Elder abuse (sometimes also called senior neglect) is a common term used to describe destructive acts against an elderly adult, such as physical abuse, sexual abuse, emotional or psychological abuse, financial exploitation, and neglect, including self-neglect.
The U.S. Administration on Aging defines elder abuse as “a term referring to any knowing, deliberate, or negligent act by a caregiver or any other individual that inflicts harm or a severe risk of harm to a vulnerable adult.”
Based on federal law, all state legislatures have approved regulations and formed organizations that work to prevent elder abuse.
However, the specific rules and definitions of terms relating to elder abuse vary among the states.
The 2010 U.S. Census discovered that 40.3 million, or 13%, of the United States’ total population, were seniors, that is, 65 years and older.
As to the National Center on Elder Abuse (NCEA), by 2050, the percentage of people 65 years old and older is expected to reach 20% of the total American population.
Because of these large numbers and increasing rates, elder abuse is likely to rise in the coming years.
According to the NCEA, there is insufficient data to conclude the numbers or percentages of elders being abused in the United States.
However, the NCEA does suggest that female elders are abused at a higher rate than are males and that older elders are abused more than younger elders.
CDC confirmed that every year many hundreds of thousands of adults age 60 and over are abused, neglected, or financially exploited around the world.
In the U.S, the CDC states that more than 500,000 are abused or neglected each year. These statistics gathered by the CDC are only estimates.
An NBC news article entitled “Aging America: Elder Abuse on the Rise” reports that as many as two million seniors are abused, exploited, or neglected every year.
However, the report states that this number could be higher because data on elder abuse has been difficult to collect.
Some studies point to data that shows that one in ten seniors has suffered abuse at least once in the latter part of their lives.
The conclusion from the National Elder Abuse Incidence Study, funded in part by the Administration on Aging, suggests that more than 500,000 individuals 60 years of age and older are mistreated or cast aside each year in the United States.
It was also revealed that four times as many occurrences of harm, neglect, or self-harm are never noted, causing researchers to evaluate that as many as two million elderly individuals in the United States are being abused each year.
In 90 percent of the cases, the abusers were family members and frequently were the adult children or spouses of persons abused.
Furthermore, exact numbers of men and women participate in harming. Nevertheless, women, particularly those 80 years of age, tend to be victimized more than men.
Elder abuse may happen anywhere, but the two leading settings confirmed by law are domestic environments, such as the senior’s home or the caregiver’s home, and institutional settings, such as a nursing home or group home.
In general, according to the Administration on Aging, there are seven basic types of elder abuse: physical abuse, sexual abuse, neglect, exploitation, emotional abuse, abandonment, and self-neglect. The types are described in the following ways:
- physical abuse—inflicting physical pain or injury by, for example, slapping, bruising, or restraining by physical or chemical means
- sexual abuse—having nonconsensual sexual contact of any kind
- neglect—failing to provide food, shelter, health care, or protection
- exploitation/financial—illegally taking, misusing, or concealing funds, property, or assets for someone else’s benefit
- emotional/psychological abuse—inflicting mental pain, anguish, or distress through verbal or nonverbal acts, for example, by humiliating, intimidating, or threatening
- abandonment—desertion by anyone who has assumed the responsibility for care or custody
- self-neglect—failing to perform essential, self-care tasks to the extent that threatens personal health or safety
Data from NCEA indicates that more than half of reported cases involve some neglect, whereas one in seven points involves physical abuse.
It is cons neglect when a caretaker strip an older adult of the necessary care required to stay away from physical or mental damage.
Occasionally the behavior of a senior person threatens his or her wellbeing; in those instances, the abuse is known as self-neglect.
Physical abuse attributes to physical force that causes bodily harm to an older person, such as slapping, pushing, kicking, pinching, or burning.
About one in eight cases of elder abuse involves some financial exploitation, which is characterized as using an older adult’s resources without his or her consent.
The NCEA describes the emotional and psychological harm as invoking pain, anguish, or distress through verbal or nonverbal deeds, such as verbal assaults, insults, intimidation, and humiliation.
