Intimidation. Negligence. Emotional blackmail and manipulation. Theft. Push and shove. Infantilization. Threat. Aggression. Abuse and neglect can take many forms.
Are you an older adult? Do you feel vulnerable in certain situations? Do you think you are being abused or neglected, but are afraid of reprisals or do not know what to do? Do you have an elderly parent and worry about his or her safety? Have you witnessed acts of elder abuse?
If so, you are not alone. Did you know that in Canada, it is estimated that between 4% and 10% of people over 65 live in situations of abuse and neglect (1)? According to the World Health Organization, elder abuse is: "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" (2).
A systematic review of 62 studies was conducted to identify ways to prevent and combat elder abuse and neglect in Canada, particularly in healthcare settings. These studies, conducted from 2000 to 2013, focused specifically on the identification, evaluation and response to abuse cases (3).
What does the research tell us
How to identify abuse and neglect
Recent deterioration of health status, mental illness, alcohol or drug use, dehydration or malnutrition, poor hygiene, bruises to the face, arms or torso: these are indicators and risk factors associated with abuse and neglect cases. Talk to your health- and social-system professional about your situation at your next appointment. They can screen for, question, identify and confirm potential cases of abuse.
How to prevent
Several studies identified in the systematic review suggest that different stakeholders do not have a good understanding of the laws and resources to protect older adults. Implementing measures to increase knowledge about abuse could help stakeholders, for example, better identify potential cases of abuse, as well as clarify their roles and responsibilities.
To prevent abuse, studies indicate that strategies to support older victims, such as support groups and organized community activities, are promising as a way to build trust with different stakeholders, promote informal exchanges, and make assistance accessible if needed.
The systematic review also reveals that caregivers are often stressed and do not always know how to adequately meet the needs of the older adults they care for. Better listening to their needs, as well as offering stress management training, support for older adults and care to address specific health issues seem to mitigate psychological abusive behaviours by caregivers.
Funding mass media campaigns to increase public information and awareness about elder abuse seems promising to improve the situation by breaking the silence and promoting reporting of abuse cases. Such awareness can also help to change attitudes and behaviours towards abuse.
Finally, establishing clear processes to report cases of abuse within health- and social-system teams is a good practice, as well as a better interdisciplinary collaboration of different stakeholders.
What organizational and systemic policies are required?
To reduce the incidence of elder abuse, the systematic review highlights the importance of putting in place measures to improve the working conditions of health- and social-system professionals, monitoring abuse in institutions providing care and services to older adults, creating training and support programs, as well as developing and publicizing the resources available to older adults and caregivers.
Whether you are an older adult or caregiver, resources exist to help you deal with abuse. Do not hesitate to seek help from a health professional or social worker.