Introduction
Nursing is a highly demanding profession, which entails providing skilled care to needy people who are sick, elderly, or handicapped. It is a vocation with numerous challenges mainly associated with the nature of people in need of care (Miller, 2009). One such group that creates a lot of challenges for nurses is the elders. This group constitutes adults aged 65 years and above. Elders are very needy and require close attention throughout, as most of them cannot do certain things on their own. Unfortunately, studies have established that elders are often treated badly in health care facilities, at their homes, or in centers that provide specialized care (Rice, 2006). Most elders are violated by family members who depend on them for various needs. According to the World Health Organization (WHO), elder abuse refers to any action done to an older person by someone they trust. The actions can be single or repeated, and end up causing injury and distress to the victims (Miller, 2009). Cases of elder abuse were first reported in the United States of America in the 1970s. There were a few elders who understood their rights and started talking about their awful experiences of abuse. Over the years, nurses have played a crucial role in identifying abused elders and offering the necessary intervention. Experts argue that there are a number of risk factors and warning signs associated with elder abuse that help nurses do their work (Miller, 2009). In order to prevent elder abuse, nurses should familiarize themselves with the various types of mistreatment, the signs of abuse, and their expected input as health care professionals who identify such cases.
Discussion
Over the years, a number of programs have been developed in the United States of America to help address this challenge. All the states have created the necessary legislation in order to facilitate easy reporting of elder abuse cases and prprovideimely intervention (Stark, 2011). The Federal government realized the seriousness of the problem and made an effort to address it through legislation. A recent survey conducted in the country revealed that more than two million elders are subjected to abuse and neglect every year (Phelan, 2013). However, more than half of all elder abuse cases that happen are not reported to relevant authorities. Some of the factors that contribute to this phenomenon include a lack of concern, ignorance, and fear. Others include lack of effective communication channels, shame, and fear of reprisal (Rice, 2006). In most cases, elders in society do not have people to talk to because there are no clear platforms that allow them to express their feelings and challenges in life.
Lack of awareness with regard to the effective measures to take in case of abuse also contributes to this phenomenon. Most elders believe that there are no systems in place to address issues such as abuse, thus they end up suffering in silence (Miller, 2009). Fear of intimidation by abusers can also compel elders not to report each time they are abused. They often think that they will be violated again when they report. According to health care experts, there is an urgent need to create public awareness about the plight of elders. Capacity-building among nurses and other professionals in the health care industry will train them on the best strategies for identifying an abused elder. In addition, they will learn about the best intervention measures to take when an elder is abused (Stark, 2011). Some of the common signs of elder abuse that nurses should look out for include visible physical injuries, signs of restraining, a controlling caregiver, malnutrition, poor hygiene, and desertion (Miller, 2009).
Types and risk factors of elder abuse
Elderly people are often subjected to various types of abuse by their caregivers or anyone else they interact with on various occasions. First, there is neglect, which entails times when elders get little or no attention from their assigned caregivers. Neglected elders often complain that they do not receive regular and timely care as it is required (Stark, 2011). Second, there is physical abuse, which refers to actions done to elders that up causing impairment, injury, or anguish. This kind of abuse is often directed towards elders who have difficulties with mobility, as they cannot defend themselves. Third, there is sexual abuse, which refers to any sexual acts done on an elder without his or her consent (Humphreys & Campbell, 2010). This form of abuse is often directed towards female elders. In some isolated cases, male elders can also be subjected to this kind of abuse.
Fourth, there is financial abuse that entails stealing money or property belonging to an elder (Rice, 2006). This form of abuse is common among wealthy elders who do not have families or their next of kin is untraceable. Fifth, there is psychological abuse that refers to threats, abusive language, humiliation, and emotional cruelty directed towards an elder (Phelan, 2013). Sixth, there is health care abuse that refers to fraudulent activities done by unethical professionals in the industry such as nurses and various hospital personnel. Examples of health care abuse include charging or overcharging elders for undelivered service, giving the wrong medication, kickbacks, and making fraudulent remedies (Rice, 2006).
