Abuse of the Elderly - Essay Example

Abuse of the Elderly Introduction  Elder abuse and neglect is a serious issue in which the healthcare worker can see something and say something about it. They can also report to authorities and also communicate with family members, providing support not just to the elderly individual, but also to the whole family system they are a part of. Care workers can also help to ease tensions that may occur when family members need to provide for the healthcare of a relative in their later life stages, and also advocate for independence and decision making. They can also look out for signs of elder abuse. Abuse and neglect are too often visited upon older individuals who have lost some degree of their independence, and many areas do not have the programs necessary to effectively counter this threat on the community level. There is even abuse and neglect that goes on with healthcare facilities, nursing homes, and home environments, and this is perhaps the most insidious sort of abuse. In some cultures, the elderly are prized and honored above all other citizens and groups, but unfortunately this is not the case in the present culture. Elder abuse can happen in healthcare or nursing home situations, or it could happen at the hands of the elder’s own family and support system. Background  In the US today, older individuals are more likely to be seen as being in the way of the young than as role models who should be exalted because of their aged wisdom. Presently, however, many individuals are treated harshly by healthcare facilities and even their own kin, making elder abuse a significant problem in society. Also, in terms of economic scales, older individuals who are of a lower socio-economic class are more likely to be abused or mistreated. These people may lack a stable caregiver. There are those who say the aged should be used as models who should be exalted because of their aged wisdom. Presently, however, many individuals are treated harshly by healthcare facilities and even, as the proposed report will show, their own families and support systems, making elder abuse a significant problem in society. “Elder maltreatment is not a new entity but is one that is recently recognized as a widespread and growing social problem” (Welsh and Morgenlander 97). It is common and insidious in home care as well as nursing home settings. There are many signs to watch out for. “Unfortunately, few physicians are trained to recognize the different forms of elder maltreatment including physical abuse, sexual abuse, and neglect” (Welsh and Morgenlander 155).Increased training procedures could help to solve the problem. “The elder, age 65 years or older, is also a unique individual with respect to pathophysiology. The natural changes of aging must be considered when assessing any physical or laboratory findings” (Welsh and Morgenlander 178). In other words, abuse may be more difficult to find and quantify in elders. Signs of abuse  In some cases among the elders, the abuse is not as clearly defined as in some other cases; however, abuse is abuse; that is, it is abuse to hold back an elder through tactics of restraint through medication, just as it is abuse to perpetrate outright physical, sexual, or psychological abuse against them. Abuse and neglect are too often visited upon older individuals who have lost some degree of their independence, and many areas do not have the programs necessary to effectively counter this threat. As noted, the abuse and neglect that goes on within healthcare facilities, is perhaps the most insidious sort of abuse. In the scenario dealt with by this paper, the abuse can also go on in a home situation, however. “Elder maltreatment is not a new entity but is one that is recently recognized as a widespread and growing social problem” (Colins, 3). As a social problem, elder abuse can be defined in many ways. For example, there is passive neglect, a very common and poorly addressed problem in the present; sometimes caregivers keep the elderly in a state of medicated sedation in order to keep them quiet and uncomplaining. This isn’t emotional abuse, which is also a serious problem that may carry psychological ramifications for older individuals, and should be met with an appropriate type of treatment such as family counseling or structural therapy; the person in this case is not mean or spiteful, or may not seem to be, and they may seem to have a stable relationship. So often, caregivers are guilty of giving a client permission to physically abuse the elderly through over-medication. This type of abuse is not as easy to see as physical abuse, but it is in the same classification. “Physical abuse is generally considered the most extreme form of elder maltreatment. 16 Such physical abuse includes slapping, blunt force trauma, bites, pinching, traumatic alopecia, burns and scalds, force feeding, overmedication, under medication, and improper medication, and improper use of physical restraints” (Collins 6). This author also goes on to note that “Physical abuse accounts for up to 14% of all elder trauma and results in death more frequently than in younger patients” (Collins 7). That is the bottom line of this situation hope that solutions can be brought to the problem of elder abuse holistically an in a manner that helps everyone involved. One must also remember that neglect is definitely a form of abuse. Although most people concentrate almost exclusively on abuse and neglect that occurs inside of healthcare facilities, the outside home environment is also a problem that needs to be addressed. Workers at facilities for older individuals need to realize that elder abuse will not be tolerated in any way shape or form, and will result in definite punitive action, because