Elderly Abuse

Over the last few years, there has been a rapid increase in the number
of aged and elderly individuals in the society. It has been argued that
the modern society is aging as a result of the maturity of the
individuals born during and after the Second World War. In addition,
there has been a massive improvement in health care which has resulted
into improved life expectancy. However, an aging society has numerous
implications on the society. The most published impacts of an aging
society has been how the elderly population will affects the social
services, pensions and the health care system. Little or no focus has
been placed on the welfare of the aged population. The growing aged
population has resulted into another social problem, elderly abuse and
neglect. Traditionally, domestic violence and abuse and related studies
has been focused on children and women. However, there is no doubt that
the elderly are becoming a major victim of abuse and neglect in
different parts of the world. The elderly members of the society are
abused by their family members as well as other parties and institutions
(Gloria and Charmaine, 1). This has called for more emphasizes and
studies to evaluate the problem and develop measures aimed at protecting
the elderly from abuse and neglect.
The definitions of elderly abuse can vary from one jurisdiction to
another. The most acceptable definition, adopted by the World Health
Organization, defines elderly abuse as “a single of repeated act or
lack of appropriate action, occurring within any relationship where
there is an expectation of trusts which causes harm or distress to
another person” (WHO, 4). The abuse and neglect may results into
serious consequences of the wellbeing and health of the elderly person.
This may include physical, psychological, emotional and financial
problems. The neglect and abuse of an elderly person can either be
intentional or not intentional. In addition, it is important to note
that abuse and neglect of the elderly is not a preserve of one society.
However, it is more common in some communities and countries compared to
others. The caring of the elderly and senior members of the society is a
culturally defined aspect of the society. Based on the cultures of
majority of the societies around the world, abuse and neglect of the
elderly, especially by the immediate members of the society is
considered to be unacceptable behavior and is associated with
dysfunctional social values and norms (WHO, 4).
Although less production, the elderly members of the society are our
parents and grandparents. Like any other abuse, abuse and neglect of the
elderly is a violation of the fundamental rights of individuals.
Therefore, the elderly need to be protected from the injuries, isolation
and despair resulting from abuse and neglect. Basically, there are three
ways in which the elderly are abused in the modern society, neglect,
violation and deprivation. Neglects involve exclusion, abandonment and
isolation of the senior members of the society by the family or the
immediate community. Violation involves the infringement of basic human
rights such as the right to medical attention, legal representation and
other basic human rights. Deprivation means being denied the right to
make choices or decisions on issues affecting their lives (WHO, 7).
While elderly abuse has existed throughout the history of humanity,
recent changes in the society has created new forms of abuse and
increased the frequency of the incidences. Some of the changes include
the gradual decay of the moral standing of the elderly in the society.
Traditionally, the senior members of the society were sources of
information and knowledge and were the moral and political authority in
the community. However, due to modernization, urbanization and
industrialization of the society, the standing of the elderly in the
society has faded away. In addition, women were the care takers in the
traditional settings. This is not the case in the modern society. There
is an increase in the number of the women in the workforce. This is
coupled with an increase in the number of elderly members of the society
who need care. This has resulted into an increased number of cases where
the senior members of the society are either mistreated or neglected.
This means that although it is a global problem, it is more prevalent in
the more developed countries where there is a larger number of elderly
and the society is more modernized. There are numerous studies that have
been done to establish the extent of the problem. Depending on the
definition of elderly abuse, the social factors and the sampling method,
the rate of abuse and neglect ranges between one percent and 35 percent
(Bulman, 4).
Nonetheless, statistics on the extent of elderly abuse represent the
tip of an iceberg, according to some experts. Some researchers have
argued that the underreporting in the abuse and neglect cases among the
elderly can be as much as 80 percent. Some studies have reported one
case of abuse in every 15 persons, while others report 1 in every 6
cases. The discrepancies in reporting and underreporting are mainly due
to social barriers, isolation resulting from the abuse, lack of
uniformity in definitions and reporting and resistance by members of
society. The resistance and lack of cooperation from the members of the
society is a major problem that has resulted into underreporting. Also,
statistics indicate that the problem is more pronounced in the developed
world. This may not be the case, if the problems associated with the
studies are considered. In the developed world, there are more elaborate
and comprehensive statistics from studies, social welfare and journalist
reports. The methods of data collection are also systematic and can
provide essential information such as financial exploitation, abuse and
neglect of the elderly. However, it is more difficult to access and
compile such information and statistics from the less developed
countries. This has created a misrepresentation of the situation
resulting into the wrong conclusion. Nonetheless, it is important to
note that the less modernized societies are less influenced by the
forces of industrialization and urbanization, which has been argued to
be a major contributor in the increased cases of neglect and abuse of
the old members of the society (Hildreth, 568).
