Signs of elder abuse and neglect

Elder abuse and neglect takes many forms and happens in many settings. Overseas research and Age Concern's experiences point to patterns indicating risk for older people and their carers.

• Note: Assessing situations of elder abuse and neglect requires special skills and only people trained in this area should undertake assessments. Some indicators of abuse, for example bruising, are not in themselves direct evidence of abuse. It is important not to jump to conclusions.

• What is elder abuse?
• Indicators of older people more at risk
• People more likely to inflict abuse/neglect
• Risk factors for carers
• Identification
• Signs of abuse

What is elder abuse?

The official definition:

Elder Abuse and Neglect 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. It can be of various forms: physical, psychological/ emotional, sexual, or financial/material abuse, and/or intentional or unintentional neglect.

- Definition from Toronto Declaration on the Global Prevention of Elder Abuse, 2002

Indicators of older people more at risk

• Dependency on one person for all or part of their care
• Mental or physical disabilities
• Communication difficulties
• Long standing negative personality traits that may have become more pronounced
• Family backgrounds of violence and tension
• Feelings of low self-esteem
• Limited social contacts and networks and isolation from ethnic support groups.

People more likely to inflict abuse/neglect

Elder Abuse and Neglect occurs for many reasons. There may be a background of family violence. Carers (including family members) may be struggling with this role and the change in their relationship with the older person/kaumatua. While many people are able to provide care competently, some can harm the people they care for because of inadequate support, supervision or training. The impact of dementia, alcohol/substance abuse and other mental health problems can all contribute.

Older people may also be abusers.

The exception is financial abuse which can be premeditated and caused by greed as much as by other factors such as economic stress.

Risk factors for carers

• Stress in other areas of their life such as unemployment, finances or health
• Previous family conflict and tension
• Difficulty controlling feelings of anger and frustration
• Background of mental health problems
• Background of alcohol or drug related problems
• Poor support and/or social networks
• Feelings of low self-esteem.
• Dependency on the older person/kaumatua for money, housing, emotional support

Family members who are caring for a dependent older relative may be reluctant to seek help for a variety of reasons. It is important that they are given support and understanding while preventing further abuse.

Identification

Older people/kaumatua may be reluctant to seek help for some of the following reasons:

• Physically or mentally unable to make a report
• Isolated and completely under the control of the abuser
• Fear of retribution from the abuser
• Fear of being blamed
• Fear consequences to other family members, fear losing contact with family members
• Unaware of support services available or believe that no one can really help them
• Ashamed to tell anyone a family member is abusing them
• Fear of having to leave their home or of their partner being institutionalised.

Signs of abuse

Older people facing abuse and/or neglect may exhibit these general behavioural signs.

• Fear of a particular person/people
• Worry and anxiety for no obvious reason
• Irritable and overly emotional
• Presenting as helpless, hopeless and sad
• Use contradictory statements not resulting from mental confusion
• Reluctant to talk openly. For example, waiting for the carer to answer
• Avoidance of physical, eye or verbal contact. (Note cultural differences in respect of such contact however).
  

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