Abuse in Older Adult over 65 years of age
Ageing as A Contributing Factor of Abuse in Older Adult Over 65 Years of Age
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Ageing as A Contributing Factor of Abuse in Older Adult Over 65 Years of Age
Introduction
There are several ways in which elderly persons are abused and hurt. The scourge of elder abuse has spread across the world's cultures. Abuse, neglect, and violence have been documented in every culture to date. Violations of an aged person's dignity may take many forms, including physical, emotional, sexual, and pecuniary. Abuse may occur in a variety of settings, including the victims' own homes, nursing homes, hospitals, and other public venues. Ageism has long been regarded as one of the leading causes of aged neglect. Abuse against older people is justified by this form of discrimination, which has led to a lack of awareness of its implications. Victims of elder abuse suffer significantly in terms of their self-esteem and, in some cases, even die due to their ordeal. Ageism and elder maltreatment have been the subject of several types of research to identify its root causes, aggravating factors, and countermeasures. Ageism and elder abuse are briefly reviewed in this study. The PICOT question used in this paper is; Is ageing a contributing factor of abuse in older adults over 65 years of age?
Literature search
Even though older individuals make up the fastest-growing segment of the population, they significantly impact the dynamics of a family. Many of the older persons' caregivers, on the other hand, are their adult children. Yes, this may add to their already high levels of anxiety and irritation. Even unintentional, it might lead to elder neglect and abuse. Elder abuse and neglect are most often linked to three problems. There's a lack of attention, physical harm, and monetary gain for the abusers. There are numerous caregivers and individuals who may come into touch with the older folks who are prone to these concerns, not only the adult children caring for their parents. The human services area is being heavily influenced by this rapidly expanding population and the efforts to empower the elderly.
Ageism and age discrimination remain significant problems since it has led to elder maltreatment. When it comes to social and healthcare, financial services, and social security, most persons over the age of 65 have experienced age discrimination at some point in their life (Ayalon & Tesch-Römer, 2018). Older individuals are often seen as a nuisance or a burden by most people. The practice of age discrimination in the social and healthcare sectors persists despite the efforts of the national service system. In addition, older persons face age discrimination in community services. For example, most local governments tend to focus on caring for young individuals with disabilities while overlooking the needs of the elderly.
A different kind of prejudice originates from the assumption and attitudes of discriminatory conduct that aged people are characterized by intellectual degeneration and diminished ability. Societal expectations have led to the hypothesis that elderly individuals are indistinguishable in conduct and personality, mental or physical impairments, and dependence on others (Alexa et al., 2020). Adults living with dementia have been isolated from the rest of society by rejecting social reciprocity and mutuality, which constitutes a social order.
It is estimated that over 21 million individuals have been affected by psychiatric disorders. Abuse and neglect occur regularly. However, Mock (2020) states that authorities are notified about one out of six incidents. Sadly, when most people think of elder abuse, they see it as occurring only in nursing homes. However, a prevalent misperception is that the perpetrator in many instances of elder abuse is a family member, a hired caregiver, or even a close friend. The term "abuse" may conjure up images of just physical abuse, but many other types of abuse may occur. In addition to physical, emotional, and financial abuse, there are many more forms of elder abuse.
The perpetrator's markings on the victim's body make it easy to identify physical abuse. When a family member or caretaker refuses to address the elderly adult's fundamental requirements, they are guilty of neglect. Food, housing, and healthcare might all be included in this. Financial abuse of the elderly may go undiscovered for many years before it is discovered. Because of their advanced age, older adults are often unaware of financial difficulties until they get collection notifications for past due invoices. People may attempt to take advantage of an older adult's age by charging them for services they don't need, which is a kind of financial abuse.
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Appraisal of the evidence
A charity action study on elder abuse, released in 2020, found that 46% of elder abuse cases were committed by family caregivers (Wang et al., 2020). The "hidden voices" study found that compensated abusers accounted for around 34% of all cases of abuse. According to the findings, there are varying rates of elder abuse in each of the distinct types of abuse. For example, 34% of victims reported psychological abuse, whereas just 19% reported physical assault. For 12 per cent, abuse was sexual. For 3 per cent, it was financial, for 20 per cent (Wang et al., 2020). Most of these assaults took place in the privacy of one's own home.
