illustrated earlier in the example for ethnomethodology. Punishment is
intended to teach them a lesson. Believing that the older adult has control
over eliminatory functions may be an inappropriate expectation.

Intolerance of the Older Adult's Behavior. Finally, an indicator of the
potential for being overwhelmed is, simply, intolerance of the older adult
(which includes the older adult's being self-deprecating in instances of
self-mistreatment). Professionals, paraprofessionals and others must
deal with difficult people from time to time. Older adults are, of course,
included in that category. Nothing one does is right. The difficult person
can be spiteful, sullen and unbelievably provocative. Sometimes older
adults can turn their anger inward and be terribly self-destructive. Each
of these instances can prompt retaliation in the form of withholding
food, harassment, isolation or bodily assault.

Human services professionals need to be alert to all four of the warning
signs for becoming overwhelmed. The lack of knowledge about elder
care, a lack of resources, inappropriate expectations about the older
adult's capacities and intolerance of the older adult's behavior become
important starting points in identification. Helping older adults manage
these four situations may very well mean avoiding being overwhelmed
at all.

As we have noted earlier, being overwhelmed is a subjective condi-
tion. However, we are beginning to develop tools that help to tap this
state objectively. Chapter 4 will present where we are in approaching
the four indicators that activate being overwhelmed. More specifically,
it distinguishes among elder mistreatment instruments and their func-
tions and levels of measurement.

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