Sunday, November 16, 2008

University of Illinois Extension - ELDER ABUSE & NEGLECT - definitions, cases, abuser characteristics

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Definitions

Physical Abuse

Using physical force that results in physical pain or injury.

Sexual Abuse

Nonconsensual sexual contact with an older person.

Emotional Abuse

Verbal assaults, humiliation, threats, harassment, intimidation, or other abusive behavior.

Neglect

Failure to make provisions for personal care (food, shelter, medical care, social contact), or forceful confinement or restraint of the older adult (either intentionally or unintentionally).

Financial Exploitation

The misuse or withholding or an older adult's resources by another, to the older adult's disadvantage.

The Victim

The typical victim of elder abuse is a widowed, white female in her mid-70s or older, and living on a limited income. The older person usually lives with the perpetrator, who is often a spouse or adult child. Elder victims often do not report being abused. Fearing retaliation by the abuser, being ashamed of the situation, or worrying about having to leave one's home are some of the reasons older adults do not report abuse.

The Abuser

The typical abuser is most often the adult child or spouse of the victim, although older family members and nonrelatives may be perpetrators. The abuser may depend on the older person for housing, financial assistance, or emotional support. Research indicates that caregiver stress, alcohol or substance abuse, and emotional and/or financial problems are factors in many instances of abuse

Case 1

Is This Elder Abuse?

Alice, 75, a widow, lived in a small apartment with her son, Frank, 54. Frank had been in and out of drug and alcohol treatment centers for years, but was doing well for the last six months since he moved back in with his mother. Alice knew here son had nowhere else to go so she took him in under two conditions: he had to find a job and he could not drink.

Frank found a job and things seemed to be going well until he stopped coming home right after work. Alice knew he was stopping at the corner bar because she could smell the alcohol on his breath. The third time this happened, Alice confronted her son. Frank immediately became belligerent, verbally abusing her and forcing her to go to her room. The next night Alice confronted him again threatening to throw him out if he continued to drink. Frank became enraged and started running toward his mother with his fist raised over his head. Fearing for her life, Alice fled to the safety of her neighbor's house.

Case 2

Is This Elder Abuse?

Carol, 24, divorced, lived on the second floor of an apartment with her two young children. Living below her on the first floor was Beatrice, 86, a nice old lady who didn't leave here apartment very often because of her arthritic knees and poor eyesight. Carol and her children visited Beatrice frequently and often helped with her laundry in exchange for occasional babysitting. Beatrice loved their company.

Every Saturday, Carol offered to do the grocery shopping for Beatrice. Because she could not do it herself, Beatrice was happy to accept Carol's help. Carol thought it was okay to keep $20 of the change each week because she was taking the time and trouble to help Beatrice; although, she was never offered any money. Carol thought Beatrice would never realize the money was missing because of her poor eyesight.

A RealityWarning Signs of Elder Abuse and Neglect

Just as there are many types of abuse, there are also numerous signs or symptoms that abuse may be taking place. The following signs do not always indicate an abusive situation, but can be important clues to possible abuse or neglect.

Symptoms of an Abused Older Person

  • Unusual or unexplained injuries (cuts, bruises, burns)
  • Unkempt appearance
  • Pressure or bed sores
  • Confinement against will (tied to furniture or locked in room)
  • Dehydration or malnutrition without a medical cause
  • Fear
  • Withdrawal
  • Depression
  • Anxiety
  • Visits to many doctors or hospitals
  • Strange and inconsistent explanations for injuries
  • Helplessness
  • Hesitation to talk openly
Symptoms of an Abuser
  • Verbally assaulting, threatening or insulting the older person
  • Concerned only with the older person's financial situation and not his or her health or well-being
  • Problems with alcohol or drug abuse
  • Not allowing the older person to speak for him- or herself
  • Blaming the older person
  • Attitudes of indifference or anger toward the older person
  • Socially isolating the older person from others
In both scenarios it is clear that elder abuse is a disturbing reality in today's society. The risk of being abused, neglected or exploited is real for many older people. Family members or other caregivers are most often the abusers. The problem crosses all geographic, socioeconomic, racial, and ethnic barriers.

According to the National Center on Elder Abuse (NCEA), "Elder abuse in domestic settings is a widespread problem, possibly affecting hundreds of thousands of elderly people across the country. However, because it is still largely hidden under the shroud of family secrecy, this type of abuse is grossly underreported." In fact, many experts agree that the reported numbers represent only the "tip of the iceberg." It is estimated that only 1 out of 14 domestic elder abuse cases is reported to the authorities.

In Illinois, it is estimated that four to five percent of the older population (approximately 80,000 persons) is abused. Only 5,000 cases or so are reported each year. Currently, six out of ten reported cases are substantiated after investigation.

Types of elder abuse may include physical, sexual, or emotional abuse; neglect, or financial exploitation. It is possible that more than one type of abuse may be suspected in any given case. Financial exploitation and emotional abuse are the types most commonly reported in Illinois.


The Elder Abuse and Neglect Program in Illinois

The Illinois Elder Abuse and Neglect Act became law in 1988 and called for the state to address the problem of domestic elder abuse. As a result, the Elder Abuse and Neglect Program was implemented under the direction of the Illinois Department on Aging (IDOA). This statewide program was established to respond to reports of alleged elder abuse, neglect and exploitation and to work with the older victims in resolving abusive situations. Services are available to those age 60 and older who live in the community. The State Long Term Care Ombudsman Program responds to many types of complaints from nursing home residents, including reports of abuse and neglect. The agency responsible for investigating allegations of abuse or neglect in long term care facilities, however, is the Illinois Department of Public Health.

After a report is made, trained case workers assess the situation and provide information and assistance to help the older person and family resolve their problems. Many different programs and services, include but are not limited to, respite care for the caregiver, adult day care, housing assistance, and nutrition resources.

As of January 1, 1999, professionals are required, for the first time, to report suspected abuse, neglect and exploitation of persons over 60 who, because of dysfunction, are unable to report themselves. The mandatory reporting requirement applies only to an older person who is unable to seek assistance for himself or herself in order not to compromise the older person's right to self-determination. Voluntary reporting continues to be encouraged for suspected mistreatment of older citizens who have the ability to self report.

Mandated reporters include a range of professionals in the medical, social service, law enforcement and eldercare fields. Reporters of elder abuse are provided by law with immunity from criminal or civil liability and professional disciplinary action.

If elder abuse is suspected, calls can be made to the IDOA hotline at 800-252-8966, 8:30 to 5:00 Monday through Friday (voice and T.D.D.), or to 800-279-0400 evenings, weekends, and holidays.


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