interview

1. 1
1. Statistics Povertyandlack of social support -leadingcausesof elderabuse indevelopingcountries
2. How to identifyEAN? Indicatorsof mistreatmentinlaterlife:
a. Abusersfrequentlyensure environmentthattheycandominate andcontrol the elders,and/orpeople
unlikelyorunable toretaliate
b. Frequentargumentsortensionbetweenabuserandthe elder
c. Changesinthe personalityorbehaviourinthe elder
d. Physical signs:brokenbones,fractures,sprains,choke marks,burnsfromcigarette,hotwater,abrasions
on arms,legsor torso resembling rope orrestraint,bruises
e. Unexplainedinjuriesorsuspiciousexplanationof the injuriesordelayedseeking
f. Bedriddenperson-bedsore,dehydration,malnourishment(sunkeneyes,lossof weight)
3. What isthe differentbetween
mistreatmentandabuse?
1. Mistreatmentvsabuse of elders
2. “A single orrepeatedactor lack of appropriate actionoccurringwithinanyrelationship where there isan
expectationof trust, thatcausesharm or distress toan olderperson”(WHO2012)
3. Five maintypologiesof EAN (WHO2002)
a. physical
b. psychological
c. sexual
d. financial ormaterial abuse
e. neglect
4. NOTE:
a. Usually eldersexperiencedmore thanone formsof abuse
b. Psychological abuse reportedtobe more commonthanthe rest.
c. Mistreatmentcouldbe intentional andalsounintentional
5. Abuse subtleties- “the nature of the mistreatmenttendedtoindicate more passiveformsof abuse,which
were obscure andsubliminal andwhichtendedtobe progressiveandincessantoveraprolongedperiod.
These typesof abuse couldoftengounnoticednotonlybythe olderpersonhimorherself,butalso bythose
whowere close tothem”
6. Insidiousandgradual innature
7. Perpetrator-caregiver,domesticviolence andhealthcare provider
8. Setting-communitysetting(ownorrelative’shouse) andinstitution(assistedlivingornursinghomes)
4. Preventivemeasuresfor
caregiversandfamilies?
1. Approachestodefine,detectandaddress EAN mustbe placedwithinacultural contextandconsidered
withinculturallyspecificriskfactors
2. Preventionof EAN forpaidcaregivers:

2. 2
a. Adequate staffing(preventjobburnout,poorworkingconditionandstress)
b. Properlytrainedstaff
c. Appropriate payforemployees
d. Adequate medical andnursingcare
e. Legislationandmonitoring(topreventexploitation,healthcare fraudandabuse thatmay be carried
out by healthcare professionals-administrators,doctors,nurses,hospital aidesetc)
3. Preventionof EAN forfamilies:
a. Supportthe family tocope withlife stresses(poverty,caregiverburnout,social isolation,substance
abuse)
b. Relookatcultural normsthat increase riskof EAN
i. Collectivism(puttingthe family’sorgroupneedsbefore self)
ii. Avoidingbringingshame tothe familyandfamilyharmonyeldersmaybe reluctanttoask
for help
iii. Genderrole expectations
iv. Perceptionof oldage (whendepictingoldage asfrail,weak,dependent  riskof perceiving
that eldersare lessworthyof governmentinvestmentorfamilycare) negative stereotype
has to be prevented
c. Increase understandingof rightsof elders
d.
5. Role of communitymembers
inEAN
1. Everybodyhasa role to play.Be aware of the existence
2. Individual level
-if one feelsthathe/she isinvolvedinEAN (as abuseror victim),seekhelp
-if one identifies anyone isbeingvictimised/abusive,dependingonthe relationshipwiththe person,do
advice the abuser/victimtoseekhelp(moral obligationratherthanlegal obligation)
6. Case studies Case 1:
A fatherwhowas abandonedatthe busstop
Case 2:
Bedboundelderperson-Neglectedpatientathome withbedsore.
Case 3:
Domesticviolence butcouplesare gettingolder
Case 4:
Nursingcare- usingrestrainforrestlesspatients

3. 3
Case 5:
Financial exploitation. A retiredgovernmentservantwithpension,stayingalone.Herdaughteralwayspayavisit
but pressedherformoney. Aggressive whennotgettinghermoney