Detecting elder abuse is challenging since the symptoms might be similar, such as anxiety and withdrawal; therefore, few studies have been undertaken and may not accurately portray the genuine picture. There are at least three worldwide studies that reveal a range of 34 per cent to 62 per cent of elderly dementia patients being abused by their caregivers, with the most common risk factors being the specific demands, problems, burdens, and strains they face (Yon et al., 2019). Abusing behaviour may be caused by the qualities of both the patient and caregiver, according to new research published in 2019. Elder abuse may be broken down into two categories. One group consists of trustworthy caretakers, locked in a continuous cycle of worry and anxiety. Unintentional neglect among this set of caregivers may be due to a lack of finances, mental stability, maturity, or physical strength or endurance (Yon et al., 2019). On the other hand, pathological caregivers engage in systematic and significant maltreatment. Violence and other psychological issues such as alcohol and drug misuse are common in this population.
Literature Review
It can be said that ageism is a significant contributor to elderly abuse. Orfila et al. (2018) examined the attitudes towards ageism, neglect, and perception of elder abuse. The study was done on working professional ad groups capable of providing assistance and support to the elderly. Based on the information derived from the 339 participants in the study, it was identified that people believe elderly abuse and neglect are social problems that should be prevented at all costs. The study also showed that people had positive attitudes towards ageism. Orfila et al. (2018) argue that people have moods and prejudices against older people because they are no longer productive and independent. Therefore, ageism can be a significant factor contributing to elderly abuse.
Another research was done by Rosen et al. (2019) to determine how ageism will have on the elderly. The study points out that ageism has been given little attention in prejudice and discrimination as more emphasis is put on sexism and racism. This is considered a cause of concern, especially in the number of older adults is expected to increase. Rosen et al. (2019) note that ageism will increase as more people reach retirement ages. The ageist attitudes and beliefs will evolve into behavioural manifestations that would result in discrimination and social exclusion. Those resulting behaviours can be considered to be forms of elderly abuse.
Kiely et al. (2019) further examined ageism by studying its negative and positive aspects. The study was carried out since the number of older populations worldwide has increased drastically over the past few years, and ageism has become a more pressing social issue. The study was integrated with the study of ageing. However, the most significant aspect of the study was the identification of critical areas for international research on ageism and effective intervention and supported older populations. Kiely et al. (2018) state that expanding study areas and methodologies used to regulate elderly abuse would be vital in preventing the vice. The authors further argue that ageism should be controlled by all means since older people also play a significant role in society by providing knowledge and expertise in different fields. Therefore, ageism should be prevented by all possible means.
On the suggestion that elderly abuse should be prevented, Herzig et al. (2022) conducted a study to assess the global situation, risks factors and prevention strategies. While the researchers provide an overview of global issues surrounding elderly abuse, they focus mainly on prevention. Herzig et al. (2022) drew primarily on population-based studies to synthesize current prevalence and risk factors associated with elderly abuse. It was established that there had been no significant scientific interventions on elder abuse. However, the study suggested five promising strategies for the prevention of vice.
These prevention strategies include caregiver interventions, monetary management programs, emergency shelter and multidisciplinary. While the suggestions seem promising, their implementation poses another challenge.
Liddell & Ferreira (2019) carried out a study to examine the current systems and challenges faced in preventing elder abuse. The study covered 1,119 private and 606 public community general support centres. It was established that private support centres experienced more challenges than public ones when it came to implementing preventive measures against elderly abuse. The study suggested that health and social care policies should be configured to address the challenges faced by these institutions when trying to prevent elderly misuse. Therefore, it is evident from this study that it is a daunting task to prevent elderly abuse.
Discussion of practice implications
A variety of study results point to several intervention strategies that target caregivers and patients to curtail the incidence of abuse. Anger management tactics, stress reduction methods, coping with alcohol and drug misuse, and counselling have all been developed for caregivers (Orfila et al., 2019). More daycare and home care services should be made available to lessen the risk of abuse. Those who have ever perpetrated abuse should also enrol in a program to help them regulate their anger and learn better-coping skills.
