Elder abuse is a growing topic in Australia. As more of the Baby Boomer generation require aged care services, the more families, friends and communities are asked to fill in the gaps.
Most people are familiar with abuse as a concept in relation to physical or sexual violence. However, many still don’t understand the length and breadth of abuse and the forms it may take.
Understanding elder abuse is paramount to ensuring the safety of all older Australians.
Here is a breakdown of the forms of elder abuse, including ones you may not realise qualify.
Elder abuse generally falls into six main categories
Physical abuse is when an elderly person experiences physical pain, injury, the threat of physical pain and/or intentional use of force. It can include pushing, shoving, slapping and/or physically moving someone around in a way where they are hurt and threatened. Situations where movement is restricted and/or impaired, and/or when someone is given little to no option due to fear of harm to their person also apply. Physical abuse can include everything from manipulating a person’s movements or applying rough pressure when completing care tasks right through to punching, kicking and causing physical harm and/or causing death.
Psychological abuse in elder care is about using fear, distress and mental anguish to control a person’s perception of safety, behaviour and/or mood. It can also include isolating a person from their friends and supports, stalking them, invading their privacy and/or humiliation and manipulation. This kind of abuse includes disrespecting a person, their beliefs, sexuality and/or lifestyle. Common techniques are verbal and non-verbal threats, covert aggression and inconsistent and/or misleading behaviour leading to a sense of ill-ease and unhappiness. It may also include features of coercive control such as monitoring and surveillance, controlling where a person goes and who they see, isolation from friends and supports, putdowns and belittling, intimidation, eroding autonomy and confidence, and asserting control over a person’s choices, finances, relationships and activities.
Financial abuse in elder care situations usually takes the form of using money, savings, property and possessions without the express permission and/or clear consent of the person in care. Or accessing funds under the guise of using them for care but spending them on unrelated items and activities. The most common occurrence is the use of money set aside for a person’s elder care being diverted to further the carer’s life instead. Or it can include the occupation and even sale of someone’s house without their permission. Common small signs of financial abuse are objects and furniture disappearing from a home, a reduction in living allowance and/or a change in a person’s living arrangements that cannot be explained.
Sexual abuse is not about attraction. It is about weaponising sex and sexuality to assume power over another person. In the elder care context, sexual abuse can span direct sexual contact through to the usage of sexual gestures, suggestive statements and obscene language in a person’s presence. It can include sexual harassment, such as not giving privacy to dress or removing items of clothing without permission. As sexual abuse is a power-based phenomenon, it can include humiliation and degradation in relation to sexuality and privacy. It can also include forcing objects, digits and body parts into or on a person without permission.
Chemical abuse is the act of utilising or denying medication to alter a person’s conscious state to gain advantage over that person. It includes but is not limited to using medication, chemicals and street drugs to stupefy or create artificial compliance in someone receiving support. It can also include the deprivation of medication through choice, belief or deliberate action that leads to a reduction in quality of life for the person in care. It includes under and over prescribing medication, failing to provide access to pain-relief and using medication in a manner contrary to it’s intention.
Neglect is when the basic needs of a human being are not met. This can include access to nutrition, the ability to bathe, or a change in the level of cleanliness. It may also include situations where a person’s needs, wants, values, beliefs or wishes are not considered when making decisions about their care. Neglect spans more than physical and life sustaining needs such as housing, feeding, toileting, cleaning and hygiene. It also means providing mental stimulation, consistent and secure environments, sleep, exercise, independence, autonomy, and acceptance.
How do you spot elder abuse?
Spotting elder abuse in the early stages is everyone’s responsibility. While abuse may take many forms, you can spot the signs of elder abuse in many instances.
Signs elder abuse may be occurring include:
- Deterioration of a person’s physical appearance – e.g. wearing long sleeve tops to cover marks, losing significant amounts of weight through under-feeding, lower levels of hygiene and presentation
- Changes in behaviour – mood swings and changes in mood are often a sign of deep distress. So too are shifts from usually optimistic, gregarious personalities to introverted and reserved behaviour
- Accelerating and/or unexplained ill-health – can point to a lack of access to nutrition, medication, sleep and other basic necessities. Or the over-use of chemicals
- Avoidance – avoiding discussing one’s living situation, avoiding eye contact, secretive behaviour and/or concerns about being overheard are all tell-tale signs of ongoing abuse and/or threats to safety and autonomy
- Unusual physical displays – jumpy, jolty and jerky physical movements can be a sign of CPTSD, fear or abuse. They may also be symptomatic of medium to long term drug usage. The fear of touch, withdrawing into one’s shoulders and/or physically keeping the head down to avoid attracting attention may also be signs of abuse
- Refusing touch and kindness – many abuse victims can come to equate touch, kindness and acts of compassion as unwanted or unwarranted acts
- The inability to pay bills and afford essential items – many financial abuse victims show early signs of this abuse through an unexplained reduction in cashflow and/or the implementation of new money-saving practices
- Removal of items from the home – furniture, home items, jewellery, heirlooms, cars and other possessions can begin to disappear from living situations where elder abuse is taking place
- Isolation from other friends and relatives – a carer’s refusal to accept outside help through to the failure to see a formerly social person engaged in their usual activities can be signs that a person is deprived of their liberty and/or are socially isolated as a means of control.
What can you do to combat elder abuse?
Combatting elder abuse is everyone’s responsibility. Proper education, conversation and consultation is key.
How you can create a safe environment, free from elder abuse includes:
- Listening to the person in care. The best way to meet the needs of the person receiving elder care is to define what good quality care looks like to them
- Utilising supports early and often. Ensuring that care is maintained throughout the later stages of life is key. And this means making use of the support services available and applying early for access
- Learn the difference between ageing, disability and disease – and apply this to your understanding of abuse. By knowing what to look for, you have a better chance of spotting it
- Checking in with elderly people on a regular basis. It’s imperative to keep an eye on elder care to ensure it is consistent and of high quality
- Don’t take on responsibilities you cannot handle. It is better to delegate elder care responsibilities and bring in supports than it is to muddle on through or burn out
- Limit the access to financial records. No single person should have control over another person’s financial situation without the appropriate checks and balances in place
- Work with your loved ones to create an appropriate care plan. Foisting care responsibilities on a person who does not have capacity, leaving care responsibilities to only one person, not timetabling and planning ahead – all these situations create a recipe for disaster when it comes to providing elder care
- Make use of the supports available. The aged care system in Australia spans a wide variety of services designed to make caring easier. Do your research and take advantage of what works for you
- Always seek clarification. Assumption is where abuse thrives. If you don’t understand why someone is behaving the way they are, ask!
If you suspect a person is a victim of elder abuse, you should report the abuse to the police. In our next blog, we will talk about the elder abuse we don’t intend.