5 Possible Ways to Prevent Elder Abuse
She was enraged at finding out that her son had applied to the courts for guardianship. From 1996 to 2007 she was the iconic Lt. Uhura of “Star Trek,” USS Enterprise chief communications officer, Starfleet Command, USS Enterprise-A chief communications officer, Starfleet Academy. Now her son was claiming that she was suffering from dementia, incapable of running her day-to-day affairs, and needed protection from being taken advantage of. Last year an L.A. County judge agreed with Nichelle Nichol’s son and appointed four conservators to take control of her finances and matters related to her health in order to prevent elder abuse.
This is perhaps the scariest part of being an older adult — losing control, yes, control over the everyday decisions in one’s life. After all, control is what ultimately confirmed us as adults. Our maturity from childhood to adolescence to adulthood was marked by our ability to make our own decisions and exercise increasingly more control over our health, our finances, where we live, where we work, all matters great and small.
Relinquishing some of this control to others—be they a family member, neighbor, or an institution—can make older people vulnerable to abuse. According to the 2016 study “Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies,” elder abuse is likely the most widespread problem of older people. A 2018 World Health Organization study of elder abuse revealed that around 1 in 6 people 60 years and older experienced some form of abuse in community settings in 2017. It also discovered that rates of elder abuse are high in institutions such as nursing homes and long-term care facilities, with 2 in 3 staff reporting that they committed abuse in 2017.
But there is some hopeful news for older people: Elder abuse is not inevitable. Elder abuse is largely preventable.
In this blog we are going to focus on prevention and discuss five ways we may prevent ourselves and our older loved ones from becoming victims of elder abuse.
But, first, some explanation of terms.
What is elder abuse?
Elder abuse has been a challenge to define for several years, as the definition needs to satisfy the standards of researchers, practitioners and legal statutes. The 2016 study referred to above describes elder abuse as
(a) intentional actions that cause harm or create a serious risk of harm (whether or not harm is intended) to a vulnerable elder by a caregiver or other person who stands in a trust relationship, or (b) failure by a caregiver to satisfy the elder’s basic needs or to protect the elder from harm.
(a) physical abuse: acts carried out with the intention to cause physical pain or injury;
(b) psychological abuse: acts carried out with the intention of causing emotional pain or injury;
(c) sexual assault;
(d) material exploitation, involving the misappropriation of the older person’s money or property; and
(e) neglect, or the failure of a designated caregiver to meet the needs of a dependent older person.
Who is vulnerable to elder abuse?
The main risk factors for victims of elder abuse are being female, presence of a cognitive impairment and disability, being older than 74 years old, and increasing dependency.
The abuser can be a family member, informal and formal caregiver, or an acquaintance.
Elder abuse can take place in community settings and in institutional settings (hospitals, nursing homes, and other long-term care facilities). Signs of abuse include treatment of head injuries, body bruises, bed sores and other diagnoses that might indicate physical abuse, sexual abuse or severe neglect. But abusive acts in institutions may also include “physically restraining patients, depriving them of dignity (for instance, by leaving them in soiled clothes) and of choice over daily affairs…over- and under-medicating and withholding medication from patients; and emotional neglect and abuse.”
So what can older persons, families and institutions do to prevent elder abuse?
How to prevent elder abuse
There are five types of intervention that may prevent elder abuse in community and institutional settings. The fifth intervention is the most comprehensive and should be pursued.
1. Caregiver intervention
(a) prevent caregiver burnout
Studies show that caregiver burnout is a contributing factor in elder abuse, be it in the community or institutional setting. It’s important, therefore, to put in place measures that would prevent caregiver burnout. These measures would include services to relieve the burden of caregiving, such as housekeeping and meal preparation, respite care, education, support groups, and day care. So, if you have a caregiver, watch for signs of burnout or stress. Ask others to step in to assist with some of their responsibilities
(b) Screen caregivers for indicators of elder abuse.
(c) Provide stress management and respite care for caregivers.
(d) Provide staff training on dementia for caregivers.
(e) Implement residential care policies to define and improve standards of care.
2. Money management intervention
Do you try to handle your bill paying yourself but you’re finding it difficult to get around to all the places? Do you depend on a single family member to pay your bills and make deposits? Are you socially isolated? Does your loved one suffer with some form of cognitive impairment? These are some of the factors that place an older person at risk of financial abuse. Having a well-trained and accredited money manager to provide “daily money management assistance, including help with paying bills, making bank deposits, negotiating with creditors, and paying home care personnel” reduces the risk of financial abuse.
3. Abuse helpline intervention
Helplines provide two important benefits to older people who are vulnerable to abuse. The first is anonymity. Older persons may experience shame about the abusive situation. A helpline allows the individual to call, receive advice and assistance and not reveal their identity if they do not want to do so.
The second benefit is that by being able to call for help or advice, the caller can facilitate early intervention that can prevent or forestall mistreatment.
Effective helplines should be staffed by trained volunteers or professionals and be able to support older abuse victims.
Find out if there is an abuse helpline in your area or in the area where your loved one lives. Know the number of the abuse helpline.
Here are some numbers in the Philly area that you should have at your fingertips:
Statewide Elder Abuse Hotline: 1-800-490-8505
Older Adult Protective Services
4. Temporary safe place intervention
A good prevention measure is to have a safe place to stay temporarily if you or your loved one is being abused or there are signs of potential abuse. We are familiar with shelters for abused women. But shelters for older women and older women with physical health problems or dementia are not as available; additionally, there are few shelters for men.
Some countries have established “specialized shelter programs for elder abuse victims….These programs offer temporary relocation for victims, providing not only a safe environment but also a medically appropriate one…providing security while allowing a plan for safety at home to be put in place.”
Here are some of the services—including protective services and legal assistance—that the city of Philadelphia provides to older people.
5. Multidisciplinary team (MDT) intervention
Burnout is one consequence of having a single caregiver rather than a team of persons involved in providing care. Another consequence is a lack of accountability. However, when there is a team of persons involved in coordinating care, there is a built-in system of responsibility and accountability which reduces the risk of caregiver burnout and abuse.
Intervention Associates (IVA ) offers older persons and their families such a team.
IVA is uniquely designed to offer interventions to prevent elder abuse. It is staffed by care managers trained to work with the geriatric population and trained social workers who can help remedy caregivers who are not trained.
IVA empowers older adults who want to keep their independence and autonomy and age in place in their home.
IVA also offers a guardianship service and is trained to handle the most extreme cases where autonomy is lost.
Having a professional agency like IVA means that older persons and their families have access to a multidisciplinary team of responsible and accountable professionals whose services and approach prevent elder abuse.