Elderly Abuse: A grim reality in India!
15 Jan 2016
Some last steps of life give our elders, the worst experience, which is a bitter pill to swallow. WE HAD a culture, we still have. We had time and we have it now also. But there is dramatic change in the attitude of people towards life, notion of people about life and of course our lifestyle. There is also one more factor which is working against us; SMALLER FAMILIES which makes caretaking of older parents difficult.
A study undertaken by NGO HelpAge India brought to notice the sorry state of senior citizens, rather parents of those who are enjoying the comfort and luxury of the materialistic world.
On the basis of a survey of 500 senior citizens of Delhi and Mumbai
· 12 per cent of them said no one cared whether they existed or not
· The most severely isolated and lonely are the people over 75, particularly women who are widowed and living alone
·21 per cent feel more or less alone and socialise rarely, even with their children
· 13 per cent feel trapped within their homes
· 33 per cent said they were left alone after their children moved away
· 88 per cent said loneliness could lead to ailments
Many elderly adults are abused in their own homes, in relatives’ homes, and even in facilities responsible for their care. As elders become more physically frail, they’re less able to stand up to bullying and or fight back if attacked. They may not see or hear as well or think as clearly as they used to, leaving openings for unscrupulous people to take advantage of them. Mental or physical ailments may make them more trying companions for the people who live with them.
Many seniors around the world are being abused: harmed in some substantial way often by people who are directly responsible for their care.
The different types of elder abuse
Abuse of elders takes many different forms, some involving intimidation or threats against the elderly, some involving neglect, and others involving financial aspects. The most common are defined below.
Physical elder abuse is non-accidental use of force against an elderly person that results in physical pain, injury, or impairment. Such abuse includes not only physical assaults such as hitting or shoving but the inappropriate use of drugs, restraints, or confinement.
In emotional or psychological abuse, people speak to or treat elderly persons in ways that cause emotional pain or distress.
Verbal forms of emotional elder abuse include:
Intimidation through yelling or threats
Humiliation and ridicule
Habitual blaming or scapegoating
Nonverbal psychological elder abuse can take the form of:
Ignoring the elderly person
Isolating an elder from friends or activities
Terrorizing or menacing the elderly person
Neglect by caregivers or self-neglect
Unusual weight loss, malnutrition, dehydration
Untreated physical problems, such as bed sores
Unsanitary living conditions: dirt, bugs, soiled bedding and clothes
Being left dirty or unbathed
Unsuitable clothing or covering for the weather
Unsafe living conditions (no heat or running water; faulty electrical wiring, other fire hazards)
Desertion of the elder at a public place
Significant withdrawals from the elder’s accounts
Sudden changes in the elder’s financial condition
Items or cash missing from the senior’s household
Suspicious changes in wills, power of attorney, titles, and policies
Addition of names to the senior’s signature card
Unpaid bills or lack of medical care, although the elder has enough money to pay for them
Financial activity the senior couldn’t have done, such as an ATM withdrawal when the account holder is bedridden
Unnecessary services, goods, or subscriptions
Healthcare fraud and abuse
Duplicate billings for the same medical service or device
Evidence of overmedication or under medication. Effects of Emotional Abuse on Patients
The effects of emotional abuse on patients manifest both physically and psychologically. Patients that are abused are 300 percent more likely to die than patients that are not abused. Depending on the type and severity of the abuse, the effects of emotional abuse may vary.
Effects of Abuse on Mental state
Patients that suffer from emotional abuse may suffer changes in personality, including development of personality disorders such as schizophrenia. Personality changes may involve becoming withdrawn or becoming violent and aggressive. Cognitive decline may begin, or if present, may worsen.
Psychological disorders that may stem from emotional abuse include:
Post-traumatic stress disorder
Effects of Abuse on Physical Health
The effects of emotional abuse can take a toll on physical health as well. Patients may engage in personal neglect or harm. Behaviours can range from lack of cooperation in bathing or grooming to actively inflicting harm in the form of self-cutting or hair pulling. Nervous behaviours such as scratching may cause inadvertent self-harm, as well.
