Abused Senior Citizens More Likely to Die in Three Years

This article on Elder Abuse is somewhat long but comprehensive; Taken from:

http://seniorjournal.com/NEWS/Eldercare/4-10-01AbuseKills.htm

this Q&A type of article is a good place to start sentizing oneself about EA. Read on ....

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Abused Senior Citizens More Likely to Die in Three Years

Oct. 1, 2004 – Senior citizens who suffer from physical or mental abuse are three times more likely to die within three years than those free of abuse, according to a new review of data on elder abuse. (see Q&A about elder abuse below news report)

A substantial number of older persons -- from 2 to 10 percent of the elderly population -- are physically or mentally abused.

Reviewing more than 50 articles, Karl Pillemer, professor of human development in the College of Human Ecology at Cornell, has collaborated with Dr. Mark S. Lachs, co-chief of the Division of Geriatrics and Gerontology at the Weill Cornell Medical College in New York City, on a detailed review in The Lancet (Vol. 364, Oct. 2: pp. 1192-1263) on the risk factors, screening, clinical manifestations, diagnosis and treatment of elder abuse.

"This vastly unrecognized and under treated problem compromises the quality of life for millions of older people worldwide," says Pillemer. "A busy physician, who might see 20 to 40 elderly patients a day, might encounter a case of possible elder abuse every day, but because of a lack of time, resources and a general lack of recognition of the problem, many cases go undetected and untreated, putting our elderly at heightened risk of physical and mental harm, and even death."

The Cornell gerontologists call for a multidisciplinary team approach to assess the situation and develop solutions that are tailored to the individual victim's needs and problems. Lachs and Pillemer assert that elder abuse directly affects quality of life, and helping patients resolve an abusive situation is one of the most gratifying experiences for physicians and other health-care professionals.

The research was supported, in part, by a National Institute on Aging Mentoring Award in Patient Oriented Research in Aging and an Edward R. Roybal Center grant, also from the National Institute on Aging.

Q&A From National Center on Elder Abuse

1. What is 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. The specificity of laws varies from state to state, but broadly defined, abuse may be:

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

o Emotional Abuse - Inflicting mental pain, anguish, or distress on an elder person through verbal or nonverbal acts.

o Sexual Abuse - Non-consensual sexual contact of any kind.

o Exploitation - Illegal taking, misuse, or concealment of funds, property, or assets of a vulnerable elder.

o Neglect - Refusal or failure by those responsible to provide food, shelter, health care or protection for a vulnerable elder.

o Abandonment - The desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.

Elder abuse can affect people of all ethnic backgrounds and social status and can affect both men and women.

2. What are the warning signs of elder abuse?

While one sign does not necessarily indicate abuse, some tell-tale signs that there could be a problem are:

o Bruises, pressure marks, broken bones, abrasions, and burns may be an indication of physical abuse, neglect, or mistreatment.

o Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression may be indicators of emotional abuse.

o Bruises around the breasts or genital area can occur from sexual abuse.

o Sudden changes in financial situations may be the result of exploitation.

o Bedsores, unattended medical needs, poor hygiene, and unusual weight loss are indicators of possible neglect.

o Behavior such as belittling, threats, and other uses of power and control by spouses are indicators of verbal or emotional abuse.

o Strained or tense relationships, frequent arguments between the caregiver and elderly person are also signs. Read our section on Family Caregiversfor more information about how caregivers can prevent elder abuse.

Most important is to be alert. The suffering is often in silence. If you notice changes in personality or behavior, you should start to question what is going on. See The Basics for more information.

3. What is self-neglect and what are the signs?

Tragically, sometimes elders neglect their own care, which can lead to illness or injury. Self-neglect can include behaviors such as:
o Hoarding

o Failure to take essential medications or refusal to seek medical treatment for serious illness

o Leaving a burning stove unattended

o Poor hygiene

o Not wearing suitable clothing for the weather

o Confusion

o Inability to attend to housekeeping

o Dehydration

Self-neglect accounts for the majority of cases reported to adult protective services. Oftentimes, the problem is paired with declining health, isolation, Alzheimer's disease or dementia, or drug and alcohol dependency.
In some of these cases, elders will be connected to supports in the community that can allow them to continue living on their own. Some conditions like depression and malnutrition may be successfully treated through medical intervention. If the problems are severe enough, a guardian may be appointed.

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4. What makes an older adult vulnerable to abuse?

