Abuse to the elderly people has been a common practice in most societies in different parts of the world, there is need to stop this trend in line with the protection of human rights. Research has found that 60 percent of elderly people are abused all over the world. This is attributed to the difficulties that the elderly undergo, ranging from violation of their rights, financial abuse, psychological torture, physical abuse and negligence. The research carried in nursing institutions ranked the nursing homes as the leading places of negligence to the elderly. Majority of elderly people are taken to the nursing homes where they are left without enough care or given last priority in terms of medical needs and the diet.
The causes of elderly abuse closely linked to institutions, employment (employee) and the specific client characteristics. This implies that there is need for formulation of policies that will act as preventive measures for elderly people especially in residential places. The policies should define who an elderly person is, their basic human needs, who to be in charge of the elderly /caregiver, the qualifications of the care giving institutions in case of an abuse.
Generally the state of the elderly people can be very pathetic in modern society due to the increasing economic recession, which is associated with difficulties hence rendering the elderly as an economic burden.
Psychological abuse in most cases is the worst forms of abuse to elderly , People who are psychologically abused will report cases that show them having been undermined or belittled; insulted, called bad names or sworn at, the prevention from seeing others; and having been excluded or repeatedly ignored by the caregivers (Coffey, 2010). In the past years these cases of psychological abuse had occurred and in most times involved the same person who was targeted by the abusers.
This paper deals with different forms of abuse in the modern society that include; violation of their rights, financial abuse, psychological torture, physical abuse, and negligence. It also explores various causes of abuse to the elderly people in the society; the specific areas that have been identified include institutional setups, nature of the employment (employee) contract and the specific client characteristics in the case of elderly people being involved in the business enterprises.
In a study that was carried out on elder abuse in long-term care, by Lachs & Pillemer, (2004) there were high rates of elderly abuse in the societies living in United States of America. The subsequent study was carried out by McCreadie Et al. (2007) it was found out that more than one third of the 577 nursing homes' staff in the United States had witnessed elder abuse, with psychological abuse cited as the most prevalent type. The authors concluded that abuse of residents in Nursing homes was sufficiently extensive to merit public concern.
However, the issue of awareness of elderly abuse amongst the health and the social caregivers has not been properly evaluated. The Nurses' knowledge of on topic of elderly abuse was extensively explored the researchers, who gave the recommendations for the educational extensions on assessment, the legal implications and the availability of possible interventions. On his attempts, (Hughes, 2006) also gave out some suggestions on the way the nurses should examine their attitude in relation to the elderly patients. In recent times, the researchers have recommendation for educational measures to help the practitioner identification and management of cases related to elderly abuse. McCreadie et al (2000) on their research on United Kingdom's GPs indicated that one of the strongest factors that can predict the diagnosis of elderly abuse was the acquisition of knowledge on the risk situations, according to the research above the GPs who frequently read articles with topics on abuse elderly people had the highest preference in diagnosing elderly abuse as compared to those who did not do the same. In the cases of long-term care, the residents' are always in need for assistance in their day to day living activities, therefore in such cases the caregivers are overloaded, the elderly people are then exposed to very abusive situations.
In the attempt to understand the causes of elder abuse, the researchers have studied other forms of family violence such as child abuse and spousal abuse. They assert that it is important to differentiate between theories and the risk factors. As (Hughes, 2006)) states , the Risk factors such as stress, is supposed to be considered as a theoretical explanation of the reasons behind elderly abuse, other risk factors include;
- Transgenerational family violence.
- Psychology of the abuser.
- Social isolation.
Attempts have also been made to the risk factors in a detailed manner with reference to the continuum of elderly abuse. The early studies based on caregivers' stress as the key issue, the main focus was on the older person's physical and mental difficulties. There is limited evidence that supports the focus on the elderly people who the victims, hence most researchers concentrate on the abuser (perpetrator)
The identification of the elderly abuse proves to be difficult for the healthcare
Workers. Most of professionals concerned with elderly people's care giving have expressed the lack of confidence in reporting the abuses. The difficulties have been attributed to the lack of awareness and the difference in the perceptions of concerning the victims(elder abuse).In a specific case in Ireland, the researchers contacted a survey on hospital workers and the doctors on how they understood the phrase 'elderly abuse', the results implicated that most of the participants felt very uncomfortable with the phrase 'elder abuse' Contrary to this, the social workers were very conversant with the phrase, variation was not taken well by the researchers, it was attributed to the type of training that social workers receive while undergoing their studies at the undergraduate level. Education and training for the Doctors should also include the chronological age structure with the focus on the adult protection. This will be very significant in the efforts to prevent of the elderly abuse.
According to, (Pritchard 2002) it has been found out that in case of the long-term care the main cause of Elderly abuse was due to the lack of awareness amongst the staff who were mostly involved in the verbal abuse by use of certain were abusive words. Despite the efforts which have been input in attempting to improve the awareness
On the issue of elderly abuse, the elderly people who reside in the long-term care units are likely to be exposed to more vulnerable situations. Research was extensively carried out to examine the knowledge and the perceptions of the staff members working in the long-term care section on what constitutes the act of elderly abuse.
