Saturday, May 2, 2009

Elder Abuse

Elder abuse, or neglect, is a difficult issue. Whether a senior is abused physically, socially, emotionally, financially, or neglected, it is our job to become involved. The community must be trained in identifying at-risk seniors. There are many neighbours who continue to watch out for failing seniors: they take our their garbage, drive them to appointments and to purchase groceries. Unfortunately, those who volunteer are not aware of proper protocols, nor the signs, in protecting seniors, sometimes from themselves.

The Canadian government has responded to concerns. According to The Ontario Network for the Prevention of Elder Abuse (ONPEA) have 3 priorities: raising public awareness, training front-line workers, co-ordinating community services, such as those that TPAs offer. We must be informed of non-profit services. In Ontario, you can phone the CCAC to advise that an individual needs help.

One US blogger cites a particular case which, in Canada, would violate privacy laws by communicating information about an individual case. We must tell these stories, however, we need to respect that there are three sides to every story: his/hers and the truth.

In my case, my mother denied to her CCAC Case Manager that she needed help. She may have appeared to have been "fine", but she was fighting fatigue, pain and an inability to do her ADLs.
In addition, neighbours, while trying to do seniors favours, end up enabling them to remain in their homes in dangerous situations, covering up their extreme needs for in-home support. My parents, both ill, required help with groceries, their finances, getting mail, doing household chores, and they were very frail. They were living in a dangerous situation in that I did not know how ill they were until I moved here and mom died 6 weeks later. In this case, it might have looked like they were being neglected, but despite nearly daily phone calls, many sons and daughters remain uninformed about issues. Adult children must be informed. PHIPA demands it.

It is important that seniors be screened for comorbidities, and symptoms of medical and mental health issues, including abuse, addictions, Sundowner's and dementia, that puts themselves at risk, as well as the rest of society if they are on the roads, or in their homes unable to safely cook, and look after basic food, clothing, transportation, and shelter needs. Those with dementia need monitoring and, with interventions, can be prevented from deteriorating too quickly. Many barriers exist in health care, not the least of these are unidentified and unresolved physical and mental health, transportation and emotional issues.

Many seniors suffer depression, and with many senior's groups, and the vast array of support and volunteer groups in communities, it should not be an issue. For aging seniors caring for an ailing spouse they must reaize that sometimes they have to enlist outside support such as Day Away Programs. You cannot look after someone else if you have been affected by the care you provide.

When intake workers, such as Case Managers, approach a couple it can be a spouse with dementia who refuses care. I know of a married couple in their 70s. She, with her own health issues, is unable to pick up her husband when he falls. The husband refuses outside support, which places a risk on her as she attempts to maintain a household with her already frail physical health. The toll on mental health is a huge one, as well. Caregivers are at such risk.

With age comes greater risk issues such as shingles, fractures, falls, cardiovascular issues, that create problems, some of which may be attributed to abuse. It takes professional involvement to understand when a senior's behaviour changes it is not their fault. Some of the clues that a senior is at risk includes an empty refrigerator, a home that is not clean, a change in behaviour, atttitude or habits. While some blame adult children for neglect, they must be informed. Dementia is a symptom that is easily hidden and denied. It causes depression, anger, marital problems, and caregivers simply may not be able to manage a spouse once the emotional issues become out of hand. My parents, struggling with Mom's cancer and Dad's brain tumour, fought bitterly over the small things. They were angry and upset with their failing bodies. It is difficult to live with this and intervention, and identification of mental health issues, are important.

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