The biggest controversy in the study of elderly abuse has been related
to the unified and clear definition of the issue. As a result, the WHO
definition of elderly abuse has been dissected to represent the
underlying themes in elderly abuse. This has resulted into several types
of elderly abuse. The most common type of elderly abuse, visible in all
societies, is physical abuse. Physical abuse refers to any physical
injury, pain or suffering inflicted on an elderly member of the society.
Due to old age, disability and effects of terminal diseases, elderly
people may be unable to physically defend themselves from other members
of the family or the society. As a result, they suffer various forms of
physical abuse such as hitting and slapping, bruising and retrain, which
results into physical suffering. In aggravated cases, rape and sexual
abuse of the elderly have been reported. Together with children, the
elderly are more venerable to physical abuse due to the likelihood of
being silenced on the issue and inability to defend themselves. Some of
these physical abuses results into serious psychological torture, in
addition to the physical suffering (Wyandt, 40).
Elderly abuse can be perpetrated by a number of individuals in the
society. Some of the most common abuser of the elderly includes family
members and relatives, spouse, solicitor, neighbors, workers (voluntary
or paid), medical practitioners and any other individual who want to
exploit the vulnerability of the elderly. Relatives and family members
include adult children and grand children while workers include paid or
voluntary caregivers responsible for taking care of the elderly. Some of
the most common abusers are family members with history of mental health
problems and drug abuse. Elderly abuse can however be perpetrated by an
individual who have been able to establish trust or someone with an
authority or some level of control over the elderly person. Family
relationships or close friends and caregivers are in a position of
trusts and therefore the most likely perpetrators of elderly abuse.
Usually, abusers, especially financial abusers, befriend the elderly
person with an aim of building a trust and a solid relationship. In case
the adult children of the elderly person are not nearby, close friends,
neighbors or caregivers may exploit the vulnerability and build a
relationship of trust to gain control over their resources. Statistics
indicates that majority of the perpetrators of the elderly are close
family members, mainly spouses and children. However, the intent of the
abuse varies depending on the relationship. For example, some family
members may abuse or neglect the elderly to avoid responsibility or gain
control over their estates and resources. On the other hand, the abuse
can be as a result of persistent domestic violence that has
characterized the marriage. In this case, one of the partners continues
with the abusive behavior against the spouse at old age (Choi and Mayer,
5).
As a result of changes in the society, some families tend to hire
caregivers or confine the elderly members of the family in a paid care
environment. This is mainly due to the increased number of terminal
diseases among the elderly, which require specialized care and changing
lifestyles where individuals work for long hours and may not have time
to take care of their aging parents. Surprisingly, elderly abuse and
neglect is very rampant in the paid care environment for a variety of
reasons. Some elderly abuses are as a result of intentional cruel acts
by a caregiver, aimed at harming the aged individual. Although very
rare, these abuses are perpetrated by repeat offenders who disguise
themselves as ethical caregivers. The more common abuses and neglects in
the care institutions are unintentional. They are as a result of
inadequate training, inadequate facilities and resources, insufficient
support and lack of knowledge. These abuses and neglects may be as a
result of common processes in an organization. Nonetheless, aggravated
neglect and abuses can be as a result of poor practices. This suggests
that elderly abuse can be perpetrated by anyone therefore with an aging
population, the cases of abuse are likely to increase in the near future
(Choi and Mayer, 5).
Another common type of elderly abuse is psychological and verbal abuse.
Unlike children, the elderly are adults who understand the various
facets of the society. As a result, psychological and verbal abuses and
intimidations can result into mental anguish and suffering. Some of the
acts that amount to psychological abuse include humiliation, threats,
yelling and intimidations that focus on the physical and health
conditions of the individual. Another important source of psychological
distress among the elderly is the isolation that has become synonymous
with old age in some societies. Some of these abuses results into
serious mental conditions such as depression, which negatively affects
their deteriorating health status. Another type of elderly abuse that
has emerged in the developed world is financial abuse. Some elderly
individuals in the developed and developing economies have accumulated
wealth through investments and pension schemes. As a result of the
declining cognitive abilities, some members of the family or outsiders
have resulted into exploitation of the elderly’s wealth. There are an
increased number of thefts, fraud and financial exploitation against the
elderly being reported as more aged people retire. Financial abuse
occurs over a long period of time which starts by the perpetrator
securing the trust of the elderly individual (Wyandt, 40).
