By Pamela D Wilson, The Care Navigator, CSA, MS, BS/BA, CG

Literature continues to explode relative to caregiving, caregivers and compromised care, commonly called elder abuse. But what type of action is really considered abuse?

Risk factors for potentially harmful informal caregiver behavior are examined in the February 2005 issue (Vol 53, No. 2) of the Journal of the American Geriatrics Society. The study focuses on elements of caregiver behavior that are detrimental the care of an older adult but may not be serious enough to report to law enforcement authorities. Tis type of abuse is more prevalent than many think.

 I have a client we will call Mary. About six months ago, Mary's son moved in with her for what was to be a short two month stay. Four months later, Mary's son is still living with her. In speaking to Mary alone, her son has totally destroyed any sense of self-confidence or self esteem Mary previously had. How?

 

The AGS study cites five indicators of psychological mistreatment: screaming and yelling, threatening with nursing home placement, threatening with physical force, threatening to abandon, and verbal abuse which includes using a harsh tone of voice, insulting, calling names and swearing. There are also five indicators of physical mistreatment: withholding food, hitting or slapping, shaking, handling roughly, and feeling afraid that a caregiver might hit or try to hurt the care recipient.

In Mary's case, the son kept moving items in the home to prove that Mary was incapable of remembering where she placed items. He verbally abused her making her feel frailer than she was and did a host of other things to undermine her self confidence. Fortunately, Mary was strong enough to tell her daughters about the situation. Mary's son soon will be leaving to go back to his own home. This was a situation where Mary felt she could "put up with the abuse" as long as she knew there was an end to the situation. When I asked her if she felt her son would "hurt" her she said, "Verbally yes, physically I don't think so." Regardless of the situation, this is truly no way for anyone to live.

The study also cites that harmful caregiver behavior is more likely in spouse caregiving situations, or when care recipients are cognitively impaired or have more physical disabilities. How many older adults remain silent for fear of increased abuse? What can be done? Family members and friends should ask about persons providing care - regardless of whether it is a family member or paid provider. Studies document abuse resulting from caregiver stress and burnout. We can only change this cycle if we are willing to be realistic about the demands of caregiving and realistic about the fact that compromised care is not acceptable. There are many options to support families in caregiving situations.

Copyright 2011 Pamela D. Wilson, All Rights Reserved.

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