One of Solution of the Problem of Elder Abuse - Engagement with the Social World - Research Paper Example

?Introduction Elder abuse is a problem in the United s as well as in the rest of the world. According to Wagenaar et al. (2009), there are between 1 and 2 million elderly victims of abuse, which might include physical, psychological, financial or material abuse, as well as violating personal rights and neglect. African Americans are at a higher risk for financial mistreatment, while Latinos are at a lower risk for verbal abuse. This report will examine some of the issue surrounding elder abuse – the characteristics of the abused and the abusers, the solutions for abuse, and how to spot such abuse. Characteristics of the Abused and the Abusers While there are many causes of abuse, certain populations have been shown to be more vulnerable than others. According to Naughton et al. (2011), the populations which are especially at risk for abuse include women, and people who have low income and/or low social and health support. For instance, they found that the elderly in Ireland who lived on the minimum pension of ?219 per week was over twice as likely to experience mistreatment as those who are living above the minimum pension. People with below average health, according to this study, were three times as likely to experience mistreatment as those people who are not experiencing below average health. People with poor social support are five times more likely to experience mistreatment as those with high social support , according to this study. Moreover, Naughton et al. (2011) also singled out perpetrators, finding that adult children made up 50% of the abusers, and that 77% of abuse happened in the elderly person’s own home. Cooper et al. (2008) also studied who was most likely to abuse elderly individuals, finding that caregivers are often perpetrators of abuse, as they found that 25% of the elderly who are dependent upon a caregiver has experienced psychological abuse, and one fifth of these elderly have experienced neglect. They state that one reason for this might be caregiver stress or because of the behavior of the elderly abuse target. Moreover, they also found that professional caregivers, in particular, exhibit a high rate of abuse behaviors – according to their study, 1/6 of professional caregivers reporting committing psychological abuse, and 10% of these professional caregivers have admitted to committing physical abuse. Although these numbers are high, they are lower than what is seen across the board with caregivers, finding that part of the reason for this is because professional caregivers only have a limited number of hours which are devoted to caregiving. Of the above characteristics, Aciemo et al. (2010) found that low social support has the highest correlation with elder abuse. They further found that it was an issue of reciprocity – they considered the possibility that elderly individuals who are experiencing abuse will report lower levels of social support. Therefore, low levels of social support would not be the cause, but, rather, one of the symptoms of abuse. However, they found that poor social support not only causes but predicts abuse, which means that poor social support may not only predict abuse but may also be used as an intervention to help combat abuse. This is echoed by Dong et al. (2011), who found that elder abuse is significantly correlated with high rates of depression and low levels of social network and social engagement. Spotting Abuse One of the main lines of defense in the war against elder abuse is physician education. Physicians who are properly trained to spot elder abuse may be able to report the abuse. That said, there may not be adequate training for physicians in this regard. This was the subject of the study done by Wagenaar et al. (2009). In this study, different groups of physicians were studied, and the focus was on finding out which groups of physicians were the most in need of more training with regards to spotting elder abuse. In particular, they focused on family practitioners and internal medicine physicians, as these tend to be the first doctors who see elderly patients on a regular basis. They found that family practitioners had a high degree of training in spotting elder abuse – a typical family doctor was trained, in medical school, to spot elder abuse through formal lecturers and didactics, as well as broad clinical exposure to elder abuse patients. In contrast, Wagenaar et al. (2009) found that internal medicine doctors did not have formal elder abuse education, therefore, the conclusion was that internal medicine doctors should have additional training on spotting elder abuse. That physicians might not have proper training to spot elder abuse is complicated