The ageing process is of course a biological reality which has its own dynamics, largely beyond human control.  In many parts of the developing world, chronological time has little or no importance in the meaning of old age. In contrast to the chronological milestones which mark life stages in the developed world, old age in many developing countries is seen to begin at the point when active contribution is no longer possible.

 WHO defines the geriatric population as persons aged  64 years and above.

Elder abuse is a general term used to describe certain types of harm to older adults.

Other terms commonly used include: "elder mistreatment", "senior abuse", "abuse in later life", "abuse of older adults", "abuse of older women", and "abuse of older men".

One of the more commonly accepted definitions of elder abuse 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. This definition has been adopted by the World Health Organization .

The core feature of this definition is that it focuses on harms where there is "expectation of trust" of the older person toward their abuser. Thus it includes harms by people the older person knows or with whom they have a relationship, such as a spouse, partner or family member, a friend or neighbor, or people that the older person relies on for services.

Many forms of elder abuse are recognized as types of domestic violence or family violence.

The fundamental common denominator is the use of power and control by one individual to affect the well-being and status of another, older, individual.

There are several types of abuse of older people that are generally recognized as being elder abuse, including:

Physical: Hitting, punching, slapping, burning, pushing, kicking, restraining, false imprisonment/confinement, or giving excessive or improper medication

Psychological/Emotional: Shouting, swearing, frightening, or humiliating a person. A common theme is a perpetrator who identifies something that matters to an older person and then uses it to coerce an older person into a particular action.

VERBAL & NON VERBAL PSYCHOLOGICAL ABUSE

It may take verbal forms such as name calling, ridiculing, constantly criticizing, accusations, blaming, and general disrespect, or  non verbal forms such as ignoring, silence or shunning.

Financial abuse: Also known as financial exploitation. e.g. illegal or unauthorized use of a person’s property, money, pension book or other valuables (including changing the person's will to name the abuser as heir). It may be obtained by deception, coercion, misrepresentation, or theft. The term includes fraudulently obtaining or use of a power of attorney. Other forms include deprivation of money or other property, or by eviction from own home

Neglect: Depriving a person of food, heat, clothing or comfort or essential medication and depriving a person of needed services to force certain kinds of actions, financial and otherwise. The deprivation may be intentional (active neglect) or happen out of lack of knowledge or resources (passive neglect).

Rights abuse: Denying the civil and constitutional rights of a person who is old, but not declared by court to be mentally incapacitated. In Nigeria traditional practices, associated with human rights abuse of the elderly are: Widowhood practices, widowhood inheritance and discriminatory inheritance and property laws.

Abandonment: Deserting a dependent person with the intent to abandon them or leave them unattended to at a place for such a time period as may be likely to endanger their health or welfare.

Signs of elder abuse.

The signs of abuse vary considerably among older people and with the type of harm being experienced. An older person who is being abused may: Say she or he is being harmed, seem depressed and withdrawn; signs of depression in elders are not getting dressed, not performing basic care of themselves that they are able to do, never going out even if they can, inability to sleep or sleeping too much.

Not accepting invitations to spend time away from their family or a caregiver, seem afraid to make their own decisions, seem to be hiding something about a caregiver, not have any spending money, put off going to the doctor, feel anxious and fearful, try to "run away," leaving their place of residence and not wishing to return.

Any of these potential signs can indicate problems other than abuse or neglect, and none of these "proves" there is harms occurring. The presence of the signs simply indicate that further inquiry may be necessary.

Common abusers of older people.

The majority of abusers are relatives, typically the older adult's spouse/partner or sons and daughters, although the type of abuse differs according to the relationship.

In some situations the abuse is "domestic violence grown old", a situation in which the abusive behaviour of a spouse or partner continues into old age.

In some situations, an older couple may be attempting to care and support each other and failing, in the absence of external support.

An abuser can be a spouse, partner, relative, a friend or neighbor, a volunteer worker, a paid worker, practitioner, solicitor or any other individual with the intent to deprive a vulnerable person of their resources.

Relatives include adult children and their spouses or partners, their offspring and other extended family members.

Children and living relatives who have a history of substance abuse or have had other life troubles are of particular concern.

Perpetrators of elder abuse can include anyone in a position of trust, control or authority. Family relationships, neighbours and friends, are all socially considered as relationships of trust, whether or not the older adult actually thinks of the people as "trustworthy".

Some perpetrators may "groom" an older person (befriend or build a relationship with them) in order to establish a relationship of trust. Older people living alone who have no adult children living nearby are particularly vulnerable to "grooming" by neighbors and friends who would hope to gain control of their estates.

Older adults may neglect themselves by not taking care of or caring about their own personal health and well-being.  Elder self-neglect can lead to illness, injury or even death.

Common needs that the older adult may deny themselves or ignore are the following: Sustenance (food or water), cleanliness (bathing and personal hygiene), adequate clothing for climate protection, adequate safety, clean and healthy surroundings among others.

Self neglect is often created by an individual's declining mental awareness or capability.

Some older adults may choose to deny themselves some health or safety benefits, which may not be self-neglect. This may simply be their personal choice. Caregivers and other responsible individuals must honour these choices if the older adult is sound of mind. In other instances, the older adult may lack the needed resources, as a result of poverty or other social condition. This is also not considered as "self neglect".

 

 Risk factors

Risk factors that may increase the potential for abuse of an older person can be identified at individual, relationship, community, and socio-cultural levels.

 

Individual

Risks at the individual level include poor physical and mental health of the victim, and mental disorders and alcohol and substance abuse in the abuser. Other individual-level factors which may increase the risk of abuse include the gender of victim and a shared living situation. While older men have the same risk of abuse as women, in some cultures where women have inferior social status, elderly women are at higher risk of neglect and financial abuse (such as seizing their property) when they are widowed.

 

Relationship

A shared living situation is a risk factor for elder abuse. An abuser's dependency on the older person (often financial) also increases the risk of abuse.

 

Community

Social isolation of caregivers and older persons, and the ensuing lack of social support, is a significant risk factor for elder abuse by caregivers.

 

Socio-cultural

Socio-cultural factors that may affect the risk of elder abuse include: Depiction of older people as frail, weak and dependent; erosion of the bonds between generations of a family; systems of inheritance and land rights, affecting the distribution of power and material goods within families; migration of young couples, leaving elderly parents alone in societies where older people were traditionally cared for by their offspring; and lack of funds to pay for care.

 

 

Prevention of elder abuse.

Globally, too little is known about elder abuse and how to prevent it, particularly in developing countries

Many strategies have been implemented to prevent elder abuse and to take action against it and mitigate its consequences. Interventions that have been implemented – mainly in high-income countries – to prevent abuse include: public and professional awareness campaign, screening (of potential victims and abusers), caregiver support interventions (including stress management and respite care), residential care policies to define and improve standards of care and mandatory reporting of abuse to authorities among others.

 

Multiple sectors and interdisciplinary collaboration can contribute to reducing elder abuse.

   Abuse knowingly   or  unknowingly   is  a societal criminality. Now that you know, change   your attitude positively to the care of the elderly. Remember we all pray to be old.