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Abused Senior Citizens More Likely to Die in Three
Years
Oct. 1, 2004 – Senior citizens who suffer from
physical or mental abuse are three times more likely to die within three
years than those free of abuse, according to a new review of data on
elder abuse. (see Q&A about elder abuse below news report)
A substantial number of older persons -- from 2 to
10 percent of the elderly population -- are physically or mentally
abused.
Reviewing more than 50 articles, Karl Pillemer,
professor of human development in the College of Human Ecology at
Cornell, has collaborated with Dr. Mark S. Lachs, co-chief of the
Division of Geriatrics and Gerontology at the Weill Cornell Medical
College in New York City, on a detailed review in The Lancet
(Vol. 364, Oct. 2: pp. 1192-1263) on the risk factors, screening,
clinical manifestations, diagnosis and treatment of elder abuse.
"This vastly unrecognized and under treated problem
compromises the quality of life for millions of older people worldwide,"
says Pillemer. "A busy physician, who might see 20 to 40 elderly
patients a day, might encounter a case of possible elder abuse every
day, but because of a lack of time, resources and a general lack of
recognition of the problem, many cases go undetected and untreated,
putting our elderly at heightened risk of physical and mental harm, and
even death."
The Cornell gerontologists call for a
multidisciplinary team approach to assess the situation and develop
solutions that are tailored to the individual victim's needs and
problems. Lachs and Pillemer assert that elder abuse directly affects
quality of life, and helping patients resolve an abusive situation is
one of the most gratifying experiences for physicians and other
health-care professionals.
The research was
supported, in part, by a National Institute on Aging Mentoring Award in
Patient Oriented Research in Aging and an Edward R. Roybal Center grant,
also from the National Institute on Aging.
Q&A From
National Center on Elder Abuse
1.
What
is elder abuse?
Elder abuse is a term referring to any knowing, intentional, or
negligent act by a caregiver or any other person that causes harm or a
serious risk of harm to a vulnerable adult. The specificity of laws
varies from state to state, but broadly defined, abuse may be:
o
Physical Abuse
-
Inflicting, or threatening to inflict, physical pain or injury on a
vulnerable elder, or depriving them of a basic need.
o
Emotional Abuse
-
Inflicting mental pain, anguish, or distress on an elder person through
verbal or nonverbal acts.
o
Sexual Abuse
-
Non-consensual sexual contact of any kind.
o
Exploitation
-
Illegal taking, misuse, or concealment of funds, property, or assets of
a vulnerable elder.
o
Neglect
- Refusal or failure by those responsible to provide food, shelter,
health care or protection for a vulnerable elder.
o
Abandonment
- The desertion of a vulnerable elder by anyone who has assumed the
responsibility for care or custody of that person.
Elder abuse can affect people of all ethnic backgrounds and social
status and can affect both men and women.
2.
What
are the warning signs of elder abuse?
While one sign does not necessarily indicate abuse, some tell-tale signs
that there could be a problem are:
o
Bruises, pressure marks, broken bones, abrasions, and burns may be an
indication of physical abuse, neglect, or mistreatment.
o
Unexplained withdrawal from normal activities, a sudden change in
alertness, and unusual depression may be indicators of emotional abuse.
o
Bruises around the breasts or genital area can occur from sexual abuse.
o
Sudden changes in financial situations may be the result of
exploitation.
o
Bedsores, unattended medical needs, poor hygiene, and unusual weight
loss are indicators of possible neglect.
o
Behavior such as belittling, threats, and other uses of power and
control by spouses are indicators of verbal or emotional abuse.
o
Strained or tense relationships, frequent arguments between the
caregiver and elderly person are also signs. Read our section on
Family Caregivers for more information about how caregivers can
prevent elder abuse.
Most important is to be alert. The suffering is often in silence. If you
notice changes in personality or behavior, you should start to question
what is going on. See
The Basics for more information.
3.
What
is self-neglect and what are the signs?
Tragically, sometimes elders neglect their own care, which can lead to
illness or injury. Self-neglect can include behaviors such as:
o
Hoarding
o
Failure to take essential medications or refusal to seek medical
treatment for serious illness
o
Leaving a burning stove unattended
o
Poor
hygiene
o
Not
wearing suitable clothing for the weather
o
Confusion
o
Inability to attend to housekeeping
o
Dehydration
Self-neglect accounts for the majority of cases reported to adult
protective services. Oftentimes, the problem is paired with declining
health, isolation, Alzheimer's disease or dementia, or drug and alcohol
dependency.
In some of these cases, elders will be connected to supports in the
community that can allow them to continue living on their own. Some
conditions like depression and malnutrition may be successfully treated
through medical intervention. If the problems are severe enough, a
guardian may be appointed.
4.
What
makes an older adult vulnerable to abuse?
Social isolation and mental impairment (such as dementia or Alzheimer's
disease) are two factors that may make an older person more vulnerable
to abuse. But, in some situations, studies show that living with someone
else (a caregiver or a friend) may increase the chances for abuse to
occur. A history of domestic violence may also make a senior more
susceptible to abuse. Read our section on
The Basics for more information about risk for abuse.
5.
Who
are the abusers of older people?
Abusers of older adults are both women and men. Family members are more
often the abusers than any other group. For several years, data showed
that adult children were the most common abusers of family members;
recent information indicates spouses are the most common perpetrators
when state data concerning elders and vulnerable adults is combined.