by the fact that elder abuse might be difficult to spot. For instance, bruises may be a sign of elder abuse, or it might be a sign of the elderly patient falling, which is not unusual for elderly patients. Patients with cancer might experience weight loss. Alternatively, the weight loss could be because the elderly patient is withheld food. An elderly patient who does not adhere to his or her medication regiment might just be forgetful, or, alternatively, there might be a withholding of the medication (Lachs & Pillemer, 2004). Therefore, Lachs & Pillemer (2004) recommend comprehensive screening whenever elderly abuse is suspected, which means that individuals with substantial clinical and psychosocial expertise in this area should be brought in to evaluate the situation. The elderly person should be interviewed away from the suspected abuser, and questions should be formulated to elicit honest answers, while being sensitive to the fact that the elderly person might be too ashamed to be forthcoming about the abuse. That said, one symptom that physicians should pay attention to is excessive bruising. According to Wiglesworth et al. (2009), elderly patients with large bruises (>5cm) which are located on the face, lateral forearm or torso should pay special attention and ask the elderly patient how that bruising occurred. Beyond this, social services agencies may also receive reports of elder abuse from other sources, such as legal professionals, other health care professionals, community organizations, city workers (postal workers, utility workers), family members, and concerned friends and neighbors (Dong et al., 2009). In Illinois, where the Dong et al. study was conducted, reporting was mandatory only in cases where the victim is unable to report the abuse his or herself and when the abuse had occurred within the prior 12 months. Solutions for Abuse As noted above, Aciemo et al. (2010) found that low social support is positively correlated with elder abuse. Therefore, they found that interventions which target poor social support might be effective in fighting elder abuse. Such interventions might include reconnecting elderly individuals with community resources, improving housing options for the elderly so that they are living in environments where they are exposed to communal interactions, and enhancing programs which bring the elderly together with their neighbors and family members. Moreover, Aciemo et al. (2010) found that the possibility that the elderly will have proper access to affordable transportation might be effective, as this gives them the freedom of mobility and would enable the elderly to seek out social contacts in the world. Conclusion Elder abuse is a serious problem, one that physicians should be trained to spot. While there are many characteristics of abused elderly patients, one persistent characteristic is that these patients are socially isolated. Therefore, in addition to physicians reporting abuse to the proper social service agencies, another remedy for abuse would be to institute programs which help the elderly engage with the social world in a better fashion. Aciemo, Ron, Melba Hernandez, Ananda Amstadter, Heidi Resnick, Kenneth Steve, Wendy Muzzy & Dean Kilpatrick. “Prevalence and Correlates of Emotional, Physical, Sexual and Financial Abuse and Potential Neglect in the United States: The National Elder Mistreatment Study.” Research and Practice 100.2 (2010): 292-297. Cooper, Claudia, Amber Selwood & Gill Livingston. “The Prevalence of Elder Abuse and Neglect: A Systematic Review.” Age and Ageing 37 (2008): 151-160. Dong, X., Simon, M., Beck, T., Farran, C., McCann, J., Mendes, C., Laumann, E., Evans, D. “Elder Abuse and Mortality: The Role of Psychological and Social Wellbeing.” Gerontology 57.6 (2011): 549-558. Dong, X., Melissa Simon, Carlos Mendes, Terry Fuhmer, Todd Beck, Liesi Hebert, Carmel Dyer, Gregory Paveza and Denis Evans. “Elder Self-Neglect and Abuse and Mortality Risk in a Community-Dwelling Population.”Journal of the American Medical Association 302.5 (2009): 517-526. Lachs, Mark & Karl Pillemer. “Elder Abuse.” The Lancet 364: 1263-1272. Naughton, Corina, Jonathan Drennan, Imogen Lyons, Attracta Lafferty, Margaret Treacy, Amanda Phelan, Anne O’Loughlin & Liam Delaney. “Elder Abuse and Neglect in Ireland: Results from a National Prevalence Survey.” Age and Ageing 0 (2011): 1-6. Wagenaar, Deborah, Rachel Rosenbaum, Sandra Herman & Connie Page. “Elder Abuse Education in Primary Care Residency Programs: A Cluster Group Analysis.” Residency Education 41.7 (2009): 481-486. Wiglesworth, A., Austin, R., Corona, M., Schneider, D., Liao, S., Gibbs, L. & Mosqueda, L. “Bruising as a Market of Physical Elder Abuse.” Journal of the American Geriatrics Society 57.7 (2009): 1191-1196. Read More