Recognizing the signs: How to Identify Elder Abuse

Patience is a virtue that can be difficult to foster, but it is essential in our relationships with others, especially when it comes to older adults. Having to go through a few trips around the sun, elderly adults are susceptible to various health challenges such as chronic illness, mobility limitations, cognitive decline or sensory impairment. These health conditions can then affect their communication abilities, mobility, and overall daily functioning; making interactions more strenuous and complicated. That said, elder abuse may happen whether consciously or subconsciously by a loved one or hired caregiver at home or in an eldercare facility when the caregivers are mentally exhausted or frustrated taking care of their elderly.

Elder abuse generally refers to any intentional or neglectful act that results in harm or distress to an older adult (someone age 65 and above). It may occur in various ways ranging from physical, emotional, financial abuse etc. Recognizing the signs of elder abuse is thus key to protect these vulnerable individuals and shower them with love instead.

Elder abuse comes in different forms

In conjunction with world elder abuse awareness day, let us look at some of the common elder abuses that may happen:

1. Physical Abuse: The use of physical force that may result in bodily injury, physical pain or impairment. This encompasses the act of hitting, pushing, slapping, restraining or using unnecessary restraints caused by other than accidental means.
2. Emotional or Psychological Abuse: Inflicting emotional pain, distress or anger through verbal or non-verbal actions. For example, threats, harassment, intimidation, humiliation, use of inappropriate names, isolation or constant belittling.
3. Financial abuse: Illegally or inappropriately taking advantage of an elderly’s vulnerability to exploit and/or use their financial resources or assets without their consent. For instance; theft, fraud, coercing or deceiving an older person into signing any official documents (ie: contracts, wills), manipulation or misusing power of attorney.
4. Sexual abuse: Non-consesual sexual contact or exploition of an elderly such as engaging in any unwanted sexual activity, forced nudity or any sexual contact achieved through threats or manipulation.
5. Neglect: Failure to fulfill a caregiver’s responsibility to care for them or provide the necessary care and support for an elderly’s well-being. Neglect can be intentional or unintentional and may involve withholding essential necessities such as food, water, medications access, hygiene or medical care.
6. Abandonment: Deserting or deliberately leaving an older person alone without making appropriate arrangements for their care or safety. Their surroundings can also appear unhygienic and unsettling where elderly are left with a high risk of infection or getting ill. This can happen both at home or an entrusted institutional elderly care facility or nursing homes
7. Isolation: Refers to preventing the elderly from keeping in touch or having access to communicate with others. This could mean locking them up in a room or hindering all forms of contact with their friends/relatives and the outside world.
8. Self-Neglect: Older individuals may also neglect their own basic needs which subsequently may lead to harm or endangerment. Examples include neglecting personal hygiene, getting the right amount of nutrition, medical care or living in unsafe or unsanitary conditions.

Signs of an elder abuse: 

1. Unexplained, sudden appearance of bruises, cuts, burns, untreated injuries or fractures
2. Change in behavior such as fear or agitation around certain individuals
3. Appears depressed, withdrawn or confused
4. Loss of appetite or sudden weight loss, malnutrition or dehydration
5. Caregiver’s refusal to allow visitors or participation in conversations without their presence
6. Poor personal hygiene, appear messy and untidy
7. Unattended medical needs or missed medications or medical conditions getting from bad to worse
8. Lack of necessary assistive devices such as wheelchair, walking stick, hearing aids, commodes etc (if applicable)
9. Has bed sores or any preventable diseases
10. Recent changes in banking or spending patterns

Risk factors for elder abuse

There is no doubt that caring for an older adult who has many different needs can be demanding, difficult and often stressful. Caregivers may need to be available around the clock to provide medical assistance, nursing care, taking care of their basic needs, and at the same time foot a lump sum of hefty medical bills. Over time, the demands and stress of caregiving can take a toll on the caregivers’ lives where abuse is more prone to occur.

Besides, other factors that may contribute to elder abuse include: 

• Mental issues faced by caregivers
• Lack of support from other caregivers 
• Substance abuse by the caregiver
• History of domestic violence within the family
• Intensity of the elderly’s illness or dementia
• Inexperienced caregivers

Who can help? 

Elder abuse is a serious concern that often goes unnoticed. Most elderly are too frail and weak to report mistreatment and take any action. Hence, family members or friends who notice these signs should always try to intervene and help whenever possible. If you suspect anyone is being abused in any way, try to find a time and way to talk to them when both of you are alone. The conversation can be as simple as you checking in and seeing if they’ve been eating well, getting enough rest and are getting their medical needs met. It is nice to encourage them to seek help and support, and continue to be a source of support throughout the process.

Efforts towards abuse prevention should also focus on:

1. increasing awareness towards building a strong family structure and cohesiveness (ie: increase accessibility for comprehensive family support towards victims such as psychosocial support, counseling)
2. increasing mental (ie: anger management, conflict resolution) and medical health literacy (ie: supplement benefits, ways to treat certain medical conditions) 
3. coping skills and promoting self-care among family members.

In Malaysia, if you know or suspect any elderly who is at risk of or is experiencing any form of elder abuse, the Welfare Department or Kasih Helpline is available to be contacted at 15999 or WhatsApp 019-261 5999 anytime. Police report should also be lodged if there is any violence involved.

You can make a difference

It is crucial to approach elderly interactions with empathy, patience and respect. By understanding and acknowledging the challenges faced by older individuals and their dependance on us, we can work towards creating a supportive environment that fosters positive interactions as well as prioritizing the well-being of the elderly.

As a family member, the first step you can do to prevent elderly abuse is to rely on a provider you can trust. Always check in with your loved ones once in a while and ensure they’re being well taken care of. If you’re the caregiver him/herself, it is highly encouraged you seek help when it gets too overwhelming or stressful to cope. Recognising predisposing factors that may contribute to elder abuse is the biggest step to getting help and preventing abuse.

This article is written by Janelle Leong, Bpharm(Hons) (DOC2US),
reviewed by Dr. Muhamad Syaqir bin Shukri, MBBS (DOC2US). 

References

1. https://worldelderabuseawareness.com/types-of-elder-abuse/ 

2. https://www.nia.nih.gov/health/elder-abuse#who 

3. https://www.helpguide.org/articles/abuse/elder-abuse-and-neglect.htm 

4. https://www.apa.org/topics/aging-older-adults/elder-abuse 

Summary 

Recognizing the signs: How to Identify Elder Abuse

Different forms of elder abuse
 

• Physical Abuse 

• Emotional or Psychological Abuse 

• Financial abuse

• Sexual abuse

• Abandonment

• Isolation

Signs of an elder abuse: 

• Unexplained, sudden appearance of bruises, cuts, burns, untreated injuries or fractures

• Change in behavior such as fear or agitation around certain individuals

• Appears depressed, withdrawn or confused

• Loss of appetite or sudden weight loss, malnutrition or dehydration

• Caregiver’s refusal to allow visitors in conversations without their presence

• Poor personal hygiene, appear messy and untidy

• Unattended medical needs / missed medications 

• Lack of necessary assistive devices such as wheelchair, hearing aids etc (if applicable)

• Has bed sores or any preventable diseases

• Recent changes in banking or spending patterns

How can we help?

In Malaysia, if you know or suspect any elderly who is at risk of or is experiencing any form of elder abuse, you may contact 

Welfare Department / Kasih Helpline

Call 15999

WhatsApp 019-261 5999 

Written By

Janelle Leong, Bpharm(Hons) DOC2US

Reviewed By

Doc2us Medical Board