Functionalmed

adding new life to years....

 Ensuring Enabling and Supportive Environments
            Neglect, abuse and violence

Causation, outcomes and prevention of abuse and violence against older persons needs extensive research. Those working with older persons who may be the subject of abuse in its many forms need training to detect abuse, and be aware of the referral and support mechanisms available. Practitioners in ageing and aged care need to be fully conversant with the root causes, manifestations and outcomes of neglect and abuse of older persons.



Research
  • Research across a broad spectrum of issues is essential. There are no uniformly accepted definitions of elder abuse and neglect. Some would suggest that mandatory retirement is a form of abuse for those facing lost income and or psychological abuse due to lost self-esteem among those forced to retire against their will.
  • Recognizing that neglect is a form of abuse, and that in home and institutional settings both actions and inactions can be abusive, the following is offered as a starting point for workable definition of elder abuse and neglect: Abuse may be defined as physical or psychological behaviors, or a lack thereof, that lead to risk of increased harm or reduced well-being of the individual.
  • Once standard definitions have been developed by consensus, rigorous scientific studies need to be conducted to establish scientifically the existing prevalence rates of elder abuse and neglect in developed and developing countries; these studies should all for the scientific investigation of subgroups at increased risk for elder abuse and neglect. Some research has demonstrated that both poverty and excessive stress among caregivers are risk factors for abuse and neglect.
  • The world community should initiate interventions at the community and the individual level to reduce the incidence of elder abuse and neglect. Interventions that provide additional or enhanced coping strategies for those at risk of abuse and neglect should have a priority. Community interventions should be rigorously evaluated so that successful interventions may be promoted as examples of best practice. It serves no useful purpose to lead others to infer that some interventions are effective when they have not been evaluated.
  • Research to identify factors that place people at risk and those which prevent abuse and neglect need to be undertaken.
  • Research to identify programs that can prevent and intervene among people at risk for abuse and neglect should be promoted as best practices and the dynamics of effective programs need to be analyzed for replication.
  • Facilitating participation and contributions to family and community by older persons may increase their perceived value to society and reduce risk of abuse. Across the life span, positive attitudes of ageing need to be emphasized.
  • Older persons perceive elder abuse as neglect resulting in isolation, abandonment and social exclusion; violation of human, legal and medical rights, and deprivation of choices, decisions, status, finances and respect.
  • Assessment procedures establishing indirect and direct indicators should be developed with multi-informant and triangulation strategies.


Education
  • Geriatrics and gerontological training should include recognition of all forms of abuse.
  • Educate and train primary providers, family members and institutional caregivers to recognize those factors likely to increase the probability of abuse and neglect.
  • Develop programs and train providers to actively initiate safeguards such as respite care, home health aids, day care, institutional personnel rotations to minimize abuse and neglect, recognize penalty for abuse and neglect.


Policy and Practice
  • Fund proactive programs that identify family providers and address specific problems that family members and elder face. Helpful institutions should be identified and efforts to establish safeguards to abuse must be undertaken. Law enforcement agencies must be prepared to take appropriate action and the community needs to provide alternative shelter for abused or neglected elders.
  • Supportive agencies need to create international resources such as websites to inform and educate communities and concerned individuals. NGOs have an important role to play in this development.
  • Older people have the right to self determination and to live free from abuse, neglect, exploitation and discrimination.
  • Governments should develop and fund a national and comprehensive strategy and action agenda to prevent, detect and intervene in elder abuse. This should include:
    1. public and professional education and awareness campaigns—including the media.
    2. participation of older people and promoting their empowerment
    3. evaluation and research programs
    4. family, community, institutional and long-term care within a supportive legal framework
  • The Office of the Commission of Human Rights should establish a task force to report on how best to promote action on the issue of abuse of older people.