The elderly are at risk of various forms of abuse

“This week, we are charting a path that we do not often do. An area that people too often gloss over but it is one that is becoming increasingly troubling. Guess who delivered this apt, informative, and thought-provoking piece?

The one and only Dr. Yaw Berko aka Yaw B who is my akonta, friend and colleague. Do not just enjoy reading but also let us all take the necessary steps to protect our priceless men and women in their golden years.”

As a child, I used to live in a compound house at Adabraka. My understanding at the time was that the complex was built by an old lady who had turned over the management of the buildings to her son who col­lected rent!

Looking back, I believe the old lady had dementia and sometimes soiled herself! This action was met with emotional and physical abuse at the hands of the son! I feel so bad I could not do anything about it, but I was a child at that time.

With the advent of this unfor­tunate pandemic and its resultant shutdown of the economy and social distancing, depression and other psychiatric illnesses have increased in incidence!

In fact, emotional and physical abuses have been rampant in this pandemic! I can imagine that our elders are not exempt from abuse in this perilous time!

I would like to bring to the fore what elder abuse is and how to prevent or report it when you witness one.

To grasp how the elderly can easily be abused, it is imperative to consider some of the physio­logical changes that occur as we all age. Our skin loses thickness and elasticity which makes it more prone to bruising!

The elderly lose muscle mass and have generalised reduction in hormone production and activity.

This results in easy bruis­ing, poor bone formation, and increased risk for falls leading to trauma and fractures! The loss of neurons and brain mass caus­es dementia. Urinary and fecal incontinence can lead to offensive smell and pressure ulcers.

What exactly is elder abuse? Up-to-date, an electronic clinical resource tool for physicians and patients that provides informa­tion on adult primary care and internal medicine defines it as any action taken by a person who has an ongoing relationship with an older person that harms the older person and is done with the intent to harm.

Abuse could be physical, emo­tional, financial, and even sexual abuse.

Physical abuse causes physical pain or injury to the older adult. Emotional abuse entails verbal assaults, threats of abuse, harass­ment, and intimidation.

Financial abuse leads to misuse or withholding of an older adult’s resources by another. Sexual abuse involves forcing the older person to remove clothing or do any sex act or downright rape!

Statistics are hard to come by in Ghana but in America, it is believed that approximately one in 10 elders experience some form of abuse! I suspect the inci­dence in Ghana is about the same or higher but will not be known because it is a taboo to talk about such.

The elderly who are at risk of the various forms of abuse are women, those older than 80 years, older people with dementia, and those with less social connections and have trouble paying bills!

Unfortunately, abusers are both women and men and in most cases are family members! Two-thirds of perpetrators are adult children (as I witnessed as a child) or even spouses! In some instances, the abuser may be someone who cares for older people, maybe a house help hired by family members to take care of their loved ones.

It is very easy to suspect abuse in the elderly. Things to look for are cuts and bruises. Pain, soreness, and bleeding in the anal or genital area are some indicators.

Pressure ulcer on the buttocks that develop when a person sits in one position for too long must arouse your antennae for elder abuse!

Elders with a strong smell of urine or faeces suggest poor hygiene and lack of proper care. Emotional abuse sometimes leads to withdrawal from normal ac­tivities, unusual depression, and frequent arguments between the caregiver and the older adult.

The effects of elder abuse are daunting. Abuse in the elderly population causes a 300 per cent higher risk of death as compared to those who have not been mis­treated.

So how does one prevent elder abuse? The most important thing to do is to keep in touch with him or her. You can also ask the elderly direct questions if you suspect abuse or neglect!

I always suggest paying un­expected visits to their homes if they are under the supervision of a caregiver!

Some coun­tries have adult protective services that seek the interest of the elderly pop­ula­tion! If none of that exists in Ghana, I strongly urge the Social Welfare Department to set up one and educate the general population about the existence of elder abuse and how it can be reported.

So just as the Bible says in Exodus 20:12, “honour your father and mother so that you may live long in the land the Lord your God is giving you.” This is the time to take care of our elders who nourished us from the womb to who we are today.

Good luck!

Source:

Dr. Yaw Berko

(yawberko2001@gmail.com)

References

● Ref National Council on Aging NCOA

● National institute on aging

● Uptodate

By Dr. Kojo Cobba Essel