Isolating elderly individuals from their friends and family and giving them silent treatment are two more emotional and psychological abuse forms.
Any sexual contact with an older individual without his or her consent is considered sexual abuse.
CAUSES AND SYMPTOMS
Elder abuse is a complex issue that many factors may cause have many symptoms, both physical and mental.
Causes According to the NCEA, social isolation and mental impairment are two factors in elder abuse.
Research studies show that people advanced in years, such as those in their eighties, who are very frail and dependent, are more prone to be victims of elder abuse than individuals who are much younger and better equipped to stand up for themselves.
Spouses make up a Big percentage of elder abusers, at least 40% statistically; research has been done that shows that a pattern of domestic violence is associated with many cases of spousal elder abuse.
The risk of senior abuse seems to be particularly high when adult children live along with their elderly parents due to financial reasons or because they have personal problems, such as drug dependency or mental illness.
Some experts have suggested that older adults living in rural areas with their caretakers may be at higher risk of being abused than those living in cities.
The idea backing this theory is that the circumstances exist for the abuse to happen, but there is less than the chance abuser will be arrested.
More study in this critical area is needed to illuminate the relationship between these factors.
Symptoms The NCEA has identified several signs of older abuse:
- Bruising, pressure signs, broken bones, abrasions, and burns can indicate physical harm or neglect.
- Unknown withdrawal from usual activities and uncommon depression can be indicative of emotional harm.
- Bruising around the breasts or genital area and unexplained bleeding around the genital area can be signs of sexual harm.
- Big withdrawals of funds from an elder’s bank account, abrupt modifications in a will, and the rapid disappearance of valuable things may be signs of financial abuse.
- Bedsores, bad hygiene, unsanitary dwelling conditions, and unanswered medical needs can be signals of neglect.
- Failing to take required medicines, leaving a burning oven unattended, bad hygiene, confusion, sudden unexplained weight loss, also dehydration can all be signals of self-neglecting.
The National Committee for the Prevention of Elder Abuse claims that Adult Protective Services (APS) caseworkers are frequent on the front lines when it comes to elder abuse.
Individuals exposed to abuse or those who believe they are being abused can talk to their local APS office for assistance.
The APS generally screens calls, keeps all information confidential, and, if necessary, sends a caseworker out to conduct an investigation.
If crisis intervention is required, the APS caseworker may arrange for any required emergency therapy.
If it is unclear if elder harm has happened, the APS worker can act as a liaison between the elderly individual and other social agencies.
As stated by the National Committee for the Prevention of Elder Abuse, “professionals in the scope of aging are frequently the first to unravel hints of elder abuse.”
Providing support and advice, they perform a crucial role in informing others about the requirements of the elderly.
They give valuable support to the victims of abuse and observe high-risk moments and gather valuable information that can help validate that abuse has taken place.
Some people may think that a person with cognitive impairment cannot describe mistreatment, but that is not so.
In fact, the guidance set by the American Medical Association advocates for “routine questions about abuse and neglect even among subjects with cognitive damage to enhance the recognition of cases and implement correct procedure and referral.”
More than a failure to describe maltreatment, what could stop an older person from reporting abuse is a sensation of shame or fear of punishment.
To complicate things, differences exist among cultural groups regarding what defines abuse.
For this reason, most states have established laws that define elder abuse and require healthcare providers to address any cases they encounter, with penalties attached for failing to do so.
Indeed, statistics show that healthcare providers, for instance, report almost 25 percent of the familiar cases of elder abuse. Hence, physicians play a vital role in identifying and treating elders who have been abused.
Still, in an article published by the Journal of the American Geriatrics Society, it was pointed out that only 1 of each 13 cases of elder abuse is reported by physicians.
There may be several reasons for this lack of reporting. In some cases, the issue may go unobserved, particularly if the physician has no apparent reason to suspect any misconduct. In other cases, the subject may hide or deny the problem.
Much media attention has been focused on elder abuse taking place in an institutional environment.
