Elder Abuse Chapter 5

Demographics Explain History Change in age structure occurred almost in chorus with the emergence of elder abuse 20th century – Birthrates = down, Life Expectancy = up The 1900 Age Pyramid shows a disproportionate population favoring those under 18 2000 Age Pyramidfigure1, the sub-18 and over-55 populations are nearly equal An inverted pyramid trend, like that in the European Union, will occur by mid-21st century

Race, Gender, and Life Expectancy Why the gender gap? Stress Jobs Lack of intimate relationships Violence Non-intimate partner violence Homicide 5th most common cause of death for African American Men

Race, Gender, and Elder Abuse Women are more likely to be victims of all types of elder abuse Except neglect Statistics and experiences of elderly women similar to that of intimate partner violence Physical abuse levels nearly match those of young women African American women 2.84% more likely to report physical violence White women more likely to report verbal abuse

Sandwich Generation Many middle-aged women are caring for both elderly parents and their children 1/8 Americans have an older relative living with them 10 million in Sandwich Generation Caring for children until late 20s/early 30s result of increasing education levels Financial dependence Delay in childbirth Investment retirement accounts lead to need for funds security Resulting in working past age 62

Elder Abuse Frequency and Types 2%-10% of elderly are victims of one of the following types of abuse: Financial Abuse Neglect and Self-Neglect Physical Abuse Psychological Abuse Sexual Abuse A majority of elder abuse goes unreported Estimated 2.5 million over age 60 experience elder abuse every year Picture: http://blog.guardly.com/guardblog/

Financial Abuse 12.3% of elder abuse is financial 5 million victims in 2005 Definition includes: Taking money/property Influence signing of deed, will, or power of attorney Receiving money/property for care that isn’t given Cons: deception to gain trust Scam: False or dishonest actions for financial gain Telemarketing Scams Picture: http://www.nocaptionneeded.com/wp-content/uploads/2009/09/elderly-audience.jpg

Scammers and Their Scams Family Member Abuse Causes: 60% of elder financial abuse is by family members Financial problems Sense of entitlement to or fear of losing inheritance Negative relationship family members Personal Relationship Scams ‘Sweetheart Scams’ – Seeking marriage without a prenuptial agreement Seeking employment to gain access to finances, and/or turn the elder against their family Impersonal and Large Target Scam Tactics Scanning obituaries and casing neighborhoods for isolated elders Business fraud (overcharging, misuse of position)

Easy Targets Conditions or factors that diminish trust: Isolation Loneliness Recent loss Conditions or factors that mark an elder as an easy target: Physical or mental disabilities Alzheimer's, Dementia Lack of knowledge on finances Family members with substance abuse problems or are unemployed

Risk Factors Receiving and cashing Social Security checks in a pattern More susceptible to large target Social Security scams Elderly control 70% of nation’s wealth because: Healthy or great health insurance More disposable monthly income Fewer fixed expenses Older women tend to lack financial experience They can easy miss markers of financial abuse They don’t know true wealth of investments

Neglect and Self-Neglect Active Neglect: A caregiver purposefully denies care or necessities For financial gain Interpersonal conflict Passive Neglect: Caregiver cannot perform duties due to illness, disability, stress, ignorance, immature, lack of resources Self-Neglect: Elder person refuses care despite need Possible perpetrators: Paid attendants, relatives, long-term care/hospital/nursing home employees Spouses as caregivers may neglect or self-neglect due to own illnesses

Risk and Indicators #1 factor: Diminished mental and/or physical capacity High care needs Alzheimer’s, Parkinson’s Signs of neglect in home: Absence of necessities, inadequate living environment In physical condition: Poor personal hygiene, improperly clothed, bedsores Behavior indicators in caregiver or abuser: Anger, isolates senior, refuses to apply for aid for senior In victim Depression, nightmares, regressive, fear of caregiver

Physical Abuse Most commonly a continuation of domestic violence Physical Indicators Fractures or broken bones Burns Abrasions that resemble rope or strap marks Internal injuries Bruises Behavior Indicators Inquires about injuries are unexplained, have implausible explanations, or accounts are inconsistent Numerous or suspicious hospitalizations Delay between injuries occurrence and medical treatment

Psychological Abuse Willful infliction of mental or emotional anguish by threat, humiliation, or other verbal or nonverbal conduct Not typical in cultures that revere old age as a sign of wisdom Asia, Africa Western cultures view aging as negative and not valuable Unable to function in technologically advancing world Lack up-to-date skills

Risk and Indicators Risk Factors: Physical Indicators Isolation or lack of support Disabled Racial or ethnic minority Women Physical Indicators Significant change in appearance, stress-related conditions Indicators in Perpetrators Isolates the senior emotionally Indicators in Elder Problems sleeping, depression, cowers near abuser Picture: http://www.elderlycare.net

Sexual Abuse Any form of nonconsensual sexual contact, including rape, molestation, or any unwanted or coerced toughing Perpetrators can be anyone who can have unsupervised contact with the victim Who is at Risk? Mostly women, disabled, isolated, lack the physical or cognitive capacity to report or understand abuse Physical Indicators Genital or anal pain, irritation, or bleeding Bruises on external genitalia or inner thighs STDs

Theoretical Explanations Psychological Models: A history of violent behavior, mental illness, and substance abuse in care givers is a greater cause of elder abuse Social Learning Theory: A caregiver who engages in elder abuse is likely to have grown up with abuse Symbolic Interaction Theory: Abuse more likely to occur when caregivers expectations of elder aren’t met Picture: http://static.howstuffworks.com/gif/depression-in-the-elderly-1.jpg

Theoretical Explanations continued Social Exchange Theory: Abuse and neglect more likely to occur when the balance of power in the relationship shifts (child is parent’s caretaker) Situational Theory: Elderly persons who have many risk factors are more likely to be abused. Care providers who are unprepared to provide care create higher risks for abuse Ecological Theory: Social networks play a valuable role in reducing the risk of being abused Feminist Theory: Patriarchy creates a gender- based hierarchy that structures all of social life