Melissa Kahn of Kahn HealthCare Consulting, LLC, sees the signs in a more subtle way. “It’s a slow process,” she says. “Most people don’t go into the caregiving experience intending to neglect or abuse another person.”
The developer of programs in aging, healthcare, and Alzheimer’s care warns against the prevailing concept of physical elder abuse. There’s also emotional abuse and financial abuse.
Family caregivers can be emotionally depleted which can lead to unintended neglect because of a lack support and/or respite. Kahn concludes that many abuses arise from caregivers’ difficult financial situations, lack of caregiver tools or being emotionally exhausted.
Substance abuses, a loss of a job, a health-related issue can also be contributing stressors that can contribute to elder abuse.
“It starts off subtly and it doesn't necessarily look like abuse right away.”
Tell-tale signs of abuse are:
• Medications not administered or purchased due to financial hardship
• Meals provided irregularly because the caregiver can't get away to buy groceries
• Caregiver stress can lead to elder people becoming more withdrawn
• Verbal abuse, especially when caregivers deal with family members with a dementia-related illness (because of lack of education on how to communicate effectively)
Kahn, who is a care consultant and has worked in aging and healthcare for more than 25 years, feels that spousal caregivers often fail to pick up on the subtle nuances that others see because of lack of support or caregiver educational resources.
Understanding how to care for someone with memory problems doesn't come naturally. Getting support is key to addressing issues of wandering, difficult behaviors and/or communication challenges.
Spousal abuse can occur by giving responsibilities to a partner who can’t deal with it, such as driving a car resulting in an accident. “Control doesn’t work; it doesn’t solve the problem,” says Kahn. Getting help from a care consultant to address driving issues is important.
Knowing how to best address driving/transportation options can minimize potential accidents and help the person keep their independence for as long as possible. Helping loved ones make important decisions can avoid situations that could turn into neglect or abuse. There has to be a plan for taking away the car keys from a person with a cognitive disorder. That’s a warning sign that develops over time.
Families may suspect elder abuse, but according to Kahn, "They don’t want to offend a fellow family member or hurt somebody’s feelings, until it gets out of control." Then, the more obvious signs, like bruising, may appear.
A financial warning sign can be when a family member always shows up on the day when a parent gets a social security check. The rest of the family can persuade the parent to opt for direct deposit. When the physical tools of finance are removed, like checkbooks, financial fraud by a family member can be obstructed.
The 'warning signs' of elder abuse are not always clear. Kahn's approach is to look at underlying issues to get support in place to prevent situations before they happen.