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[edit] Physical Elder Abuse

Over the last decade, elder abuse has become an increasing problem which has earned a lot of attention from society internationally (Sachs & Pillemer, 2004). A common form of elder abuse is Physical Abuse. Physical elder abuse tends to receive the most attention from the media, and can be defined as intentional actions that cause bodily harm, or risk of bodily harm to an elder (Sachs & Pillemer). This abuse tends to be given by someone who is trusted by the elder, or is in a caregiver role. In many studies physical abuse generally includes hitting, restraining, or deliberately injuring in some other way (Ron Acierno, PhD, Melba A. Hernandez, MS, Ananda B. Amstadter, PhD, Heidi S. Resnick, PhD, Kenneth Steve, MS, Wendy Muzzy, BS, and Dean G. Kilpatrick, PhD, 2010). In a Canadian based study (abstract) data was collected from 2,008 elderly persons regarding abuse. Author found 80 elderly persons reported being abused. Interestingly, physical abuse by the caregiver is reported more often by the caregiver than from the elderly person who is being abused (Ron Acierno, PhD, Melba A. Hernandez, MS, Ananda B. Amstadter, PhD, Heidi S. Resnick, PhD, Kenneth Steve, MS, Wendy Muzzy, BS, and Dean G. Kilpatrick, PhD, 2010).

[edit] Who is at risk

A majority of the abuse directed at elders tends to be given by caregivers and people in trust to the elder (Lachs). According to Mihong lee, elders at risk of being victimized physically tend to share some common characteristics with each other. First, many victims live in a shared living situation with their caregiver who is abusing them. Elders who do not live with their caregiver are at much lower risk of victimization. Secondly many studies have found that elderly people are more likely to be victims of physical abuse if they are suffering from dementia. This is likely attributed to the stress this disease can cause on the caregiver. Social isolation is a third variable that appears to be present in families in which elder abuse occurs. Social isolation that some elders seem to prefer actually increases familial stress which can give rise to an abusive environment. It is also possible that the abusers may isolate the elderly person so no one is able to find out about the abuse. There are many other situations and characteristics which are theorized to contribute to elder abuse as well. Elders who live with a family member who misuses drugs or alcohol are also at a greater risk. It is also important to note that most caregivers who abuse an elderly person tend to also be heavily dependent on the elder person.

[edit] Prevalence

Canadian and American instances of physical abuse on elders differ quite a bit. A study on recent international physical elder abuse states that it is likely that 4.3% of elderly adults are physically abused in some way. As mentioned previously, these rates are said to be higher if the victim lives with the caregiver who is abusing them.(Bruising study). A Canada wide study found somewhat inconsistent results, and published that 1.6% of elderly people were physically abuse or mistreated in some way. This study also found that approximately 31% of the abuse cases were reported to the police. (Prevalence and Risk Factors of Suspected Elder Abuse Subtypes in People Aged 75 and Older).

[edit] Prevention

The two most important aspects in stopping physical abuse are recognition and reporting. There are systems in place that aim to do these two things, as well as prevent physical abuse from occurring at all. If abuse is taking place, one of the first lines of defense is recognition. Due to the fact that many elderly people have to visit a general practitioner more frequently than younger adults, the general practitioner is someone who should be skilled in recognizing signs of abuse (source). One way that GP’s may do this is by looking at bruising on the elderly person. Bruising can be a sign that physical abuse is occurring. GP’s can differentiate between normal age related, or poor health related bruising by checking to see the size of the bruises. Bruises resulting from abuse have been documented as large, and are typically found on the face, on the torso, or on the arm. (source). A second important way to both prevent as well as recognize signs of abuse is by training all health care professionals to identify elderly who are at risk. These high risk cases were discussed previously in the “who is at risk” section. Lastly, having social support programs available to both the elderly person and their caregiver can also help alleviate the stress that may foster an abusive environment.

[edit] Psychological Elder Abuse

Psychological elder abuse is an act done on purpose that causes emotional or psychological harm or distress to and elderly person^[1]. Psychological elder abuse is also known as emotional elder abuse. Specific behaviours that have been studied are name calling, being criticized, and being possessed or controlled by some one else ^[2].

[edit] Who is most affected by Psychological Elder Abuse

Being verbally abused is the most common form of psychological abuse, however abuse types are often co-occurring among the elderly. Psychological abuse is the most common and the most prevalent in women of the types of elderly abuse, and although it is the most common, psychological abuse is often accompanied by physical or sexual abuse^[2]. Elderly women who experience psychological abuse are often dismissive about the abuse, as they are thankful that physical and sexual abuse is not occurring, or it has ended ^[2]. Once psychological abuse occurs, it is more likely to occur again, more than half of elderly women who have been abused psychologically have been repeatedly abused^[2]. In a survey of nearly one thousand women age 55 or older, nearly half of the women said that they had suffered from at least one form of abuse since becoming elderly ^[2]. These women were less likely to be as healthy as their elderly counterparts how were not abused.Psychological abuse can also affect health, negative health effects include (but are not limited to) chronic stress, depression, anxiety, and cardiac problems ^[2]. Another study showed that in the United States, African-Americans are almost twice as likely to be abused psychologically than non African Americans, the rates are 24.4% versus 13.2 percent, which suggests that racial differences are in play and this information should be researched further by health professionals and psychologists alike^[3]. Psychological or emotional abuse is more common than physical abuse, but only slightly^[2].