Why Elder Abuse Is Everyone's Problem

What you're about to read makes me angry, because it's a true story. A story of elder abuse.

[In 2010], prosecutors in Seattle charged Christopher Wise with the murder of his mother, Ruby. His crime? Letting her rot to death with eight huge pressure sores, several to the bone, while he played Internet poker and lived off her pension. His excuse? She didn't want to go to a nursing home or a doctor; he was just respecting her wishes.

Ruby Wise was imprisoned in her bed by immobility, dementia, and isolation. She moaned and cried out for help continuously in the weeks before her death. Neighbors closed their windows and her son put in earplugs to muffle her cries. No one called Adult Protective Services or 911. It's hard to believe the response would have been the same had the cries come from a child, a younger woman, or a dog.

-- Testimony by Marie-Therese Connolly, Director, Life Long Justice (an elder justice initiative of Appleseed) before the Senate Special Committee on Aging, March 2011

We have an enormous problem with elder abuse, by which I mean the physical, psychological or sexual harm, neglect (self-neglect or by a caregiver) or financial exploitation of vulnerable older people. Elder abuse in all its forms is ugly, painful, costly and simply wrong. The problem is also bigger than most people realize. It's seriously under-reported, but an estimated one in 10 older people experiences some kind of abuse every year.

The most common form of abuse is financial exploitation, what Richard Cordray, director of the federal Consumer Financial Protection Bureau, has called "the signature crime of the 21st century." Perpetrated by family, "friends," caregivers and predatory outsiders, this problem is sufficiently complex and important that I will devote an entire post to it soon.

Elder abuse experts say a key challenge is that abuse "flies under the radar." Excuses abound, as does a lack of awareness and preparation. It gets excused ("she bruises so easily"), rationalized ("he was going to inherit that money soon anyway") or simply missed by good people in a position to help who didn't know what to look for, or how to intervene.

Perhaps it surprises you to see elder abuse included in this series on older adult health, but in fact they are closely related. We now know that elder abuse has devastating and far-reaching health consequences, and triples the risk of premature death, compared to a group of older adults with similar medical problems who do not experience abuse. Compared with their peers, victims of elder abuse are also three times more likely to be admitted to the hospital and four times more likely to be admitted to a nursing home .

"These things really jar your senses," says Lidia Vognar, MD, assistant professor at Brown University's Alpert School of Medicine, a scholar at the Hartford Center for Excellence in Geriatric Medicine there, and an expert on elder abuse, who often works with Adult Protective Services, the agency primarily tasked with intervention in cases of reported abuse. "We must break down the taboos that surround elder abuse. There is no reason for anyone to be silent."

If there is any good news here, it is that elder abuse has become a domain of increasing scientific scrutiny, with more research, education, and awareness in the past twenty years. In an arena like this, where health care, finances, the law, and social services intersect, knowledge is power, and empowerment is a big part of the solution.

Here are some important things to know:

Who's at risk?
No victim of abuse is ever to blame for mistreatment, but it is true that some people are at increased risk.

As a group, women suffer disproportionately more from abuse, and may suffer more physical and psychological damage from it. The older people are, the higher their risk. Other at-risk groups include people who are socially isolated; people who need a lot of help with activities of daily living, such as bathing, dressing, or using the bathroom; people with disabilities; people who live with someone with mental illness or substance abuse issues; and people with mental impairments or dementia. The last group, those with cognitive problems, faces considerable risk that gets even greater if their disease causes them to "act out" with difficult behaviors.

Who are the abusers?
90 percent of elder abuse and neglect is perpetrated by someone well known to the victim, usually family members, specifically grown children or spouses. While there is no excusing such behavior, and it demands the full available range of prevention and intervention, it is also worth reflecting on why it happens.

The stresses of caregiving, particularly long-term caregiving for someone whose problems may be extremely demanding, can be overwhelming. While important new research reminds us that, for some, even dementia caregiving can be well managed and yield positive experiences, many people who find themselves thrust into the role are ill-equipped for it. Many who never harm the person they are caring for find instead that it takes a terrible toll on their own physical and emotional health. Physical and emotional illnesses are more common, and these dedicated caregivers do not have time or energy to attend to their own health care needs.

So why do some caregivers turn nasty or neglectful, while others never do? The problem is important enough that the National Center on Elder Abuse has a publication dedicated to the topic, Preventing Abuse by Family Caregivers. Factors influencing the likelihood of abuse may include how well caregivers and the person receiving care got along in the past; how the caregivers perceive the job and the amount of support they feel they get from family, social networks, and the community; and whether the person receiving care has shown aggressive or difficult behaviors.  (Continue Reading)

Full Article & Source:
Why Elder Abuse Is Everyone's Problem