Elder Mistreatment

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It is estimated that over 2 million older adults are mistreated each year in the United States. While the awareness of elder mistreatment has increased in the past 20 years, the extent of abuse is somewhat unknown due to differing definitions, poor detection and lack of reporting.

Most people, including health care professionals, are reluctant to address the mistreatment of older people, even when the traditional signs point to abuse. Physicians are in an ideal position to detect and manage the mistreatment because they may be the only people outside the family who regularly sees a mistreated elderly person.

People who are most at risk of being abused include those who are older, have little income and feel isolated from the rest of the world and those who have not completed 12 or more years of education. In addition, people who are substance abusers or are under the care of a substance abuser, have a psychological problem, a history of family violence or are physically challenged are also at risk of being abused.

Elder abuse ranges from physical abuse to mismanagement of finances. Physical abuse includes incorrect physical contact that causes pain or injury. Physical neglect is the withholding of food, medical treatment, or failure to provide for quality of life. Psychological abuse, such as degradation or verbal harassment, causes mental anguish in the elderly person. Elderly persons still have basic human rights.

Recognizing elder mistreatment is difficult. If the elder person’s mental or speaking ability is impaired, he or she may be unable to describe mistreatment. Elderly people with illnesses such as Alzheimer’s disease may be unable speak to a physician, making it a challenge to determine if mistreatment is taking place.

Elder abuse is often discovered in routine physical examinations, so it is imperative that the physician be attuned to subtle comments that may reveal deeper problems. Physicians should ask questions about where the elderly patient is living, diet and quality of life. A simple blood count can establish if the patient is receiving adequate food and water.

If the physician thinks mistreatment is occurring, and examinations and tests confirm these thoughts, the physician should attempt to discuss the situation with the patient. The patient, if able, should help decide a resolution to the problem. By law, all health care providers are required to report elder abuse to proper authorities. The appropriate governmental agency will assign a social worker to investigate and intervene.

Source: American Academy of Family Physicians (AAFP)

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