Elder Abuse

One of the biggest problems older people are faced with today is the prevalence of elder abuse in assisted living facilities. Far too many people are neglected and must deal with emotional and, at times, physical abuse from there so-called caregivers. Elder abuse can be defined as any act of commission or omission that results in harm to the health or well being of an older adult (Castle, p. 403) Assuming incompetence, people will often harass the elderly by verbal, psychological, physical, or even sexual abuse. It is clearly understood that abuse of this nature has a large negative impact on one’s daily life. Elder abuse is highly associated with poor health consequences, including depression (Castle, p. 403).

Older people are vulnerable to abuse because it is not uncommon for aging individuals to experience cognitive impairment and physical limitations. The high incidences of elder abuse in nursing homes are staggering. “The National Elder Abuse Incidence Study…identified that 50,000 cases of abuse were reported in nursing homes.” (Castle, p. 404) The most common forms of abuse in these cases are neglect, emotional abuse, and physical abuse. These numbers are very unsettling. I am very close with my grandparents, and have lived with them off and on for the past twelve years. I cannot imagine them having to experience the distress that is often caused by mistreatment in nursing homes. My late great-grandmother lived in a few different nursing homes over the course of seven years and she constantly had things stolen from her, presumably by one of the nursing home staff members. This kind of treatment to our elders is absolutely unacceptable. Usually, when one is placed into an assisted living facility, such as a nursing home, their family expects that they will be taken care of and shown respect. Unfortunately, this is not always the case.

There have been alarmingly high rates of elder abuse in nursing homes, and most of these are self report. Many people will not report abuse, meaning that cases of elder abuse are even higher than we could even know. It is not uncommon for older people to believe they are unable to report abuse because they are fearful of the consequences of retaliation and many believe that reporting their abuser(s) will cause even more negative effect to their lives.

Elder abuse has significant implications, as “…there is a growing awareness that causes of death in nursing home residents are often unknown.” (Castle, p. 405) Evidence has suggested that abuse of elderly people has been associated with increased rates of mortality. Individuals who have been abused or neglected are also more likely to develop severe depression, for obvious reasons, as well as dementia and malnutrition. In a large longitudinal study of old people, those who were mistreated were three times more likely to die during a three year period than those who were not (Lachs & Pillemer, p. 1269) If an older person is constantly neglected or ignored in a nursing home, then it is likely that their basic health needs are not being met.

It is important to recognize that aging adults are likely to be mistreated by family members, as well as by staff in assisted living facilities. It is far too common for people to lose patience with the elderly and mistreat them to the point of neglect or abuse. I think there needs to be more done in order to monitor the care of older patients in nursing homes, and those aging in place, to make sure they are not being taken advantage of. Unfortunately, it is not always easy to measure neglect or abuse in these types of settings. If more people are aware of the issues elder patients face, perhaps we can prevent the mistreatment of older people in years to come.

 

 

Works Cited & Referenced

 Lachs, M., & Pillemer, K. (2004, October 2). Elder abuse. Retrieved from http://webspace.psychiatry.wisc.edu/walaszek/geropsych/docs/lachs-lancet-2004.pdf

Castle, N. (2010, November 19). Nurse aides’ reports of residential abuse in nursing homes.

Retrieved from http://0-jag.sagepub.com.opac.sfsu.edu/content/31/3/402.full.pdf html

Quality of Life

American prison systems face a lot of problems today, but one of the main issues is certainly overcrowding. The percentage of prisoners over the age of fifty five rose from 1.5% to 2.2% between the years of 2002 and 2006.(Gaydon & Miller, p. 686) These numbers are only expected to increase as people are living longer. California is especially impacted by the high population of aging inmates because of the Three Strikes Law; this law states that any person who already has two felony convictions must serve twenty five years to life on their third felony conviction. “This law has more than quadrupled California’s prison population since 1980.”(Gaydon & Miller, p. 687) Because of this overcrowding, elderly individuals are often denied the time and care that is required to maintain their health.

The issue of overcrowding also impacts taxpayers. The expenses of incarcerating the elderly are extremely high. It costs roughly 65,000 dollars to house and care for one elderly inmate, whereas it costs about 22,650 to take in a younger prisoner.(Gaydon & Miller, p. 687) These differences are easily explained by the medical bills of the elderly. Medical costs are extremely high for these people because inmates are not eligible for Medicare or Medicaid. (Gaydon & Miller, p. 687)

Those with functional impairment and disease are the ones who require the most care. Unfortunately this applies to a large percentage of the aging population. Older prisoners will often stop alerting guards if they are having medical issues because they either know they will end up dying in prison, or they think their needs will not be met by prison staff. This is a serious problem, because even though these people are behind bars for presumably good reason, it is their human right to receive adequate health care.

There are specific health procedures for older inmates. It is suggested that they be checked for ailments, such as high cholesterol or blood pressure. Elderly inmates need to be closely monitored, as they often have a harder time engaging in the routine activities than their younger counterparts. Crawling into a top bunk, or even walking long distances can prove to be a struggle for some of the older prisoners.

Aside from physical health, many aging inmates suffer from deficiencies in their mental health. According to a 2001 study, the prevalence of depression and various other mental illnesses were observed five times more in the elderly population than that of younger inmates. (Fazel et al.) This could be explained by the length of time behind bars and stress over medical issues, as older people tend to have more health problems. Unfortunately, the mental well being of older inmates is often underdetected and undertreated.

Since the effects of aging can seriously impact physiological and psychological functioning, there are some suggested strategies in American prison systems to address the health care of elderly inmates. For example, prisons should “…modify existing work and education programs to include health care education, preventive medicine, and counseling of the elderly [and] establish special geriatric units for inmates requiring specialized care.” (Reimer, p. 206) If more programs are established to aid in the care of elderly inmates, there is a good chance rates of depression would decrease. I believe better medical care would greatly benefit these prisoners, as aging behind bars is bound to come with mental and physical complications over time.

Works Cited & Referenced:

Beth Gaydon and Monica K. Miller (2007). Elders in the Justice System.

Wiley Interscience Publishing.

Glenda Reimer (2008). The Graying of the U.S. Prisoner Population.

Sage Publications, on behalf of The National Commission on Correctional Health Care.

Seena Fazel, Tony Hope, Ian O’Donnell, and Robin Jacoby (2001). Hidden Psychiatric Morbidity in Elderly Prisoners.

TheBritish Journal of Psychiatry.