A caregiver must also get knowledge about dementia and the various treatment options. The legal and financial independence of the patient should also be taken into consideration by caregivers. All caregivers should be provided with emotional support during their care and have their health care requirements met (Kiely et al., 2018). Voluntary organizations and local government financing are also important sources of assistance. For example, the United Kingdom must create a support network for caregivers and get the necessary training in this area. Psychological counselling should be given to caregivers of persons with dementia experiencing discomfort or adverse psychological effects. Elder abuse is a problem that affects both the elderly and their caregivers.
A rising body of research suggests that as the senior population grows, human services and health care fields will become more critical (Miller, 2020). Many persons over the age of 65 face rising healthcare expenditures due to planned annual increases in healthcare prices. As a result, there are no immediate measures to alleviate the financial burden on the senior population. Many non-profit organizations and agencies are in existence to monitor the efforts to avoid chronic illness. Older individuals are protected by laws in the legal system and by the courts themselves. All 50 states have Adult Protective Services. The problem is that each of these governments has its regulations and agencies on how to report abuse and manage the intervention.
In recent years, older people's safety and well-being have become a significant issue, intending to ensure that the elderly have a secure and comfortable place to call home. Elderly care workers should be concerned with protecting the elderly and ensuring that they have proper medical help, appropriate living arrangements, and a nutritious diet. The placement and care of an older adult who has been rescued from abuse or neglect necessitates that their basic needs be satisfied. The social worker must take the client's desires into account and ensure that the client is well taken care of in the future (Rosen, 2019). Many want to be placed with relatives, but that isn't always the most excellent option for their needs and well-being.
Changes in Social Policy
Many individuals may believe that they should not become involved in another person's family matters since they are outside their sphere of influence. They may be apprehensive about the consequences or believe it isn't their concern. Teaster et al. (2020) claim that this way of thinking might hurt the well-being of ageing adults and lead to a lack of incidents of elder abuse being reported. In response to the increased number of elder abuse cases, neglect, and exploitation, all 50 states have established legislation that affects how human service providers serve this group. Long-Term Care Ombudsman (LTCO) and Adult Protective Services (APS) are two organizations created to examine allegations of elder abuse and neglect (Phelan, 2020). In addition to providing therapy and care for the victims, this organization also acts as a safety net.
Nursing homes assisted living institutions, and board and care facilities all fall under the purview of the Long-Term Care Ombudsman (LTCO). In certain jurisdictions, health care providers, police officers, and social workers are among those who are legally obligated to report suspected and known occurrences of elder abuse to the American Society on Aging (Phelan, 2020).
Current Legislation
There is currently no law in place in the UK to address elder abuse. There are various rules to safeguard vulnerable individuals, even though this is the case. When it comes to protecting vulnerable individuals, the NHS and community care act of 1990 is a good example (Mock, 2020). Community Care and the delivery of services in our communities have been affected and modified by this legislation. The statute mandates that all local governments are responsible for determining the needs of their citizens and ensuring that they are fulfilled. Local governments are required by Section 47 of this act to perform an evaluation of elderly residents and take action against any abuse or neglect (Mock, 2020). But it's hard for the authorities to catch this kind of abuse since it relies on the patient's willingness to come forward and if they can see the signs of mistreatment.
The government issued "No longer scared" recommendations in 1993 to combat domestic elder abuse. This policy only addressed physical abuse, failing to take into account other forms of maltreatment, such as financial or psychological, and its impact on those with dementia. When the government realized it needed to do something about these problems, it released the "No secrets" policy in 2000. Many elderly individuals were relieved as a result of this strategy, which reformed services for those at risk of abuse and modified the way abuse claims were investigated. As part of the COVID19 pandemic, the process aids in recognizing and establishing professional training for social care workers in addition to health care experts. Since the introduction of the "no secrets" policy, the reporting systems of the United Kingdom have undergone a number of modifications. Effective risk assessment techniques and tools that social workers and healthcare professionals may employ across many contexts are still lacking.
