Physical Elder abuse can happen during the holiday season , a joyous season also fraught with family tension.
Family caregivers are of the most vulnerable. . They teeter on a thin ledge where they can slip on the knife’s edge of elder abuse. Neglected, untrained, unpaid yet representing 78% of the long-term care system, family caregivers are stress on steroids. You may personally know what I mean. Most kin, in spite of the constant worry and tension, do a heroic job. Yet certain groups of caregivers are vulnerable to cracking up and some are predisposed to a cycle of violence. How do we know who might be a perpetrator?
Let’s take a step back and see who is a caregiver. The aging 21st century family is no longer the nuclear family made up of 50’s TV Ozzie and Harriet, and their famous kids Ricky and David. Divorce and long distance have shattered what we knew of that family. Now the aging family and its’ care providers are not just blood relatives. It’s not just David who cares for Harriet and Ozzie. Ricky, if he were still alive, might be divorced or both he and David might have new wives .So we have multiple caregivers and grandchildren who are steps, halves and fictive kin.
Or you may have partners caring for older family members, friends, neighbors, and significant others the aging family .The family itself has washed over its banks just like the Mississippi flooding New Orleans.
Because growing old means suffering chronic conditions like Alzheimer’s and cancer, the care receiver demands more and more care. The caregiver may be unwilling or unable to keep filling up this bigger and bigger plate. Their backs get more and more weighed down like the proverbial camel. Some last straw, some new demand may just shatter that spine and cascade the family member over the ledge, falling down Niagara without a barrel. In their terrifying freefall some family caregivers commit elder abuse
What are some triggers to elder abuse in families? The number one detonator of elder physical or financial abuse is bad past relationships. That miserable family past might harbor child abuse, child neglect, child abandonment, or alcohol or drug use involving the now aging parents. When the some inner barrier that holds back pain cracks, it can result in violence and deceit. If the family of 50 years ago suffered some searing hurt which carries through to the present, that old wound can turn into a fist or a slap in the here and now. So some adult children and family caregivers are horribly vulnerable to violence in the present aging family.
In a susceptible family caregiver, what are some care receiver triggers that can make them snap.
• Verbal aggression
• Refusal to eat
• Refusal to take meds
• Calling police
• Embarrassing displays- taking of clothes
• Physical aggression
• Vulgar habits – example spitting
• Disruptive behavior
If you have concerns about caregivers and elder abuse., call you local Adult Protective Services . I have also included a chapter a caregiver assessment in my text Care Managers and the Aging Family, Jones and that has a section on caregivers and elder abuse. You can order the book on my website as well.
Fiscal Elder abuse can be detected during the holiday season by visited family / Paula Span, in her New Old Age column in the New York Times gave some very savvy tips that you should check out.
The worst perpetrators are not professional con artists. The most dangerous elder financial abusers aren’t folks running a scam like Bernie Madoff or crooks offering free lunches to retirees then swindling their money. Vicious financial abusers are most frequently the older person’s own family. All we have to do is look at the infamous Brooke Astor case. Her son Anthony was convicted of siphoning millions and sentenced to one to three years in prison.
After the trial one prosecutor called it “grand theft Astor,” with Mrs. Astor’s son on an “a six-year crime spree involving a series of larcenies”
A survey of State Adult Protective Abuse of Adults Over Sixty showed that the most common fiscal abuser was a son or daughter. Adult children perpetrated 33 % of the fiscal exploitation substantiated by APS. Other family members were the next biggest group of fiscal abusers investigated by APS. These other kin represented almost 22% of the financial abuser reported nationwide to adult protective services
What are red flags for adult fiscal abuse
Financial abuse can have many faces
➢ Someone paying bills but bills are not paid
➢ Money missing from accounts
➢ Family member /caregiver withdrawing large amounts of money from accounts
➢ Someone taking money under false pretenses,
➢ forced property transfers
➢ purchasing expensive items with the older person’s money without permission
➢ denying the older person access to his or her own funds or home.
➢ Scams perpetrated by sales people
Elders rarely report elder abuse according to a Met life study on the crime. Only the tip of the iceberg of this con is reported for various reasons. Elders often believe that they are responsible for allowing themselves to be swindled or abused. They frequently fear they will be placed in a nursing home if they report the crime. Older victims hold back in turning the perpetrator in because they are afraid the person will harm them further. And finally, since the tormentor is often a son or daughter their motherly urge is to protect the criminal in their nest.
Psychosocial Assessment, which we have been following in my You Tube series along with the functional assessment, provides the foundation for all the care management that follows. Combined, the functional and the psychosocial assessments are not only critical to developing a relevant and appropriate care plan, but in fact they provide an in-depth perspective of the older adult’s quality of life. The goals of clinicians and researchers alike have moved from focusing on how long a particular intervention can extend an older adult’s life, to a more holistic approach that recognizes the importance of increasing the quality of the older adult’s life. Within the fields of social work and care management there has also been a shift from focus on assessing client deficits (impairment or disease) to a broader perspective that focuses on the strengths of clients and their family systems.
The knowledge gained from a comprehensive psychosocial assessment provides objective measurable information about the cognitive, social, psychological, spiritual, financial, and legal dimensions of the client system, as well as important subjective information about the entire client system’s coping mechanisms and relationships In the previous You Tube’s on Psychosocial assessment blogs have primarily focus on the cognitive, psychological, economic, and social dimensions In the next few blogs we will focus on assessing the potential for substance abuse, legal dimensions and elder maltreatment and how to put all the assessment data together in a care plan.