Chapter 4
Elderly Abuse

Intervention Concerning Abuse of the Elderly

Each year hundreds of thousands of older persons are abused, neglected and exploited by family members and others. Many of the victims are people who are frail, vulnerable and cannot help themselves, and depend on others to meet their most basic needs. (www.ada.gov; Elder Abuse).

Elder abuse is an umbrella term used to describe one or more of the following: (www.ada.gov; Elder Abuse).

v      Physical abuse is the willful infliction of physical pain or injury, e.g., slapping, bruising, sexually molesting, or restraining.

v     Sexual abuse is the infliction of non-consensual sexual contact of any kind.

v      Emotional or psychological abuse is the infliction of mental or emotional anguish, e.g., humiliating, intimidating, or threatening.

v      Financial or material exploitation is the improper act or process of an individual, using the resources of an older person, without his/her consent, for someone else's benefit.

v     Neglect is the failure of a caretaker to provide goods or services necessary to avoid physical harm, mental anguish or mental illness, e.g., abandonment, denial of food or health related services.

v      Self-neglect is characterized as the behavior of an elderly person that threatens his/her own health or safety.

The 1998 National Elder Abuse Incidence Study funded in part by The Administration on Aging (AoA) found the following:

v      551,011 persons, aged 60 and over, experienced abuse, neglect, and/or self-neglect in a one-year period;

v      Among known perpetrators of abuse and neglect, the perpetrator was a family member in 90 percent of cases. Two-thirds of the perpetrators were adult children or spouses. (www.ada.gov; Elder Abuse).

v     Persons, aged 80 years and older, suffered abuse and neglect two to three times their proportion of the older population;

v      Almost four times as many new incidents of abuse, neglect, and/or self-neglect were not reported as those that were reported to and substantiated by adult protective services agencies;

The State of Florida requires that any person who has knowledge of or suspects that an elderly person or child has been abused, neglected or exploited must report this immediately to the abuse hotline at 1-800-962-2873. Any person willfully failing to report such treatment is guilty of a class A misdemeanor, punishable as provided in Florida Statute 775.082 or 775.083.

A physician should first report the incident to adult protective services. In flagrant abuse cases where the physician feels eminent danger to the abused elder, immediate admission to a hospital, alternative caregiver, or nursing home or adult congregate living facility is mandatory to remove the endangered elder from the abusive situation.

What may be surprising is that many abused elderly will refuse help.  In fact, the victim will often deny obvious abuse.  The causes of this behavior seem rooted in embarrassment and fear.  The elder is possibly ashamed of being abused.  They may also have the fear of reprisal, abandonment, or being committed to a nursing home.

While remaining an advocate for the patient, the doctor must forge a positive partnership, rather than an adversarial relationship, with the abusing caregiver. The elder must be told the mistreatment may continue to escalate with time. Success is a relative term in such cases.  It should not be surprising that even when intervention was completed, most of these cases were not felt to be satisfactorily resolved.

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