Social isolation and mental impairment (such as dementia or Alzheimer's disease) are two factors that may make an older person more vulnerable to abuse. But, in some situations, studies show that living with someone else (a caregiver or a friend) may increase the chances for abuse to occur. A history of domestic violence may also make a senior more susceptible to abuse. Read our section on The Basics for more information about risk for abuse.

5. Who are the abusers of older people?

Abusers of older adults are both women and men. Family members are more often the abusers than any other group. For several years, data showed that adult children were the most common abusers of family members; recent information indicates spouses are the most common perpetrators when state data concerning elders and vulnerable adults is combined. Find out more … A Response to the Abuse of Vulnerable Elders: The 2000 Survey of State Adult Protective Services.
The bottom line is that elder abuse is a family issue. As far as the types of abuse are concerned, neglect is the most common type of abuse identified. Review our Fact Sheet for more information about who abuses.

6. Are there criminal penalties for the abusers?

Although there are variations across the country, in most states there are several laws that address criminal penalties for various types of elder abuse. Laws vary state to state. Some states have increased penalties for those who victimize older adults. Increasingly, across the country, law enforcement officers and prosecutors are trained on elder abuse and ways to use criminal and civil laws to bring abusers to justice. Read about state elder abuse laws, important legal issues, and how to access the laws in our Laws & Legislation section.

7. How many people are suffering from elder abuse?

It is difficult to say how many older Americans are abused, neglected, or exploited, in large part because surveillance is limited and the problem remains greatly hidden. Findings from the often cited National Elder Abuse Incidence Study suggest that more than 500,000 Americans aged 60 and over were victims of domestic abuse in 1996.
This study also found that only 16 percent of the abusive situations are referred for help - 84 percent remain hidden. While a couple of studies estimate that between 3 percent and 5 percent of the elderly population have been abused, the Senate Special Committee on Aging estimates that there may be as many as 5 million victims every year.
One consistent finding, over a ten-year study period, is that reports have increased each year. Click on NCEA Fact Sheets and the 2003 National Academy of Sciences' Study Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America for more information.

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8. Who do I call if I suspect elder abuse?

Each one of us has a responsibility to keep vulnerable elders safe from harm. The laws in most states require helping professions in the front lines -- such as doctors and home health providers -- to report suspected abuse or neglect. These professionals are called mandated reporters. Under the laws of eight states, "any person" is required to report a suspicion of mistreatment.

Call the police or 9-1-1 immediately if someone you know is in immediate, life-threatening danger.

If the danger is not immediate, but you suspect that abuse has occurred or is occurring, please tell someone. Relay your concerns to the local adult protective services, long-term care ombudsman, or police. For a list of reporting numbers go to this important link: Where to Report Abuse.
If you have been the victim of abuse, exploitation, or neglect, you are not alone. Many people care and can help. Please tell your doctor, a friend, or a family member you trust, or call the Eldercare Locator help line immediately.

You can reach the Eldercare Locator by telephone at 1-800-677-1116. Specially trained operators will refer you to a local agency that can help. The Eldercare Locator is open Monday through Friday, 9 a.m. to 8 p.m. Eastern Time.

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9. What should I expect if I call someone for help?

When making the call, be ready to give the elder's name, address, contact information, and details about why you are concerned.
You may be asked a series of questions to gain more insight into the nature of the situation.
Are there any known medical problems (including confusion or memory loss)?

o What kinds of family or social supports are there?

o Have you seen or heard incidents of yelling, hitting, or other abusive behavior?

You will be asked for your name, address, telephone number, etc., but most states will take the report even if you do not identify yourself.

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10. How can elder abuse be prevented?

Educating seniors, professionals, caregivers, and the public on abuse is critical to prevention. On an individual level, some simple but vital steps to reduce the risk:
o Take care of your health.

o Seek professional help for drug, alcohol, and depression concerns, and urge family members to get help for these problems.

o Attend support groups for spouses and learn about domestic violence services.

o Plan for your own future. With a power of attorney or a living will, health care decisions can be addressed to avoid confusion and family problems, should you become incapacitated. Seek independent advice from someone you trust before signing any documents. <

o Stay active in the community and connected with friends and family. This will decrease social isolation, which has been connected to elder abuse.

o Know your rights. If you engage the services of a paid or family caregiver, you have the right to voice your preferences and concerns. If you live in a nursing home or board and care home, call your Long Term Care Ombudsman. The Ombudsman is your advocate and has the power to intervene. Please visit our Help for Elders and Families section to learn more.

All states have adult protective and long-term care ombudsman programs, family care supports, and home and community care services that can help older adults with activities of daily living. Call the Eldercare Locator at 800-677-1116 for information and referrals on services in your area.
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