Elder abuse in America is, unfortunately, no longer uncommon. Next to children, the elderly are the most vulnerable and susceptible to possible abuse. This is further enhanced by the fact that the elderly are often isolated socially and mentally impaired. The rising number of elderly suffering from Alheimer’s and other forms of dementia help to make them easy targets for mistreatment.
Abuse of the elderly doesn’t always take place in a nursing home. It also takes place in high priced retirement communities, within the individual’s own home, the home of a family member, and even right out in public.
Those who abuse the elderly are not easy to identify. You cannot look at someone and automatically say, he (or she) probably abuses the elderly. They are much more clever at hiding their true nature. But just like bullies in a school yard, these individuals get off on taking advantage of the elderly because they can’t stand up for themselves.
My husband certainly had no inkling, when he placed his mother in a nursing home, she would suffer at the hands of her supposed healers. He counted on the doctors and nurses there to protect and take care of her because she was too ill to remain at home. A combination of strokes had destroyed her mind and the disintegration of the discs in her back had left her immobile. She required around the clock medical care. Instead of that much needed care, however, she died at the hands of an angry intern.
Abusers may be professional caregivers – – as was the case with my mother-in-law – – or they may be relatives, spouses, partners, or even complete strangers. Elder abuse is a complex issue. Although most people recognize its existence, there is no clear cut definition of everything that it encompasses. In truth, abuse can take on one or more forms, including mental, emotional, social, economic, and the most obvious – – physical.
Although reprehensable, it must be noted that spouses make up a large percentage of elder abusers. In most of these cases there is also a pattern of previous domestic violence. This particular type of abuser has an innate need to exert control over another human being and the spouse, of course, is the easiest target. In such instances the abused individual generally relinquishes power to their abuser, leaving themselves wide open to emotional abuse, physical violence, isolation, and in extreme cases even torture.
In other instances, which may be even more insidious, the abuser is an adult child. This is often someone who is actually dependent upon their parent for financial support, housing, or some other kind of assistance. In such cases, it is not unusual for the abuser to suffer significant mental or emotional problems themselves. They are often alcoholics, drug abusers, or socially dysfunctional individuals. For this reason, they believe the only power they actually have is that which they wield against an elderly parent.
There are a lot of different theories about the specific cause of elder abuse. However, the phenomenon is still relatively new in terms of it actually being recognized as an issue. Therefore there is insufficient information available to definitively point to any theory or set of theories. In fact, it is possible that the various reasons behind elder abuse may never be narrowed down to any specific pattern or cause. However, many theorize that the following likely account for at least a small percentage of elder abuse cases:
- Caregiver stress. This theory assumes that caregivers may, at times, become so overwhelmed with the burden of caring for the elderly that they may lose momentary control, resulting in their neglect of a patient in their care. The neglect may take the form of either physical or pyschological abuse or elder neglect.
- Condition of the elderly. Many people, as they age, become more difficult to handle. Sometimes this is just a result of strong personality traits. Other times it can be related to physical issues like Alzheimer’s or dementia. However, whatever the cause, these individuals often exhibit belligerant or disruptive behavior. Add to this situation the need for significant medical care, and an uncomfortable and difficult situation may arise.
- Domestic violence pattern. Some pychiatrists believe that domestic violence is actually a behavior that can be cyclical in nature. In other words, it is possible that, if the parent once abused the child, the child may return the favor by abusing the parent once they become elderly and unable to defend themselves.
Physical abuse is the one form of elder abuse that often times can be easily recognized since it will typically result in some form of injury. It generally includes acts of violence like:
- Assault (such as would occur during a mugging);
- Beating, whipping, hitting, slapping, or punching;
- Pushing or shoving;
- Choking;
- Shaking; or
- Throwing things at them.
Some physical abusers will go so far as to physically restrain their victims; tieing them to a bed or chair; leaving them alone in a bathroom, closet, or basement; and either force feeding or denying food and water. A few may even drug their victim.
The National Center on Elder Abuse reports the following as signs and symptoms of physical abuse include but are not limited to:
- Bruises, black eyes, welts, lacerations, and rope marks;
- Bone fractures, broken bones, and skull fractures;
- Open wounds, cuts, punctures, and untreated injuries;
- Sprains, dislocations, and internal injuries or bleeding;
- Physical signs of punishment or restraint;
- Lab finds of medication overdose or underdose of necessary medication;
- A change in the elderly person’s behavior or demeanor; and
- A caregiver’s refusal to allow visitors to see the elder alone.
Although much more difficult to diagnose is psychological abuse. This can include both mental or emotional manipulation. Often times, the elderly patient is too ashamed to admit to this form of abuse. Other times, the abuser makes certain that the abused individual is totally cut off from the outside world so that they cannot complain about their treatment.
Psychological abuse is defined as the intentional infliction of pain through verbal or nonverbal communication which is not inherently physical in nature. Verbal assaults generally involve yelling or screaming and include insults, name-calling, ridiculing or threatening as well as from intimidation and humiliation. Other forms of psychological abuse include ignoring the elder person altogether or isolating them from family or friends. It may also include blaming the individual for their condition or even terrorizing them because of it.
Signs and symptoms of emotional/psychological abuse generally cause a distinct change in the behavior of the edlerly person. They may seem constantly upset or agitated or they may become withdrawn and non-responsive. They may attempt to hide away, curl into a ball, or rock back and forth in a dazed condition. Sometimes they will actually attempt to strike back by being aggressive in nature; biting, kicking, and hitting.
Probably the most recognized form of elder abuse, and the one with which we are most familiar, is elder neglect. This is defined as a refusal or failure on the part of the caregiver to help, protect, or care for the elderly individual. It often involves the denial of those things that are considered to be the necessities of life like food, water, clothing, shelter, cleanliness, medication, and personal safety.
Signs and symptoms that point to elder neglect include dehydration, malnutrition, untreated health issues, and hazardous, unsanitary, or unsafe living conditions. In extreme cases, neglect may include outright abandonment, including any discontinuation of fudicary responsibility or even theft of the elder’s money, stocks and bonds, or other items of value. Less recognizable but perhaps more damaging than anything else is the withdrawal of affection and attention that every human being requires to live.
Whether the elderly individual lives alone at home, with a family member, or in a nursing home or retirement community, they still require attention. Like children, they need protection because of their vulnerability. Most of all, because of who they were – – and still are – – they deserve to be loved, cherished and respected. After all, someday each one of us will be that elderly individual. If it is true that you reap what you sew, perhaps it is time to sew unconditional love.