The human rights acts of 1988 are another critical piece of legislation that has significantly influenced the evolution of social assistance and health care practices for elderly and vulnerable people. This legislation defined a number of items relating to the maltreatment of older adults with dementia. Rights to life, security, and personal liberty; the prohibition of torture and other cruel or unusual punishments; the freedom of speech; and even the right to private family life and an intimate relationship with one's spouse are all included (Makaraun et al., 2020). In 2000, the government passed the Care Standards Act, which ensured the safety of senior citizens living in both the community and in nursing homes. A "criminal record check" is required for all social care and health personnel to determine their fitness to deal with persons with dementia.
Finally, in 2007, the government passed the Mental Capacity Act of 2005, implemented in 2007. In order to help elderly individuals with dementia and those at risk of abuse, this legislation was passed. To determine what is in the "best interests" of a person without capacity, decision-makers must evaluate a number of factors (Mock, 2020). All of the factors mentioned earlier are taken into account while making a decision. Through this law, neglect and ill-treatment of someone who lacks ability became a crime. As a result, all of these regulations and laws are still valid and may be used to help prevent and deal with elder abuse. In order to keep up with the rapid evolution of society, families, and institutions, more law is necessary.
Recommendation
For an older adult who has suffered abuse, the case manager has to examine the issue and determine their client's requirements before developing a treatment plan to eliminate the problem and aid in their recovery from their experiences. Elder abuse victims must come to terms that they are not to blame for what has occurred to them. They should also be aware that there is never a good excuse for someone to be emotionally or physically abusive to them. These individuals' fundamental needs must never be denied, and they must never be humiliated. The case manager should also educate the family and caregivers about elder abuse and the actions they may take when feeling "burned out".
When they need a break from their caregiving tasks, the case manager may assist them in obtaining resources. There are a variety of services available, including counselling, peer support groups, and respite care. Case managers are able to connect their clients with mental health agencies so that they can conduct an assessment to determine if the ageing adult is capable of meeting their basic needs, making decisions about services to protect them from abuse, offering testimony, and determining if they pose a danger to themselves and are in need of treatment. Counselling for victims and vulnerable adults helps them assess their alternatives and devise strategies for their protection, overcoming trauma and conflict resolution (Mock, 2020).
Empowerment
Elderly victims of abuse and neglect often feel as though they've earned it. Elderly abuse victims often opt not to report their abusers for a variety of reasons, including the fact that they don't understand why their abusers think they deserve to be harmed in the first place. They won't feel like they deserve to be abused again and speak out on their behalf if they are.
However, the elderly and tiny children are two of the most vulnerable groups, so putting up a program that allows them to connect and celebrate their uniqueness might go a long way toward helping the elderly realize their value as individuals. Older persons may develop a sense of self-worth and worthiness by participating in activities like reading and playing with little children with the assistance of a support team. The only thing one can hope for is that everyone would speak out when they feel they are being mistreated. Elder abuse may be prevented if caregivers are supported. Even though each situation is unique, for many individuals, taking care of their elderly parents is simply another burden on top of the many other duties they already have to deal with. You may be able to prevent elder abuse by letting the caregiver know about the stressors and providing them with strategies for coping with them. Older adults who can no longer care for themselves should be forced to have someone check in on them like a foster parent.
Conclusion
It is predicted that older people will account for the majority of the population during the next several decades. In the next several years, it will be critical that we identify measures to safeguard them and develop programs to address any current or potential future needs they may have. Every day, more and more people are abusing their elders. Physical abuse, neglect, and financial exploitation are just some of the ways that older individuals may be mistreated and taken advantage of. In order to slow down this form of crime, it is essential for caregivers and older people to be aware of the warning indications of abuse.
Ageism and elder maltreatment have been emphasized in the literature study. According to the majority of studies, ageism and elder maltreatment are closely linked. Research and attention to ageism and mistreatment of the elderly are similarly under-researched. Other research has indicated that implementing preventative techniques is a difficult challenge, despite some ideas on how to avoid elderly abuse. Ageism has been linked to maltreatment of the elderly. The proposed preventive actions and methods should be implemented as a result.
Regardless of age or health status, every person is entitled to be treated with respect and make their own life decisions. This is not always an easy situation for caregivers, who may make difficult decisions that conflict with the patient's views or thoughts. Older people have been left to live on their own in our communities because of demographic shifts and an ageing population. That's what drove me to do something about the possible mistreatment of the elderly, especially those over 65 years old: raise awareness about it.
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