The abuse of children and domestic
violence are two major social problems which have been frequently raising
issues since mid of the 20th century whereas elderly abuse have
remained hidden public issue and made it only private matter. The number of
elderly people is rising because of betterment in health care system and easy
access to sophisticated health technology.
However, lack of health care
professionals in geriatric care setting, poorly trained workforce, and myths
about ageing and older people (older people usually sick, frail, and dependent
on others) may older people vulnerable for abuse and negligence. The
information about extent of elderly population abuse is scant.
The few population based studied have suggested that between 4 to 6% of older
people have experienced some form of abuse in the home (WHO, 2002).
The elderly people are also risk of
abuse in institutional setting such as in nursing home, hospitals and other
long care setting. In one study in the United states for example, 36% nursing
home staff having witnessed at least one incidence of physical abuse of elderly
patient previous year and 10% admitted having committed at least one physical
abuse where as other 40% said they abused the patient psychologically (WHO,
2002). The global report on elderly shown it has been increasing day by day.
The institutional abuse is also restraining them physically, depriving of
dignity and choice over daily affairs and insufficient care (leave the patient
to develop pressure ulcer)
In this essay I am going to critically discuss
about elderly abuse, the various types of abuse, and its recognition and prevention.
It is
generally agreed that abuse of older people is either an act of commission or
of omission (in which case it is usually described as ‘‘neglect’’), and that it
may be either intentional or unintentional. Abuse and neglect are usually
something done to someone, but unfortunately, self-neglect is common problem in
the older adult population. It is more likely to be seen when an older person
has few or no close family or friends, but it can occur despite their presence.
It has been identified that people with dementia are more likely to experienced
abuse, although their increased risk may be explained only partly by their
cognitive impairment (Homer & Gilleard, 1990). International Network for
the Prevention of Elder Abuse states that: ‘‘Elder abuse is a single or
repeated act, or lack of appropriate action, occurring within any relationship
where there is an expectation of trust which causes harm or distress to an
older”. Such abuses can divide in to five categories- Physical, psychological,
sexual, and financial and neglect. Different types of abuse appear to arise for
different reasons; Eastman (1994) suggests that the abused person is usually
severely mentally or physically impaired, very old and usually female. Action
on elder abuse (1997) reported that three times as many women were victims of
abuse but perpetrators of abuse were carers in only 5% of all incidents. They
tend to be abused by relatives, live with those relatives and experience
repeated incidents of abuse.
The
physical abuse of older adults’ means infliction of pain or injury, physical
coercion, or physical and drug induced restraints. The abuse involves physical
attack upon a frail elderly person who cannot defend himself/herself from
younger or stronger family members. Some older people are starved by their
family members or given food that is unsuitable or unfit for human consumption.
Failure to provide adequate food and fluids also constitute physical abuse.
Another type abuse is psychological or emotional abuse which means infliction
of mental anguish; this often includes behaviors such as isolating, ignoring,
or depersonalizing older adults. Emotional abusers may forbid visitors and
isolate the older person from more responsible and sympathetic friends or
family members. They may prohibit use of the telephone or interfere with
communication by mail. The sexual abuse includes non-consensual sexual contact
of any kind of older people. Some people may rape the older adults. Similarly,
the illegal use of fund or material has exploited without consent of older
people which is simply called financial or material abuse. Children and grandchildren may take money
from the older family members. On the other hand, it is not abusive when older
peoples’ resource use for their individual care. The final type of abuse is neglect
which means that the refusal or failure to fulfill a caregiving obligation.
This may or may not involve a conscious and intentional attempt to inflict
physical or emotional distress on the older person. In this condition physical
abuse involves one or more actions that cause harm. Neglect is a passive form
of abuse in which care giver fails to provide for the needs of the older person
under their care. Neglect, whether intentional or unintentional, accounts for almost
half of the verified cases of elder abuse.
There are
number of risk factors that put elderly in abusive situation. A number of
situations appear to put the elderly at risk of violence. In some cases,
strained family relationships may worsen as a result of stress and frustration
as the older person becomes more dependent. In others, a caregiver’s dependence
on an older person for accommodation or financial support may be a source of
conflict.
Social
isolation is a significant risk factor for an older person to suffer
mistreatment. Many elderly people are isolated because of physical or mental
infirmities, or through the loss of friends and family members.
Cultural
and socioeconomic factors that may affect the risk of elder abuse include: the
depiction of older people as frail, weak and dependent, erosion of the bonds
between generations of a family, restructuring of the basic support networks
for the elderly and systems of inheritance and land rights, affecting the
distribution of power and material goods within families. Older men are at risk
of abuse in about the same proportion as women. But in cultures where women
have inferior social status, elderly women are at special risk of being
abandoned when they are widowed and having their property seized.
Within
institutions, abuse is more likely to occur where care standards are low, staff
are poorly trained or overworked, interactions between staff and residents are
difficult, the physical environment is deficient, and where policies operate in
the interests of the institution rather than of the residents.
The
recognition of elderly abuse done through various procedures here are some
points.
·
delays
between injuries or illness and seeking medical attention
·
implausible or vague explanations for injuries
or ill-health, from either patient or caregiver
·
differing case histories from patient and
caregiver frequent visits to emergency
departments because a chronic condition has worsened, despite a care plan and
resources to deal with this in the home
·
functionally-impaired older patients who
arrive without their main caregiver
·
Laboratory
findings that are inconsistent with the history provided.
Public
awareness and education raising is the most important element to prevent the
elderly abuse and neglect in the society. The education should be focused
specially to inform the practitioner and general public about elderly abuse,
types of abuse and how we identified (sign and symptoms) and prevention of
elderly abuse, and where we can find help.
The media
is also important tool to changing attitude and reduce stereotyping towards
elderly. Education aimed to elderly themselves is also very important including
topics about women rights, successful aging and elderly health care.
Mostly,
elderly abuse prevention strategy is focused with health and social care. The
abused or neglected elderly provided with various social supports such services
includes legal, medical, psychological, financial and providing housing and
other environmental safety issues.
In
nutshell, elderly abuse is being a major social problem all over the world
however the information relation to it has been leaked very scant because of many
elderly take it is a private matter, although the problem is being a serious in
the society which has detrimental effect on older peoples’ health. The cultural
myths about older people and older age are remaining in each level of society,
which is main reason for elderly abuse. It is very important to know the
important mark to recognition of elderly abuse which helps to early prevention
of it. The public awareness among each
level of people in the society about older people is very important and everybody
must realize todays’ younger will be tomorrows’ elderly person which is
universal truth that’s why you should respect your grandparents.
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