"Pity the sorrows of a poor old man,"
- Thomas Moss (1740-1808), English minister and poet
"The Beggar" (1769)
I Have written about the "battered child" but unfortunately, at the other extreme is its (less known) equivalent, the "battered elder." The Merck Manual defines "elder abuse" as the "physical or psychologic mistreatment, neglect, or financial exploitation of the elderly." So it's clear that there are so many more layers of abuse possible in the old. In fact, abuse takes many forms, according to the US Administration on Aging:
• Physical abuse - inflicting physical pain or injury on a senior. For example, slapping, hitting or restraining by physical or chemical means.
• Sexual abuse - non consensual sexual contact of any kind.
• Neglect - the failure of the responsible to feed, provide shelter or health care, or protection of the vulnerable elder.
• Exploitation - the illegal taking, misuse, or concealment of funds, property or assets of a senior for someone else's benefit.
• Emotional abuse - humiliating, threatening, intimidating - inflicting mental pain and anguish or distress on an elder person through verbal or non verbal acts.
• Abandonment - desertion of a vulnerable elder by anyone who has assumed responsibility or custody of that person.
• Self-neglect -the failure of a person to perform essential, self-care tasks and that such failure threatens his/her own health or safety.
Signs of Abuse. Sadly, statistics reveal that up to 85% of elder abuse is inflicted by their own relatives. This could be a spouse, child, or younger sibling that was left the responsibility for the care of the elder. Obvious signs of physical abuse are bruises, broken bones, burns. Examine for broken dentures or eyeglasses. Joint swellings are not necessarily just arthritis but could be sprains or dislocations. Bedsores, poor hygiene, unattended medical needs, and weight loss may be signs of neglect. Abused old people are usually withdrawn and will not want to talk about his or her suffering in an attempt to sometimes protect the provider.
Complex situation. Most of the time, elder abuse is the expression of problems from both the victim and the perpetrator. An old person with cognitive impairment from dementia (Alzheimer's disease) may be aggressive and disruptive. Caregivers may become frustrated and lose patience. Perpetrators can have a history of violence, drug abuse, alcohol addiction, making it easier for them to hurt the vulnerable old. In the Philippines, add the over arching burden of poverty.
What to do. If a victim seen at the Emergency Room is in immediate danger, consider admitting the patient and informing the police. This is also reportable to the Department of Social Welfare and Development (DSWD) (632)931-81-01 to 07; DSWD website http://www.dswd.gov.ph
A US 13-year longitudinal study shows that abused elderly people are at a higher risk of death compared to the non-abused. The abused had a survival rate of 9% versus 40% for the non-victimized. Let's open our eyes to this hidden shame. We should love our old, not hurt them.