Elderly abuse has been present in society from past times. Evidence of elderly abuse can be found in Shakespeare writings and literature, and also in Greek mythology. Despite its’ constant presence throughout time, it is only recently that serious attention has been given to elderly violence. The main reason for the new recognition of this old problem is the increasing number of aging Americans. (National Center for Victims of Crime). Elderly abuse in modern times is more prevalent that in ancient times, because of the few that were tasked with the duties. In past generations, the duties of caring for the elderly were shared among the members of large extended families. However, due to the emergence of a strained economy, and smaller nuclear families there is less time and family members to care for the elders within each family. The definition for elderly abuse varies from state to state within the US. A common middle ground in all definitions is that elderly abuse is any physical, psychological, or maternal abuse towards an elderly person. In summary, it is the violation of the elder’s rights to safety, security and adequate healthcare. (Wyandt). Due to the various definitions of elderly abuse across the board, the act has been categorized in different typologies. Physical abuse, Verbal/Psychological abuse and Financial abuse are three main types of elderly abuse.
TYPES OF ELDERLY ABUSE
The physical abuse of elderly may include restraining, slapping, hitting, bruising, and other forms of physical abuse that result in pain or injury, sexual abuse, sexually molestation, and rape. Verbal abuse or psychological abuse usually involves inflicting mental anguish, humiliation, intimidation, yelling, and threats. Keeping an elderly person isolated from others can also cause psychological distress and lead to more serious issues such as depression.
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While caring for elderly most time caregivers tend to illegal or improperly exploit and use the funds of their patient; this denote financial abuse. Theft, fraud, and taking advantage of a cognitively impaired older person for profit or personal gain also constitute as financial abuse. Financial abuse of the elderly tends to occur overtime rather than a single, overt act such as robbery, purse snatching, or carjacking.
The most common and painful abuse for most elders is spousal abuse. Spousal abuse can occur throughout the adult life span. For older people who report physical abuse from a spouse, the abuse has likely occurred for many years throughout the relationship and continues into the elderly years. For others, spousal abuse may occur with a significant life change that sometimes accompanies older age, such as mental or physical illness of a spouse. In addition, other forms of domestic violence, including family relationships with longtime partners, adult children, and grandchildren have resulted in elder abuse.
Refusing or failing to fulfill care-taking obligations, abandoning an elderly person, or denying food or health services are forms of neglect. Another type of neglect is self-neglect. This may include not fulfilling activities of daily living that the elder is physically able to do. For example, this may include not eating, bathing, and taking medications, or seeking necessary health services. Neglect and self-neglect may be due to intentional acts with the conscious attempt to inflict pain and suffering or may be unintentional due to ignorance, infirmity, or laziness on the part of the person responsible.
HISTORY OF ELDERLY ABUSE
In 1950, elder abuse initially emerged on the national scene with efforts to assist weak elder Americans. This first appearance cause welfare officials to develop a new approach called the Protective Services Units. The approach sought to help vast numbers of older citizens who were unable to manage on their own. The Protective Services Units provided social services, legal assistances and guardianship.
The first public appearance in 1970, stemmed from the 1950 legislation pass by Congress as a part of the Social Security Act. This Act was supposed to provide funds to the local states for setting up the Protect Service Units. The plan failed miserably, because some states took the federal dollars but did not set up the Protective Service Units, and those that set up the Units were not very effective. As a result, there was much criticism of the programs; the main one being that the programs were too costly and they infringed on the rights of elders. As time progress interest in elder abuse became visible due to continuous congressional hearings. At these hearings, witnesses discussed the different form of abuse experienced. One type of abuse was “granny battering.” (Bonnie, Richard J; Wallace, Robert B; National Research Council (U.S.). Panel to Review Risk and Prevalence of Elder Abuse and Neglect.) With so many witnesses coming forth at these hearings, Congress’ interest for the Proctective Services was revived. In 1981, a legislation to launch a National Elder Abuse Center was proposed by Congress, but this bill was never passed. In 1989 however, Florida Senator, Claude Pepper re-emerged the same proposal as an amendment to the existing Older Americans Act. This amendment was successful put in place, and the national center was funded the following year. As a result, the elder abuse had been recognized in federal legislation.
Initially, the purposes of the national center were to involve public welfare, and provide social services. As things progress however, a larger number of the population gained interest and such became more involved in this system. The interest and responsibility shifted from federal and state to private (non-profit) organizations. These organizations emphasized their interest and attentions on elder abuse/abused elder and their care-giving. In their perspective the problem was that the victims were impaired (elderly parent) and their care-giver could not manage to care for them because of life’s stresses-job, family among other issues. This portrait was broadcasted by the media and Congress.
In the 1980s, a family violence workshop was held by a well know Surgeon, General Louis Sullivan. Surgeon Sullivan affirmed that the problems of elder abuse and neglect were that of one in the public health and criminal justice systems. As such they should be placed under the family violence category. This new identification resulted in a positive effect for society, because it made the medical and criminal justice communities broaden their interest in the topic.
CAUSES AND PREVENTION OF ELDER ABUSE
As you are now aware elder abuse is an extremely common and difficult problem. There are several notions as to the cause of elder abuse. These factors are usually of each other, and as such do not operate independently, but rather with each other. However, this depends on depends on the victim and perpetrators’ situation.
Caring for an ill aging adult that may suffer from mental and/or physical impairment can be very stressful. Special training and skills are needed to be successful in such duties. With that being said, most care-givers do not have these training and skills to perform care giving, so they get stressed out and frustrated regardless if the elder is a loved one. The lack of skills, combined with stress may lead to elder abuse and neglect.
