Elder Abuse and Mistreatment

Globally, elder abuse and mistreatment is a severe problem that urgently requires the attention of relevant stakeholders. With a constant increase in the adult population, elder mistreatment is becoming an even pressing challenge. The abuse constitutes physical, sexual, psychological, emotional, and financial abuse that leads to loss of dignity and respect (Adib et al., 2019). Elderly abuse is a human right violation and has dire health consequences such as the risk of morbidity, mortality. These consequences also affect their families and society. Additional effects of the abuse include the deterioration of life quality, increase in hospital admission, lower survival rates, and high social costs (Breckman et al., 2018). Elder abuse occurs in different settings and is afflicted by professional healthcare providers or family members. According to WHO, one in six people above 60 experiences some form of abuse in the community. Nonetheless, the prevalence differs depending on the population setting, cultural background, abuse definition, and methodological measure (Molinelli et al., 2017). It is necessary to identify and comprehend the victims’ vulnerability and abuse prevention measures with such a vice. The research offers insight into elder maltreatment forms of abuse, barriers to seeking help, and recommendations to curb the abuse. 

Forms of Abuse

Financial Abuse

Financial abuse occurs when elderly financial resources are illegally and improperly used for personal gain. Financial exploitation includes sudden changes such as banking practices, including additional names on the older adult’s banking record, unauthorized withdrawals, unexpected disappearance of valuables or funds, among others (Orfila et al., 2017). Financial abuse is a precursor to other forms of gross abuse and, in many cases. The risk of financial abuse may rise due to diminishing mental capacity and inexperience of dealing with fiancés (Adib et al., 2019). Risk factors that increase financial exploitation include the need for constant assistance, dementia, history of drug and alcohol use, psychiatric disorder, and social isolation. Additionally, abuse of power by an attorney has recently gained attention as reports suggest that they are using their power to exploit rather than protect their elderly clients.

Physical Abuse

Physical abuse consists of incidences of deliberate violence, the excessive discipline of the elderly, including hitting, beating, pushing, shoving, kicking, or biting. When a caregiver or other person in influence uses force to cause unnecessary pain or injury, the behaviour can be regarded as physical abuse (Orfila et al., 2017). Any inappropriate use of medication and physical punishment implies abuse.  

Caregiver neglect

Here, neglect occurs when the caregiver fails to protect an elder from harm or provide their needs unsatisfactory, which increases the risk of harm. Neglect can be intentional or unintentional and constitute any caregiving strategy that withholds appropriate attention from the elderly. In a recent study, participants considered neglect the most common type of abuse though victims are unlikely to self-report due to its subtle nature (Wangmo et al., 2017). The maltreatment, which involves neglect of elderly person hygiene, medical, and social needs, can lead to the victim being psychologically affected

Barriers to seeking help

Elderly abuse is hidden but a growing problem globally with significant health implications, Incidences of elderly Abuse are significantly underreported for various reasons. Even with mandatory reporting laws, the victims are reluctant to report such maltreatment. A recent study in the US indicates that fewer than 5% of the incidences are reported (Adib et al., 2019). In addition, a significant number of the reported cases end up being unresolved due to inadequate coordination among service providers. Some of the reasons for the reluctant include

Personal attitude toward abuse

The majority of the older population facing abuse faces fear and concern over their indefinite future. Research indicates the elderly with strong family ties had fear over dishonour, being blamed for the misdoing, the abuser’s revenge, aggravation of abuse, and refusal to hold a deserving funeral for them if the caregiver is their children (Orfila et al., 2017). The abused fear-seeking help much force their relatives to discard them, leading to more isolation. In a study, the elderly abused argued reported leads to undesired outcomes such as increased abuse, a conviction of perpetrators, and institutionalization of the victim (Adib et al., 2019). Hence, seeking help was a self-sabotage endeavour and only increased maltreatment and other forms of abuse such as restriction or total neglect. Some are reluctant to seek help since the maltreatment does not involve physical harm and are unsure about handling such a scenario.

Cultural, social, and religious barriers

Certain social, cultural, and religious attitudes contribute to the violence against the elderly and make it easy for maltreatment without detection or intervention. These factors promote the devaluation of and lack of respect for older adults and the social belief that whatever happens at home is private (Wangmo et al., 2017). When the elderly are regarded as insignificant, society fails to acknowledge the significance of assuring dignified, supportive and nonbiased life for the elderly (Orfila et al., 2017). Additionally, certain cultural values, beliefs, and traditions massively influence the elderly intergeneration relations, family dynamics, and ways in which families define their mandates and respond to daily challenges.