Another type of elderly abuse is spousal abuse. Spousal abuse can
occur at any stage of the marriage life, but when the victim is an
elderly person, it is a form of elderly abuse. Spousal abuse among the
aged is more common in couples with a significant age difference. It can
also happen when an individual is more disabled or affected by the old
age and terminal diseases relative to the spouse. However, abuse among
elderly couples is relatively less common compared to younger couples.
Sociologists have argued that the risk factor in families that
predisposes an individual to spousal abuse is relatively the same in
elderly and young couples. In addition, in cases where physical abuse
among the elderly by their spouses has been reported, the abuse did not
start at old age, but has been persistent throughout the marriage life.
As a result of the physical health of the individuals involved, spousal
physical abuse at old age can have more life threatening consequences
compared to a younger and healthier individual. Spousal abuse can also
result from changes in the lives of the couple as a result of old age.
For example, mental illness associated with old age can result into
physical abuse against the spouse. The abuse can also be as a result of
other factors in the family such as domestic violence and adult children
among others (Wyandt, 40).
Neglect is one of the major problems associated with an aged society.
Majority of the elderly are unable to take good care of themselves
therefore rely on members of the family or the society for primary care.
The problem becomes worse if the individual is suffering from a terminal
illness. In addition to being neglected by others, elderly people also
neglect themselves. An elderly person can be neglected by failing to
fulfill caregiving obligations such as food, shelter and medical care.
Self neglect involves the elderly individual refusing to fulfill the
daily obligations which he or she is able to do. For example, the
individual may refuse to eat, seek medical care or take a bath. Although
majority of the neglects are intentional and aimed at causing suffering
and avoiding responsibilities, some neglects are unintentional and may
result from infirmity, ignorance or lack of financial abilities (Wyandt,
40).
According to Childs et al (75), age groups have different perceptions
of elderly abuse and neglect. The age of an individual have an important
influence on how an individual perceives abuse against the senior
members of the society. As such, young people and middle aged people
view elderly abuse differently. Although majority of people,
irrespective of their age, will identify some elderly abuses such as
physical abuse and their impacts of the victim, the young people are
less likely to identify psychological abuses or emotional effects of
other abuses and neglect. As a result, young people perceive the
physical abuse as the most significant abuse. This means that if there
is no physical abuse, a young person may conclude that there is no
abuse. In addition, young people do not believe that they can be victims
of elderly abuse in the future. On the other hand, the experiences and
consequences of abuses against the elderly have influenced their
perception and views on abuse. Although there are a variety of factors
that have an influence on the perception of youths, middle aged and
elderly individuals on elderly abuse, social and economic factors,
ethnicity and acculturation have been identified to be the most
important factors. Due to historical factors, among other social and
economic factors in the developed world, elderly abuse is more common
among the minority societies and ethnic groups. Other factors that play
an important role in the extent and perception on elderly abuse among
minorities in the United States includes immigration status, level of
education, proficiency in English, length of residence, income level,
living arrangement and the familiarity with the relevant laws. Although
the cultural and ethnic factors plays an important role, overemphasizes
on the ethnic and cultural diversity has resulted into other non
cultural factors being ignored. It is important to note that elderly
abuse in the modern society is not a preserve of a particular society,
ethnic or cultural group. Thus, ignoring other factors may result into
ethnic labeling of the social problem (Childs, 75).
As a result of the challenges in formulation of a unified definition of
elderly abuse, it has been difficult to establish what are the risk
factors associated with elderly abuse. There are victims as well as
perpetrators based risk factors that predispose the aged to intentional
and nonintentional abuses and neglect. Although there are no
comprehensive studies that have been conducted in different social
setting to determine the risk factors, there are some social and
demographics factors that have been argued to predispose individuals to
elderly abuse. According to Jogerst, et al (513), high incidences of
elderly abuse have a strong correlation with poverty and population
density. This means that neighborhoods with higher rates of poverty and
dense populations (families with higher number of children) have higher
cases of elderly abuse. Race, age and disability and impairment, both
physical and mental are also an important victim based risk factors. For
example, low income non Caucasian individuals with advanced age and
physical and cognitive impairments form majority of the victims of
neglect and abuse in the United States. However, financial abuse has
mainly targeted the middle and high income elderly population due to
their venerability and large pool of resources (Jogerst, 513).
