Will you be able to help and protect yourself when you grow frail? How can you stop elderly abuse by personality exploration and learning which pitfalls to avoid?
What You Can Do
Are you more a directive or an informative person? Do you ask for direction and easily give it? Or do you seek and give information?
Your stance can help you take action to prevent elderly abuse-for yourself and others. How will you position yourself to avoid, prevent, and stop abuse of the aged? What can you do right now?
Preliminary findings of four research studies made by the U.S. Department of Health and Human Services suggest that some potential causes of abuse of the elderly include the following:
1. The majority of abused elderly cannot care for themselves.
2. The abuser was experiencing stress. Often the elderly victims and the care they required were identified as the source of stress.
3. Violence begets violence. It’s banked throughout life and spent on the person who has the least power over us. Sometimes violence continues from generation to generation as the normative response to stress.
4. Most older individuals are not abandoned by their children. Seventy-five percent of the elderly live with these children or live less than 30 minutes away. Eighty percent of home care to the aged is provided by family members living in the same household.
5. The middle aged adult today is more likely to have a living parent than his counterpart of the past.
What Causes Violence Against The Elderly?
6. Economic and population changes are the number one causes because they affect the caretaking abilities of adult children. As medical costs increase, so does stress on the person paying the bills. The demand for alternative living arrangements is increasing. Service availability is inadequate.
7. Change creates the potential for abuse. Change is seen as stressful. The sense of control over the caretaker’s life as well as the older person’s life is decreased.
8. As dependency increases, so does violence.
9. Mental and physical impairment often angers caretakers because it increases their frustration.
10. The inability to see the parent in any way other than the parent role can create conflict as the dependency of the older person increases.
11. The married couple in conflict may batter each other.
12. Many people believe a marriage license is a hitting license. University of Ontario studies show over 50 percent of married men lose respect for their wives and beat them when under stress by doing anything from filling out a tax return to having a car stall or being served. Mature people who can’t care for themselves are focused on survival needs. The family is the usual source of emotional, physical and financial needs.
13. Physical impairments and social losses make the elderly vulnerable to crime and abuse by family members or unrelated helpers who are more interested in the older person’s money or possessions than in caring for those who are no longer able to care for themselves.
14. The typical abuser is a 35-year old grandson with a history of addiction to drugs, alcohol or foods, separated from his wife and children, whom he also abused. He tends to steal money, food and possessions from the elderly infirm.
Also common is the son’s wife who resents the older mother-in-law for not being more generous with time and money, especially focused around her inability to baby sit the grandchildren due to her disability. In some cases, the son’s lack of attention to his wife and possibly children is reflected in the hostility of the daughter-in-law to the infirm mother-in-law, especially when her own mother has passed on.
15. Abuse is the produce of a) social isolation, b) lack of treatment for illness c) disturbed family functions.
16. Abuse is rarely found among the elderly in housing projects or among the elderly who are an integral part of the standard family system or community.
17. Abuse is commonly found where there is a lack of resources in a non-protective living environment such as time limits on emergency shelters. This causes premature institutionalization.
18. Services are perceived as threatening to the family.
19. The types of abuse include: physical, verbal, medical (too many drugs to keep the elderly still or lack of medical care), psychological assaults, financial, misuse of property, and violation of rights.
20. Isolation leads to emotionally disturbed behavior resulting from prolonged lack of sensory stimulation.
21. The elderly are talked down to as if they were toddlers. There is loss of respect and intimidation by society and sometimes police brutality. Persons ill from medication are sometimes thought to be drunk and arrested. Seniors are sometimes falsely arrested for shoplifting because the media tells us the majority of shoplifters are poor seniors or senile seniors.
22. Abuse always occurs when there are no witnesses.
23. The victims cannot or will not tell or they deny abuse.
24. Pigeon drop schemes trick the older person out of money. Persons imitating police officers or bank examiners ask a person to withdraw money or someone says he found money.
25. Financial fraud is always committed by people who look as if they were honest.
26. Family members or friends have the senior’s accounts transferred to their own banks when the older person becomes dependent.
