Elder Abuse

Name: Lucy Klein

Assignment 02

TITLE
Explain the term “abuse and neglect of the elderly” and fully discuss the nature and extent of elder abuse. Substantiate your discussion with a case study or newspaper/internet article on the topic and discuss it in relation to the theory in your assignment

Table of Contents

General Information Title
Page No.
1. Introduction 4
2. Definition of key concepts 5 2.1 Elder Abuse
2.2 Neglect
3. Nature and extent of elder abuse 6 - 7
4. Causes 8 - 9
5. Prevention and recommendations 10 - 11
6. Conclusion 12
7. Newspaper article 13 - 15
8. Bibliography 16

Introduction
Elder abuse occurs across all economic, ethnic, religious, gender and cultural groups. Abuse is harm caused by people the older person knows or with whom they have relationship such as their spouse, partner of a family member, friends, neighbours and care givers.
What is elder abuse? It is the neglect, exploitation or “painful or harmful” mistreatment of anyone who is 65 or older (or anyone aged 18 to 64 who falls under the legal definition of a “dependent” adult). It can involve physical violence, psychological abuse, isolation, abandonment, abduction, false imprisonment or a caregiver’s neglect. It could also involve the unlawful taking of a senior’s money or property.
According to Twain (2008:1), elder abuse is a relatively new phenomenon, not only in South Africa but globally. When I think about the word abuse, the first representation that comes to mind is a violent beating of some sort and not so much mental abuse. One of the most commonly accepted definition is a single or repeated act occurring within a relationship where there is an expectation of trust. It is most commonly the use of power and control by one individual to affect the well-being and status of another older individual.

Understanding how elderly people are being harmed is important. It helps one identify the problem and prevent the person from being harmed .It also helps prevent abuse of elderly people in future.
People often see the abuse and say nothing, most are family members and caregivers who are afraid to speak up because they think that their co-workers or other family members will retaliate. Then there are those that think that they may lose their jobs at work or be viewed as outcast and shunned by the family. There are some elderly people with adult children who also abuse them, because they can’t deal with the stress of taking care of their elderly parents, they think of them as being a burden and don’t have the time or the patience and rather not deal with them.

Definitions of key concepts
The definition of the national NGO Action on Elder Abuse South Africa (AEASA) is conservative and refers to "…any act of commission or omission, intentional or unintentional, that causes an older person to experience distress, harm, suffering, victimization or loss that usually occurs within a relationship where there is an expectation of trust" (AEASA, 2006).
Wikipedia describes Elder abuse (also called "elder mistreatment," "senior abuse," "abuse in later life," "abuse of older adults," "abuse of older women," and "abuse of older men") 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."

Other researchers define elder abuse as the physical, sexual, or emotional abuse of an elderly person, usually one who is disabled or frail (Heap 2008:15).

Nature and extent of elder abuse
Abuse of the elderly is on the rise, it is a silent epidemic, because people fail to notice the signs such as bruises or pain that the elderly is in and also that some realizes the signs and don’t care.
An awareness of elder abuse as a problem in South Africa started to grow from the mid-1980s and efforts to address the abuse began earnestly in the early 1990s. In 1981 The SA Council for the Aged spoke out against abuse of the elderly and held seminars throughout country (Eackley & Vilakazi 1995).
In 1987 the term “abuse and neglect of the elderly” was used to describe situations in which individuals over the age of 65 experienced battering, verbal abuse, exploitation, denial of rights, forced confinement, neglected medical needs or other types of personal harm, usually at the hands of someone who was responsible for help them in their daily activities.

Legislation to protect older persons from mistreatment and abuse was embodied first in the Aged Persons Act 18 of 1967, as amended from time to time, appearing ultimately in the Aged Persons Amendment Act 100 of 1998. The August 1, 1995 “You” Magazine carried an article on abuse in white old age homes in Cape Town. The article was about a voluntary group called the Concerned Friends of the Frail and Aged. Over this period the CFFA received 300 complaints from people mistreated in old age homes.

In March 2000 Keikelame and Ferreira (2002) published a report on Elder Abuse in black townships on the Cape Flats. They focused their research from groups of the elderly in three townships. Based on this report they found that more instances of emotional/verbal than physical abuse were reported because of accusations of witchcraft. Instances of sexual abuse outnumbered all other types of abuse. Systemic abuse was also referred to and included bad treatment at clinics, pay points and grant offices.

