Elder abuse is defined as a single or repeated act or lack of appropriate action, occurring within any relation where there is expectation of trust which causes distress to an older person”. This could be physical, psychological, emotional, financial or even sexual. This could be either intentional or unintentional.
This at many times goes unrecognized. This serious social problem is quite kept out of public view as it is considered private matters. But increasing evidence of their occurrences now indicates that it is an important public health and societal problem. This problem is under reported despite it being present both in developed and under developed countries. The current available information from various countries places it between 1-10% though exact worldwide statistics is unavailable.
The approach to detect and address elder abuse needs to be placed within cultural context for the risks are culture specific. From a health and social perspective unless both the primary health and social service sectors are equipped to identify and deal with problem elder abuse will be under diagnosed and overlooked.
Some facts about elder abuse:
- Around 4-6% of the elderly have experienced some form of maltreatment at home.
- Maltreatment of the elders can lead to serious physical injuries and long-term psychological consequences.
- Elder maltreatment predicated to increase with increasing ageing population.
Elder maltreatment could be single or repeated act, or even lack of appropriate action occurring within relationships where there is an expectation of trust which causes harm or distress to the older person. This type of violence constitutes a violation of human rights.
The Scope of The Problem: 4-6% of the elderly people in high-income countries have experienced some form or other of maltreatment at home. The information in developing countries in not available. The elder people often are afraid to report cases of maltreatment to family, friends or to the authorities.
Reports of abuse in institutes include physically restraining the patient, depriving them of dignity (like leaving them in soiled clothes) and choice over daily affairs, intentionally providing insufficient care (resulting pressure sores) over and under medicating with holding medication from patients. Emotional neglect and abuse. The maltreatment could lead to physical injuries ranging from minor scratches and bruises to broken bones and head injuries leading to lasting disabilities and serious sometimes stretching the convalescence. With age even minor injuries can lead to serious injuries or even turn fatal.
Risk Factor: at the individual level include dementia, mental disorder, if the individual is a substance abuser then alcohol abuse. Abandoning, while elder men run the same risk of abandonment as elder women in some cultures women have a lesser status or usurping the property from widows are all seen. Relationship risk would be in the case of shared living. In lower economic families the financial stress particularly as the person becomes dependent increases. The abuse could be from children or even spouse. With more women joining the work force they have less spare time, caring for the older people this increases the risk of abuse particularly psychological more so when the elder becomes frailer and more prone to injury. Community social isolation of caregivers as the elder person is isolated provokes a certain kind of maltreatment by the care-givers. Many elders are isolated because of physical or mental infirmities or through the loss of friends and family members.
Elders Abuse In A sociocultural Context
- Erosion of bonds between generations of a family
- Systems of inheritance and land rights, affecting the distribution of power and material goods within families.
- Migration of young couples leaving elderly parents alone, in societies where older people were traditionally cared for by their off springs.
- Financial constrains to pay for senior citizen care.
Institutional Abuse May Occur:
- Healthcare, welfare services and care facilities are low.
- Under paid and over worked staff.
- Physical environment in the infrastructure of the institution is deficient.
- Where policies of the institution operates in the interest of the institution rather than the residents.
Prevention of elder abuse
- Public and professional awareness campaigns and screening of potential abusers and victims.
- Care-giver supportive interventions.—like stress management, respite care.
- Care-giver training on senior challenges.
- Mandatory reporting of maltreatment to authorities.
- Adult protection service.
- Home visitations by police and social workers
- Self help groups, self houses and emergency shelters.
WHO collaborates with its partners to prevent elder maltreatment through initiatives that help to identify, quantify and respond to the problem, this includes building
- Understanding the nature and magnitude on a global level.
- Developing guidance’s in all relevant sectors to strengthen the effort to prevent maltreatment to elders.