Complications Stemming from Abuse
Patients may have trouble eating or sleeping due to fear or stress. Issues with eating or sleeping can cause the patient to become irritable at first, but can develop into more severe complications. Improper rest can lead to a distressed immune system, making patients susceptible to illnesses.
The most immediate probable physical effects include the following:
Welts, wounds, and injuries (e.g., bruises, lacerations, dental problems, head injuries, broken bones, pressure sores)
Persistent physical pain and soreness
Nutrition and hydration issues
Increased susceptibility to new illnesses (including sexually transmitted diseases)
Exacerbation of pre-existing health conditions
Increased risks for premature death
Improper nutrition can lead to a range of disorders and health problems including:
High blood pressure
Type 2 diabetes
Deficiencies of certain nutrients
Severe weight changes
One of the major reason for elder abuse is hidden in one factual premise. It’s difficult to take care of a senior who has many different needs, and it’s difficult to be elderly when age brings with it infirmities and dependence. Both the demands of caregiving and the needs of the elder can create situations in which abuse is more likely to occur. Taking care of elders often brings about stress in caregivers.
Risk factors among caregivers
Many nonprofessional caregivers—spouses, adult children, other relatives and friends—find taking care of an elder to be satisfying and enriching. But the responsibilities and demands of elder caregiving, which escalate as the elder’s condition deteriorates, can also be extremely stressful. The stress of elder care can lead to mental and physical health problems that make caregivers burned out, impatient, and unable to keep from lashing out against elders in their care.
Among caregivers, significant risk factors for elder abuse are:
· Inability to cope with stress (lack of resilience)
· Depression, which is common among caregivers
· Lack of support from other potential caregivers
· The caregiver’s perception that taking care of the elder is burdensome and without psychological reward
· Substance abuse
Even caregivers in institutional settings can experience stress at levels that lead to elder abuse. Nursing home staff may be prone to elder abuse if they lack training, have too many responsibilities, are unsuited to caregiving, or work under poor conditions.
Preventing elder abuse and neglect
What you can do as a caregiver to prevent elder abuse
· If you’re overwhelmed by the demands of caring for an elder, do the following:
· Request help, from friends, relatives, or local respite care agencies, so you can take a break, if only for a couple of hours
· Find an adult day care program
· Stay healthy and get medical care for yourself when necessary
· Adopt stress reduction practices
· Find a support group for caregivers of the elderly
· If you’re having problems with drug or alcohol abuse, get help
· And remember, elder abuse helplines offer help for caregivers as well. Call a helpline if you think there’s a possibility you might cross the line into elder abuse.
· Seek counselling for depression, which can lead to elder abuse
What you can do as a concerned friend or family member
· Watch for warning signs that might indicate elder abuse. If you suspect abuse, report it.
· Take a look at the elder’s medications. Does the amount in the vial jive with the date of the prescription?
· Watch for possible financial abuse. Ask the elder if you may see bank accounts and credit card statements for unauthorized transactions.
· Call and visit as often as you can. Help the elder consider you a trusted confidante.
· Offer to stay with the elder so the caregiver can have a break—on a regular basis, if possible.
Protecting yourself, as an elder, against elder abuse
· Make sure your financial and legal affairs are in order. If they aren’t, enlist professional help to get them in order, with the assistance of a trusted friend or relative if necessary.
· Keep in touch with family and friends and avoid becoming isolated.
· If you are unhappy with the care you’re receiving, whether it’s in your own home or in a care facility, speak up. Tell someone you trust and ask that person to report the abuse, neglect, or substandard care to an elder abuse helpline or long-term care ombudsman, or make the call yourself.
Do reach out to us to share your concern and issues as a caregiver or care- receiver. The stress and depression resulting from being in this situation can be overwhelming. We shall be this in this journey with you.
If as a caregiver, you have seen your elder suffering with emotional abuse or emotional difficulties, we can help ease out the suffering for you and your parent by dedicated caregiver counseling and emotional and mental health support
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