They also saw elder abuse as part of endemic domestic violence, with contributory factors being the weakening of family structures and urbanisation. They also talk of “the demise of social welfare and the collapse of formal support structures following reprioritization. This undoubtedly makes sense if one must consider the difficult socio economic conditions faced by South Africa today.

According to the report of the Committee on Social development (2001) much of the early research was problematic. It highlights the facts that conclusions from studies were vague, definitions were overly broad, samples were non-random and the various forms of abuse were not distinguished.

A variety of techniques has been used to collect information, mostly focusing on stress and dependency as precipitators to abuse. Others identified functional disability or impairment as antecedents of abuse. Research on detection was problematic due to lack of uniformity and standardized methods of detecting elder abuse.

Other studies provided a background to the study of elder abuse, but suffered from methodological weaknesses as they were based primarily on cases uncovered through surveys of professionals (nurses, doctors, social workers, legal aid), the data collected did not come directly from victims.
Causes

As elders become more physically frail, they’re less able to deal with bullying and or fight back if attacked. They may not see or hear as well or think as clearly as they used to, leaving openings for unscrupulous people to take advantage of them. Mental or physical ailments may make them more trying companions for the people who live with them.

Every year elderly adults in South Africa are abused in their own homes, homes of relatives, and even in places that are responsible for their care. There are different forms of elderly abuse that can be identified: They include the following:

• Physical Abuse - Inflicting, or threatening to inflict, physical pain or injury on a vulnerable elder, or depriving them of a basic need.

• Emotional Abuse - Inflicting mental pain, distress on an elder person through verbal or nonverbal acts in ways that cause emotional pain or distress. * Verbal forms of emotional elder abuse include: Intimidation through yelling or threats, Humiliation and ridicule, Habitual blaming or scapegoating. * Nonverbal psychological elder abuse can take the form of, Ignoring the elderly person, Isolating an elder from friends or activities, Terrorizing or menacing the elderly person.

• Sexual Abuse - Non-consensual sexual contact of any kind. Such contact can involve physical sex acts, but activities such as showing an elderly person pornographic material, forcing the person to watch sex acts, or forcing the elder to undress are also considered sexual elder abuse.
• Exploitation - Illegal taking, misuse, or concealment of monies, property, or assets of a vulnerable elder. This involves unauthorized use of an elderly person’s money or property, either by a caregiver, unauthorized family member or fraudster. An unscrupulous caregiver or family member might: Misuse an elder’s cheque book or bank account, credit cards, steal their pension or grant money, or household goods if the caregivers are living in the elders’ home, forge the elder’s signature and/or engage in identity theft.
Neglect - Refusal or failure by those responsible to provide food, shelter, health care or protection for a vulnerable elder. This can be picked up through signs of unusual weight loss, malnutrition, dehydration, untreated physical problems, such as bed sores, unsanitary living conditions: dirt, bugs, soiled bedding and clothes, Being left dirty or unwashed, unsuitable clothing or covering for the weather, unsafe living conditions (no heat or running water; faulty electrical wiring, other fire hazards), desertion of the elder at a public place
In 1999, the International Year for Older Persons, the Health Department issued a report on the Abuse of Elderly, quoting an opinion survey based on questionnaires sent to organizations dealing with elderly. No age or race breakdowns were given.

Of the responses these were the results: * 69% had heard of abuse, * 32% reported ill-treatment, * 37% knew of emotional or psychological abuse, * 36% of financial abuse, * 11% of general maltreatment.

Although sexual abuse was not mentioned, elderly respondents considered financial abuse the most important form: it included theft of pensions and being made to work for children without payment. Elder abuse was focused upon by researchers in the field of family violence and led directly from the “discovery” of child abuse and domestic violence/spouse abuse. A breakdown of abusers was identified as grandchildren, children, spouses and caregivers.

