Elder abuse is on the rise. The results of the 2004 Survey of State Adult Protective Services found that reports of elder abuse rose 19.7 percent since 2000. Of those, 15.6 percent were substantiated. Most of this abuse (89.3%) occurred in a home setting, and 32.6% of the alleged abusers were adult children. Nineteen of the 32 states that reported the presences of elder abuse found that self neglect was the most prevalent cause of abuse at 37.2% with caregiver neglect not far behind at 20.4%.
Signs and Manifestions of Elder Abuse
The National Center on Elder Abuse (NCEA) defines six types of elder mistreatment and the most likely clinical manifestations as follows:
- Self-neglect which is defined as allowing or ignoring the behavior of an elderly person that could cause injury or is a threat to that person’s safety (manifested by manifestations seen in cases of neglect as noted below).
- Physical abuse resulting in bodily injury—Clinical manifestations could include unexplained bruises and welts, burns, fractures, lacerations and abrasions.
- Sexual abuse, or nonconsensual sex of any nature. Clinical manifestations could include blood stained undergarments; difficulty ambulating, bruising, itching, pain in vaginal or anal areas.
- Emotional/psychological abuse, or intentionally spoken or unspoken acts toward the elderly that cause anguish, pain or distress are another form of elder abuse. Clinical manifestations could include habit or conduct disorders such as rocking and being “antisocial”, neurotic disorders such as sleep and/or speech problems; psychoneurotic reactions such as hysteria, compulsion and phobias.
- Neglect, or refusing to care for the patient in a manner that is expected---Clinical manifestations could include hunger, poor hygiene, fatigue, inappropriate clothing, hypothermia, inadequate medical attention.
- Abandonment by leaving the elderly person unattended for periods of time, could manifest as signs of neglect, already noted.
- Financial or material exploitation or illegal or improper use of the funds, assets or property of an elderly person accounted for 14.8% of elder maltreatment according to the study. Evidence of exploitation could manifest as sudden changes in bank balances, or number of withdrawals; new signed documents (that could be forged), the addition of names on bank accounts; sudden changes in a will or ownership or beneficiary status of any financial documents. Coercing an elderly person to sign a document or agree to something is deceit and because of the often deteriorating cognitive status of the elderly person, is often difficult to detect.
Reporting and Preventing Elder Abuse
Reporting elder abuse is the responsibility of everyone and anyone who has contact with an elderly person. According to the NCEA, the most common sources of reporting abuse are family members, social workers, friends and neighbors. Efforts have been put in place by the NCEA to increase awareness and training to others who tend to have frequent contact with the elderly, such as postal workers, and utility repairpersons.
A more accurate means of data collection and measures of reporting, that is uniform at the state and national levels, is also suggested by the NCEA as a way to better track and study the incidences of abuse. Information about who is causing the abuse is also necessary and according to the NCEA, critical to prevention, intervention and advocacy.
Awareness and Education Regarding Elder Abuse
Educating the public and anyone who has contact with the elderly is imperative if we have any hope of decreasing the prevalence of elder abuse in our society. Silence about a suspected case of abuse is not an option. Our parents and loved ones are living longer. Caretakers and others in their lives need to understand their vulnerabilities and work hard to protect them from the abuses they are suffering, in increasing numbers, through education, training, and awareness.
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