ELDER ABUSE (Definitions) David Amesbury Workplace and HR Aged &Community Care Victoria
What is Elder Abuse Elder abuse is the infliction of physical, emotional, and/or psychological harm on an older, vulnerable adult at the hands of a family member, a non-family member in a trusting relationship, or a paid carer in an institution. Assessments of a potential or actual situation of abuse should also take account of the cultural context in which it has occurred.
The definition of elder abuse used by the Elder Abuse Prevention Unit is "Any act occurring within a relationship where there is an implication of trust, which results in harm to an older person. Abuse can include physical, sexual, financial, psychological and social abuse and/or neglect". (This definition was endorsed by all Australian states and territories through the Healthy Ageing Taskforce (HATF) on 8 December 2000)
Another definition A single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person United Nations Economic and Social Council
Types of Abuse Elder abuse can take many forms including Physical Psychological/Emotional Sexual abuse Neglect. Social Financial Each type of abuse can result in behaviour changes that indicate to others around them that something is not right.
Physical Abuse A non-accidental act which results in physical pain or injury, it includes physical coercion and physical restraint, under or over medication Abusive Physical Behaviour Includes hitting, slapping, burning, pushing, punching, pinching, biting, arm twisting, cutting, hair pulling, forced confinement to room, chair or bed.
Signs of physical abuse include: Discrepancies between injury and history Facial swelling or missing teeth, bruises Burns, broken or healing bones Unexplained accidents or injuries / unexplained hair loss Bruising and abrasions Conflicting stories between residents, carers or family members. Cringing or acting fearful Lacerations or abraisons
Examples include: Sexual Abuse: Rape - Sexual intercourse against the wishes of an individual. Indecent assault - Inappropriate sexual handling and touching. Sexual harassment - Inappropriate comments / labeling about general appearance, attitude and behavior. Any behavior that makes an older person feel uncomfortable about their body or gender.
Signs of Sexual Abuse Bruising around the breasts or genital area or inner thighs Unexplained sexually transmitted disease or genital infections Torn, stained, or bloody underclothing Presence of sperm in the vagina or anus Difficulty in walking or sitting not associated with a medical condition Fear of certain people or places Withdrawal, disturbed sleep/ recurring nightmares
Psychological/Emotional Definition: Psychological abuse is the infliction of mental anguish, involving actions that cause fear of violence, isolation or deprivation, and feelings of shame, indignity or powerlessness
Psychological/Emotional Examples include: Verbal intimidation - being forced into making decisions against their will. Humiliation and harassment - being called names or experiencing behaviours that are degrading, in a public or private place, being treated like a child. Shouting-Threats of physical Harm - e.g. "If you don't hurry up I'll give you something to be quick about". Threats of institutionalization - "Do what I say or I'll put you in a home". Withholding of affection - refusing access to grandchildren. Removal of decision-making powers. Withdrawal of affection
Signs of Psychological Abuse Psychological abuse may be verbal or non-verbal and is usually characterized by a pattern of behaviour repeated over time and intended to maintain a hold of fear over the victim. Loss of interest in self or environment Apathy Fearfulness Lack of eye contact with practitioner, carer or other person Huddled or nervous around carer or other person Reluctance to talk openly Helplessness Withdrawal Insomnia/sleep deprivation Paranoid behaviour or confusion not associated with illness
Financial exploitation/abuse can range from misuse of an older family member s funds to embezzlement. Financial exploitation includes fraud, taking money under false pretences, forgery, forced property transfers, purchasing expensive items with the older person s money without their knowledge or permission, or denying the older person access to his or her own funds or home. It also includes the improper use of legal guardianship arrangements, powers of attorney
Signs of financial abuse Loss of jewelry and personal property Unprecedented transfer of funds Improper attainment, or misuse of a Power of Attorney or Enduring Power of Attorney Loss of financial material eg. Bank books, credit cards, cheque books Bills not paid when money entrusted to a third party Management of a competent persons finances by another person Sudden inability to pay bills: rent, buy food or participate in social activities Unexplained withdrawal from bank accounts Cashing of personal cheques Removal of cash from a wallet Frequently changes mind about their power of attorney
Neglect Is the failure of a carer to provide the necessities of life to a person for whom they are caring. Neglect can be intentional or unintentional. Unintentional neglect occurs when a carer does not have the skills or knowledge to care for a dependent person. They may not be aware of the types of support that are available, they may be ill themselves and unable to provide care. Intentional neglect is when an older person is abandoned, not provided with adequate food, clothing, shelter, medical attention or dental care. Neglect may be the improper use of medication, poor hygiene or personal care or the refusal to allow other people to provide adequate care.
Signs of Neglect Poor hygiene or personal care Absence of health aids eg dentures, hearing aids, glasses and mobility equipment Unkempt appearance, inappropriate, or lack of, clothing Weight loss Secretiveness or agitation Lack of personal items eg photos, ornaments
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