Prevention and recommendations
Fear is one explanation/motivation as to why older persons do not report abuse or seek help. In many cases the perpetrator of the abuse may perhaps be a family member or relative. The victim fears reporting such abuse will result in losing ties with that relative or that the relationship will be upset.
In several circumstances the victim would be dependent on a family member as a care giver and they may be afraid of ending up in long term care if they report the abuse. There may also be the fear that the abuser may find out. They might not have the confidence in who they confide in-afraid they won’t remain anonymous.
Most elderly would be unaware of who to report to or if indeed there is anyone they can report to. Furthermore, there is possibly a failure to recognize abuse. They don’t know that what is happening to them is classified as abuse as some may have mental challenges and illnesses that make it easy for them to be doubted.
Less than one-third of professional respondents had written “procedures” or “protocols” for detection. Many other studies provided a background to the study of elder abuse, but suffered from methodological weaknesses. The studies were mainly based primarily on cases uncovered through professional surveys such as nurses, doctors, social workers, legal aid etc. The data on elder abuse did not come directly from victims
The key to prevention and intervention of elder abuse is to be able to recognize the warning signs of when it is happening. Signs of elder abuse may differ dependent on the type of abuse the victim is suffering. Each type of abuse has distinct signs associated with it as mentioned. There are several ways to help prevent or reduce the incidence of elder abuse this includes * Educating and training those in the criminal justice system, such as police, prosecutors, and the judiciary, on elder abuse, as well as increased legislation to protect elders. * Listening to seniors and their caregivers * Checking for visible signs on the elder if it is suspected that physical abuse may be occurring * Looking out for changes in the demeanour and behavior of the elder * Intervening when you suspect elder abuse * Educating others about how to recognize and report elder abuse * Reporting the abuse to the authorities immediately.

Conclusion
Each year many elder adults are victims of physical, verbal, emotional and other types of elder abuse as stated. According to statistics most elder abuse occurs in the family home and not in a nursing home. The attached article is one of many sources which confirm that. Furthermore with rising living costs and it would seem obvious that elders who can afford private care are a minority as opposed to those who become the responsibility of the state, family and relatives. One can be almost certain that this is based on the difficult and dismal socio economic conditions that many are faced with in our country today.

As the population ages, more seniors will likely be victimized by abuse. Some people may suspect that an elderly adult they know is being abused physically or emotionally by neglect or an overwhelmed caregiver or being preyed upon financially.
As mentioned above there are solutions that can be built on existing resources.

For example, care givers should be trained so as to help them acquire skills to manage the elderly people. As indicated in the attached article abuse of the elderly is prevalent within the family unit itself. Counseling sessions and mandatory regular home visits should be a norm to homes where there are registered pensioners. This can be coordinated by the Department of Social Development, social workers and concerned family members.

If elderly abuse is something one feels strongly about and one is not in a direct position to help an elder personally, you can volunteer or donate money to the cause of educating people about elder abuse, and you can work together with NGO’s to strengthen criminal justice system and policing so that elder abuse can be investigated and prosecuted more readily.

After all the life you save down the line may ultimately be your own or that of a loved one.

