Isolation and the Elderly, the Risks Continue
Guest blogger: Pauline Morris:
I was fortunate to hear a presentation from ONPEA last week, the Ontario Network for the Prevention of Elder Abuse. They offer some very helpful hints on what to look for if you think your client might be a victim. They also have courses and screening tools that you might like to explore.
The hallmark feature of abuse is ISOLATION. After all, a person who is well-connected and well-supported is hard to abuse because they have resources. So one big red flag is if you find that you are never left alone with the senior, or he/she is not allowed to speak freely. More often than not, the abuser is someone close to that person: a son or daughter, a spouse, a caregiver. You may encounter many sorts of abuses in your practice, from obvious neglect or physical harm, through psychological and emotional abuses to major and minor financial ones. Abused individuals are uncomfortable disclosing their situation. After all, they feel vulnerable and fear further abuses. But other barriers to disclosure include shame/humiliation, self-blame (they feel they caused this somehow), fear of loss of affection or support, strong cultural barriers about privacy or family honour, a history of abuse, and worry about what will happen , either to themselves or the abuser, if the situation is exposed. This is even more true when the senior is an immigrant and language is a barrier, is dependent on the family for survival, and fears the consequences if sponsorship is withdrawn. It makes it tough to get the full story when you suspect abuse is going on.
So watch out when you are working with someone over 75 who is widowed or living alone, socially isolated, under the control or influence of another person, physically frail and dependent on others, and mentally capable but experiencing some degree of incapacity. Make sure you have an opportunity to speak to that person in private, where you cannot be overheard. Listen to and watch for the emotional component. Recognize the potential conflicts of interest and opportunities for abuse by the substitute decision-maker. And respect what they have to say. They have the right to live with risk, but need to feel that there are safe options, and they are not really alone. You are one of those links they need. Nurture that privilege. We all have a duty to protect the vulnerable.
By: Pauline Morris, MSW, RSW