What is considered neglect of the elderly?

Elder neglect occurs when a caregiver fails to protect an older adult from harm, resulting in serious injury or illness. Most incidents of elder abuse do not occur in nursing homes and other residential settings. Occasionally, there are shocking reports of staff abusing residents in their care or of a resident physically or sexually abusing another resident. While this type of abuse occurs, the vast majority of older people living in nursing homes and other residential settings have their physical and emotional needs met without suffering abuse or neglect.

Most Elder Abuse and Neglect Occurs at Home. About 95 percent of older people live alone or with their spouses, children, siblings or other family members who are not in institutional settings. When elder abuse occurs, family, other household members, or paid caregivers are often the abusers. Although there are extreme cases of elder abuse, abuse is often subtle, and the distinction between normal interpersonal stress and abuse is not always easy to discern.

Elder abuse, like other forms of violence, is never an acceptable response to any problem or situation, no matter how stressful it may be. Effective Interventions Can Prevent or Stop Elder Abuse. Raising awareness among doctors, mental health professionals, home health workers, and others who serve older adults and family members can help break patterns of abuse or neglect, and both the abuser and the abuser can receive needed help. Caregiver neglect can range from care strategies that withhold the person's proper care to intentionally failing to meet the older person's physical, social, or emotional needs.

Neglect may include failure to provide food, water, clothing, medication, and assistance with activities of daily living or help with personal hygiene. If the caregiver is responsible for paying the older person's bills, negligence can also include failure to pay bills or failure to manage the elderly person's money responsibly. Family caregivers may inadvertently neglect older relatives due to their own lack of knowledge, resources, or maturity, although this is a less common form of abuse. There is no single explanation for elder abuse and neglect.

Elder abuse is a complex problem that can be caused by multiple causes, including family stressors, care stress, and social and cultural problems. Sometimes there can be spousal stress between an older couple when they must share a house with their adult children. Or, new living arrangements could cause tension between an adult child and his or her spouse. When problems and stress increase, the possibility of abuse or neglect increases.

Caregiver stress is a major risk factor for abuse and neglect. When the demands of the daily care of an elderly person are imposed on caregivers who have not received training or information on how to balance the needs of the elderly person with their own needs, they often experience intense frustration and anger that can lead to a variety of abusive behaviors. The risk of elder abuse is further increased when the caregiver is responsible for an elderly person who is sick or has a physical or mental disability. Caregivers in such stressful situations often feel trapped and hopeless and unaware of the resources and assistance available.

If they don't have the skills to handle difficult behaviors, caregivers may find themselves using physical force. Particularly when there is a lack of resources, situations of negligence can arise. When older people are considered to be insignificant, society does not recognize the importance of ensuring decent, supportive and non-abusive living circumstances for all older people. The idea that what happens in the home is private can be an important factor in keeping an elderly person locked up in an abusive or negligent situation.

Non-family members who observe or suspect abuse or neglect may not intervene because they believe it is a family problem and it is none of my concern or because they fear misunderstanding a private dispute. Shame and shame often make it difficult for older people to disclose abuse. They don't want others to know that such events occur in their families. Certain cultural values, beliefs and traditions influence family dynamics, intergenerational relationships, and the ways in which families define their roles and responsibilities and respond to daily challenges.

These differences make some situations difficult to distinguish from abuse or neglect. Older people who belong to ethnic minorities, particularly recent immigrants, may face language barriers and financial or emotional dependence that influence their ability or willingness to report abuse. The first and most important step in preventing elder abuse is to recognize that no one of any age should be subjected to violent, abusive, humiliating, or neglectful behavior. In addition to promoting this social attitude, we can take positive steps, such as educating people about elder abuse, increasing the availability of respite care, promoting greater social contact and support for families with dependent older adults, and encouraging counseling and treatment to address personal problems and family problems that contribute to abuse.

Violence, abuse, and neglect of older people are signs that those involved need help right away. Don't let your fear of meddling in someone else's affairs stop you from reporting your suspicions. You could be saving someone's life. The reporting agencies in each state are different, but each state has a designated service to receive and investigate complaints of elder abuse and neglect.

Even if these agencies determine that there is only the possibility of abuse, they will make referrals for counseling (call the Eldercare Locator at (800) 677-111.If you recognize that abuse, neglect, or violence is one way you often resolve problems, you will need expert help to break old patterns. There is help and hope for you, but you must take the first step as soon as possible. You can learn new ways of relating that aren't abusive. Talk to someone who can help a trusted friend or family member, a counselor, or their pastor, priest, or rabbi.

If alcohol or drugs are a problem, consider contacting Alcoholics Anonymous or some other self-help group. Adult Protective Services (APS), present in all 50 states, are designated to receive and investigate complaints of elder abuse and neglect. Each state has a main agency that hosts APS. This can be the Area Agency on Aging, the Division on Aging, the Department of Aging, or the Department of Social Services.

Federal law requires each state attorney general's office to have an MFCU that investigates and prosecutes Medicaid provider fraud and patient abuse and neglect in health care programs and home health services that participate in Medicaid. Contact information for individual state MFCUs is available online. In general, Adult Protective Services (APS) agencies receive and investigate reports of suspected abuse or neglect of individuals. Elder neglect is the failure to provide an elderly person with important needs, such as adequate food, water, medication, or safety.

Physical negligence can mean not providing an elderly person with adequate and necessary medication or physical therapy, failing to take care of their personal hygiene needs, or forcing them to live in unhealthy or potentially harmful conditions. Elder abuse can also take the form of intentional or unintentional neglect of an older adult by the caregiver. When a caregiver fails to meet the needs of an older person who cannot care for themselves, it can result in neglect. Neglect is a relatively common form of elder abuse because older adults have a higher prevalence of medical conditions and functional limitations that make them vulnerable to neglect.

When someone with power over an elderly person intentionally harms them or puts them at risk of harm, their actions or inaction are considered elder abuse. Psychological neglect can mean leaving an older person alone for long periods of time or not providing them with the social contact, activities, and information necessary for an older person to thrive. While many seniors face health problems as they age, they should never have to suffer abuse or neglect. Emotional and psychological changes can often go hand in hand with other types of elder abuse, such as physical harm or neglect.

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Erika Shipley
Erika Shipley

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