Introduction

Abuse of the elderly has emerged as an important and disturbing societal problem. Usually the frail and poor elderly are at higher risk of being abused. Abuse of elderly people is defined as the physical, sexual, psychological (emotional), social, financial maltreatment or other forms of abuse of an older person by an individual who has a relationship with them. The violation can manifest itself once or repeatedly.

Factors that lead to abuse:

• Elderly People
  • Overdependence on caretaker for daily living
  • Communication barriers
  • Aggressive and stubborn behavior
  • Suspiciousness and refusal to respond to help or efforts.
  • Elderly people who are demented are especially vulnerable because they are unable to report abuse.
  • Immobility and bedridden
• The Abuser
  • Stressful living with the elderly people because of lack of knowledge and understanding on ageing and elderly care,
  • Forced to care for the elderly parent because there is no other choice
  • Lack of support from other members of the family and
  • Financial difficulties in maintaining the care and needs of their elderly people.
  • Relationship problem in the past with the patients.
  • Past conflict with parent that have not been resolved.
  • Being abused before

There is no data on elderly abuse as many cases go undetected.

Signs and Symptoms

Non accidental physical harm eg. slapping, hitting, burning, inappropriate restraint on movements, deprivation of nutrition, involuntary isolation and confinement.

• Physical Abuse

Unconsented sexual activities with the elderly people creating fear, agony, physical harm and dishonour.

• Sexual Abuse

Thefts, misuse and cheating of money of the elderly people by other persons e.g. withholding pension.

• Financial Abuse

This includes humiliation, harassment, insults, dishonour, disobedient and manipulation e.g. constantly shouting at them, emotional blackmail, failure to provide glasses or hearing aids, or proper clothing.

• Psychological or Emotional Abuse

Denying the elderly people the opportunity to meet up with other people or take part in social activities and denying them access to health and welfare services as well as their rights and privacy.

• Social Abuse

Administration of inappropriate drugs, or deprivation of prescribed drugs e.g. over sedation to obtain peace and quiet, withholding drugs to precipitate admission to the ward.

• Others

Complications

• Cycle of abuse
• Depression
• Medical complications – fractures, immobility, head injuries, infection, intellectual impairment

Treatment

• Treat medical complication
• Treat psychiatric problems if present
• Reduce isolation
• Enhance communication between carers and the elderly by correcting sensory impairment and referral to speech therapist if required
• Counseling services

Prevention

• Education and increase awareness among careers
• Sharing of tasks among caregivers
• Enhance communication
• Offer respite care to prevent caregivers burnt-out

Rehabilitation

Daycare activities for the elderly:

• Assessment and activities to enhance ADL
• Reduce High Express Emotion(HEE) by reducing contact

Support Groups

AFDM (Alzheimer’s Disease Foundation of Malaysia) (www.adfm.org.my) Majlis Pusat Kebajikan Malaysia Gerantology Association of Malaysia (http://www3.jaring.my/gem)