Elder abuse is a silent problem that robs seniors of their dignity, security and in some cases, costs them their lives.
The World Health Organization declares elder abuse to be a violation of human rights and a significant cause of illness, injury, loss of productivity, isolation and despair.
Adult Protective Services agencies show an increasing trend in the reporting of elder abuse. In Ashe County alone, there were 91 reports in 2012 for 12 months. In the past nine months since July 1, 2014, the agency has received 92 reports.
Even though there are mandatory reporting laws for elder abuse in most states an overwhelming number of cases go undetected and untreated each year. A vast majority of abusers, 90 percent, are family members, most of whom are adult children, spouses, partners and others.
Interpersonal violence occurs at disproportionate and elevated rates among men and women with disabilities. Individuals who have dementia are thought to be at a greater risk of abuse and neglect than those in the general population.
May is Elder Abuse and Vulnerable Adult Awareness month. One of the main purposes of the Ashe County Elder Abuse Prevention Team is to promote awareness regarding abuse, neglect and exploitation of this population in our community.
We will be presenting a series of four articles meant to highlight the types of mistreatment of the elderly and vulnerable adult that place their safety and well-being at-risk. Our goal is to equip the citizens of our communities with information so that they will be able to recognize the signs and indicators of abuse, learn how to report it and find help and resources to intervene and assist to prevent it.
Part I-Physical, Sexual & Mental Abuse
Bessie, 85, lost her husband last year. Because of her severe arthritis and congestive heart failure, she is no longer able to care for herself and has moved in with her daughter, Denise.
Denise is divorced, has four children, one who has just become a college freshman, and is having a difficult time managing financially. The house is small and everyone feels as if they have no privacy. Sometimes Denise feels as if she is at the end of her rope. Caring for her mother, struggling to keep the bills paid, especially.
Knowing that the next semester’s tuition is due and “keeping the peace” at home is taking its daily toll on Denise. Denise has been finding herself calling her mother names, telling her mother that “it’s all her fault, that she is having so many problems and that if she doesn’t start doing more for herself, she’s going to put her in the nursing home.”
Yesterday, Bessie wet the bed twice and Denise became so upset, that she grabbed her mother by the arms, shook her and slapped her face. Bessie feels so frightened, trapped and worthless and prays that her life will end soon. A tear runs down her cheek as she looks hopelessly out the window.
Physical Abuse is physical force or violence that results in bodily injury, pain or impairment. It includes assault, battery and inappropriate restraint.
Physical indicators or signs of possible physical abuse are:
• Sprains, dislocations, fractures or broken bones
• Slap marks and/or pressure marks
• Burns from cigarettes, appliances or hot water
• Abrasions on arms, legs, or torso that resemble rope or strap marks
• Internal injuries evidenced by pain, difficulty with normal functioning of organs, and bleeding from body orifices
The following types of bruises are rarely accidental:
• Bilateral bruising to the arms (may indicate that the person has been shaken, grabbed, or restrained
• “Wrap around” bruises that encircle an older person’s arms, legs, or torso (may indicate that the person has been physically restrained)
• Multicolored bruises (indicating that they were sustained over time)
• Injuries healing through “secondary intention” (indicating that they did not receive appropriate care)
• Signs of traumatic hair and tooth loss
Behavioral indicators, ways the victims and abusers act or interact with each other are:
• Injuries are unexplained or explanations do not “fit” with the injuries observed
• Family members provide different explanations of how injuries were sustained
• A history of similar injuries, and/or numerous or suspicious hospitalizations
• Victims are brought to different medical facilities for treatment to prevent medical practitioners from observing a pattern of abuse
• Delay between onset of injury and seeking medical care
Sexual Abuse is physical contact with an elderly person without the elder’s consent. It includes rape, molestation or any sexual conduct with a person who lacks the mental capacity to exercise consent.
Sexual Abuse can also involve activities such as showing an elderly person pornographic material, forcing the person to watch sex acts, or forcing the elder to undress.
Physical indicators for Sexual Abuse are:
• Genital or anal pain, irritation, or bleeding
• Bruises around the breasts, or on external genitalia or inner thighs
• Difficulty walking or sitting
• Torn, stained, or bloody underclothing
• Sexually transmitted diseases
Behavioral indicators are:
• Inappropriate sex-role relationship between victim and suspect
• Inappropriate, unusual, or aggressive sexual behavior
Mental or Psychological Abuse is the willful infliction of mental or emotional anguish by threat, humiliation, or other verbal or nonverbal conduct. It can be any of the following:
• Rejecting or denying a person’s value or presence
• Degrading, ridiculing, insulting or name-calling to lessen the self-worth and dignity of another person
• Terrorizing by inducing intense fear in someone, intimidating and coercing; or threatening physical harm to a person or a person’s loved one, pets or possessions.
• Isolating, confining or limiting another’s freedoms
• Detaching and denying emotional care or affection
Physical indicators are:
• Significant weight loss or gain that is not attributed to other causes
• Stress-related conditions, including elevated blood pressure
Behavioral indicators are:
• Caregiver isolates the elder emotionally by not speaking to, touching, or comforting him or her
The elder person:
• Has problems sleeping
• Exhibits depression and confusion
• Cowers in the presence of abuser
• Is emotionally upset, agitated, withdrawn, and non responsive
• Exhibits unusual behavior usually attributed to dementia (e.g., sucking, biting, or rocking)
Keep in mind that any of the above mentioned indicators or behaviors can be legitimately explained as created by some other cause. No single indicator can be taken as conclusive proof of abuse.
One should look for patterns or clusters of indicators that suggest a problem.
If you suspect or observe any of these indicators, it is the responsibility of every citizen in the state of N.C. to make reports. Contact numbers to report in Ashe County are; Ashe County DSS 846-5719, Ashe County Sheriff’s Office at 846-5600 and A Safe Home for Everyone (A.S.H.E.) for domestic violence issues 982-8851. Let’s stop the hurting.
The Elder Abuse Prevention team will be hosting an event from 10 a.m.-2 p.m. on May 16, at the Old Jefferson Courthouse on Main Street in Jefferson. There will be service providers in our community there to give information about services and resources available for the elderly and or disabled.
We also will have an Awareness Walk at 11 a.m. Please come and join us and help to Stop the Hurting.