From a distance, it can be hard to assess the quality of your parent's caregivers. Ideally, if there is a primary caregiver on the scene, he or she can keep tabs on how things are going. Sometimes a geriatric care manager can help. You can stay in touch by phone and take note of any concerns that might indicate neglect or mistreatment. These can happen in any setting, at any socioeconomic level. They can take many forms, including domestic violence, emotional abuse, financial abuse, and basic neglect.
The stress that may happen when adult children care for their aging parents can take a toll on everyone. In some families, abuse continues a long-standing family pattern. In others, the older adult's need for constant care can cause a caregiver to lash out verbally or physically. In some cases, especially in the mid-to-late stages of Alzheimer's disease, the older adult may become physically aggressive and difficult to manage. This might cause a caregiver to respond angrily. But no matter what the cause or who is the perpetrator, abuse and neglect are never acceptable responses.
If you feel that your parent is in physical danger, contact the authorities right away. If you suspect abuse, but do not feel there is an immediate risk, contact someone who can act on your behalf: your parent's doctor, for instance, or your contact at a home health agency. Suspected abuse must be reported to adult protective services.
Elder mistreatment is the intentional or unintentional hurting, either physical or emotional, of an older person. Some signs to watch for:
- Bruises, pressure marks, broken bones, abrasions, and burns may indicate physical abuse, neglect, or mistreatment.
- Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression may indicate emotional abuse.
- Sudden changes in financial situations may be the result of exploitation.
- Bedsores, unattended medical needs, poor hygiene, and unusual, unexplained weight loss can indicate neglect.
- Behavior such as belittling, threats, and other uses of power and control by spouses may indicate verbal or emotional abuse.
- Strained or tense relationships, and frequent arguments between the caregiver and older person can indicate mistreatment.
If your parent is in a long-term care facility, the facility must take steps to prevent (and report) abuse. Nursing homes, like hospitals, are subject to strict state licensing requirements and federal regulations. Even so, neglect and abuse can occur. For more information, contact the National Center on Elder Abuse. The Resources section of this booklet has details on how to contact the Center.
Signs of Self-Neglect
Self-neglect describes situations in which older people put themselves at high risk. People who neglect themselves may have a disorder which impairs their judgment or memory. They may have a chronic disease. Knowing where to draw the line between self-neglect and a person's right to independence can be hard. Here are some signs that may mean it's time to intervene:
- Failure to take essential medications or refusal to seek medical treatment for serious illness
- Leaving a burning stove unattended
- Poor hygiene
- Not wearing suitable clothing for the weather
- Inability to attend to housekeeping
If these signs are present, talk to your parent and try to determine what is causing the behavior. Keep in mind that neglect may be the first sign that your parent is no longer able to care for himself, making it time to think about alternate living arrangements.
Source: The National Institute on Aging (NIA), one of the 27 Institutes and Centers of the National Institute of Health (NIH).