Watching for signs of abuse of elderly

May is elder abuse prevention month in Texas and across the nation. Every year an estimated 2.1 million Americans are victims of physical, psychological, or other forms of abuse and neglect. This abuse shows no preference for gender, ethnicity, economic well-being or health status. The abuse can occur at the hands of paid caregivers or family members. It can occur at home or in institutional, long term care settings. However, because only about 4 percent of older adults live in long term care facilities, such as nursing homes, the vast majority of abuse and neglect takes place at home. The majority of elders live in their own home or with children or other relatives. Often the abuse and neglect is subtle and difficult to detect.

The three largest categories of abuse/neglect include:

• Physical or psychological neglect.

This neglect may be obvious or subtle, overt or covert, intentional or unintended. As in all types of elder abuse, it is important to recognize that the abuse may be real or simply threatened.

• Physical or psychological abuse.

Obvious acts of violence, sexual misconduct, misuse of external devices designed to help the patient, such as restraint or medication, withholding of goods or services designed to assist the elderly, such as hearing or visual aids.

• Exploitation of the elderly, financial abuse or violation of the elder individual’s rights.

This includes scams designed to cheat or fraudulently take advantage of elderly, blatant stealing of money, possessions, etc. or mismanaging the elder person’s estate and assets.

Manifestations of elder abuse can include poor hygiene, inappropriate clothing, depression, untreated medical problems, dehydration, malnutrition, etc. However, it is important to understand that many of these difficulties may be due to illness or deprivation due to factors other than abuse.

There are many different possible causes for elder abuse, many of which are complex and involve several different factors. One of the most common arises because of stress on the caregiver. Many times the caregiver does not have the adequate skills or knowledge to take care of the older person, and this in turn can cause much frustration and stress for the caregiver. Caregivers with their own emotional, financial, or physical problems may also be at risk for abusing and neglecting the one they are caring for.

Detection of abuse often comes during medical examinations, or quite often from third party observation. Older people are often unlikely to report abuse for a variety of reasons including fear of retaliation, fear of not being believed or a desire to protect the abuser.

An excellent resource for information on abuse, neglect and exploitation on the internet is www.notforgotten.org. Another excellent resource is the National Elder Care locator:
1-800-677-1116.