The most vulnerable members of our society are generally those with disabilities, the very young and the elderly. People who are vulnerable are at greater risk of being abused or otherwise mistreated, especially in residential care facilities. This is currently being made distressingly clear at the aged care Royal Commission.
We discuss what elder abuse in care looks like, how it can occur and what factors can make an impact on the investigation of alleged abuse.
WHAT IS ELDER ABUSE?
"Elder abuse" is an umbrella term, which encompasses a number of forms of abuse, including but not limited to:
- Physical abuse. This means that a person, often a carer or loved one, is deliberately inflicting physical injury or pain on an elderly person. Importantly, this also includes the use of physical and chemical restraints.
- Psychological/emotional abuse. It is difficult to define exactly what constitutes emotional abuse. However, examples include making threats or intimidation, humiliating the elderly patient, failing to provide access to services (such as restricting access to clean clothing or washing facilities) or telling the patient that they have dementia when they don't.
- Social abuse. This includes restricting a patient the right to see or interact with their family or loved ones.
- Financial abuse. This is one of the most common types of elder abuse. It involves mismanaging, improperly using or otherwise dealing dishonestly with an older person's financial assets. Examples include forcing the elderly patient to provide bank details so that the carer can use them for their own purposes. Another example is forcing the patient to sign over money or goods in their will.
- Sexual abuse. This is dealing with an elderly person in a sexual way without consent. It ranges from speaking about sexual activities to inappropriate sexual contact.
- Neglect. Another very common type of elder abuse, this involves withholding basic human rights such as food, shelter, hygiene or medical assistance from the patient.
Like many other types of abuse, elder abuse is significantly under-reported. This is because of shame, fear of reprisal, or in certain circumstances the elderly patient not understanding that they are being abused. However, according to a report
published by the Australian Institute of Family Studies, up to 14% of older Australians may be subjected to elder abuse.
In late 2018, a Royal Commission into Aged Care Quality and Safety was announced. Amongst its terms of reference is the specific requirement to consider poor care, including "mistreatment and all forms of abuse
". An interim report commenting on initial findings is due to be published by 31 October 2019.
WHAT ARE THE SIGNS OF ELDER ABUSE?
Determining whether an elderly Australian in care is the victim of abuse can be extremely difficult. However, some key factors which can cause a suspicion of abuse include:
- Sudden personality changes such as unusual anger, anxiety, fear or depression;
- Obvious poor personal hygiene;
- Changes in eating and sleeping patterns;
- Changes in social activity and interaction such as becoming non-verbal, becoming isolated and lack of motivation;
- A failure for simple medical conditions to clear up as expected (indicating maltreatment);
- Inexplicable disappearance of money or possessions; and
- Visible signs of injury or trauma.
WHO IS MOST AT RISK?
Although potentially all older Australian in residential care facilities are at risk, those with mental health issues are at greater risk of being abused. This is because the victim may be confused themselves, about whether the abuse is even occurring. Further, even if the victim does make a complaint, those with organic brain issues and diseases or significant mental health problems may not be believed.
CHALLENGES OF AN INVESTIGATION
Investigations into elder abuse are challenging due to a number of different factors. These include low reporting rates and difficulty in obtaining accurate reporting and evidence about the specific details of abuse. There are unlikely to be third party witnesses because abuse can and often does, occur in the victim's private room. Victims may also be poor witnesses due to difficulties with memory and recall or other mental health illnesses and conditions.
The Royal Commission into Aged Care Quality and Safety has revealed how the treatment of the elderly in aged care facilities can go unnoticed. If you require assistance into the investigation of elderly abuse complaints in a care setting, contact WISE to discuss your needs, and how we can help. Alternatively, we provide Investigating Abuse in Care training.
WISE Workplace is a multidisciplinary organisation specialising in the investigation of workplace behaviour. We investigate matters of corporate and professional misconduct, resolve conflict through mediation and minimise the impact of inappropriate behaviour through our whistleblower services.
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