There are a number of risk factors that predispose elders to various types of abuse. It is important to note that risk factors by caregivers are different compared to those of elders (Phelan, 2013). One of the main factors is elders sharing living space with other people. This can easily lead to elder abuse because the level of contact and chances of conflicts erupting is high. In such situations, elders are often disadvantaged because high tensions leave them helpless, especially if they rely on the same people that disagree with them to complete various tasks (Summers & Hoffman, 2006). On the other hand, people living with elders often take advantage of their needy state to mistreat them and use them to their advantage.
Another risk factor is elders or caregivers with dementia (Phelan, 2013). People with this condition have a short temper and aggressive tendencies. Working for such a person can easily lead to emotional and physical abuse. In addition, elders with the condition are highly vulnerable to abuse because they can easily get mad or irritated with someone because of simple mistakes (Humphreys & Campbell, 2010). Studies have also established that a history of drug and substance abuse can predispose elders to different forms of abuse. The reason for this is that drugs often lead to impaired judgments. This can worsen if the primary caregiver has a medical condition such as dementia (Rice, 2006). Drug abusers easily get aggressive or take financial advantage of elders, especially when they do not have money to maintain the habit.
A history of mental illness by a caregiver can also lead to elder abuse. This normally happens when a caregiver cannot control his or her actions towards an elder. In most cases, people with mental illness have aggressive tendencies that harm people they confront. Another common risk factor of elder abuse is physical disabilities (Summers & Hoffman, 2006). Experts argue that some people often take advantage of such situations to physically or emotionally abuse elders because they cannot defend themselves against an attack. Other notable risk factors include lack of resilience, depression among caregivers, and lack of support from colleagues (Stark, 2011). Negative perceptions, the intensity of an elder’s condition, social isolation, and history of domestic violence also contribute to elder abuse.
Roles and responsibilities of nurses
Nurses have a huge role to play with regard to preventing elder abuse. They are the primary caregivers, thus have a better chance of detecting unusual things in elders. Statistics indicate that most elders make more than ten visits to a physician annually. This is a clear indication of the extent to which the problem has developed over the years. This accounts for slightly over 2% of all elder abuse cases, as most of them are unreported due to various reasons (Summers & Hoffman, 2006). There is an urgent need for nurses to be trained about the various dynamics of elder abuse in order to play a bigger role in preventing any incidents. Experts argue that nurses should closely examine the elders all the time by observing their bodies for any scars, checking their physical condition, and interviewing them to assess any notable changes (Nerenberg, 2007). One of the best strategies that nurses can use to prevent elder abuse is by empowering them to talk about their experiences more often. Abusers take advantage of the fact that most elders cannot defend themselves if they are attacked (Humphreys & Campbell, 2010). Conducting regular interviews with the elders helps them to gain confidence in nurses and eventually open up about their experiences.
Nurses are advised to document all the reports they make after interviewing the elders. The reason for this is that they can be helpful in case legal action is taken against a violator (Summers & Hoffman, 2006). Nurses are also advised to always give priority to the plight of elders in situations where they have been abused. This involves calling for emergency services during highly delicate circumstances that require quick handling (Nerenberg, 2007). Nurses have the ethical responsibility of ensuring that elders do nloseose their self-respect, delight, and confidence through abusive acts (Humphreys & Campbell, 2010). Nurses act as advocates for elders who mostly lack the motivation and willingness to stand up for their rights. Experts believe that nurses can effectively use this capacity to prevent cases of elder abuse. They will instill the necessary knowledge, which will allow the elders to stand up for their rights (Phelan, 2013).
