In this guest post, Dr Kailas Roberts explores the often forgotten topic of elder abuse and practical approaches carers can take in identifying and dealing with it, including the importance of managing their own mental health.
Vulnerability is for many the bedfellow of the autumn years. With age, there is often deterioration in physical and cognitive health, creating an increasing reliance on others. This renders the elderly especially susceptible to behaviours by others that are not in their best interest.
Elder abuse is an understudied phenomenon and probably more common than most of us realise. For a start, the data we have about abuse is based on what is reported to authorities. But what about that which is never disclosed? I suspect what we know may only be the tip of the iceberg.
At least, however, there is increasing recognition that elder abuse exists and needs to be addressed: there is now even an annual World Elder Abuse Awareness Day (WEAAD), held on the 15th of June.
Abuse can take many forms, including the obvious ones like physical, emotional, and sexual abuse. For the elderly, financial abuse is also a particular concern, in part owing to poor cognition that erodes awareness of one’s financial situation. Sadly, I have seen this on a number of occasions in my years working with the elderly.
Then there is neglect and abuse that stems from the absence of care. If prolonged, this can lead to serious physical and mental health consequences and even death.
It is important to recognise that although no abuse is acceptable, the motivation behind it can vary and this may influence how to deal with it.
For those instances where there is a criminal or nefarious intent, there should be appropriate legal consequences. Editor: Inside Ageing recently carried a guest post from Dr Bryan Keon-Cohen, AM QC – Founder and Chairman of Aged-care Legal Advocacy and Reform Matter (ALARM) who provide legal services for victims of abuse in aged care. He also makes mention of the obligation providers have to provide support and transparency in this area.
In many cases though, the abuse comes from an inability of the carer to manage what is often a very difficult situation. Looking after a family member with dementia, for instance, can be very stressful, particularly if that person being cared for is violent or disturbed. Sometimes this stress becomes too much and results in abusive behaviour on the part of the carer. Depending on the details, a legal approach may not be the best one, and it may be better to initially offer support to the carer so that they can function in their role in a more adaptive fashion.
Abuse is more likely in scenarios where there is a high level of carer stress and where the carer has drug or alcohol problems. If the relationship between the carer and the person they care for has always been difficult and conflicted, again the chances of abuse occurring are increased. Isolation – in the form of geographical distance, though also social and language-based – is another risk factor for abuse.
There are some tell-tale signs of abuse. These include bruising and other unexplained injuries, signs of fear when the perpetrator is around, and sudden changes in financial circumstances. Withdrawal from usual activities and changed behaviours in the person being cared for can also be red flags.
There are two important messages when it comes to abuse.
One is that, if you are a carer, it is vital to monitor your own mental health and behaviours and to seek help if the situation is becoming too much to manage – before it gets to a point where inadvertent abuse occurs. And, secondly,
In some cases – where there is no immediate risk, and the carer is fundamentally well-meaning – the best initial approach might be to gently discuss with the carer how you can help them, and to closely monitor the situation. If there is a risk of nefarious intent to the abuse, or if it is persistent, however, you should alert the authorities. Urgent situations may demand the involvement of the police; otherwise, in Australia, there is an elder abuse phone line – 1800 353 374 – that is a good source of guidance and support.
Dr Roberts is a medical specialist and expert in cognitive assessment and is the founder of the Your Brain in Mind cognitive optimisation clinic, where he works alongside a team of experienced and passionate healthcare professionals to assess clients’ brain health. He is also the author of Mind Your Brain: The Essential Australian Guide to Dementia (UQP, 2020) and the creator of BrainScan, a phone app that allows users to know and address their risk factors for poor brain health and dementia.