Introduction
Abuse is the improper usage or treatment of an individual or entity, often to unfairly or improperly gain benefit. Abuse can come in many forms, such as physical or verbal maltreatment, injury, assault, violation, rape, unjust practices; crimes, or other types of aggression. An elder is someone with a degree of seniority or authority. Old age comprises "the later part of life; the period of life after youth and middle age. The United Nations has during their first attempt at an international definition of old age agreed that 60+ years might be used to denote old age. Scientifically old age may be defined as the end of the human life cycle as it describes ages nearing or surpassing the longevity of people. Terms and euphemisms for the elderly include old people (worldwide usage), seniors (American usage), senior citizens (British and American usage), older adults (in the social sciences), the elderly, and elders (in many cultures).
Senior citizens often have limited regenerative abilities and are more susceptible to disease, syndromes, and sickness than younger adults. The organic process of aging, senescence, has an effect of leaving the elderly to be more in need of protection than their younger counterparts. As a result, they are easier to mistreat as they may not be able to resist abuse. Elderly abuse also referred to as "elder mistreatment," "senior abuse," "abuse in later life," "abuse of older adults," "abuse of older women," and "abuse of older men" 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 person." This definition has been adopted by the World Health Organization (WHO) from a definition put forward by Action on Elder Abuse in the UK. Laws protecting the elderly from abuse are similar to and related to, laws protecting dependent adults from ill-treatment.
The Medical, Psychosocial, Social or Political Condition
As elders become more physically delicate, they are less able to stand up to harassment and bullying or fight back if attacked. They may not see or hear as well or think as clearly as they used to, leaving openings for unscrupulous people to misuse and take advantage of them. Mental or physical ailments may make them more susceptible to intimidation and or harassment. Older people are physically weaker and more vulnerable than younger adults, their bones are more brittle, and convalescence takes longer. Even a relatively minor injury can cause severe and permanent damage. Many older people survive on limited incomes so that the loss of even a small sum of money can have a significant impact. They may be isolated, lonely or troubled by illness, in which case they are more vulnerable as targets for fraudulent schemes
Many seniors around the world are being mistreated or harmed in some substantial way often by people who are directly accountable for their upkeep and care. In the U.S., more than half a million reports of abuse against elderly Americans reach authorities every year, and millions of more cases go unreported. Elder abuse tends to take place where the elder lives. For example, in the home context where abusers are often adult children, other family members such as grandchildren, or spouses/partners of elders. Elder abuse can also occur in institutional settings, especially in long-term care facilities.
Forms of Elder Abuse: Recognizing Patterns and Types
Abuse of elders takes many different forms, some involving intimidation or threats against the elderly, some involving neglect, and others involving financial trickery. Some of the most common forms of elder abuse include physical abuse, emotional abuse, verbal abuse, sexual abuse, neglect or abandonment by caregivers, financial exploitation, and healthcare fraud and ill-treatment.(Jackson and Hafemeister 2013)
- Physical elder abuse is the non-accidental use of force against a senior citizen that results in physical pain, injury, or impairment. Such violence includes not only physical assaults such as hitting or shoving but the inappropriate use of drugs, restraints, or confinement.
- In emotional or psychological abuse, people speak to or treat elderly persons in ways that cause emotional pain or distress, including:
- Verbal forms of emotional elder abuse include intimidation through yelling or threats, humiliation, and ridicule, habitual blaming or scapegoating, ignoring the senior citizen, isolating an elder from friends or activities, terrorizing or menacing the elderly person
- Sexual elder abuse is contacted with a senior citizen without the elders consent. Such contact can involve physical sex acts, but activities such as showing an elderly person pornographic material, forcing the person to watch sex acts, or forcing the elder to undress are also considered sexual elder abuse.
- Elder neglect is a failure to fulfill a caretaking obligation. It constitutes more than half of all reported cases of elder abuse. It can be intentional or unintentional, based on factors such as ignorance or denial that an elderly charge needs as much care as he or she does.
- This involves unauthorized use of a senior citizens funds or property, either by a caregiver or an outside scam artist. An unscrupulous caregiver might misuse an elders personal checks, credit cards, or accounts and steal cash, income checks, or household goods. Some caregivers may even forge the elders signature or engage in identity theft. Typical scams that target seniors include the announcements of a prize that the elderly person has won but must pay money to claim phony charities and Investment fraud
Healthcare Fraud and Abuse: Unethical Practices in Care
Healthcare fraud and abuse are carried out by unethical doctors, nurses, hospital personnel, and other professional care providers. Examples of healthcare fraud and ill-treatment regarding elders include: Not providing health care, but charging for it, Overcharging or double-billing for medical care or services, Getting kickbacks for referrals to other providers or for prescribing certain drugs, Overmedicating or under medicating, Recommending fraudulent remedies for illnesses or other medical condition and medical fraud.