Anyone who thinks that a loved one is being abused at the nursing home or any other institutional setting should call the authorities for assistance immediately.
The mortality rate of elderly persons who have been mistreated is higher than the mortality rate of elderly persons who have not experienced abuse.
Still, numerous success stories exist regarding successful interventions. Social workers, healthcare professionals, and concerned citizens from various walks of life have played the main role in identifying and obtaining treatment for abused elders.
SPECIAL CONCERNS FOR SENIORS
Some seniors in long-term care facilities have problems that sometimes cannot be resolved satisfactorily.
To resolve these problems, the federal government created the National Long-Term Care Ombudsman Resource Center (NORC).
The NORC gives support, technical assistance, and training to 53 state long-term-care ombudsman programs.
These programs, in turn, coordinate a network of nearly 600 regional and local programs.
All of them provide long-term care ombudsman programs to advocate on behalf of seniors.
The long-term care ombudsman programs, in general, provide assistance and advocacy to residents of long-term care facilities.
The main duty of an ombudsman is to protect the rights of long-term care residents.
Residents of long-term care facilities, many of whom are frail, can experience problems, such as those involving the quality of their care.
They may not have anyone to help resolve their problems.
The residents of long-term care facilities can receive help from long-term care ombudsman programs.
Dong, XinQi, ed. Elder Abuse: Research, Practice, and Policy. Germany: Springer, 2017.
Jackson, Shelly L. Understanding Elder Abuse: A Clinician’s Guide. United States: American Psychological Association, 2018.
Phelan, Amanda. Understanding Advances in Elder Abuse Research: Practice, Legislation, and Policy. Germany: Springer, 2020.
Gallione, Chiara, et al. “Screening Tools for Identification of Elder Abuse: A Systematic Review.” Journal of Clinical Nursing 26, no. 15–16(2017): 2154–2176.
Wangmo, Tenzin, Karin Nordström, and Reto, W. Kressig. “Preventing Elder Abuse and Neglect in Geriatric Institutions: Solutions from Nursing Care Providers.” Geriatric Nursing 38, no. 5 (2017): 385–392.
Yon, Yongjie, et al. “Elder Abuse Prevalence in Community Settings: A Systematic Review and Meta-Analysis.” The Lancet Global Health 5, no. 2 (2017): e147–e156.
“About NORC.” National Long-Term Care Ombudsman Resource Center. http://www.ltcombudsman.org/about (accessed June 11, 2020).
“Elder Abuse.” World Health Organization. http://www.who.int/ageing/projects/elder_abuse/en/ (accessed June 11, 2020).
“Elder Abuse Prevention.” Centers for Disease Control and Prevention. June 5, 2017. http://www.cdc.gov/Features/ElderAbuse/ (accessed June 11, 2020).
“What Is Elder Abuse?” Administration for Community Living. http://www.aoa.gov/AoA_programs/elder_rights/EA_prevention/whatisEA.aspx (accessed June 11, 2020).
“What Is an Ombudsman?” Elder Abuse Reporting. http://www.elder-abuseca.com/what-is-an-Ombudsman.html (accessed June 11, 2020).
AARP, 601 E St. NW, Washington, DC 20049, (888) 687-2277, firstname.lastname@example.org, http://www.aarp.org .
Coalition of Organizations Protecting Elders, 2500 N. Reynolds Rd., Toledo, OH 43615, (419) 537-1999, (800) 272-3900, email@example.com, http://www.protectingelders.org.
National Center on Elder Abuse, 1000 S. Fremont Ave., Unit 22, Bldg. A-6, Alhambra, CA 91803, (855) 500-3537, http://www.ncea.aoa.gov .
National Committee for the Prevention of Elder Abuse, 1730 Rhode Island Ave. NW, Ste. 1200, Washington, DC 20036, (202) 464-9481, (800) 272-3900, firstname.lastname@example.org, http://www.preventelderabuse.org .
National Institute on Aging, 31 Center Dr., MSC 2292, Bethesda, MD 20892, (800) 222-4225, http://www.nia.nih.gov .