The subtle signs of elder abuse
My kids are lucky enough to have healthy, fit and loving grandparents with whom they have a very special connection. Despite two of them living half a world away, they are close to them all. I hope they view them as wise, kind influences in their lives: people who will always cheer them on from the sidelines, even if just in a metaphorical way. People who are forever keen to hear about the latest success at school or on the soccer pitch, are interested in their lives, and supportive of their choices. They’re lucky indeed.
Sadly for many older people, respectful, loving, caring and nurturing relationships are not the norm, and in a world where we all seem to be increasingly busy and pre-occupied with our own lives, abuse of our elders is common and often unrecognised.
This isn’t a problem confined to New Zealand. Globally, this is a huge issue as well, with between 3 and 10 per cent of older people reporting abuse of one kind or another. This horrifies me.
In my mind it’s pretty simple – the older people in our community are the ones who deserve the most attention, care, respect, and time.
They have shaped our society, formed our families, and this is their time to sit back and enjoy that – hopefully in an engaging, supportive environment where they can thrive, surrounded by people who love them and who want to learn from their wisdom.
Instead of this idyllic and perhaps overly simplistic view of old age, the reality is that many older New Zealanders will end their days feeling frightened, confused, alone or in pain.
They will have been the victims of abuse, at a vulnerable time of life when they had the right to feel protected, safe and nurtured.
Abuse in this age group can take many forms – yes, it can be as obvious as a black eye from a push, or bruises from being slapped – but it can be, and usually is, far more subtle:
❚ Neglect – where the physical and emotional needs of an older person aren’t met. This can include failing to provide the basics such as food, clothing, warmth, shelter, healthcare, and assistance with personal hygiene, or often a more subtle form where emotional support and social contact are withheld.
❚ Psychological abuse – any behaviour that leads to unnecessary fear, stress or anguish for the older person. This can include verbal abuse, threats, harassment, humiliation, ridicule, withdrawal of emotional affection, social isolation or excluding the older person from being involved in decisionmaking.
❚ Physical abuse – although this can involve actual assaults, it can also include things such as force-feeding, physical ‘‘punishments’’, or using unnecessary force to mobilise or restrain someone. ❚ Sexual abuse – any inappropriate or nonconsensual sexual behaviours or acts, especially in people who are cognitively impaired and no longer have the capacity to consent.
❚ Financial abuse – this type of abuse is common and, I suspect, often undetected. It can include things such as not paying the bills for heating, power or residential care when you are ‘‘looking after’’ an older person’s finances, removing or selling their belongings without their consent, or living in their home without contributing to the overheads or upkeep. ❚ Institutional abuse – where an institution fails to provide for the cultural, emotional or physical needs of an individual. This can be as simple as insisting on a meal at a set, rigid time of day that doesn’t feel right for the older person, ‘‘rationing’’ incontinence products, or failing to acknowledge and address their cultural needs.
Abuse doesn’t choose particular cultures, gender, backgrounds or ethnicities – it can affect anyone – but we do know that some people are especially vulnerable. This includes people who are physically or mentally frail, through illness, dementia or mental ill health; those who need to rely on caregivers; and ‘‘non-verbal’’ older people,
Abuse doesn’t choose particular cultures, gender, backgrounds or ethnicities – it can affect anyone – but we do know that some people are especially vulnerable and at risk.
who aren’t able to communicate about things that may be distressing.
It is also more likely to happen in families where there has previously been conflict or difficult relationships. Often it is the carers themselves, whether family members or paid caregivers, who inflict the abuse. Although this can never be excused or condoned, I suspect if we had a system that better supported our carers, financially and emotionally, this would be much less of an issue.
There is no simple solution to this widespread and awful problem – supporting and enabling our caregivers to provide a safe, loving, nurturing environment for older people is undoubtedly a part of it, but raising awareness and trying to change the societal attitude to our elders is the bigger and more challenging part of the puzzle.
For my part, I hope I am raising children who respect, include, support, honour, enable and love the older people around them – for one day, they may well be the caregivers themselves.