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Elderly find themselves trapped in abuse
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February 17 2008 at 12:42pm
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By Brenda Nkuna
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Lack of finances and long waiting lists at old-age homes are leaving elderly people in Cape Town trapped in their communities, where they are often vulnerable to abuse and exploitation.
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Out of six old-age homes contacted in Cape Town, all reported long waiting lists, with some saying access to sufficient funding was a constant struggle.
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Social workers caring for the elderly say there are high levels of under-reporting of abuse, and that older people are subject to physical, financial, psychological, emotional, sexual and verbal abuse.
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Women are particularly vulnerable and those who are mentally and physically weak are seen as "easy targets".
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Halt Elder Abuse Line (Heal) Khayelitsha co-ordinator Winnie Dywili said it was "heartbreaking" to see elderly people who were "scared and ashamed" to speak out about being abused.
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In cases involving rape, she said it was "very hard" for black elderly women who had been raped to report their attacks because of an inclination among the elderly not to talk about sex and a fear that their families would be "disgusted".
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She said although many elderly people did seek counselling, they were reluctant to approach police and as a result the abuse continued.
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One woman who has experienced abuse first hand from multiple family members is Letecia Kondlo, 67, (not her real name) from Khayelitsha.
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She said after suffering a stroke in 2002, her two sons had abused her physically and verbally over a period of five years.
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After her stroke she had gone to live with a younger son in Johannesburg, who had taken her social grant money and used it for his own needs.
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When she had demanded her money, she said her son and his girlfriend had accused her of witchcraft and kicked her out of their home, forcing her to leave behind her furniture, blankets, and clothing.
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Having moved in with an older son in Khayelitsha in 2005, she said she had been "klapped and hit" continuously.
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"I could not believe that my once innocent children turned into monsters with no respect," she said.
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Having spoken to members of her church about her abuse she was able to gain placement in a Khayelitsha old-age home last year.
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But many older people risk being stuck in situations of abuse.
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Dee Willis, programme manager at Neighbourhood Old Age Homes (Noah), which helps poor elderly people in the Western Cape, said its home in Khayelitsha was "desperate" for help, because it could only accommodate 20 people, but "a thousand more need assistance".
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"Abused elders end up in a situation where they don 't have a choice. We need to help them," she said.
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In Mitchells Plain, Beaconvale Home for the Aged general manager Raymond Mitchell said it was hard to accommodate people.
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He said as the only home in Mitchells Plain, it could only take 135 residents.
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He said there had been "rapid growth" of its waiting list, which was currently at 75. In most cases it was forced to turn people away because it was full.
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Mitchell said poverty, crime, and unemployment created a hostile environment for elderly people in communities.
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"We need to get more facilities, so we can remove them before it is too late," he said.
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Jan Honing, superintendent at the George and Annie Starck Home in Bellville, said old-age homes battled due to a lack of money. Attracting suitable staff was also a problem.
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He called on the government to increase subsidies for old-age homes.
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The social development department currently funds registered old-age homes according to different categories, with amounts varying between R750 and R1 200 per person accommodated monthly.
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Western Cape social development department spokesperson Phumzile Simelela said an amount of R116 047 000 was allocated to 130 old-age homes in the Western Cape last year.
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But Heal director Pat Lindgren said there was a desperate shortage of money and maintenance at homes.
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She said more and more people wanted to be looked after in old-age homes.
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Lindgren said renewed respect and dignity needed to be shown to older people in acknowledgement of their wisdom, life experiences and their contribution to society as caregivers to sick adult children as a result of HIV/Aids. - West Cape News

References a) Action on Elder Abuse South Africa. (2004). AEASA brochure. Cape Town. Internet: www.actiononelderabusesa.co.za. Accessed 7 February 2012 b) Elder Abuse South Africa - AEASA. Website http://www.elderabuse.co.za. Accessed 23 February 2013 c) Elder Abuse and Neglect: In Search of Solutions, American Psychological Association 2003, Internet: http://www.apa.org/pi/aging/resources/guides/elder-abuse.aspx. Accessed 18 March 2013 d) Joubert, J., & Lindgren, P. (2003). HEAL: An intervention project addressing elder abuse in South Africa. Internet: http://www.heal.org.za/abuse/report_final.pdf. Accessed 7 February 2013 e) Nkuna, B. IOL. 2008. Elderly find themselves trapped in abuse. Internet: http://www.iol.co.za/news/south-africa/elderly-find-themselves-trapped-in-abuse-1.389602. Accessed 24 March 2013 f) Speak up about elder abuse, it could be you one day - The Witness, Internet: http://www.witness.co.za. Accessed 12 March 2013 g) Study Guide. Department of Criminology and Security Science. Victimology (Only study guide for CMY3705). Pretoria: Unisa

References: a) Action on Elder Abuse South Africa. (2004). AEASA brochure. Cape Town. Internet: www.actiononelderabusesa.co.za. Accessed 7 February 2012 b) Elder Abuse South Africa - AEASA. Website http://www.elderabuse.co.za. Accessed 23 February 2013 c) Elder Abuse and Neglect: In Search of Solutions, American Psychological Association 2003, Internet: http://www.apa.org/pi/aging/resources/guides/elder-abuse.aspx. Accessed 18 March 2013 d) Joubert, J., & Lindgren, P. (2003). HEAL: An intervention project addressing elder abuse in South Africa. Internet: http://www.heal.org.za/abuse/report_final.pdf. Accessed 7 February 2013 e) Nkuna, B. IOL. 2008. Elderly find themselves trapped in abuse. Internet: http://www.iol.co.za/news/south-africa/elderly-find-themselves-trapped-in-abuse-1.389602. Accessed 24 March 2013 f) Speak up about elder abuse, it could be you one day - The Witness, Internet: http://www.witness.co.za. Accessed 12 March 2013 g) Study Guide. Department of Criminology and Security Science. Victimology (Only study guide for CMY3705). Pretoria: Unisa