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Understanding Elder Abuse

Kanshi Ram , a homeless,  87 years old farmer, feels  like carrying the dead weight of life being abandoned by his own children and uprooted from a house which he used to command and direct a few years ago. He is surviving on the charities of distant relatives. It is piteous that, Kanshi Ram’s perpetrators are his own children whom he taught to say their first word and take their first step. There are ostensibly inadequate reasons to smile and laugh for this Octogenarian, who prays everyday that lord will come and help him.

This was about his predicament ofelder abuse, neglect and humiliation. In present world, “elder abuse”, “elder mistreatment” or “senior abuse” has become a topic of grave concern.  It’s very important to understand, meaning ofelder abuse, its typesand common abusers of elder people and what are the signs of elder abuse and its repercussions on life of elder people.Elder abuse, is a general term used to describe certain type of harms to older adults.World Health Organization has defined Elder abuse as "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. It includes harm by people the older person knows or with whom they have a relationship, such as a spouse, partner or family member, a friend or neighbor, or people that the older person relies on for services. Any senior can be abused, despite of his nation, culture, community, social status, religion, gender etc. It can happen anywhere behind closed doors or in a public place. Some older people live in day care centers, old age homes, and hospitals. Such people also experience abuse by the staff of the institution on whom they are dependent for their need.

There are several forms of elder abuse like physical abuse (hitting, punching, slapping, burning, pushing, kicking, restraining, false imprisonment/confinement),  more subtle form like emotional or psychological abuse ( eg. shouting, swearing, frightening, blaming, ridiculing, constantly criticizing, ignoring or humiliating), Financial abuse ( eg.illegal or unauthorized use of a person’s property, money, pension book or other valuables) and Sexual abuse and neglect (eg. depriving a person of food, heat, clothing or comfort or essential medication) etc.

In later life of older adults, life becomes full of physical vulnerability ( due to ailments) and mental frustration and emotional despair for senior citizens who suffer abuse by their carer, family member or partner. The personal looses associated with elder abuse can be devastating and include the loss of independence, home , life savings, health, dignity and security.

There is constantly a feeling of powerlessness and insecurity in such senior citizens because of old age crisis and also mental disgruntlement, anger because of alienation and neglect by family members.  Due to constant mistreatment, the person feels incomprehensible in his/her social life and feels the “absurdity of life”. In other words, life seems to be meaningless to an elderly victim who has devoted all his time to nurture his family and has high expectations of being understood, nurtured and valued, but is isolated and neglected. It has been found that almost a third of elderly victims are abused in their own home and almost as many are abused in residential care.

The role of such older adults is marginalized in family or society at large. They are often considered just like trash, decaying entities unfamiliar with modern, fast paced life style. The dilemma witnessed by older people in  hostile, unsympathetic , alienated scenario is very piteous and melting.

We are a society in transition. Although scientific advancement and technological progress have made our life easier but individuals and society, at large is becoming increasingly materialistic and individualistic, earthly minded.

In India, few years back, in joint families, the cord that used to knit the family members together was  not possession of property but the relationships love, discipline and respect within the family members. Joint families used to act like a social unit, an institution where younger generation learnt manners like respecting elders, touching their feet as a sign of respect, speaking in a dignified manner. The newer generation used to acquire wisdom from the experiences of elder people as grandfasthers and children used to live under one roof, a strong relationship based of love and respect used to flourish among family members. It has been seen, that present day India is increasingly following the system of nuclear families where children cannot imbibe the essence of Indian values of respecting for elders, cooperation and discipline. The offspring’s in such families usually grow up in adults having very self absorbed and independent, acquisitive mindset. Thus the dwindling of joint families system, rise of dual career families, insufficient housing and economic hardship have added to the complexities of social problem of elder abuse.

Elder abuse is definitely a complex social issue. This problem persists not only in developing nations but in developed countries also and requires globally orchestrated response to deal with it. World Elder abuse day is 15 June, 2006 which serves as call to action for individuals, organizations and communities to raise awareness about elder abuse, neglect and exploitation. The International Network for the Prevention of Elder Abuse (INPEA) has produced the Community Guide to Raise World Awareness on Elder Abuse Tool Kit.

By increasing awareness among physicians, mental health professionals, home health care workers and others who provide services to the elderly and family members, patterns of abuse or neglect can be broken, and both the abused person and the abuser can receive needed help. The concerned professionals hold such key position for identification and treatment of abuse as a strong relationship of trust and respect exists between patients and health care providers. It is a very challenging task for a physician to assess and treat a abuse victim. The physician should follow a holistic approach to deal with abuse. Physician has to develop a rapport with the patient and the caregiver and take an initiative in finding the problem. There is a clear need to provide emotional support, arrange for social and income generation activities for them. Physician should provide education and proactive interventions to prevent and manage this significant crisis. There is huge need to spread awareness about this sensitive topic in individuals, organizations and communities about this sensitive topic so that senior, more experienced and aged strata of society can lead a independent, dignified , secure, socially fulfilling life.


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