Elder Mistreatment-Research and Policy Gero 408 Jan 2011

Background At a macro level we need to look at this issue through the social constructions of old age, the risk of being mis-treated or mis-treating others and what will be done about it. At the micro level we are looking at the individual victim and the perpetrators and the surrounding social network. Issues include defining clear terms, conducting research, developing policy initiatives and theoretical frameworks in which to apply services. Terms can include-elder mistreatment, maltreatment, elder abuse. Who are the likely victims and who the perpetrators.

Introduction There are ongoing issues with legal definitions, culpability and intent, covert and overt conflict in social relationships, private, semi-private and residential home settings. We must consider the dynamic of power relations within families, clients and care providers, and a whole range of informal care givers. There are clearly different dynamics at work if the abuser is a spouse and carer burnout, to mis-treatment by adult children due to growing dependencies or external abuse for a variety of reasons (crime, punishment, gerontophobia, etc)

Perspectives The life course perspective looks at historical or continuation patterns. Age associated vulnerability looks at diminished abilities for self-care and protection and distinguishes elder mistreatment from other forms. Categories include: Physical, Psychological, Financial and Neglect. See Def on Page 283 Abuse is conduct by responsible caregivers or other individuals and neglect is Omission by responsible caregivers. This may cause disconnects in both policy and research

Prevalence 2006 data suggest from 3-10% of older persons suffer from some form of mistreatment. Many studies rely on reported cases and this data is often weak and under-reported. Elder Abuse may be embedded in Family Violence issues and not filtered out. Rates of intimate partner violence are similar across the age span. Three possible reporters of mistreatment are perpetrators, victims, and third parties. Victims are often fearful to report due to retaliation, withdrawal of support, feeling foolish, feeling partially responsible for the perpetrators behavior.

Reporting There may be a legal requirement to report abuse or not. Assault falls under the Criminal Code, Financial Abuse is often under-reported. If third parties are family members there may be some reluctance to become the “Whistle Blower” Causal Factors include-women in poor health, living with someone else who is isolated and without support, lack of financial resources due the a constellation of problems. Mistreatment by adult children has now overtaken that of the spouse and sons are more likely the perpetrators than daughters. Inherited assets and lost resources often are a source of family confict.

Care Issues Relying on Carers who have substance problems, who are unemployed, who is the only person providing support and assistance, increases the risk of mistreatment. About 4-6% of Canadians are living in Care Facilities. In US 30% of Nursing Homes were cited for abuse violations from Theft %-19% depending on who is reporting. Physical abuse is much more difficult to determine and to identify without clear guidelines and ongoing holistic reviews.

Policy Issues Legislation Adult Protection Coordinated Legal, Medical and Psychosocial Services. Risk Model development Legal responses and criminalization has not been particularly effective Preventative measures Community bases services to deliver care and support Intensive informal support for families.