it is against the law. There may be signs of improper turning of the patient or bedsores. There may be improper use of restraints. “While the Nursing Home Reform Act did not prohibit the use of restraints entirely, it did set up strict guidelines and parameters that must be met before the use of restraints are considered appropriate. This legislation has dramatically lowered injurious restraining incidents since it began to be enforced in 1990” (Improper 3). In terms of profile, it is important to remember that, as noted above, another goal of the proposed report is to focus on physical abuse, while still paying attention to other forms of abuse and neglect. “Physical abuse is an act carried out with the intention of causing physical pain or injury” (Colero 54). Elders can in many cases in healthcare facilities or home situations, certainly are the victims of “accidental, non inflicted trauma. Such trauma includes abrasions and contusions over bony prominences and long bone and vertebral fractures” (Colero54). However, if there are cuts and bruises or abrasions in unnatural areas for common stumbles, or frequent black eyes, this is a different story: “Worrisome traumatic injuries include those to areas not commonly impacted during daily activities or even secondary to accidental trauma” (Colero 58). They can also look out for signs of elder abuse. “The Nursing Home Reform Act of 1987 stated, among other things, that: The resident has the right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience, and not required to treat the residents medical symptoms” (Perception, 2003). This can be extended to the home as well. As noted, one can tell a lot about a society by how it treats its elderly citizens, and unfortunately, many elderly Americans, especially those who live in low-income environments like many inner city areas, and who may have physical or mental impairments, are treated harshly, exploited. Nursing homes vs. home care  Surprisingly, elder abuse is statistically more likely from a support group or family member, than it is from a nursing home. One author states that Pillemer “found… that abusers were very likely to be dependent on the older person for housing and financial assistance. Indeed, only one-third of the abusers were financially independent of the abused elder” (Atchley, 399). It is not the intention of this report to question or bring naïve criticism to Atchley’s work, but at certain times, this may miss the human element of the problem. There is a whole range of individual experience in the world, and just because one researcher found in a controlled study that independent older individuals were more likely to be abused does not mean that dependency in older individuals is somehow absolutely not related to abuse and neglect. The fundamental question of this situation deals with ethics as something that either can or cannot be implemented as a universal condition. This assumes that ethics can be considered to operate across boundaries of nations and culture and unite people through a framework that is shared. Basically the situation is about whether or not a universal definition of ethics is possible and if so, how the universally accepted definition regards ethics as an individual or group’s ability to make choices regarding how to act and how to behave. There are statistical similarities that tend to unite elder abusers, but there is no blanket policy or profile. “The typical perpetrator, or abuser, is a relative who lives with or near the elder.25,31 Three characteristics of the perpetrator are known risk factors: a history of mental illness and/or substance abuse, excessive dependence on the elder for financial support, and a history of violence within or outside of the family” (Improper,98). This was not a family with a history of violence, so this decreased the likelihood Conclusion  Elders are more likely to be abused by financially dependent family members than they are by healthcare workers and nursing home workers. This may be surprising reading the mainstream media and statements on the issue, one would think that the reverse would be true. Healthcare workers still need to work as advocates to end elder abuse, whether it is being visited upon single older persons living alone by healthcare professionals, or whether it is being visited upon them by their own family. This report has looked at the presenting ethical problem, and then taken discussion in support of, and against, the author’s own ethical actions in relation to this problem, before concluding. Elder abuse is a complicated subject, because there are so many categories of abuse. In talking about these categories of abuse, one must also not lose sight of a subject of potential future research: the relationship between elder abuse and elder neglect, in terms of its commonality. Neglect is often under reported because it is not viewed as being as serious as abuse, but one must remember that neglect is a form of abuse, and is a legitimate category. “Physicians who take care of elderly patients encounter the victims of abuse and neglect, but often the problem is not identified, and appropriate interventions are not made.” (Halphen, 29). This is a problem that is under-reported. It is therefore vital to look at the problem of elder abuse today. In terms of the factors (individual, social, environmental, and political) which have led to the development of vulnerability in this population, there are many levels. On the political level, action is often given to programs like Medicare while ignoring elder abuse. On the levels of the environment and society, programs dedicated to stopping the spread of elder abuse should function from a holistic perspective that includes the older individual’s family and support