Troubling Issue of Elder Abuse & Neglect Recent research by the U.S. Department of Health & Human Services (HHS) reveals that one in ten Americans over the age of 60 have experienced physical abuse or neglect. Thesis: Family members and others should be alert to incidents of abuse against older people and should report those incidents to the proper authorities so that justice can be served and elderly people can be protected from harm.

Official attempts to solve the problem of elder abuse date back a few years

Evidence that this is not a new problem, or just now recognized, can be found in the Report from the Secretary's Task Force on Elder Abuse, prepared in 1992. The document is loaded with bureaucratic language that encourages the Department of Health & Human Services to develop and fund a "data collection strategy"; develop a "training program"; target public education activities; conduct "workshops"; prepare reports, etc. (HHS). Even if all the recommendations in this document had been followed point by point, there is no doubt there would still be one in ten or more elderly people being abused. The point of this paragraph is that taking action on a family, personal level against abuse of older people is far more relevant than governmental guidelines and task forces, in terms of solving this growing problem.

Responding and intervening in elder abuse

Elder abuse exists in every country in the world, according to Bridget Penhale writing in the peer-reviewed journal Ageing International. The neglect of older people is reflected in literature through the ages, including Shakespeare's King Lear (an older father is engaged in a dysfunctional relationship with his daughters), however the seriousness of the problem has only been discussed in the last twenty to thirty years (Penhale, 2010). Elder mistreatment issues have been "very much a taboo topic until comparatively recently," Penhale explains (236).

There are several levels during which abuse and general mistreatment can occur, according to Penhale's research. They can happen at the individual level (micro: one-on-one interactions between family members); at the community level (meso: someone unrelated to the family harms an older person); and at societal levels (macro: discrimination or neglect on the part of a nursing home or other facility) (Penhale, 237). Moreover, there are various locations and settings where abuse may take place; it may happen in a home, or in an institutional setting.

There are three theories that attempt to explain physical violence within families: a) intra-individual theories (the use of alcohol / drugs or "flawed characteristics" of family members); b) social psychological theories (the study of interactions between people; social learning theory, Exchange theory, et al.); and c) Socio-cultural theories (emphasis of social structures with the "development of violence" (Penhale, 238).

Professionals need to be prepared

The National Center on Elder Abuse (NCEA) reports that in 2009 some 2.16 million older persons were being abused, albeit estimates show that for every one case of elder abuse that is reported, " ... four go unreported" (Vandsburger, et al., 2012). Hence, because by 2050 about 20% of the U.S. population will be over 65 years of age, the abuse issue is a very serious social problem in America. A culture-specific examination of elder abuse shows that it is not well understood " ... within most cultures"; and it is defined differently across the world and the literature on how professionals should be prepared to intervene in elder abuse "is scarce and largely based in medical fields," Vandsburger explains on page 359.

Meanwhile, 44 professionals who work with older people studied the best ways to approach elder abuse. The overall implications of this research showed that there is a " ... strong need and desire for more community-based educational and training" for healthcare and social service professionals that work with older adults (Vandsburger, 370). In addition, the research showed that more work needs to be done in order to correctly define what exactly constitutes abuse; there needs to be an expansion of "informal and formal educational opportunities" for people in the field and those wishing to be part of the field (Vandsburger, 370).

Self-neglect is also a form of elder abuse

Older people can become involved in self-neglect by being inattentive to personal hygiene or cleanliness in their own homes or environments, according to Eloise Rathbone-McCuan writing in the peer-reviewed Journal of the American Society on Aging. Older people can also become neglectful of their own health when they are abused or exploited; and the neglect they bring on themselves can occur in hospitals and long-term-care facilities albeit it usually happens when an older person lives alone.

Some authors have defined self-neglect as a " ... separate phenomenon" and quite apart from elder maltreatment, albeit neglect whether brought on by the individual or by a caregiver neglect is a danger to an older person. The therapeutic intervention in cases of self-neglect can include working with the older person on six dimensions: a) sense of self; b) sense of will; c) awareness of capacity to be happy; d) awareness of improved capacity; e) awareness of "existing environmental supports"; and f) awareness of supplemental assistance" (Rathbone-McCuan, 83).
Social workers impacted on the front lines of elder abuse

An article in the Journal of Family Violence references the World Health Organization (WHO) and its definition of abuse and neglect. The WHO explains that abuse and neglect can be " ... one-time or ongoing actions, or lack of appropriate action," which can occur in relationships that are "trust-based" between caregivers (or family members) and older adults (Band-Winterstein, et al., 2014). These actions -- that are physical, psychological / emotional, sexual and can also be financial -- can and do cause harm and distress to the elderly person.

The peer-reviewed article conducted research to indicate how experienced and efficient 17 social workers respond vis-a-vis their interactions with victims and perpetrators with regard to elderly violence. The article points out that caregivers or healthcare professionals sometimes do experience what the authors call "vicarious trauma or compassion fatigue" after being exposed to the traumatic experiences of victims of elder abuse (Band-Winterstein, 798). Caregivers can become "infected" when witnessing the results of abuse; younger social workers may also experience what the authors call "countertransference, secondary traumatization, stress and burnout" (Band-Winterstein, 798).

In this study, which used a qualitative and phenomenological approach, found that among the 17 female social workers surveyed most revealed that witnessing violence against older people, and violence in intimate older relationships caused "strong emotional involvement" (Band-Winterstein, 798-99). The emotional trauma that social workers must deal with sometimes impacts their person lives when it comes to " ... intimacy, childrearing," and their own relationships between themselves and their parents and their children as well (Band-Winterstein, 799). All of the 17 social workers surveyed struggled with a sense of "helplessness," and one of them quoted by the authors reported:

"I check myself all the time, and whether all kinds of situations could develop in my relationship with my husband. I think about my children, and wonder how they will behave toward us when we are old: Will they take care of us, respect us? ... And with our marital relationship also: What will happen if one of will need care? I see the constant nagging of some women patients and it drives their husbands crazy.

And they I think: 'Wait a moment, do I nag like that?'

(Rivka, who has had four years' experience working with older adults in abusive situations).

This study found that these 17 Israeli social workers, while coming into contact with a wide range of emotions at work, show a certain fear of " ... taking responsibility" for family problems. Additionally, for these social workers (involved with elder abuse) see their work as a kind of "magnifying glass" that is aimed at their "personal future" and their great concern those future scenarios may become violent (Band-Winterstein, 804).

What else can be done about the abuse of elders?

The HHS has created what it calls The Elder Justice Roadmap, which resulted from tapping into the knowledge and experience of more than a hundred private and public stakeholders across the country. Associate United States Attorney General Tony West stated in the report that elder abuse " ... is a problem that has gone on too long"; but the publication of the "Roadmap," he believes, can help bring positive changes in how officials, families, and healthcare professionals take the steps needed to combat the "multi-faceted dimensions of elder abuse and financial exploitation" (HHS.gov, 2014).

The gravity of the problem is very serious given the fact that every day from now until 2030 roughly 10,000 baby boomers will turn 65 years of age, according to Kathy Greenlee, assistant secretary for the HHS Administration for Community Living. And the " ... fastest-growing population is people 85 years old and older," many of whom are vulnerable to abuse, Greenlee explained. In order to slow down the "tide of abuse," friends, neighbors,…