Being treated as an invalid is not a welcoming feeling for most elders; therefore, elders that have always been independent throughout their whole lives may become resentful, rude and uncooperative towards their care-givers. The can cause abuse, especially if the elders are in poor health conditions, and are dependent on their care-givers financially. The care-giver is believed to resort to abuse to show the elders who has more power, and they (the care-givers) are in charge.
Dealing with the ailments of elders, and their dependency can be very stressful if being done full-time. The situation can get tense when external stress, such as financial, job and additional stressors are added. According to studies, the result of all these stressors will cause abuse, as there is clear correlation between stress and abuse.
A sociological cause for elder abuse is the social learning theory between generations. Individuals that grew up in abusive homes tend to be a lifelong participant in the cycle of violence. Usually, when violence is present during childhood, anger, conflict and tension are present. These feeling stay with the individual throughout life, and thus arise when during care-giving. A common saying which explains elder abuse is “what goes around comes around” theory. This theory assumes that the elder had abused their child in the past, and care-giver (usually the same abused child) is simply returning the same treatment.
Recognizing the problem is the first step to prevention, as such the violent, humiliating, and neglectful behavior should be condemned. In order to deem these behavior unacceptable, positive steps to improve social attitude and educating people about elder abuse is required. Increasing care, support and social contact for care-givers are positive steps to eliminating elder abuse.
As mentioned in the previous paragraph, elder abuse can be prevented through formal or media education. The publicizing of abuse within nursing home has made society aware of the problem, and thus came up with ways to prevent it. Unfortunately, abuse of elders is most frequently committed by family members and care-givers within the privacy of the home. Therefore, it is necessary to continue to educate the public in all forms of media about the special needs and problems of the elderly, and about the various risk factors for abuse.
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Prevention of elder abuse, can also be lessen if the care-givers’ stressors are lessen. This can be done by providing care in intervals. The duties can be split amongst two to three persons per week, instead of the same person all weak. This will allow the different care-givers time to alone to unwind and rejuvenate, free themselves from the worry and responsibility for constantly catering to someone else’s needs. Care-giving in intervals are strongly suggested for individuals that care for the elders that are diagnosed with Alzheimer’s disease or other forms of dementia or of elders who are severely disabled.
Support in the form of socializing can be very effective for both elders and their care-givers. Releasing tension within a social circle prevents high levels of built up frustration and anger. Family members who care for elders should spend time with other family members in group to share problems and solutions, instead of withholding all the pressure and resentment that goes with care for the elder. The most important reason for social support is that it abuse is less likely to go unnoticed, because elders that are placed in isolation increases chance to be abused.
Alcoholism, drug addictions, behavioral and personal problems are significant factors that cause care-givers to be abusive. Counseling for such problems can prevent and find solutions to stress; the stressors that cause abuse. Usually when drugs are a problem for the care-givers, treatment will help in the prevention of violence against the elder family members. It is also suggested that during treatment or counseling, the older family member should relocated to a relative or a home where he/she is safer and more equipped to handle the emotional and physical responsibility.
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LITERATURE REVIEW
Since there has been no definitive explanation of what constitute as elderly abuse, there has been several exploratory research that has been done. Researchers, Hudson and Carlson (1998) compared similar characteristics from the abuse of public with those of a group of experts with regards to elder mistreatment. It was identified in both groups that physical, psychological, social, and financial abusive were common factors. Sexual abuse was also noted by both groups as examples of physical force.
The context in which the violent behavior occurred affects the interpretation of it. Thus, creating valid and reliable operational definitions of elder abuse remains challenging because it is difficult to build complete context into a single definition.
It was also illustrated by Blakely and Dolon in their 1998 research that most adults fail to believe or admit that they will ever be abused during their elderly years. Both researchers also revealed that young adults were less likely to recognize or report elderly abuse. This was due to the fact that they elderly seemed invisible to them.
Due to the multiple definitions, researchers did panel comparisons of four African- American groups with each other. Researcher sought to find the similarity and differences among minority groups. It was found that there was a high degree of support for all groups and categories of elder abuse. As a result of the comparison, the expert panel indicated that abuse is defined by terms “of sufficient frequency and/or intensity,” whereas, the African-American groups defined abuse as a single act, therefore frequency and intensity were important factors in determining the severity of the abuse.
Hudson, Armachain, Beasley, and Carlson (1998), conducted a similar comparison of Native American groups. Coincidentally the results from the comparison the two Native American groups were the same as the comparison of the African American groups. Just as the African Americans, the Native Americans groups agreed that elderly abuse was unacceptable in their society. They also agreed that the majority of behavior by caretakers was labeled as abusive. Native American groups indicated clearly that elders are to be treated with respect and honor, as well as they are to be cared for and about. These beliefs are derived from cultural norms that elders should be respected.
Le (1997) pilot and explorative study illustrated the observations of mistreatment of among the Vietnamese race elders living in America. The four areas of abuse that were explored were verbal, emotional, financial, and physical abuses. There was not physical abuse identified among the participants of this study; however the most often reported types of abuse were verbal and emotional. One factor that increases the risk of elder abuse within this study is that many of the Vietnamese elders reported being unhappy as a result of living in a foreign country. The second factor is language barrier; many of the Vietnamese elders are not proficient in the English language. The language barrier made them more likely to be unaware of public services offered to elders, and so dependent on family.
CONCLUSION AND RECOMMENDATIONS
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