Elder Abuse

This is a trauma undergone by thousands of elders across India. Problem is, no one talks about it, no one reports it, and naturally no one stops it. Let us understand it to try and prevent it.

Victims of Elder Abuse are often:

  • Older than others, above 70 or 75 years
  • Women are more likely to be victims
  • Widows or living alone
  • Socially isolated
  • Having physical or cognitive problems
  • Extreme dependence on care givers

Abusers are often:

  • Often younger than the person abused
  • Close relative or care giver
  • Living with the elder
  • Psychologically stressed
  • Financially dependent
  • May have history of alcohol and drug use

HOW TO SPOT IT

It is not always easy to identify abuse. Many symptoms that are listed below, may result from the disease a person has or by the medication that is being prescribed.  But there will be signs that cannot be explained away by medical reasons.

Signs of Physical Abuse

  • Bruises or grip marks around the arms or neck, rope marks or welts on the wrists and/or ankles
  • Repeated unexplained injuries, dismissive attitude or statements about injuries
  • Refusal to go to the same doctor or emergency service for repeated injuries 
  • There may be indications of burns, acute signs of hair and tooth loss, broken bones, or internal injuries
  • Bruises, both old and new, particularly those in the shape of specific objects or even fingers, on areas such as the wrists, upper arms, inner thighs, and neck could be worrisome
  • The improper use of a medication, such as an overdose of a tranquilizer, as a form of restraint

Signs of Verbal / Emotional Abuse

  • Hesitation in speaking openly with others, especially when a particular person is around
  • Withdrawal and unresponsive to communication
  • Fear and agitation
  • Anxiety and helplessness
  • Changes in sleep pattern, appetite
  • Behavior unreasonably fearful or suspicious
  • Lack of interest in social contacts

Signs of Sexual Abuse

  • Unexplained vaginal or anal bleeding
  • Torn or bloody underwear
  • Bruised breasts or buttocks
  • Venereal diseases or vaginal infections 
                                                                
Signs of Financial Abuse or Exploitation
  • Lifestyle doesn't match the individual's financial assets
  • Large withdrawals from bank accounts, accounts that have been switched
  • Unusual ATM activity.
  • Abrupt changes in a will, power of attorney, or financial documents
  • Signatures on checks don't match the older person's signature 
  • Unexplained and sudden transfers of money/ property to a care giver
  • Non-payment of bills which is not characteristic of the person.
  • Unexplained disappearance of valuables and money
Signs of Caregiver Neglect
Lack of basic hygiene, poor personal hygiene
Inadequate food and water, or clean and appropriate clothing
  • Person with dementia left unsupervised
  • Untreated pressure bedsores,
  • Lack of medical aids (glasses, walker, teeth, hearing aid, medications)
  • malnourishment or dehydration
  • Unsafe or hazardous living conditions (lack of heat or running water, improper wiring).

 

Signs of Self Neglect

  • Indications of self-neglect are similar to those of neglect by a caregiver. Individuals may be unkempt, have poor dental and personal hygiene, or appear malnourished and/or dehydrated. They may not be taking medications properly or might appear listless, confused, or depressed. Their living environment may be dirty, lacking in electricity or water, and unsafe. Frequently there is a need for an assessment to determine the competency of the individual and his/her ability to appropriately manage health and safety issues.
  • It is more common among very old people-   age 85 and older. They may be confused and socially isolated. Family may be involved to a limited extent. The older person wants to remain independent. This poses several risks.

 

HOW TO REPORT IT
Ideally the problem of Elder Abuse has to be approached holistically. A variety of health and social services is required to identify the underlying causes of abuse, stop the abuse, reduce the likelihood that it will recur, and treat the abused for the negative impact of abuse. 

Mental Health Services  
The older person needs to be assessed to determine if he or she is capable of meeting the basic needs and make decisions and protect oneself. Assessment of abuser to determine their need for treatment and if they pose a danger to others is also required.

Counseling
Vulnerable adults or victims can be counseled to assess their options for safety and to resolve conflicts in family. Counseling will also help the abused overcome the trauma. Group or individual counseling may be used. Main objectives of such intervention would be: to educate victims about resources and options; break through denial and shame; make plans to avoid future abuse (safety planning);  build support networks;  and manage post-traumatic stress. Family counseling is useful to resolve or mediate conflicts and tensions in the family that give rise to neglect or abuse.

Legal Assistance
Subsidized or free legal aid should be available for victims. Legal help may be needed to recover property or assets, to restrain the abuser or restrict contact between perpetrators and victims, for guardianship issues (when the elder is not capable of taking care of self) and for prosecuting the offenders.

Respite care and Support services
Respite care programs at home, adult care and at institutions is vital to support families and carers.  Caregiver stress may be reduced by providing services in the community that reduce burden and provide relief.  Managing the finance of elders to avoid frauds, support groups for care givers, respite programs, home delivered meal programs for elders living alone, adult day-care services and friendly visitors to homes of isolated seniors, routine telephone ‘check-in’ programs to reassure lonely elders, are other support services.

Violence Prevention programs
Domestic violence programs may be extended to cover seniors also. Services such as crisis lines, shelters for abused, support and counseling services in safe homes would be required for abused elders also. 

Interventions for Abusers
A range of physical, rehabilitative, behavioral and legal measures should be available to prevent abuser from repeating violent behavior.

Sensitizing Public and Advocacy for Elders
NGOs, voluntary groups, charitable trusts and Senior Citizens Associations can create awareness.

HOW ELSE CAN YOU HELP
There are various ways you can help prevent abuse in your neighborhood. All it takes is a little initiative and the will to help those who are vulnerable.

  • Empowering elders in your area through awareness campaigns, informing them of the utility of the ‘Maintenance and Welfare of Parents and Senior Citizens Act (2007)’
  • Provide elders with the local Police Station number which they can call in times of emergencies
  • Give more power & provide Guidelines to local Police to take action against Elder Abuse
  • Help in establishing Counseling Centers or use the existing Community centres for providing legal, financial, psycho – social help to elders.
  • Form a Senior Citizens Forum in the community which can act as a powerful agency in cases of detection, prevention and amelioration of domestic abuse
  • Set-up Vigilance Committees in urban residential colonies that need to work in collaboration with Residents Associations/Mohalla Committee of the area to deal with cases of Elder Abuse