Elderly Health
Elder Abuse

​​Overview:

By elder abuse is meant the violent treatment or neglect by a caregiver to the older person, in a manner that causes harm to him. That harm may be an emotional suffering, a bodily injury, pain, denial of his human rights, or affecting the quality of his life.

Elder abuse as defined by WHO:
 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.

Names:
Elder abuse

Types of elder abuse:

Elder abuse is of several types:

Physical abuse: is any action that intentionally causes pain, a bodily harm, a severe or chronic disease, etc.

Psychological or emotional abuse: is any verbal or non-verbal action that emotionally hurts the older person, or causes him to be afraid or sad. Such actions include hurtful words, yelling, threatening, etc.

Financial abuse: is the illegal use of the older person’s money or possessions without permission.

Sexual abuse: involves forcing an older adult to be part of any sexual acts.

Neglect: occurs when the caregiver does not try to respond to the older person's needs, or protect him.​​

​Signs of abuse:

  • Physical abuse: 
    • Unexplained bruises, wounds, burns, or scars.
    • Unexplained fractures or bruises.
    • Broken glasses or eyeglass-frame.
    • Signs of violent treatment (e.g. sings of handcuffing).
    • The caregiver refusing to allow the older person to have a private conversation with the visitor.
  • Mental or emotional abuse:
    • Threatening, insulting or humiliating the older person by the caregiver.
    • The older person’s behaviors are similar to those of senility (e.g. nail-sucking, self-talking, etc.)
  • Financial abuse:
    • Withdrawing a large sum from the older person’s bank account.
    • Abrupt change of the older person’s financial status.
    • Disappearance of money.
    • Suspicious changes in the older person’s will or power of attorney (POA).
    • Activities or transactions on the older person’s bank account that he can’t do (such as withdrawal of a large sum while he is bedridden).
  • Sexual abuse:
    • Bruises near the breasts or genitals.
    • Unexplained vaginal or anal bleeding.
    • Stained or torn underwear.
  • Neglect:
    • Unexplained weight loss, malnutrition or dehydration.
    • Medical conditions caused by neglect (e.g. bedsores).
    • Signs of neglect (for example, if the older person looks messy, with unwashed hair or dirty clothes).
    • Wearing cloths inappropriate for the weather conditions.
    • Living in improper or unsafe places (e.g. dirty places inhabited by insects, places including uncovered electrical cables or unsafe connections, or places in which no running or hot water is available).
    • Leaving the older person in a public place.

Who is at risk?
  • The weaker the older person, the greater the risk of abuse;
  • Women are at higher risk than men;
  • The older persons not surrounded by their families or friends;
  • The older persons with disabilities or suffering dementia;
  • The persons depending on others for daily care (e.g. bathing, dressing, medical care, etc.).

Risk factors:
  • Drug or alcohol addiction by the caregiver.
  • Severe anxiety and stress.
  • The caregiver suffering depression.
  • Lack of social support.
  • Severe diseases or dementia.
  • The older person's maltreatment of the caregiver at a younger age.
  • Domestic violence.

Consequences of elder abuse:
The consequences of elder abuse are of two types:
  1. Health conditions, including:
    • Injuries
    • Permanent disabilities
    • Deterioration of the health condition
  2. Mental or psychological problems, including:
    • Solitude
    • Hopelessness and lack of confidence
    • Anxiety

How to avoid elder abuse?
  • Role of those around the older person: 
    • Observe the signs or abuse, and report them immediately;
    • Figure out how to support older persons and report any abuse they may be exposed to;
    • Visit the older person on a regular basis;
    • Offer care to the older person every now and then, to allow the caregiver to take rest;
    • Pay attention to the older person’s medicine schedule;
    • Check the older person’s bank accounts, by way of taking his permission and tracking the transactions.
  • The older person’s role: 
    • Keep in touch with your family and friends;
    • Take care of his health;
    • Plan for your future;
    • Know your rights;
    • Have a personal phone;
    • Have access to the means of communication (e.g. email, phone, etc.);
    • Don’t give your personal information over the phone;
    • Seek help from the entities offering it (e.g. drug control, mental healthcare, etc.);
    • Engage in support groups that provide protection against domestic violence, and learn about the services they offer;
    • Seek the advice of a trusted person before signing any documents;
    • Make sure that your possessions have not been dispensed of without your permission;
    • Review the will every now and again.

How to handle elder abuse?
  • Avoid direct confrontation with the abuser; this may result in greater troubles for the older person—unless you are able to move the older person to a safer place;
  • If the family members suspect that the older person has experienced abuse, it is advisable that a group of them attempt to convince him to get better care—he is likely to respond to the advice given by a group;
  • The abuse may be embarrassing to the older person; therefore, the earlier the intervention the better.
  • In case of neglect, the following guidelines are recommended:
    • Even if the older person rejects intervention, it will still be advisable to keep an eye on him, check his health condition, and pass by every now and then.
    • Secure access for the older persons to health services—it’s also recommended to let the doctor know about your worries that the older person may neglect his health;
    • Secure domestic services for the older persons (e.g. home delivery services, a personal assistant, etc.), and attempt to convince him by enumerating the favorable impact of such a move.

To the caregiver:
Caring for the elderly is a noble act for which Allah will reward you. This is not to say that it is an easy task. A caregiver is expected to organize the older person’s diet, care for his health, pay attention to his medicine schedule, and when to head out to the hospital, and so forth. A caregiver may need to quit his work to have the time and energy for caring for the older person. As the pressures of caregiving accumulate, the caregiver may not be able to proceed as efficiently, which may result in unintentional neglect of the older person, or treating them violently.

Tips for the caregiver:
  • Take care of yourself, maintain a healthy diet, exercise, and maintain a healthy lifestyle; 
  • Take a rest for selfcare;
  • Seek the help of other family members and friends;
  • Seek the help of a healthcare or social service center;
  • Handle pressures immediately, and try to alleviate them;
  • Learn anger control mechanisms;
  • Seek the help of other on the onset of depression symptoms;
  • Join the groups of caregivers, share with them your experience and the challenges you are facing, and discuss the solutions;
  • Seek help if you encounter a case of drug-addiction, etc;
  • Seek medical help from medical professionals when necessary.


Clinical Education General Department
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