For many, the realities of reaching an advanced age can be difficult to imagine until they happen. This lack of empathy and understanding manifests as ignorance, dismissiveness or even ageism towards older people. At its worst, this (along with other factors) can lead to elder abuse.
Trauma from elder abuse can result in damage to psychological and physical health and even death – yet despite growing awareness about this issue, a combination of factors can create barriers to proving nursing home neglect as well as domestic violence against older people.
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What Elder Abuse Is
Elder abuse is defined by the Department of Justice as a betrayal of trust through a singular or repeated “act or lack of appropriate action” which “causes harm or distress to an older person”. The five subtypes of abuse include:
- Physical abuse
- Psychological and emotional abuse
- Financial exploitation
- Sexual abuse, assault or harrassment
- Neglect of basic care needs
Why Elder Abuse Goes Unreported
According to NCOA, only one in 24 cases of elder abuse are reported to authorities. While it can be easy to blame physical or mental barriers to communication (such as impaired speech), elder abuse may go unreported for a number of other reasons. Elders may not disclose their abuse due to:
- Fear of retaliation
- Dependence on the abuser
- Fear the abuser will get into trouble
- Fear they will be removed from their home
- Feelings of shame about the abuse
- Not wanting to be a “burden”
The abuser may also attempt to convince the older person that “nobody will believe them” or that the abuse is their own fault. This is known as gaslighting: a form of psychological manipulation. Ageist assumptions may even lead others to disbelieve victims, worsening their situation.
Red Flags
Insufficient staffing, training and safeguarding at nursing facilities is another major cause of unreported abuse, while in both home and institutional settings it can also result from a failure to recognize key warning signs, such as:
- Wounds, bruises or other physical signs such as weight loss
- Unusual changes in sleep or behavior
- Unusual financial activity
- Signs of sexual abuse, such as unexplained sexually transmitted illnesses
- Non-verbal cues, for example threatening or controlling behavior from the abuser
Safety in Numbers: Preventing Abuse
While there is no single defining cause of elder abuse, a common number of factors include substance abuse, family dysfunction, addiction and ageist views which can lead to a dismissive or even punitive attitude towards elders.
In both home and institutional settings, caregiver fatigue (often resulting from a lack of support, resources and training) can lead to poor mental health and subsequent abuse or neglect. To counteract this, older people and those who care for them require a support network.
In addition to resources for caregivers, such as counseling to help decrease stress, training and carer support groups, friends, family and neighbors can help by making regular visits. Doing this can provide respite for caregivers, while empowering and supporting the older adult so that they can stay connected and feel safe.