groups in terms of care and treatment that is integrated into a professional paradigm of observation, especially in cases in which there are signs of elder abuse. There are many different types of neglect and abuse that require different solution measures in terms of putting forth effective programs to ameliorate the factors leading to elder abuse. Passive neglect, for example, should perhaps be highlighted by prevention programs because it seems to be very common and poorly addressed in the present sense. Emotional abuse is also a serious problem that may carry psychological ramifications for older individuals, and should be met with an appropriate type of treatment such as family counseling or structural therapy. Active neglect and physical abuse, although not as common as these other types of neglect and abuse, should also be addressed appropriately through counseling and therapy “Despite longer life expectancy, overall health and disability continue to worsen in the elderly population.1 The resulting frailty of elderly people who depend on the help of others can be a risk factor for various forms of elder abuse from relatives or carers” (Jones and Powell, 200). There are many effects that abuse has on the elderly, depending on whether it is verbal, physical, or even sexual abuse. In terms of the impact of these issues on the health of this population, it is important to not concentrate only on physical abuse. This makes the definition of violence broader. In terms of physical abuse, this facet of elder abuse can be divided into sections of mild abuse, severe abuse, and abuse resulting in injury. For psychological abuse, which, almost always accompanies physical abuse, there are also categories. These are those of verbal aggression, such as shouting and yelling; emotional manipulation, such as using shame and humiliation to control an individual or make them not tell about the abuse; and dominance and restriction, in which the individual is isolated and could be harder to reach. The professional must also learn to categorize and define sexual abuse. In this, the first level is using coercion, or using emotional levers and/or guilt to force someone into a sexual situation. Other, perhaps more serious, categories are the threat of force or the actual use of force as sexual abuse. Women are typically more likely to be injured than men in domestic abuse situations. There is a lot of theory that can be applied to elder abuse, such as feminist theories such as patriarchal authority encouraging violence in males and sex role socialization. Substance abuse and low anger control are also equated with abuse in many instances. There are also links of low income to elder abuse and neglect being more prevalent, and learned about the power of context, or a violent environment in which individuals witness violence, as a factor in abuse and neglect. “The salient nursing and social care literature have also highlighted the predominance of discriminatory and poor quality care that have pervaded practice in this area” (McGary, 247). There may be embarrassment or fear of reporting by those who have been subject to it, the frailty of the older person and the lack of physical means to report. There is even abuse and neglect that goes on within healthcare facilities, and this is perhaps the most insidious sort of abuse. In some cultures, the elderly are prized and honored above all other citizens and groups, but unfortunately this is not the case in the present culture. Older individuals are more likely to be seen as being in the way of the young than as role models who should be exalted because of their aged wisdom. Presently, however, many individuals are treated harshly in society. Elder abuse and neglect would never be tolerated in a society where the elderly were treated with respect and deference as a matter of social custom. But too often, in US society, we relegate our elderly to powerless and victimized positions in managed care facilities. Conclusion It is important to address issues of elder abuse and neglect. “Exploiters, whether family, acquaintances, or strangers, use their power to deceptively gain control over the decision making of their victim” (McGary, 249). One issue I would like to consider as a side issue in the framework is abuse. There is even abuse and neglect that goes on within healthcare facilities, and this is perhaps the most insidious sort of abuse. In some cultures, the elderly are prized and honored above all other citizens and groups, but unfortunately this is not the case in the present culture. Older individuals are more likely to be seen as being in the way of the young than as role models who should be exalted because of their aged wisdom. Presently, however, many individuals are treated harshly in society. Elder abuse and neglect would never be tolerated in a society where the elderly were treated with respect and deference as a matter of social custom. But too often, in US society, we relegate our elderly to powerless and victimized positions in managed care facilities. Work Cited Atchley, Robert C. Social Forces and Aging: An Introduction to Social Gerontology. Belmont,Ca: Wadsworth , 2000 Print. Colero, Larry . “A Framework for Universal Principles of Ethics”. Crossroads U.B.C. Center for Applied Ethics 2003.Web. 1Nov.2010 ... Collins, Kim, A “ Elder Maltreatment..”. Archives of Pathology & Laboratory Medicine. 130 9 (2006):1290-1296. Web..1 Nov.2010. ,. Halphen, J. “Recognizing elder abuse.” Geriatrics 2009. Jones and Powell. “Old age vulnerability and sexual violence.” ICN 2008. McGary, C. “Identifying, and preventing elderly abuse.” Nursing Older People, 2008. “Improper Use of Physical and Chemcial Restraints E lder Abuse Law Center 2007.Web. 1 Nov. 2010. . Read More