In research that was carried out in the United Kingdom the prevalence figures ranked neglect as the leading form of mistreatment in the with 1.1%, financial abuse followed with (0.7%), the physical and psychological abuse were ranked 3rd with both having 0.4% and the sexual abuse was ranked last with 0.2%. Compared with the surveys done in other countries, the prevalence was lower for all types of abuse, but highest when it came to neglect. This was a reflection of the differences between the UK and the other countries, (O'Keeffe et al, 2007)
In order to find out more insides on the findings that indicate women to be having a long lifespan as compared men and followed by mistreatment, an interview was carried out and Mrs. Jones was the main corresponded, Mrs. Jones is a an Elderly woman who lives in the Caregiver units established by the government. Asked on the above topic, she reported that she had witnessed men aged 85 years and over, she said that these were likely to experience financial abuse as compared men in younger age groups, contrary to this she said that women who were aged 85years and over were more likely to be exposed to negligence.
According to her, the prevalence of abuse with the exclusion of negligence, increased with age for men, while it decreased with age for women.
Concerning the variation of elderly abuse with various factors she said that;
- Mistreatment varies with the socio-economic position of the elderly majority of those who last worked in semi-routine and full routine jobs who worked for small employers being at higher risk. Overall, those who were living in the rented housing had the highest tendency to be neglected.
- She had witnessed the highest level of mistreatment by separated or divorced to partners as compared to those who were widowed. However she said that People who were living alone were more likely to experience financial abuse as compared to those living with others.
- She said that mistreatment by the health status tends to increase with the declining health status. The level of elderly abuse was highest for people with: a self-reported status of bad or worse health, especially for a limiting long-term kind of illness, and lower living standards.
When questioned about the Perpetrators abuse to the elderly she replied that
A greater percentage of mistreatment in her past experience mainly involved a partner / spouse, although other family members were involved to a small extent, the care worker followed and closes friends being the least implicated.
- Men comprised of the highest percentage in the interpersonal elderly abuse are it physically, psychologically and sexually with women being less abusive.
- The age structure of most perpetrators tended to be younger especially for those who carried out financial abuse as she compared to those carried out interpersonal abuse. she emphasized that most of the perpetrators were living in the victims house during the times of abuse
When asked on whether she has ever been abused she agreed with the statement that the most commonly effects she felt when abused was emotional with such feelings as anger or upset, and social effects which made her feel cut off from family and friends.
On the mode of reporting the incidences of elderly abuse, she said that the majority of the incidents were reported or sought help. However she sited under-estimation because of the conservative nature of the way that was used to measure the kind of mistreatment
According her the problem of negligence stood out as a predominant type of elderly abuse, followed by the financial abuse (Buzgová & Ivanová, 2009). This contrasted to the common assumptions the notion of "abuse" as only physical violence. She confirmed that the risk factors for negligence included; female gender, aged of 85 years and above, severe suffering or a much deteriorated health status and the likelihood of one being in receipt of, or in close touch with, the services.
The issue of elderly abuse is a very vital, There is need to address it, particularly in the long-term care settings where the elderly
People totally depend on external help and are more vulnerable to abuse. This study ascertains the perceptions that different people take concerning the state of elderly and the associated abuse. Amongst the nurses and social workers who worked in long-term care setups for older people.
Most of the staff in the care units doesn't have the basic education which can enable them deal with the elderly abuse and there was a considerable uncertainty on what constitutes elderly abuse.
There is need to setup the standards for the providers of care and support services to the elderly people. These standards should be based on key factors such as the risk factors for them to be relevant to the efforts of prevention of the abuses
The following steps need to be taken in order to improve on the elderly care units. These include;
o Rooting out age discrimination.
o Person centered care.
o mental health in older people
o Legislation has to be introduced in order to extend the regulation to the area of private care units.
o Access to Care Services should be fair.
o the criteria for eligibility for adult social care should aimed at the provisions for those who have been assessed to have their basic needs, independence granted, well-being and choice
o Emphasis should be on the positive aspects of risk and the importance of personalising care through which people can be more involved in making choices between the type and level of support they need. These developments aim at influencing the background on which abuse is recognised as a very big social problem.
The government department in charge of Health should launch a Dignity campaign in Care, coupled with the dignity tests, championship and a dignity challenge that ensures zero tolerance of all forms of abuse in the provision of services and to ensure that the elderly people feel freely to complain without the fear of retribution (Mowlam Et al 2007).
The significance of partnership working between the hospitals and the social care units, between the social care and the police, the voluntary and independent sectors was a reflection of very successive policy documents.
Adults are at the highest risk because they are susceptible to be affected by disability, mental disorders, illness, ageing, the elderly are unable to provide themselves with protection from abuse and are vulnerable to abused than young persons.
Abuse therefore should be defined to mean any conduct which can harm or exploit an individual be it physically, psychologically or through actions such as theft, embezzlement, fraud and extortion.
Self-abuse is also a serious issue that should be addressed together with any other conduct which may cause fear, an alarm or a lot of distress.
Elderly neglect should be grouped into three main categories which include;
- The day to day activities such as shopping for food or clothing, preparation of meals, carrying out routine housework, traveling or transportation
- The Personal care and hygiene such as washing, bathing, dressing, undressing, and eating
- Help when it comes to correct dosage and the timing of medication.
- For those who live alone, or in receipt of elderly services, those with a worsened health status, the elderly men, and divorced women, separated, or lonely. The risk of financial abuse is very high.
Most of the elderly women who were aged 60 and above experienced the highest risk of interpersonal abuse. While men felt lonely in their old age, however both men and women reported three or more depressive symptoms in association with elderly abuse. The highest rate of interpersonal elderly abuse was reported amongst the women who were separation or divorced with their husbands.