|Sunday, 10 February 2008 ||
Old age is a risk factor for a range of conditions, including elder abuse and neglect which manifest through conditions such as bedsores, impaired mobility, incontinence, falls, dehydration, malnutrition and confusion.
Australia's aged care infrastructure is groaning under the lack of funding resulting in inadequate care, being given to our elderly citizens. That strain is also obvious in that many aged care advocacy agencies, as well as the media, have consistently reported on the shameful state of our aged care system. Many of our facilities are clearly unable to cope with providing the level of care that is required to look after our precious elderly citizens.
As the older population increases, so does the need for comprehensive geriatric evaluation and treatment of our elderly in hospitals and nursing facilities. Carers charged with the responsibility of caring for the elderly need to be able to provide thorough evaluation and treatment of geriatric symptoms.
Definition of Elder Abuse - too "tricky" for government?
Since April 1 2007 aged-care proprietors/managers have been required to report all instances of "sexual and severe physical assault".
The ACCT is not alone in urging the Federal Government to extend reporting to include other common forms of abuse - including psychological abuse.
Update: 7 June 2013
The tragic case of 88 year-old Cynthia Thoresen recently made headlines in Queensland. Mrs Thoresen’s sad decline and the extent of her injuries have been comprehensively documented.
Despite shocking neglect, her carer, daughter Marguerite, could not be successfully prosecuted in the context of existing laws. As a result of the case, Queensland’s deputy state coroner called on the state attorney-general to consider relevant law reform. Such a review would include, it seems, the criminalisation of mistreatment of older people.
Types of elder abuse
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.
Elder abuse can affect people of all ethnic backgrounds, social status and gender.
An extract found in one of eight commissioned papers prepared for: 2020 A Vision for Aged Care In Australia - The Myer Foundation:
Morbidity among Older People in Residential Care:
Why Don't We Know More About Abuse or Neglect of Older People?
It's not a "sexy" subject, is it? It's despicable, distasteful, it's certainly not "dinner" conversation, is it? But unfortunately, it exists. If you don't care about it now, it could be too late when it happens to someone you love. That someone could be you.
The Australian newspaper's Aged Care writer, Kate Legge reported in June 2004:
"There are no reliable national statistics to confirm the size of the problem. There is no mandatory reporting. No policy framework for investigating complaint. Not even an agreed definition of what constitutes elder abuse"
"They are hidden away. They don't go to school or out to the shops. No one sees them. Vulnerability and dependency are the two main prerequisites of elder abuse..."
Some of the reasons attributable to abuse and neglect of the elderly are:
There are many locations where abuse can occur, such as in a domestic situation, nursing homes, assisted living facilities, and other long term care facilities. Abuse can even occur in adult day care centers and community centers. Abuse can happen to anyone.
Some medical conditions can be difficult to deal with - especially if you have not had any experience OR exposure to it before. As a starting point, we would suggest that you browse through this site, where you will find many links, resources, and articles.
What are the Causes of Nursing Home Neglect and Abuse?
Nursing home neglect and abuse has often been attributed to under qualified and insufficient staff. When staff are not properly trained, or overworked because there are too few workers, the results can be deadly. Some instances of nursing home neglect and abuse are acts of frustration. Nursing home staff has been viewed as "under-valued". Most aged-care workers earn only $13 or $14 an hour, despite many having to care for 60 or 70 residents a night (note there are no guidelines for actual number of staffing levels). Fast-food giant McDonald's pays workers over 21 almost $14 an hour.
Elder abuse or neglect by staff in care facilities may occur because of:
Neglect is a type of elder abuse defined as the refusal or failure to fulfill any part of a worker's obligations or duties to a nursing home resident. Neglect and elder abuse in nursing homes may also include the failure to provide necessary care. Neglect typically means the refusal or failure to provide a nursing home resident with such life necessities as food, water, clothing, shelter, personal hygiene, medicine, comfort, personal safety, and other essentials included in an implied or agreed-upon responsibility to a resident.
The following descriptions are not necessarily proof of abuse, neglect, or exploitation, but they may be cues that a problem exists.
Signs and symptoms of elder abuse and neglect include but are not limited to:
Signs by Caregiver:
Medical Neglect is the failure to provide proper medical geriatric care to the elderly. There have been recent reports alleging that nursing homes or hospitals, have failed to provide appropriate medical treatment to the elderly.
Signs and symptoms of medical neglect include but are not limited to:
Self-neglect is characterised as the behavior of a nursing home resident that threatens his/her own health or safety. Self-neglect is elder abuse that generally manifests itself in a resident as a refusal or failure to accept adequate food, water, clothing, shelter, personal hygiene, medication (when indicated), and safety precautions. The definition of self-neglect excludes a situation in which a mentally competent nursing home resident, who understands the consequences of his/her decisions, makes a conscious and voluntary decision to engage in acts that threaten his/her health or safety as a matter of personal choice.
Signs and symptoms of self-neglect include but are not limited to:
Physical elder abuse is the use of physical force that may result in bodily injury, physical pain, or impairment. Physical elder abuse may include acts of violence like striking, with or without an object, hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning.
The inappropriate use of drugs and physical restraints, force-feeding, and physical punishment of any kind also are examples of physical elder abuse.
Signs and symptoms of physical elder abuse include but are not limited to:
Emotional or Psychological Abuse
Emotional or psychological elder abuse is defined as the infliction of anguish, pain, or distress through verbal or nonverbal acts. Emotional/psychological elder abuse includes but is not limited to verbal assaults, insults, threats, intimidation, humiliation, and harassment. In addition, treating a nursing home resident like an infant; isolating a nursing home resident from his/her family, friends, or regular activities; giving a resident the "silent treatment;" and enforced social isolation are examples of emotional/psychological elder abuse.
Signs and symptoms of emotional/psychological elder abuse include but are not limited to:
Abandonment in the form of elder abuse is the desertion of a nursing home resident by a nursing home worker, who has assumed responsibility for providing care for the resident.
Signs and symptoms of abandonment include but are not limited to:
Sexual elder abuse is defined as non-consensual sexual contact of any kind with a nursing home resident. Sexual contact with any person incapable of giving consent is also considered sexual elder abuse. It includes but is not limited to unwanted touching, all types of sexual assault or battery, such as rape, sodomy, coerced nudity, and sexually explicit photographing.
Signs and symptoms of sexual elder abuse include but are not limited to:
Financial or material exploitation is the illegal or improper use of a nursing home resident’s funds, property, or assets. Examples of this elder abuse include, but are not limited to, cashing a nursing home resident’s checks without authorization/permission; forging a resident's signature; misusing or stealing a resident’s money or possessions; coercing or deceiving a resident into signing any document (contracts or will); and the improper use of conservatorship, guardianship, or power of attorney.
Signs and symptoms of financial or material exploitation include but are not limited to: