Concern over the abuse of elderly people has become an important factor in many societies, along with the realization that the elderly population will increase dramatically in the coming decades. It is predicted that the number of people aged 60 or older will more than double, from 542 million in 1995 to around 1.2 billion by 2025.
The definition established in 1993 by Action on Elder Abuse, an organization based in the United Kingdom, and adopted by the World Health Organization, states that elder abuse is "a single or repeated act or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person".
The main feature of this definition is that it focuses on an expectation of trust which is eventually violated. It does not include harm made by strangers, unless they have abused the expectation of trust. Generally, people who abuse the elderly are in a position of trust and exploit a special relationship.
The abuser is often a person whom the abused knows very well such as a partner, a relative, a neighbor, a friend or a health or social worker. Elderly men and women are both at risk of being abused.
Abuse of older people can be either intentional or unintentional. Passive or unintentional abuse occurs when someone lacks the skills or the external support to take care of an elderly person and fails to accomplish the task. Whether it is intentional or unintentional, abuse will surely result in injury or pain and a decrease in the quality of life for the older person.
The Action on Elder Abuse in the United Kingdom divided elder abuse into physical abuse, psychological abuse, financial abuse, sexual abuse and neglect.
Physical abuse includes hitting, pushing, kicking or prescribing and administering improper medication. The signs of physical abuse are untreated injuries such as bruises or scars, broken bones, sprains, dehydration, loss of weight and poor skin condition.
Physical abuse is something elderly people often try to hide. The reasons for doing so are related to the fact that they might feel ashamed or embarrassed about the abuse, they may feel guilty and start to think they are to blame for the abuse, or the abuser has made them think they deserve it. Elderly people might try to hide the abuse just because they don't want to feel vulnerable and weak.
Psychological abuse is one of the most common types of abuse reported by the elderly. It includes yelling, threatening, name-calling, criticizing and humiliating the elderly. It involves the abuser identifying something that matters a lot to the elderly person (such as a pet) and threatening to do something against it or endanger it unless the older person doesn't comply with a demand.
Psychological abuse has a strong impact on the minds of abused people. The most common signs of emotional abuse are hopelessness, confusion, disorientation, sudden change of behavior, hesitation to speak openly, anger without an apparent cause and fear.
Financial abuse is the illegal exploitation or use of funds, pension, property and resources of an older person. The abuser can be either a care worker who steals money or other valuables from the older person's purse or house, or family members whose actions can include changing the person's will so that they become heirs.
The signs of financial abuse include signatures on checks which do not resemble the older person's signature, changes in bank accounts, inclusion of new names on the older person's bank account, the unexpected disappearance of valuable items such as jewelry and transfers of assets to a certain member of the family.
Sexual abuse, a rarely discussed subject, is the non-consensual sexual contact with another person, including any situation where the abused person is not able to consent to the sexual contact, as in the case of people suffering from dementia. The forms of sexual abuse include rape and incest.
Signs of sexual abuse include bruises around the breasts and genital area, a sudden change in behavior, vaginal or anal bleeding and torn clothing.
Neglect is the lack of interest in an older person's well-being by a caretaker. The abuser's refusal or failure to fulfill an obligation can be either intentional or passive, out of lack of knowledge or resources.
Signs of neglect include dirt and the smell of urine in the older person's living environment, poor or inadequate clothing, dehydration, malnutrition, poor medication and personal hygiene and lack of assistance with eating and drinking.