You have the role of caregiver for your parent. Whether you volunteered for it or found that there were just no other options, here you are. Either way, you now have a huge responsibility in your hands. You have the responsibility to ensure that the senior’s well being is maintained in all areas, and that they are free from any type of abuse or harm. But senior abuse comes in so many shapes and forms and unless you know how abuse is defined, you might not recognize it when you see it, or when you are inflicting it yourself.
There are six types of abuse that I’m going to talk about here. Many people think of abuse as a repeated act, but don’t fool yourself; even one incident of any of the following is considered elder abuse. The following includes the formal definition of each type of abuse, followed by a scenario that you might not of thought was abuse, but is.
Types of Elder Abuse
1. Physical – Use of physical force that may result in bodily injury, physical pain, or impairment. This may include hitting, punching, slapping, burning, pushing, kicking, restraining, false imprisonment/confinement, or giving too much medication or the wrong medication in order to overly sedate.
Physical abuse is not always so obvious. Helen is a senior who suffers from Alzheimer’s Disease and she lives with her daughter Ruth and Ruth’s adult son, Dillon. Helen needs a diaper change, but she always becomes very frightened and won’t let Ruth change it. Ruth asks Dillon to hold Helen down against their will so that Ruth can change the diaper. Helen ends up with bruises on their arms. Even though it happened while Ruth was trying to help provide care to her mother and Dillon was just helping, this would be considered physical abuse.
2. Emotional/Psychological – Infliction of anguish, pain, or distress through verbal or nonverbal acts. This would include yelling, cursing to, or making threats to a senior or causing them to feel intimidated or humiliated. May also include use of manipulation, coercion or guilt in order to get a senior to do what you want.
Frank was recently widowed and his daughter Julia moved in with him to help him with light housekeeping, shopping and driving. Franked loved going to the senior center 3 days a week to meet with his friends to visit and play cards. It was his only socialization outside of the house. But he hasn’t been able to go since his wife died as she always drove Frank to the senior center. He was looking forward to going again now that Julia was going to drive him. Franks other daughter, Cindy, also lived close by and Frank enjoyed when she came over and brought the grandkids for a visit. After a few weeks of Julia driving Frank to the senior center, she and her sister Cindy got in a huge fight and Julia did not want Cindy in the house. Julia told her father Frank that if he let Cindy into the house that she would dump him in a nursing home. Every time Frank was on the phone with Cindy, Julia would stand close by and snarl “nursing home”, as a reminder to Frank that he was not to invite Cindy to the home and to make an excuse. When Frank walked by the picture of Cindy and her family hanging on the wall, Julia would whisper “nursing home”. Not only was Frank not allowed to see Cindy, but the grandkids too. This caused him much emotional distress, and would be considered psychological abuse.
3. Financial – Illegal or improper use of an elder’s funds, property, or assets. Not only does this include the big things such as blatantly stealing money or items or signing financial documents on the seniors’ behalf, but also the smaller things such as not returning the proper change after shopping for a senior, purchasing personal items when you should be shopping for the senior with the seniors’ money, or “borrowing” money from a senior and not paying back. Financial gain is often a motivator behind other forms of abuse.
Oscar lived alone, and was no longer able to manage his money and finances, so his daughter, Melissa volunteered to become his payee and tend to the finances. Oscar’s roof starting leaking one winter and the water soaked into his carpets, eventually causing mold to grow. There were funds in Oscar’s checking account, but instead of having the problems repaired, Melissa wrote a check to her daughter out of Oscar’s account as a downpayment on a car for her birthday present “from grandpa”, without Oscar knowing about it. Even though Melissa says that it is what her father would have wanted to do if he was able to understand his financial situation, it would be considered financial abuse.
4. Sexual – Non-consensual sexual contact of any kind with an elderly person or with an elder who is unable to give consent. May also include the taking of lurid pictures or the exhibition of the senior.
Jessica is a college student who is home for the holidays. Her grandmother has moved in with Jessica’s mother so she can receive family care. Jessica’s mother asked her to help out and get her grandmother undressed and ready for a bath. While the grandmother was undressed, Jessica took pictures of her with her cell phone and shared them on social media and made jokes about how she was never going to look like that when she was old. While this is not what you usually think of when you hear of sexual abuse, it is still considered abuse.
5. Neglect – Refusal, or failure, to fulfill any part of a person’s obligations or duties to an elderly person. Neglect may be intentional or unintentional. Caregivers may never neglect to give the services or items that they are being paid to provide and while in their care, and it is their responsibility to protect the senior from harm. The senior should never be deprived of food, appropriate temperature, mental and/or physical stimulation or appropriate health care. Failing to change incontinence products to the point of causing harm to the senior, or leaving a demented senior alone and at risk may be considered neglect.
Sarah was 83 and suffered from Alzheimer’s Disease. She lived with her daughter, Gloria, and Gloria’s family. During a recent hospitalization, the doctor and the social worker both documented that they spoke with Gloria regarding keeping Sarah safe at home and educated her on the importance of reducing the risk of wandering, since Sarah had wandered out and got lost twice before. They provided her with information and resources to help Gloria keep her mother safe and prevent further wandering episodes. They recommend that Sarah is never left alone. Gloria never put into place any of the recommendations from the professionals. A few weeks later, Gloria went to work in the afternoon and Sarah was left with her teenage grandson, Jeff. One day Jeff got engrossed in playing his video game and Sarah wandered outside and was found down on the street a half a mile away from home; a victim of a hit and run. Gloria argued that she never hit, or abused her mother, that she loved her and took good care of her. While this may be true, Gloria did not fulfill her duty to make sure that Sarah was free from harm. Sarah was neglected and this is abuse
6. Abandonment – Desertion of an elderly person by an individual who has physical custody of the elder or by a person who has assumed responsibility for providing care to the elder.
James lived with his wife and their adult daughter. James was a difficult man to live with. He was always yelling, and putting his wife and daughter down. There was no love between James and the women in his household. One day, James was hospitalized following a stroke. His recovery was going to be slow, and he would require a lot of assistance at home with his personal care. While he was hospitalized, his wife and daughter thought that it would be a good time to move to another city and change their cell phone numbers. They never visited James at the hospital after the first visit and hospital staff were unable to contact them to make a discharge plan. Desertion, even of an offensive man who is mean to you, would be considered abandonment if you were responsible for him, and that would be abuse.
Elder abuse is not always obvious. It doesn’t necessarily mean that that the caregiver is not loving or attentive in other areas. But it can be subtle or unintentional. Caregiving can be very difficult, and sometimes you do what you have to do, but if any of these scenarios strike a nerve with you and feels familiar, get help, information and resources at your local Area Agency on Aging office, or the Office of Aging in your area. You can also get information and resources from social workers at the hospital or nursing facility, or you can obtain the services of a geriatric case manager to help you with problem solving. Then you can continue on being the great caregiver that you want to be.