Some elderly abused consider their suffering because of past action and hence accepts and tolerate it. Here, elders accuse and blame themselves for failing to raise their children (Adib et al., 2019). The self-blame leads individuals to accept personal responsibility for the negative events in their life Breckman et al., 2018). The excessive guild hinders the victims from asking for help. Additionally, suffering and patient is considered desirable concept in mainstream religion. For instance, a study conducted in Iran with Islamic as the main religion indicates the elderly abused failed to seek help since the suffering led to salvation (Wangmo et al., 2017).

Insufficiency of social support systems

Elders abused are unaware of the social support services available. Research indicates that most victims cannot use the social support available due to age-related illnesses (Adib et al., 2019). Additionally, the older adults are pessimistic about the level of care they can receive from the healthcare facilities since most service providers are inexperienced in handling such matters and hence could not comprehend their situation. The conception is that the caregivers are young and inept, increasing the cynics of seeking help. Finally, victims believe seeking help would convict their caregivers leading them to be institutionalized against their wish.

Recommendation to curb the elderly abuse

In the past few decades, great efforts have been made to address the abuse and neglect the elderly abused face. Despite the efforts, there remains variability in practice, and well-intentioned approaches and policies may be inadequate, ineffective, and disrespectful (Wangmo et al., 2017). Some ways to minimize the abuse include education, recruiting more competent caregivers, and developing a comprehensive assessment tool.

Education

Education is the most critical tool to prevent elder abuse. Since most of the abuse occurs in the home with family members as the perpetrators, healthcare providers must educate the public about the special needs that the elderly require and the risk they are exposed to because of the maltreatment (Wangmo et al., 2017). Elder abuse is rarely addressed in healthcare curricula, with only a few alternatives available through professional learning programs.

Recruiting more and competent caregivers

 More nursing prisoners can be hired to allow better care provision at the institutional and family-based-caring level. Ensuring good recruitment is essential. The responsible caregivers must be vigilant to assess why the abuse occurs. Hiring elderly caregivers should be a priority since they can form a part of the victims’ social circle and prevent tension and abuse from reaching an unmanageable level (Molinelli et al., 2017). The therapeutic relationship involves a caring attitude and behaviours based on trust, respect, and empathy.

Developing a comprehensive asessement tool

With the technology advancement, a risk assessment instrument that fulfils the necessity to thoroughly, user-friendly, and multidisciplinary asses can be created to comprehensively assess the signs of the abuse and the risk the elders face (Wangmo et al., 2017). Instruments that can be used by various professionals in multiple and district settings would be useful. Most of the available tools only take the caregiver mode of accounts and ignore the autonomy of the elderly abused or the possibility of non-dependent elder experiencing abuse.

Elder abuse and treatment have a tremendous effect on families, individuals, and communities. The vice continues to occur globally due to a lack of reporting and proper community sensitization. It is challenging to deal with elderly abuse like any other social challenge if the vice is unidentifiable. The abuse occurs in homes and healthcare institutions. Comprehension of the vices magnitude is the initial step for public health to prevent such type of abuse. Maltreatment is exhibited in different forms, including neglect, physical abuse, and financial exploitation. Some applicable measures to curb the elder’s abuse include education, hiring adequate and supportive health practitioners, and developing an assessment tool that comprehensively assesses the signs of the abuse and the risk the elders face. It is essential to create social programs that had better manage the phenomenon of old age.

Annotated Bibliography

Elder abuse is a critical public health issue. More than 10% of older adults aged above 60 years face abuse. In the US, the elders lose more than $2.9 billion dollars annually, with survivors reporting higher rates of depression and withdrawal social interaction. The articles below are some of the essential literature that accompanies the growing concern by relevant bodies to understand the concept, barriers, effects, and preventive strategies to deal with the vice.

Molinelli, A., Ventura, F., Pinto, S. L., Drommi, M., & De Stefano, F. (2017). Elder abuse in Europe’s “most elderly” city: an assessment of the phenomenon and an analysis of the Penal Court of Genoa data from 2010 to 2015. Ageing clinical and experimental research, 29(6), 1285-1290.