27. The person who handles the older person’s money will end up with it.
28. The obstacles to acknowledging financial abuse are: a) fear b) pride c) embarrassment d) lack of access to services. Older people who cannot care for themselves also have difficulties banking by phone or banking and shopping by Internet use, which may be unavailable, or they may not be able to see or hear well enough to use equipment, or may not be able to afford computers. If there are age-related, chemical, or genetic cognitive disorders, they may not be able to learn to use technology.
29. Self abuse includes refusal to eat properly or to accept needed care and medical help. It occurs when the person lives alone and can include excessive drug use.
30. Neighbors are too frightened to deal with abuse.
31. Most of the abused seniors were found to be widowed and living alone in private homes. They were not able to walk without aid of another person or a wheelchair or walker. Most were confused or incontinent or had a visual or hearing impairment. Over 3/4 of all abused elderly persons had at least one major physical or mental impairment and 87 percent lived at home, according to a recent study of the elderly abused by Human Development Services.
32. Violations of rights include being forced out of one’s dwelling into another setting–most often a nursing home.
33. Physical abuse includes beatings, lack of personal care, lack of food, lack of medical care and supervision.
34. Psychological abuse includes verbal assault, threats, fear and isolation.
35. Material abuse includes theft of money, property, misuse of possessions or trickery such as the pigeon drop scheme.
36. Violation of rights includes being forced from one’s home or a nursing home, being dumped by the nursing home a hospital’s emergency room and left there unclaimed, and being manhandled or arrested by the police.
37. Of abused elderly persons, three fourths are physically abused and over half incur psychological abuse.
38. The elderly react to abuse by denial followed by resignation, withdrawal, fear and depression. Few seek protection on their own because they can’t move about or are mentally confused. Denial protects the abuser.
39. The abuser beats the elderly person because of perceived mistreatment by someone who has power over him and he lets out the anger on the helpless person under his care.
40. The abuser has suffered early life dependency conflicts in which hostility to and dependency on the abused person are entwined. The abused person makes the abuser feel guilty, and he hits because it releases the guilt and anger. Abuse may increase the guilt. So he hits again.
41. Violence usually escalates. Once you hit, it’s easier to hit the same person again-harder.
42. Care of the elderly becomes a burden carried by great ambivalence.
43. The abuser who is a child of the abused elderly hasn’t matured enough to see the elderly parent as a person with his/her own rights, needs and limitations. He can’t see the elderly person had a life long before his child came into the world.
44. Such an adult child in his 40s or 50s can’t be dependable without taking on a parental role.
45. Adult children are no longer legally responsible for the care of elderly parents.
46. Children see the dependent parent as stilling his relationships.
47. Society sees grown children as panaceas. Smaller families offer less support, greater burdens of stress and more beatings.
48. Caregivers who themselves are elderly, ill and mentally disturbed are common.
49. Community resources are less available to the elderly cared for by the family than to the isolated elderly.
50. Anyone in conflict and under stress is a potential abuser. Impatience may be a problem in caregivers. Most often when the older person does not give full attention to the abuser, it provides a reason for abuse.
51. Constant negative responses and personality conflict in conversation escalate bickering into violence.
52. Parents who have cared for schizophrenic, retarded, and alcoholic children throughout their adulthood are now left in these children’s care. They can become neglectful or abusive due to their inability to make judgments or perceptions with the best choices for their parents.
53. Abusive people are generally not aware of their behavior.
54. The chronically ill person who is elderly and mentally confused is not valued by society. His money, if any, may have dwindled.
55. Fear of loss of control or loss of independence can cause self abuse, such as refusing to eat or take medicine.
56. Good adult protective laws may not be enforced if the situation is not brought to anyone’s attention. Younger neighbors may never think to check on the elderly person or couple next door if they assume family is looking after them or see relatives around the home.
57. The abuser can be the young couple the elderly person met in a supermarket and took in to live with her. They slowly gain access to her checkbook or clean out her possessions. The abuser can also be a neighbor, friend or any family member.
58. Through home aides, intervention can be started and positive interactions can be substituted for institutionalization.
