Monday, May 18, 2009

Spotting elder abuse

1. Physical abuse

Seniors can have fractures, dislocations, lacerations, abrasions, burns, injuries (head, scalp, face), bruises on upper arms (from shaking), wrists or ankles (from being tied down), bruises on the inside of thighs or arms.

The clue, however, is sudden evasive moves when you move suddenly. People instinctively protect their faces and heads from a possible attack. Look for PTSD-type fears: seeing the whites of their eyes when inappropriate.

2. Sexual abuse (non-consensual sexual contact).

Look for sexually transmitted diseases, pain, itching, bleeding, bruising in the genital area.
In young children they can exhibit inappropriate sexual behaviour that tells you something is wrong. I have had students in elementary school with too much information, using inappropriate sexual language.

For some, being in a position of authority and power leads them to this type of abuse. In addition, caregivers have been guilty of sexual misconduct as they try to assist the disabled in relieving sexual frustrations. If this is done by hired personnel: write down the details, take photos, take them to a doctor, contact the employing agency, and contact the police.

3. Psychological abuse

Go to "Push" page
Look for signs of threats, intimidation, humiliation in a family member of client. A new movie, from the book Push, by Sapphire, is being made into a movie set to come out in the fall. It is called Precious. Check out the trailer of Mo'Nique's movie: Precious Movie Trailer -

The impact of this abuse results in low self-esteem, anxiety, withdrawing, mood swings, depression, suicidal ideations or behavior, confusion, disorientation. (These are signs of dementia, and other organic issues. Be careful to get a proper diagnosis.)

Another good reference: one of those fictional stories that illuminate such as T is For Trespass, by Sue Grafton.

4. Financial abuse

Some family members find that their loved ones are spending money all over the place. Some come to adult children to borrow money. Adult parents can be tricked into lending money and enabling loved ones to misspend. Watch for changes in spending habits, canceling planned trips, or an empty refrigerator, a lack of food or medication.

5. Neglect

This issue is a difficult one. In order for an adult to be neglected, it must be proven that they are being refused help. I have found, in my travels, that some independent seniors refuse resources and other supports in a desperate bid to remain in their homes, and to be left alone.

My mother, for example, refused to accept such health care support. My attempts at caretaking were abject failures, and I have seen this in other family situations. I know of health care providers who enter a home, only to deny that they need help and refuse such care as Transfer Payment Agencies freely provide. Some dementia patients can cover up their illnesses, and lead apparently normal lives until disaster strikes in the form of an accident or trauma.

Indications of neglect may include poor personal hygiene, signs of over- and under-medication (polypharmacy), poorly dressed seniors (in soiled or dirty clothes), elders left alone and deprived of stimulation and affection, exhibiting signs of malnutrition. Adult Day Away programs, such as those offered in many communities, can help.

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