 The author assesses the frequency and modality of elder abuse in Genoa and compares the data with those documented in the literature. The article’s objective is to get evidence-based information on the current situation to aid authorities in combating the phenomenon. From the data regarding crime, only 19 cases were of (7%) of elder abuse. Besides, most of the cases happened in a domestic setting and rarely in residential facilities. Notably, the findings differ from the alarming media coverage impression that the elderly institutions are the major causes for elderly mistreatment and abuse. The research indicates that the media heighten the people’s fear of the institution. The study reveals the need for daily caregiving. However, enforced cohabitation with family increases the risk of maltreatment and often acts as a source of stress and uneasiness in the long term.

Wangmo, T., Nordström, K., & Kressig, R. W. (2017). Preventing elder abuse and neglect in geriatric institutions: Solutions from nursing care providers. Geriatric Nursing, 38(5), 385-392.

The article is essential in developing solutions to curb elderly abuse in nursing home facilitates. The study explores the reasons and ways in which neglect occurs in geriatric institutions. Face-to-face interviews were conducted with 23 nursing care providers in eight months. Neglect by the caregivers to satisfy the elderly was the most common form of abuse. The nurses were struggling with turnover, stress, and burnout, which led to poor care. Some of the solutions for the nurses to provide adequate healthcare include addressing the staff-to-patient ratio, addressing rising challenges swiftly, fostering team dynamics, providing appropriate healthcare, and proper administrative distribution of work. The research is limited since it concentrated on a small sample size of employees, making it difficult to generalize in the population. The research was conducted at the workplace and might have influenced the interviewees’ responses.

Orfila, F., Coma-Solé, M., Cabanas, M., Cegri-Lombardo, F., Moleras-Serra, A., & Pujol-Ribera, E. (2018). Family caregiver mistreatment of the elderly: prevalence of risk and associated factors. BMC public health, 18(1), 1-14.

The current study aims to estimate the prevalence of risk of abuse against the elderly population that is highly dependent on family caregivers. In addition, the research purposes of illustrating the relation between risk the magnitude of the caregiver’s anxiety, depression, and responsibility. The multivariate analysis that was performed using logistic regression indicated that the majority of caregivers were women (82.8%), most caregivers and dependents lived in the same room (87.4%) and had a better previous relation (86.6%). Most recipients were women (65.6%), and 64.25% of the dependents had moderate-severe cognitive impairment. Finally, the study indicates a high risk of family caregiving, with caregivers feeling the burden, anxiety, and perception of aggressive behaviour, 95% and above. The results can only be applied in a similar situation. In addition, the CASE tool used has high sensitivity and low specificity and does not scan for all abuse.

Breckman, R., Burnes, D., Ross, S., Marshall, P. C., Suitor, J. J., Lachs, M. S., & Pillemer, K. (2018). When helping hurts: Nonabusing family, friends, and neighbours in the lives of elderly mistreatment victims. The Gerontologist, 58(4), 719-723.

The research aim was to identify the non-abusing support system of the victim (family, friends, and neighbours) and the level of distress they experienced in helping. The study involved a random sampling of 1000 candidates. Data were collected via telephone survey with multiple regressions to test the association between helping status and distress. Notably, almost 30% of the respondents had known a friend, neighbour, or relative who experienced abuse. 67% of the respondents reported distress, high-level distress exceeding 80% of the measuring criteria. Hence, helping the abused elderly was highly correlated with the level of personal distress.

The study helps offer an alternative perspective to elderly abuse. However, it is limited since the survey questions are restricted, forcing the participants to choose based on prevalence rather than comprehension. In addition, the information required is spread throughout a lifetime rather than specific periods like annual prevalence.

Adib, M., Esmaeili, M., Zakerimoghadam, M., & Nayeri, N. D. (2019). Barriers to help-seeking for elder abuse: A qualitative study of older adults. Geriatric Nursing, 40(6), 565-571.

The research explored the barriers the elderly abused and mistreated face. Additionally, the research aimed to study preventive measures and strategies to curb the abuse. 18 elderly maltreated were selected through purposive sampling. Structured interviews were utilized for data collection.

The barriers to seeking help for the elders abused were grouped into three: personal attitude toward abuse, the inefficiency of the support system, and dependency on others. The abused elders were tolerant of abuse and attributed their suffering from their family members as atonement for their sins. The study was limited by the advanced age of the participants that interrupted or prolonged the interview and the small sample size, invalidating the generalization of the data to many areas. However, the research aids in comprehending the way culture and personal attitude influenced the mistreated elders in seeking help.