Find out more … A Response to the Abuse of Vulnerable Elders: The 2000
Survey of State Adult Protective Services.
The bottom line is that elder abuse is a family issue. As far as the
types of abuse are concerned, neglect is the most common type of abuse
identified. Review our Fact Sheet for more information about who abuses.
6.
Are
there criminal penalties for the abusers?
Although there are variations across the country, in most states there
are several laws that address criminal penalties for various types of
elder abuse. Laws vary state to state. Some states have increased
penalties for those who victimize older adults. Increasingly, across the
country, law enforcement officers and prosecutors are trained on elder
abuse and ways to use criminal and civil laws to bring abusers to
justice. Read about state elder abuse laws, important legal issues, and
how to access the laws in our
Laws & Legislation section.
7.
How
many people are suffering from elder abuse?
It is difficult to say how many older Americans are abused, neglected,
or exploited, in large part because surveillance is limited and the
problem remains greatly hidden. Findings from the often cited
National Elder Abuse Incidence Study suggest that more than 500,000
Americans aged 60 and over were victims of domestic abuse in 1996.
This study also found that only 16 percent of the abusive situations are
referred for help - 84 percent remain hidden. While a couple of studies
estimate that between 3 percent and 5 percent of the elderly population
have been abused, the Senate Special Committee on Aging estimates that
there may be as many as 5 million victims every year.
One consistent finding, over a ten-year study period, is that reports
have increased each year. Click on
NCEA Fact Sheets and the
2003 National Academy of Sciences' Study Elder Mistreatment: Abuse,
Neglect, and Exploitation in an Aging America for more information.
8.
Who
do I call if I suspect elder abuse?
Each one of us has a responsibility to keep vulnerable elders safe from
harm. The laws in most states require helping professions in the front
lines -- such as doctors and home health providers -- to report
suspected abuse or neglect. These professionals are called mandated
reporters. Under the laws of eight states, "any person" is required to
report a suspicion of mistreatment.
Call the police or 9-1-1 immediately if someone you know is in
immediate, life-threatening danger.
If the danger is not immediate, but you suspect that abuse has occurred
or is occurring, please tell someone. Relay your concerns to the local
adult protective services, long-term care ombudsman, or police. For a
list of reporting numbers go to this important link: Where to Report
Abuse.
If you have been the victim of abuse, exploitation, or neglect, you are
not alone. Many people care and can help. Please tell your doctor, a
friend, or a family member you trust, or call the Eldercare Locator help
line immediately.
You can reach the Eldercare Locator by telephone at
1-800-677-1116. Specially trained operators will refer you to a
local agency that can help. The Eldercare Locator is open Monday through
Friday, 9 a.m. to 8 p.m. Eastern Time.
9.
What
should I expect if I call someone for help?
When making the call, be ready to give the elder's name, address,
contact information, and details about why you are concerned.
You may be asked a series of questions to gain more insight into the
nature of the situation.
o
Are
there any known medical problems (including confusion or memory loss)?
o
What
kinds of family or social supports are there?
o
Have
you seen or heard incidents of yelling, hitting, or other abusive
behavior?
You will be asked for your name, address, telephone number, etc., but
most states will take the report even if you do not identify yourself.
10.
How
can elder abuse be prevented?
Educating seniors, professionals, caregivers, and the public on abuse is
critical to prevention. On an individual level, some simple but vital
steps to reduce the risk:
o
Take
care of your health.
o
Seek
professional help for drug, alcohol, and depression concerns, and urge
family members to get help for these problems.
o
Attend support groups for spouses and learn about domestic violence
services.
o
Plan
for your own future. With a power of attorney or a living will, health
care decisions can be addressed to avoid confusion and family problems,
should you become incapacitated. Seek independent advice from someone
you trust before signing any documents. <
o
Stay
active in the community and connected with friends and family. This will
decrease social isolation, which has been connected to elder abuse.
o
Know
your rights. If you engage the services of a paid or family caregiver,
you have the right to voice your preferences and concerns. If you live
in a nursing home or board and care home, call your Long Term Care
Ombudsman. The Ombudsman is your advocate and has the power to
intervene. Please visit our Help for Elders and Families section to
learn more.
All states have adult protective and long-term care ombudsman programs,
family care supports, and home and community care services that can help
older adults with activities of daily living. Call the
Eldercare Locator at 800-677-1116 for information and
referrals on services in your area.
11.
What
is being done to stop elder abuse?
At the national level, Elder Justice Act legislation has recently been
proposed to provide federal leadership to help reduce elder abuse. The
Elder Justice Coalition is working to help pass the
Elder Justice Act S. 333.
Community collaborations, meanwhile, are playing an increasingly
important role in educating the public and professionals. In recent
years, State Attorneys General offices and law enforcement have stepped
up efforts to prosecute. On the front lines, "multidisciplinary teams"
(social workers, nurses, lawyers, etc.) have begun to be created to
better target interventions.
Elder abuse coalitions also are working to make life safer for
vulnerable elders and are an important step forward in the fight against
elder abuse. Find out how you can be involved.
12.
How
can I help stop elder abuse?
Knowing the warning signs of abuse is a first step toward protecting
elders. Some specific tips: Become a community
"sentinel" - Keep a watchful eye out for loved ones, friends, or
neighbors who may be vulnerable. Speak up if you have concerns.
That means even if you are not sure. You have a right to question. Be
involved. Volunteer with older adults in your community. Support
initiatives to increase and strengthen adult protective services in your
state.
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