INTRODUCTION:

The term “Elder abuse is the infliction of harm on an older person”. Abuse is any act or failure to act that endangers the health and/or well being of the older person. Abuse is simple, meaning abuse is when one person purposefully hurts another. Each year hundreds of thousands of older persons are abused, neglected, and exploited. Abusers of older adults are both women and men, and may be family members, friends, or trusted others. Elder abuse is a general term used to describe harmful treatment toward an elderly person.

This includes physical abuse, emotional abuse, sexual abuse, psychological abuse, financial exploitation and neglect. Elder abuse can also occur in institutional settings, especially long – term care facilities. Old person has suffered injury, deprivation, or unnecessary danger, and that a specific other individual is neglected.

Definition:

Elder abuse is a term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult.

(WHO) The World Health Organization defines elder abuse as “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.”

“Any knowing, intentional or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult.”

(National centre on elder abuse)

Causes of Abuse:

1. Negative attitudes

2. Caregiver

3. Dehumanizing stereotypes

4. External stress

5. Violence

6. Social isolation

7. Dependent for basic needs

8. Suffering from a physical or mental impairment

9. Fear

10. Withdrawal depression or helplessness

11. Emotionally and financially weak

Types of elder abuse:

1. Physical Abuse:

Physical elder abuse is non accidental use of force against an elderly person that result in physical pain, injury or impairment such abuse includes not only physical assaults such as hitting or shoving but the inappropriate use of drug, restraints, or confinement. There are many signs of physical abuse. If you see any of the following signs please get help right away. 2.6% in community settings and 14.1% in institutional settings.

Physical abuse includes Broken bones, sprains, or dislocations, Broken eyeglass, Unexplained signs of injury such as bruises, welts, or scars, especially if they appear symmetrically on two side of the body, Overdose of medication, Signs of being restrained, such as rope marks on wrists, Caregiver’s refusal to allow to see the elder alone, Wilful infliction of physical pain or injury, Hitting, slapping, shaking, striking with objects, use of physical or chemical restraints

2. Emotional Abuse:

When caregiver harms In emotional or psychological abuse, people speak to or treat elderly persons in ways that cause emotional pain or distress.in addition to the general signs of physical abuse. 11.6% elder abuse in community settings and 33.4% elder abuse in institutional settings. Emotional elder abuse includes verbal forms and nonverbal form.

Elder abuse include: In addition to the general signs above, indications of emotional elder abuse

Threatening, belittling, or controlling caregiver behaviour that you witness, Dementia, such as rocking, sucking or mumbling to oneself

3. Sexual Abuse:

Sexual elder abuse is contact with an elderly person without the elder’s consent. Such contact can involve physical sex acts but activities such as showing an elderly person pornographic material, forcing the person to watch sex acts. 0.9% elder abuse in community settings 1.9% elder abuse in institutional settings.

Sexual abuse include:

Unexplained vaginal or anal bleeding, Stained or bloody underclothing Genital infections, Bruises around breasts or genitals.

4. Neglect or Abandonment by Caregivers:

Elder neglect, failure to fulfil a caretaking obligation, constitutes more than half of all reported cases of elder abuse. It can be active (intentional) or passive (unintentional, based on factors such as ignorance or denial that an elderly charge needs as much care as he or she does) self-neglect means older family member, friend, or neighbour living alone is no longer taking care of themselves. 4.2% elder abuse in community settings and 11.6% elder abuse in institutional settings.

Neglect abuse include:

Weight loss, Malnutrition, Dehydration, Bed sores Dirty, bugs, soiled bleeding under clothes, Unbathed, Unsuitable clothing or covering for the weather, Unsafe living condition, Desertion of the elder at a public place

5. Financial Exploitation:

This involves unauthorized use of an elderly person’s funds or property, either by a caregiver or an outside scam artist.6.8% elder abuse in community settings 13.8 % elder abuse in institutional settings.

An unscrupulous caregiver might

· Misuse an elder’s personal cheques, credit cards, or accounts.

· Steal cash, income checks, or household goods .

· Forge the elder’s signature

· Engage in identity theft

Financial abuse include:

Items or cash missing from the senior’s household, Sudden changes in the elders financial condition

6. Healthcare Fraud and Abuse:

Carried by unethical doctors, nurses, hospital personnel, and other professional care providers, examples of health care fraud and abuse regarding elders include

· Medicine fraud

· Not providing healthcare, but charging for it

· Overmedicating or under medicating

· Overcharging or double – billing for medical care services

Risk Factors:

· Cognitive impairment

· Psychiatric illness or psychological problems

· Behavioural problems

· Poor physical health

· Low income or wealth

· Trauma

· Past history of abuse

· Burden

· Stress

· Poor conflictual relationship

· Low social support

· Poor living condition

· Inability to perform activities of daily living

· Social isolation

· Depression, confusion, substance abuse or dependence

Assessment:

· Perform cognitive assessment such as mini – mental state examination

· Ask brief screening questions such as, “how are things at home” do you feel safe at home ?

· Assess the elderly person’s general appearance. Such as skin integrity, hygiene, clothing, nutrition.

· Assess the sings of abuse such as burns, cuts, broken bone, bruises around the genitals or breast. Personality change, lack of regular activities or change in mental status.

· Evaluate risk factors of abuse

· Collect the patient history such as medical, surgical, psychiatric

· Look for signs of neglect such as weight loss, malnutrition, bedsores, poor hygiene, urine burns, dehydration, improper health care.

· Assess the relationship between the patient and his caregiver. If you observe the caregiver or another family member making threats, belittling the elderly adult or exerting unnecessary power.

Role of Community Health Nurse in Prevention of Abuse Elderly:

· Community health nurse advice mass awareness about the problem and education regarding causes, prevention and control of the problem

· Maintain a safe, clean and healthful environment for the patient

· Care of the patient welfare socially, intellectually, spiritually, physically and emotionally

· Guide and assist the patient in their personal hygiene

· Caregiver must be a good listener

· Caregivers are hidden patients in need of protection from physical and emotional harm

· Identify key caregiver

· Assess caregiver roles and relationship to patient

· Identify need of caregivers

· Guidance and counselling of family members

· Participating in the individual and group psycho therapy session and activating the implementation of the cats.

REFERENCES:

1. Dr. T. Vasundhara Tulasi, Dr. G. Gnana Prasuna “Community Health Nursing”, second edition, Frontline publication, page no, 380-382.

2. Bijayalaskhmi Dash “A Comprehensive Textbook of Community Health Nursing”, Jaypee publication, page no 643- 645.

3. G. Gnana prasuna “Community Health Nursing”, frontline publication, page no 580- 583

4. https://www.who.int/news-room/fact-sheets/detail/elder-abuse

5. Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies. Pillmer K, Burnes D, Riffin C, Lachs M. The Gerontologist. 2016; 56(2); 194-205. https://pubmed.ncbi.nlm.nih.gov/26994260/

6. Anja Botngård A. [Internet]. 2022 [cited 10 January 2022];. Available from: https://pubmed.ncbi.nlm.nih.gov/31900138/

7. Yongjie Yon Y. [Internet]. 2022 [cited 10 January 2022];. Available from: https://pubmed.ncbi.nlm.nih.gov/28104184/

8. M S Lachs M. [Internet]. 2022 [cited 10 January 2022];. Available from: https://pubmed.ncbi.nlm.nih.gov/9279035/

Received on 10.01.2022 Modified on 28.01.2022

Res. J. Humanities and Social Sciences. 2022;13(3):208-210.

DOI: 10.52711/2321-5828.2022.00033