It is important to note that majority of the caregivers are
nonprofessional, which includes children, spouses, friends and
relatives. While some of these caregivers, depending on the cultural and
family ties and values, find care of an elder as an important and
satisfying obligation, the fact that they are untrained is one of the
most important risk factors. This is because the responsibilities of the
caregivers and the demands for professional services increases as the
conditions of the aged person deteriorate. The associated stress and
lack of training and facilities may result into unintentional neglect
and abuse. Impatient among the caregivers dealing with mentally and
physically disabled may force the caregiver to neglect or mishandle the
elderly person. The inability to cope with the associated risk among
caregivers and inadequate of resilience is an important challenge in
caregiving. Studies also indicate that depression and other serious
mental problems among untrained elderly caregivers are very common,
which predisposes the elder to neglect and mishandling. Caregiving to an
elderly member of the family is a corrective responsibility. However, in
many cases, the responsibility is left to one member of the family. The
lack of or insufficient support from other members of the family or
potential caregivers is also an important risk factor in elderly abuse
and neglect. There is no doubt that taking care of the elderly is a huge
and demanding responsibility. If there is no perception of psychological
reward and a sense of responsibility on the caregiver, there is a risk
of neglect (Gloria and Charmaine, 3).
There are also some social factors that predispose some elderly persons
to abuse and neglect. Some of these factors explain why some elderly
persons are at a higher risk compared to others. A history of social
isolation of the elder will ultimately result into isolation and neglect
in old age. The intensity of illness and mental or physical disability
can also result into neglect. Some elderly persons have a history of
abusive behaviors against their children and spouses, who may neglect
them at old age. In addition, some elders are aggressive and violent,
both verbally and physically which predisposes them to neglect and
abuse. However, these preexisting conditions do not warrant any
intentional or unintentional abuse or neglect (Richard and Robert, 4).
In conclusion, elderly abuse is one of the major problems affecting the
modern society due to the increasing aged population. The abuse can be
intentional or unintentional and is as a result of several factors.
Unintentional abuse is mainly perpetrated by caregivers mainly due to
inadequate training and resources. However, there are concerns over the
increased cases of intentional abuse and neglect, especially financial
abuse aimed at exploiting the vulnerability of the aged and rich for
economic benefits. With the cases of abuse and neglect expected to
increase due to increasing number of aged individuals, measures to
prevent intentional abuse and neglect should implemented. Caring and
protecting the elders in the society should be a corrective
responsibility in the society.
Works Cited
Bulman, P. “Elder abuse emerges form the shadows of public
consciousness. NIJ Journal. (2010). 265, 4-7. Print.
Childs, H. W., Hayslip, B., Radika, L. M., & Reinberg, J. A. (2000).
Young and middle-aged adults’ perceptions of elder abuse. The
Gerontologist, 40(1), (2000). 75-85. Print.
Choi, N.G., and Mayer, J. (2000). Elder Abuse, Neglect, and
Exploitation. Journal of Gerontological Social Work, 33(4), (2000):
5-25. Print.
Gloria, M Gutman and Charmaine, Spencer. Aging, ageism and abuse: moving
from awareness to action, Amsterdam Boston: Elsevier. (2010). Print.
Hildreth, C.J. Elder Abuse. JAMA. 306(5), (2011): 568. Print.
Jogerst, G. J., Dawson, J. D., Hartz, A. J., Ely, J. W., & Schweitzer,
L. A. (2000). Community characteristics associated with elder abuse.
Journal of the American Geriatrics Society, 48, (2000). 513-518. Print.
Richard, J Bonnie and Robert B Wallace. Elder mistreatment: abuse,
neglect, and exploitation in an aging America, Washington (D.C.):
National Academies Press, cop. (2003). Print.
WHO. A global response to elder abuse and neglect: building primary
health care capacity to deal with the problem worldwide, Geneva,
Switzerland: World Health Organization, 2008. Print.
Wyandt, Mary, A. A Review of Elder Abuse Literature: An Age Old Problem
Brought to Light, Californian Journal of Health Promotion, 2(3), (2004),
40-52. Print.
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