under the funding of New Horizons for Seniors Program.
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