There are other numerous ways through which nurses can prevent elder abuse. These strategies focus on the preventive measures that can be used to eliminate situations that have the potential to cause harm to elders (Nerenberg, 2007). They include seeking counseling, physical exercise, adapting stress reduction practices, and creating connections with all elders under ones’ care. Experts argue that good interpersonal relationships between elders and their caregivers play a crucial role in preventing abuse. The reason for this is that they help nurses to identify any safety concerns that might increase the vulnerability of elders to abuse (Summers & Hoffman, 2006). Nurses should also try their best and avoid picking up arguments with the elders because changes that come with aging and social isolation can easily lead to aggressive behavior. Elders, who seek the opinion of a nurse before making major decisions, reduce their chances of being abused. Talking to elders about the same things repeatedly helps nurses identify any inconsistencies in the information given and make the necessary interventions (Summers & Hoffman, 2006). This is very helpful with regard to identifying the possibility of an elder being abused by a caregiver or family member.
Strategies for reducing elder abuse
There are a number of strategies that health care organizations and other involved stakeholders can use to effectively reduce cases of elder abuse. The first strategy is creating education and training programs to create awareness about elder abuse (Quinn & Tomita, 2006). Studies have established that most people have very little knowledge about the challenges faced by elders. Such training should incorporate professionals from the health care industry and legal experts. When legal experts understand the numerous dynamics of elder abuse, it will become easier for victims to get justice. In addition, they will push for the creation of better legislation that will offer more protection to elders.
Another effective strategy for reducing elder abuse is increasing the involvement of community members in awareness and policy development processes (Quinn & Tomita, 2006). Experts argue that communities have a huge role to play in terms of promoting the safety and welfare of elders through the creation of structures that focus on meeting their needs. A good example is the United States of America, where numerous communities have created programs to protect elders against various forms of abuse. These programs are mainly run by volunteers who have experienced the plight of elders before or mainly have a strong desire to increase public awareness (Quinn & Tomita, 2006).
Health care professionals and legal experts make good volunteers for such a cause. The reason for this is that they will help to enlighten elders about their rights and various ways in which they can get help in case someone abuses or does something to them without their consent. In order to reduce cases of elder abuse, it is also necessary to ensure that the elders live in an inclusive environment that encourages them to have equal opportunities and the power of selself-expressionuinn & Tomita, 2006). Experts argue that most cases of elder abuse happen because they do not have someone to talk to or the ones available are not concerned. In addition, some caregivers constantly belittle the elders for the situations and circumstances. Social support is a strategy that can be effective in reducing cases of elder abuse (Quinn & Tomita, 2006).
Conclusion
Cases of elder abuse often happen at homes, health care facilities, and other areas where elders interact with caregivers. Despite the high prevalence rate of elder abuse, most cases are not reported to the authorities because of factors such as lack of information, ignorance by elders about their rights, shame, and fear. There is an urgent need to develop effective mechanisms for preventing and reducing elder violence because it has numerous health consequences for the victims. Such consequences include stress, depression, increased dependency, poor functional abilities, malnutrition, and death in severe cases. Nurses should familiarize themselves with the various risk factors and the best intervention measures for cases of elder abuse.
References
Humphreys, J., & Campbell, J.C. (2010). Family Violence and Nursing Practice. New York: Springer Publishing Company.
Miller, C.A. (2009). Nursing for Wellness in Older Adults. New York: Lippincott Williams & Wilkins.
Nerenberg, L. (2007). Elder Abuse Prevention: Emerging Trends and Promising Strategies. New York: Springer Publishing Company.
Phelan, A. (2013). International Perspectives on Elder Abuse. New York: Routledge.
Quinn, M.J., & Tomita, S.K. (2006). Elder Abuse and Neglect: Causes, Diagnosis, and Intervention Strategies. New York: Springer Publishing Company.
Rice, R. (2006). Home Care Nursing Practice: Concepts and Application. San Francisco: Elsevier Health Sciences.
Stark, S. (2011). Victims of Abuse, an Issue of Nursing Clinics. San Francisco: Elsevier Health Sciences.
Summers, R. W., & Hoffman, A.M. (2006). Elder Abuse: A Public Health Perspective. California: American Public Health Association.