Violence against the elderly: high number of unreported cases

            

Who are the perpetrators?

Salmon: Based on the few data available to us on the problem, we can see that the perpetrators are mostly the adult children of the victims or the spouse. They are more likely to be male, have had or have had problems with drug abuse or drugs in the past, are suffering from mental or physical illness or have already come into conflict with the police. In addition, they are mostly socially isolated, unemployed or in financial difficulties and suffer from severe stress.

Again and again you can hear about violence among elderly people, for example in retirement homes. Why is that? And what can be done about it?

Salmon: We are increasingly seeing this kind of violence against older people, and we have to give it a lot of importance. According to our findings, it is probably much more likely to experience violence in a retirement home by other residents than by the nursing staff. There are many reasons for this, but a significant factor is that many patients in the facilities live with dementia or behavioral problems in a confined space. Our group is currently developing and testing an intervention strategy designed to prevent abuse between residents of facilities.

Zank: People with dementia often misunderstand roommate behaviors as aggressive behavior or threats. Here nurses can intervene de-escalating. Above all, it is important to have a precise analysis of what happened: What triggered the aggressive behavior? Is it possible to recognize a pattern of recurring situations? And: Can you avoid them in the future?

How can the victims be protected?

Salmon: An important strategy is first of all to detect abuse. We need to make sure that those who come into contact with older adults look for signs of abuse. Doctors are not yet particularly involved in this area, although sometimes they are the only people who have contact with the victim of abuse outside of the victim-victim relationship. Once a case is known, there are several ways to tackle abuse.

Although there are no randomized controlled trials to date, one promising strategy in the United States is to use multidisciplinary teams that bring together specialists from diverse fields such as medicine, law, social work, housing, and police to create a comprehensive plan to protect the victims , I believe that this strategy can also be applied very well in many other countries and societies. The intervention approaches should be the same.

Professor Zank, what political decisions are needed to prevent abuses?

Zank: For people in need of care, the same rights apply as for all other people. Nevertheless, there is a special responsibility of the state and society to be looked after with dignity and without danger to life and health. However, legally we often move in a gray area.

Therefore we need a Altenhilferecht in accordance with the child and youth welfare law! Any suspicion of endangerment of the child is checked – the main questions are whether there is a risk to the child and whether or which need for action exists. The possibility of enforcing such a review does not exist with the elderly. Only in case of danger to life and limb there is an immediate need for action, free nursing services of secrecy and allows police intervention. That should change.

What Can Relatives, Nurses, Doctors, and Elderly Patients Do To Protect Themselves?

Salmon: Stay alert when dealing with older people. Familiarize yourself with the signs and symptoms. Engage with non-governmental organizations and other institutions in your area with whom you can work together to educate and work together to prevent the abuse of the elderly.

Zank: In Institutions: Do not Just Take Violence! Instead, addressing the person who has misbehaved. Meeting with a trusted person such as the nurse, shifter or home director. Caregivers and physicians should gain safety through training in identifying maltreatment and neglect. At the same time they should become familiar with intervention measures.

Relatives and professional caregivers must be alert and accept help for signs of overwork, exhaustion, depressive symptoms . This can be advice, for example, leads to the use of relief options such as day care, vacation, volunteers or self-help groups. In institutions there should be supervision offers. Psychotherapy may be indicated for longer-term stress or overwork situations.