“The longer I live, the more beautiful life becomes.” This quotes by Frank Lloyd Wright should be the way we feel about getting older.  Unfortunately, some people think differently.

Aristotle said, “Old people are pessimistic, distrustful, malicious, suspicious, small-minded, lacking in generosity, and cowardly.”

Elder abuse is a significant public health problem. Each year, hundreds of thousands of adults over the age of 60 are abused, neglected, or financially exploited. Elder abuse, including neglect and exploitation, is experienced by 1 out of every 10 people, ages 60 and older, who live at home. This statistic is likely an underestimate because many victims are unable or afraid to disclose or report the violence.

The following six types¹ of maltreatment occur among persons over the age of 60.

• Physical abuse:  the intentional use of physical force that results in acute or chronic illness, bodily injury, physical pain, functional impairment, distress, or death. Physical abuse may include, but is not limited to, violent acts such as striking (with or without an object or weapon), hitting, beating, scratching, biting, choking, suffocation, pushing, shoving, shaking, slapping, kicking, stomping, pinching, and burning.
• Sexual abuse: forced or unwanted sexual interaction (touching and non-touching acts) of any kind with an older adult.
• Emotional abuse: verbal or nonverbal behavior that results in the infliction of anguish, mental pain, fear, or distress. Examples of tactics that may exemplify emotional or psychological abuse of an older adult include behaviors intended to humiliate (e.g., calling names or insults), threaten (e.g., expressing an intent to initiate nursing home placement), isolate (e.g., seclusion from family or friends), or control (e.g., prohibiting or limiting access to transportation, telephone, money or other resources).
• Neglect: failure by a caregiver or other responsible person to protect an elder from harm, or the inability to meet needs for essential medical care, nutrition, hydration, hygiene, clothing, basic activities of daily living or shelter, which results in a serious risk of compromised health and safety. Examples include not providing adequate nutrition, hygiene, clothing, shelter, or access to necessary health care; or failure to prevent exposure to unsafe activities and environments.
• Abandonment
• Financial abuse: the illegal, unauthorized, or improper use of an older individual’s resources by a caregiver or other person in a trusting relationship, for the benefit of someone other than the older individual. This includes, but is not limited to, depriving an older person of rightful access to, information about, or use of, personal benefits, resources, belongings, or assets. Examples include forgery, misuse or theft of money or possessions; use of coercion or deception to surrender finances or property; or improper use of guardianship or power of attorney.

Working to Prevent Elder Abuse

CDC works to prevent violence before it occurs. Our prevention activities include:

• Documenting the extent of the problem.
• Conducting research on the factors that put people at risk or that protect them from violence.
• Creating and evaluating the effectiveness of prevention programs.
• Helping state and local partners plan, implement, and evaluate prevention programs.
• Conducting research on the effective adoption and dissemination of prevention strategies.

Risk Factors

A combination of individual, relational, community and societal factors contribute to the risk of becoming a perpetrator of elder abuse. They are contributing factors and may or may not be direct causes.

Understanding these factors can help identify various opportunities for prevention.

Risk Factors for Perpetration

Individual Level

• Current diagnosis of mental illness
• Current abuse of alcohol
• High levels of hostility
• Poor or inadequate preparation or training for caregiving responsibilities
• Assumption of caregiving responsibilities at an early age
• Inadequate coping skills
• Exposure to abuse as a child

Relationship Level

• High financial and emotional dependence upon a vulnerable elder
• Past experience of disruptive behavior
• Lack of social support
• Lack of formal support

Community Level

• Formal services, such as respite care for those providing care to elders, are limited, inaccessible, or unavailable

Societal Level
A culture where ―

• There is high tolerance and acceptance of aggressive behavior
• Health care personnel, guardians, and other agents are given greater freedom in routine care provision and decision making
• Family members are expected to care for elders without seeking help from others
• Persons are encouraged to endure suffering or remain silent regarding their pains
• There are negative beliefs about aging and elders

In addition to the above factors, there are also specific characteristics of institutional settings that can increase the risk for perpetration of vulnerable seniors, including the following:

• Unsympathetic or negative attitudes toward residents
• Chronic staffing problems
• Lack of administrative oversight, staff burnout, and stressful working conditions

Protective Factors for Elder Abuse

Protective factors reduce the risk for perpetrating abuse and neglect. Protective factors have not been studied as extensively or rigorously as risk factors. However, identifying and understanding protective factors are equally as important as researching risk factors.

Several potential protective factors are identified below. Research is needed to determine whether these factors do indeed buffer elders from abuse.

Protective Factors for Perpetration

Relationship Level

• Having numerous, strong relationships with people of varying social status

Community Level

• Coordination of resources and services among community agencies and organizations that serve the elderly population and their caregivers.
• Higher levels of community cohesion and a strong sense of community or community identity
• Higher levels of community functionality and greater collective efficacy

Protective factors within institutional settings can include the following:

• Effective monitoring systems
• Solid institutional policies and procedures regarding patient care
• Regular training on elder abuse and neglect for employees
• Education and clear guidance on durable power of attorney and how it is to be used
• Regular visits by family members, volunteers, and social workers

Enjoyed this post? Share it and read more here.  Jay Harold has put together a Resource page that you may find useful when trying to improve your health and wealth. Please take this advice of  Muhammad Ali and give back to others. “Service to others is the rent you pay for your room here on earth.” ~ Muhammad Ali

Bibliography

1. https://www.cdc.gov/features/elderabuse/index.html
2. http://www.eldercare.gov/Eldercare.NET/Public/Index.aspx
3. https://www.cdc.gov/violenceprevention/elderabuse/riskprotectivefactors.html