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Elderly Abuse: The Sad Reality

Last week a member of the SAGE community (and a dear friend) reached out to ask for prayers. In the past few years, her father has developed a condition that rapidly induces dementia and Alzheimer’s.  Sadly, a fight over both his care and money has broken out among family members and taken a lot from her. She could use our prayers as she fights those in his life looking to profit off of the situation.

After having discussions with her and reflecting on my own grandparents, I thought that a deeper dive into Elderly Abuse was something we could tackle here in the SAGE community.  I was shocked to find that elderly abuse was more common in those who had both suffered abuse in their lives and those who perpetrated it.    

So lets take a closer look…

The Stats

According to the National Council on Aging, up to 5 million older Americans are abused every year!  Can you guess what the estimated annual monetary loss in the US is?  An INSANE 36 BILLION DOLLARS.  That’s right BILLION.  Elderly abuse costs seniors billions of dollars.

Why is it only an ‘estimate’?  Good question.  The reason these numbers are only estimates is because elder abuse often goes unreported. Elder Abuse is classified into many categories.  It is easy for abuse to go undetected and therefore unreported.  Only an estimated 1 in 24 cases are actually reported.

Contributing Factors

There are a lot of risk factors for elder abuse, but the biggest culprits are social isolation and mental impairment due to dementia or Alzheimer’s. 

My grandmother was blessed, depending on her mood, to live until she was 95. During her last few years, she needed more assistance than my mother could physically handle so we found an assisted living facility nearby to help with care.  My mom went every day and there was a steady stream of visitors to keep Grandma occupied, but it was still hard.  While she retained most of her faculties and carried on lively conversation, she found it difficult to connect with other residents, leading her to isolate in her room.

Even with all the visitors and staff I know she struggled with being alone.  Her freedoms to move about like she pleased were gone.  Most of her friends had passed away and she found it difficult to carry on conversations with many of the other residents.

Although she didn’t always show it, I know my grandma was happy to have our family and friends as consistent visitors.  She would comment on the number of residents who said their children were too busy or who were simply alone.  Its sad to realize how true this is for so many elderly people in the United States. 

Let’s take a deeper dive into Social Isolation.

Social Isolation

In the book, Social Isolation and Loneliness in Older Adults, The National Academy of Sciences describes social isolation as “the objective state of having few social relationships or infrequent social contact with others.” They define loneliness as “the subjective feeling of being isolated.”  The book went on to site seniors who lacked a friend group, church community or a link to the outside world as the most vulnerable.  To add insult to injury older adults who are socially isolated had an increased risk of mortality.  It is suggested in the book that healthcare systems can play a bigger role in creating community among the elderly as a form of treatment/potential disease prevention.  Society should be able to help with that as well.

When I was in high school my church started a youth volunteer program at the local assisted living center where we would help take the residents from their rooms to the chapel every Sunday.  We would sit with a group of a few seniors and help them manage their hymnal and follow along as needed.  This wasn’t a particularity exciting way for a teenager to spend an afternoon but looking back I see how special that was.  Some residents wanted to tell you all about their lives and how their week was.  Others never said a word.  I can’t help thinking what a difference it would make if more of us spent time with them.  We could lift the loneliness, if only for a few minutes.

It is important to note that not everyone over 65 is lonely or experiencing social isolation, however, it is one of the biggest risk factors to elder abuse and mortality.  Maybe we can make a difference.

Immigration/Ethnic Differences

While researching this article I came across a study out of Canada that provided a look into elder abuse among immigrant communities titled Elder Abuse Risk Factors: Perceptions Among Older Chinese, Korean, Punjabi and Tamil Immigrants to Toronto.

The article explained that migration to a new country often changes the family dynamic.  The younger generation is expected to take on different roles such as cultural liaison, interpreter, and caretaker.  The study argued that migrant parents are more reliant on their children now than they would have been if they stayed in their home country. If the children and family are unwilling to play that role, this increases the risk for elder abuse or neglect. It is also important to highlight that many older immigrants do not qualify for social programs like Social Security or Medicare. 