59. Most elderly people wonder why they should be institutionalized if an abuser is violating their rights.
60. Caregivers feel “tied-down” to the elderly.
Esther Rains, Director of the Ombudsman Program of the Area Agency on Aging (AAA) headquartered in San Diego during the nineties, said back then, “The elderly battered woman often refuses to tell people about the abuse because that man is all she really has. And she would rather believe that somehow she deserved the abuse than to believe that she didn’t have anybody.”
It’s hard to get a message to the elderly because fundamentally they deny that they are being abused. “If the senior citizen has only one relative that she can depend upon for companionship and that she believes cares for her, something is better than nothing at all,” Rains admitted. “It’s just like the abused child who thinks by protecting the abusing parent, the home is kept together.”
Actually the parallel between the abused child and the abused elderly person is nearly identical. Both would rather deny and protect the abuser out of fear of being pulled from the home which is seen as security. Low self esteem, illness, and fear are reasons for the denial.
“If my own husband or child treats me this way, how will those cold, cruel aides treat me in a nursing home when they are paid minimum wages and often are hired from the ranks of recently discharged ex-mental patients?,” reasons the elderly person. “My husband or child is supposed to love and care for me when I’m old. Why else have children or get married?”
“Abuse is really the result of pressures on the whole family,” Rains explained. “There are seven kinds of abuse: neglect, physical abuse, psychological abuse, verbal abuse, financial abuse, legal rights abuse, and medical abuse.”
Physical abuse befalls the senior who is physically dependent -chronically ill or debilitated. If you’re too weak to walk out of the home and move elsewhere, you are helpless and at the mercy of a person who feels so powerless and burdened by your care and his own problems, that he will risk anything for one moment of absolute power. That’s his case for releasing bottled up rage.
Often mentally ill children are the only persons left to care for their elderly parents. Rains said, “Very often there are situations in which an older person is physically dependent and emotionally independent. If that someone named to look after the older person is mentally deranged, then the older person is a sitting duck.”
Rains says this problem is fairly common. “For example, if a son has been in Patton State Mental Hospital and is released and lives on disability, he can say ‘I’ll take care of mother because I’m home all the time.’ “
Does she see a lot of this? “Not a lot,” said Rains, “but more than I’d like.”
Elderly persons left in the care of an already overburdened person who doesn’t really want the caretaking role can result in anything from locking the senior person in a room all day, threatening to withhold food, expressing exasperation, shoving or hitting.
“The person who is most likely to be home and is the hour to hour caretaker is most likely to be the abuser,” says Rains. “There are more old ladies abused than old men because there are three times older women around.” With financial abuse, Rains said, the Area Agency on Aging (AAA) sees more of that than any other kind of abuse.
“A typical case,” said Rains, “is where there’s a caretaker and the elderly person is thought to be both physically and mentally disabled. What they do is simply use the older person’s money as their own.”
Whether the person is slightly mentally disabled, just depressed, or can be cured with vitamins is a moot question. Who has the right to judge? “The older person doesn’t object for the simple reason that if she did, she would lose her caretaker,” Rains disclosed.
That’s the time when Adult Protective Services comes into the picture. The actual role of Adult Protective Services to the senior citizen is to go out to people’s homes upon getting a complaint from neighbors, family, doctors, or the person him-self.
A typical reason for calling Adult Protective Services (APS) is if your apartment is so arranged that you can’t take care of yourself or do ordinary housework, of you can’t get a rental because you have severe medical problems, or you can’t follow doctor’s directions on taking medicines, you’re forgetful and leave the gas on. APS tries to send a caretaker into the home so the old person will not have to leave and go to a nursing home or mental hospital.
“What we really are doing,” says a spokeswoman from Adult Protective Services,” are sorting things out, rearranging things so that the older person is able to manage life in his own home.”
Occasionally APS will find older people in their own home, surrounded by “loving” children and grandchildren, and the incontinent elderly person is lying covered with his own excrement and full of bedsores deep as the bone. The procedure APS follows to correct the situation is to advise, assist, persuade and assign medical care. APS will arrange to have doctors and lawyers in mobile vans to come to the home to give services, but not to every location in the county.
Also, as another alternative to nursing home care, APS has Adult Day Health care Centers. APS takes the people for the day and brings them down to the Centers and will provide nursing care, social services, rehabilitation, physical and occupational therapy, and speech therapy.