In Chinese societies, several reasons have been suggested for the mistreatment of older: people, including a lack of respect by the younger generation; the tension between traditional and new family structures; restructuring of the primary support networks for the elderly; migration of young couples to new towns, leaving elderly parents in deteriorating residential areas within city centers.
As regards sub-Saharan Africa in particular, societal and community factors include the systems of patrilineal and matrilineal inheritance and land rights, affecting the distribution of power; the way societies view the role of women; the erosion of the close bonds between generations of a family, caused by ruralurban migration and the growth in formal education; the loss, through modernization, of the traditional domestic, ritual and domestic arbitration roles of older people.
Social Policy and Programs
Various governments such as the United States government have put in place measures to ensure the information dissemination of vital facts concerning elderly abuse particularly the signs to look out for to identify such mistreatments such as Frequent arguments or tension between the caregiver and the elderly person.
United States: National-Level Response and Support Systems
The United States is furthest advanced regarding a national-level response, with a fully developed system for reportage and handling cases of elder abuse. This system operates at the state level, the federal governments involvement being limited to supporting the National Center on Elder Abuse, which gives technical assistance and a small amount of funding to the states for their elder abuse prevention facilities. A focus at the national level is also provided by the National Committee for the Prevention of Elder Abuse, a non-profit organization formed in 1988, and the National Association of State Adult Protective Services Administrators, established in 1989.
International Efforts: Australia, Canada, New Zealand
In Australia and Canada, some provinces or states have set up systems to deal with cases of elder abuse, but no official federal policy has been announced. New Zealand has established a series of pilot projects throughout the country. All three of these countries have national groups. The New Zealand National Elder Abuse and Neglect Advisory Council were formed in the early 1990s to provide a national perspective on strategies for the care and protection of older people. The Australian Network for the Prevention of Elder Abuse was set up in 1998, as a point of contact and information-sharing for those working with older people in abusive situations. In 1999, the Canadian Network for the Prevention of Elder Abuse was created with similar aims to find ways to develop policies, programs, and services to eliminate elder abuse.
European Focus: United Kingdom, Norway, Latin America
In the United Kingdom, Action on Elder Abuse, a national nongovernmental organization, has helped focus government attention on the abuse of older people, giving rise to policy documents from the Department of Health and the Social Services Inspectorate. Norway leads among the Scandinavian countries, having obtained parliamentary approval for a service project in Oslo and a resource center for information and research on violence, the latter largely as a result of action by campaigners against elder abuse.
The Latin American Committee for the Prevention of Elder Abuse has actively campaigned to draw attention to the problem of misuse of the elderly within Latin American and Caribbean countries, and it offers training at regional and national meetings. For some countries including Cuba, Peru, Uruguay and Venezuela awareness of the problem is still emerging, and activities consist mainly of meetings of professionals and research studies.
In Buenos Aires, Argentina, the organization Proteger, dealing exclusively with elder abuse cases, was established in 1998 as one of the programs of the Department for the Promotion of Social Welfare and Old Age. Professionals and other workers in this program receive 6-month training in gerontology, focusing mainly on the prevention of violence and intervention in cases of elder abuse. Proteger also runs a free telephone helpline.
In Brazil, official support for training on elder abuse has been provided by the Ministry of Justice, Health and Welfare. In Chile, as a result of the work of the Inter-ministerial Commission for the Prevention of Intrafamilial Violence, a law against violence in the family was passed in 1994.The law covered all acts of domestic violence, including those directed at the elderly.
Asian Context: Challenges and Limited Action
In Asia, studies by researchers in China (Hong Kong SAR), India, Japan and the Republic of Korea have drawn attention to the problem of elder abuse, but no official action, regarding policies or program development, has followed so far.
African Nations: Prioritizing Amidst Other Concerns
For African nations, efforts to deal with elder abuse are overshadowed by other seemingly more pressing concerns such as conflicts, poverty, and debt. With a rapid expansion of activities worldwide Most of the programs set up to tackle the problem of abuse of the elderly are found in high-income countries. They are conducted under the auspices of the social services, health care or legal systems or in conjunction with programs to combat family violence. Although elder abuse has been proven to exist in several low-income or middle-income countries, few specific programs have been established. In these countries, cases of elder abuse are handled by governmental or nongovernmental social service agencies, even though the staff of such agencies might not always be knowledgeable about the subject.
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