The study went on to ask members of each community what the biggest issue was, in their opinion. For the Korean community the most prevalent risk factors were social isolation, financial dependance on family and lack of English.  However, for the Chinese population financial dependence, physical dependence and emotional dependence were the biggest concerns. For the Tamil population, English proficiency was the biggest issue and for Punjabi it was social isolation.

Regardless of ethnicity, we owe it to all elder communities to make sure they are protected later in life.

Now let’s talk about Types of Abuse

Physical and Sexual Abuse of the Elderly

Elderly physical abuse is defined as an illness, pain or injury caused by hitting, kicking, pushing, slapping, and burning.  Elder sexual abuse is defined as forced or unwanted sexual interaction when the victim is over 65 years old.

We never ever want to hear these kinds of stories, but they happen and it’s important to talk about it in hopes of stopping future abuses.  According to the CDC, from 2002 to 2016 more than 643,000 older adults were treated for abuse in the ER and there were over 19,000 homicides that resulted.  Men had a higher rate of hospitalization compared to women and men in minority groups were more likely to be victims of a homicide. 

As far as sexual abuse goes, most cases are left unreported, about 70%.  You might be surprised to learn that most of the sexual abuse is by a family member and/or primary caregiver.  The victim often does not report because either they don’t have the mental capacity or they fear they won’t be believed.  The lack of options and outside support leave the elderly extremely vulnerable.

If any elder abuse is suspected the best course of action is to call adult protective services.  To find more information and local resources visit the National Adult Protective Services website.

Abandonment

For some of us we cannot fathom abandoning a loved one in need.  But it happens and according to the CDC the largest risk factors as to why a spouse, child or other family member might choose abandonment is past family conflict.   Often this includes past alcohol or drug use by either party, past disruptive behavior, and inadequate coping skills by one or both parties.  Childhood trauma both inflicted by and perpetrated by the parent is also a cause of abandonment.

Financial Abuse

Sadly, in many cases the fight over money takes center stage.  Money can be very stressful and figuring out what money goes where and to whom can often put elderly persons into dire straits.  Children and spouses are forced to decipher an algorithm of assets that they were never meant to understand.  What are the bank records? Who needs to be paid? Where does the money go?

Then you have the family members who misuse funds for their own gain.  If the elderly person has any type of memory issue, this is extremely concerning as they are no longer in control of their day-to-day bills.  Money could be spent elsewhere, and they would never know and suddenly they don’t have enough money left for basic care.  Financial Abuse is almost always perpetuated by a child or spouse.

Although its never easy, planning for your future with a lawyer or accountant can help eliminate potential financial abuse in old age.

Neglect and Self-Neglect

Neglect is defined by the CDC as a failure to meet an older adult’s basic needs i.e., food, water, clothing, hygiene, and essential medical care. There is debate about the definition of Self Neglect but the NIH defines it as the ‘inability, due to physical or mental impairment or diminished capacity, to perform essential self-care.” Unfortunately, elder Self Neglect is a growing problem in the United States. 

Think about all the elderly people out there who don’t have family or don’t have family who is willing to help care for them. Perhaps family doesn’t have the ability to care for them or the mental capacity to find appropriate help.  As you can imagine, social isolation only contributes to the problem of self neglect so check in on your elderly loved ones if you can.  Neglect and Self Neglect are easy to slip into and hard to correct.

Conclusion

If you made it all the way to the conclusion, thanks, I know this is a very hard topic to discuss.  There are so many different types of abusive relationships and part of our mission at SAGE is to educate without judgement.  Some of you, like my friend, may be fighting for your loved one’s safety and security.  Others may be dealing with fractured and broken relationship with an elderly parent and reckoning with past abuses.  This article was simply intended to highlight elderly abuses in hopes of making a difference.

If you would like some more information or to volunteer, check out the American Society on Aging at https://www.asaging.org/

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