“The first thing we do is get in touch with the individual’s doctor,” said a spokeswoman for APS. “We’re not talking about a person who’s bedridden, but someone who cannot get out by himself or who’s not safe left alone.”
When the person is bedridden, the question is who is taking care of her or him? Some alternatives to a battering spouse or frustrated children could be homemakers, attendants, home health aides, home health nurses, public health nurses. However, most people who can’t afford the high premiums of long-term care insurance at an advanced age with little savings may not be able to afford home health care unless they are financially destitute.
The fear that the house will be taken away or savings used up instead of going to grandchildren is another problem. Whether any one of these alternatives is going to be brought in depends upon the individual characteristics of the case and the size of the family.
What guidelines would APS give an abused older person with no money of her own seeking help?
1) Ask for outside help. APS can provide help fast.
2) Phone the District Attorney’s office for abuse cases, especially financial abuse or fraud. Bill Holman, San Diego Deputy District Attorney, recently won an important law suit and case against the Casa Blanca nursing homes. Other nursing home suits are in the files of the District Attorney’s office.
3) Or you can phone APS and they can intervene. APS can also call the District Attorney for you.
4) Phone Pro-Tech, Senior Citizens Legal Services. Pro-Tech is funded by the federal government to help the elderly free of charge and will send a paralegal to your bedside. They are known for sending legal help to bedridden elderly persons.
5) Call the Area Agency on Aging (AAA). This organization maintains an Ombudsman Program. An ombudsman will go inside any nursing home to evaluate how it treats any person and report findings to such organizations as the licensing bureau. Contact is made with the district attorney, and others who can help any abused elderly person. The AAA has a referral service that will put a person in touch with any one of the other services that they think they’ll need.
6) For mental health problems or abuse, phone Senior Citizen Program, through County Mental Health.
7) If you are able to walk and care for yourself and are being beaten by a family member, go to a Battered Women’s Shelter, sometimes called a Safe House. They will provide a room and help, if they are not full. However, the safe house may be full.
Each week a support group meets. The battered women’s hotline reports that older women in the shelter are in-creasing. But this is not a place of permanent residence.
Anyone who goes into the home and reports abuse is able to refer the elderly person to any of the available services. If you get a home health aide, nurse in the home, a welfare worker, someone from the District Attorney’s office, a paralegal, or someone from the Mental Health Counselor’s office to come into the home and you or someone else reports the abuse, help can be started.
Look into the possibility of contacting a free of charge home health aide provider service if there is abuse in the home. Any one of those people could intervene for you. Contact your local Area Agency on Aging and ask whether there is available a free of charge home health aide in the case of family elderly abuse. The police might intervene. But the police can usually only take you to a hospital or make a report and refer you to other channels, usually medical.
What you’re looking for is someone to come to the home first and secondly have legal clout to get you the best possible alternative care or whatever you want for yourself. For the elderly person who’s mentally disoriented, there’s the problem of obtaining a guardianship or conservatorship.
When you first call the APS, for example, they would immediately send out a social worker to your home. So would several other agencies. Back in the nineties, Wayne William Daniel Miller, Director of the Office of the Counselor in Mental Health, Mental Health Services for the Superior Court of San Diego explained that once the first shove or abuse is dealt, it becomes easier and easier to abuse the next time. He didn’t advise waiting to see whether you can be perfect enough to control the battering.
Miller explained an example of wife battering in the golden years: “An 87 year old woman, who as a result of diabetes had her leg amputated, was restricted to the home under the care of her 88-year old husband. “The husband had been a moderate (social) drinker through-out his life. The drinking problem increased after retirement.”
Also see the article, “60 Points You Should Know About Elderly Abuse” originally has been published at the Go60.com site in 2007 and also in Anne Hart’s 2002 nonfiction book,How To Stop Elderly Abuse: A Prevention Guidebook. Published: July, 2002, paperback. Pages: 515. ISBN: 9780595235506. Anne Hart is the author of more than 91 books. Website is at Anne Hart’s Novels and Non-Fiction How-To Books.