You think you know the answer to that, right? Well, not so fast. I did too until I started looking into elder abuse for us. There are a zillion definitions, several kinds of abuse, no useful statistics and differing laws in every U.S. state.
It's amazing how many ways people can find to hurt others and although I feel I've only scratched the surface, I already know more than I want about this shameful problem that should be of concern to everyone. I'll try not to overwhelm you with too much information all at once.
Over time, I'll break down a complex phenomenon into something resembling coherence. Let's begin today with getting the terminology and basic facts straight.
There are many definitions of elder abuse. This one is from the National Center on Elder Abuse (NCEA), a program of the U.S. Administration on Aging. It is particularly simple and clear:
”[A]ny knowing, intended, or careless act that causes harm or serious risk of harm to an older person – physically, mentally, emotionally, or financially.”
Elder abuse generally falls into three categories – domestic, institutional and self-abuse which are self-explanatory. Domestic refers to maltreatment caused by someone with a special relationship with the elder - a spouse, a sibling, a child, a friend or a caregiver.
Institutional abuse refers to that which occurs in residential facilities – nursing homes, group homes and varieties of care facilities where the abuse is usually perpetrated by people who have a contractual obligation to provide for elders.
TYPES OF ELDER ABUSE
Here, in no particular order, is a breakdown of types of elder abuse. I had no idea there are so many possibilities:
• Physical abuse - inflicting physical pain or injury such as slapping, bruising, restraining by physical or chemical means.
• Emotional abuse - inflicting mental pain, anguish or distress through verbal or nonverbal acts such as humiliation, intimidation or threats.
• Financial abuse - some call this exploitation but I don't think that makes the point strongly enough. It is the illegal theft, fraud, misuse, concealment or neglect, or use of undue influence to gain control of an elder's money or property for another person's benefit.
• Sexual abuse - non-consensual sexual contact of any kind.
• Neglect - failure by caregivers to provide food, shelter, health care, physical safety or emotional needs.
• Desertion - desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.
What is horrifying to realize is the detail of this list could not exist if these acts did not regularly occur.
In addition, there is “self-neglect” described as the inability of an elder to understand the consequences of action or inaction to such an extent that it will lead to harm or endangerment. For now, I am assuming this item is included because people who should notice and do something sometimes do not.
ELDER ABUSE STATISTICS
There are none. No one knows how many elders are affected. Estimates range from half a million to five million people annually and most experts believe that the majority of elder abuse, maybe as much as 80 percent, goes unreported.
THE LEGAL PICTURE OF ELDER ABUSE
Laws and penalties for elder abuse vary widely across states. There are criminal penalties for some forms of elder abuse and where there are not, a growing number of prosecutors are using other kinds of criminal and civil laws to bring abusers to justice. Perhaps, as this series continues, we can get the TGB elderlaw attorney, Orrin Onken, to address some of this for us.
The U.S. Administration on Aging (AoA), the Centers for Medicare and Medicaid Services (CMS) and the Department of Justice (DoJ) provide information and some funding to state and area agencies in support of their prevention activities and victim assistance programs.
But although federal laws on domestic violence and child abuse provide federal funds and shelters for victims, there is no comparable or direct federal assistance for elder abuse victims.
The Affordable Care Act, just upheld by the U.S. Supreme Court last week, includes the Elder Justice Act which, when enacted, will “help prevent and eliminate elder abuse, neglect, and exploitation.” Or so says the White House [pdf].
”Specifically, the law requires the secretary of HHS, in consultation with the Departments of Justice and Labor, to award grants and carry out activities that provide greater protection to those individuals in facilities that provide long-term services and support, and provides greater incentives for individuals to train and seek employment at those facilities. It also requires the immediate reporting of suspected crimes to law enforcement officials.”
The ACA also establishes uniform reporting standards along with a nationwide program for national and state background checks for employees who have direct contact with patients in long-term care facilities.
I suppose that's a start, but it does not address domestic abuse at all.
Here is a short video I would like you to watch. It is from Alberta, Canada and the government intervention does not necessarily apply in the U.S. states. But it gives a good picture of how elder abuse can develop.
So. That's a general overview of elder abuse in the United States. Future posts will deal with warning signs, prevention, local resources, how to report abuse and whatever else I think we should know.Elder Abuse Part 2: Institutional Abuse Overview
At The Elder Storytelling Place today, Stroppy: Daintree Country, Ozzie Style