Elder abuse can be intentional and unintentional. Intentional acts are when a person is deprived of what they need or mistreated in some way. We highlighted elder abuse in a previous blog, and you can see the split between where outright abuse exists and where ambiguity may play a role.
Unintentional elder abuse can be as insidious and painful as the intentional.
Let’s take a look at what forms unintentional elder abuse can take – and what you can do to avoid it.
It’s in our attitudes to care
We’ve spoken about dignity of risk previously. This was developed as attitudes towards people with disabilities were often patronising and paternalistic in nature. Our natural bias in society is one of ableism. The world is built from an unrealised and unrealistic position of health.
Systems, processes and even language assume that disability is a deficit. This is not the case. However, the attitudes leave deep stains in how we approach care. And this is especially true of elder care.
When people begin to age, they lose physical, mental and even emotional capacity compared to their previous baseline. This is often mistaken for a reduction in capability. And this assumption that capability is reduced can have a negative impact on our attitudes towards people requiring elder care.
Even if capacity or capability changes, this does not mean a person cannot self-advocate. Instead, we need to find different ways to include the person receiving care in the decision-making process. Expedience, convenience and what we assume care should look like should not hamper a person’s ability to make decisions or receive care that are not in keeping with their values, wishes, needs and wants.
All good elder care begins with including the say of the person receiving that care. If you find yourself speaking for someone, making decisions without their input, or not consulting their hierarchy of values or advance care plans, you should stop making decisions until you can be better informed.
It’s also a societal problem
Elder care has a few issues to overcome in the recipient as well. Many ageing Australians refuse to acknowledge the changes in their physical, emotional and intellectual capabilities. The self-directed stigma associated with ageing and disability can stop usually applied, organised and forthright people from asking for the help they need.
In our desire to take the path of least resistance, we can allow situations to become problematic.
We can allow people to neglect their own needs by giving them greater control over situations than we should. For example, allowing someone who is clearly unable to shower safely on a daily basis to continue living at home alone without any daily care service. Or assuming that a person with a history of falls can remain at home without contact and supervision.
When we place people in a situation where their health, wellbeing and hygiene declines through fear of admitting to age or disability, we are neglecting their needs. And the irony is this neglect puts them at greater risk of needing more invasive and intensive care sooner.
Always focus on the big picture. Challenge the denial in real terms and don’t enable poor behaviour by ignoring it. You will need to have some tough conversations with people as they age. Treat these conversations with respect and dignity. Work to improve a person’s situation through education and support.
It’s in our ignorance
New parents do a lot of reading, studying and classes to understand how to take that precious new baby home. Even the most seasoned parents can be found in the bookshop or at the support groups asking how to deal with their newly emerged teenager.
Eldercare and looking after someone effectively as they age is no different. When we don’t know what is available and what is needed, we cannot help someone in the most effective way.
Yet so many people do not make use of the resources, classes and information available when transitioning a loved one to elder care.
If you have someone entering the last stage of their life, treat it like a research adventure. Check out trusted resources such as the My Aged Care resources library. Read additional information on the ExSitu blog. Look for events run by your local area council that cover elder care topics. Take the opportunity to attend events and explore the many available resources together.
It’s in the detail
While we may believe elder care begins and ends with feeding, toileting, bathing and staying upright, the process is far more involved.
Sadly, Australian men over eighty are an emerging high-risk group for suicide. Australian women over fifty-five are at greater risk of homelessness. How these groups get to these situations is through a lack of understanding and neglect of vital areas of life that contribute to elder care.
Take for example older men and their increased risk of suicide. A lack of consistent care, independence, responsibility, autonomy and stimulation is a growing problem for older Australian men. To remain connected, feeling important and valuable is as much a part of elder care as providing meals and shelter. This is true of all older people but has an especially profound impact on older men and how they perceive their value to society.
Including people in the detail of their lives helps them feel connected, supported and loved. The more isolated a person is from their decision-making, the less connected they will feel with their lives overall. By providing regular check-ins, social activities, involvement on a deeper level with older people in the lives of their children, grand children and great children, we have a greater opportunity to provide the care our elders need.
It’s in thinking of the person in front of you
We all need affection, tenderness, and patience. Appropriate boundaries provide security. And continuing the teaching of life skills, involving people in decision-making and providing appropriate quid pro quo helps keep a relationship positive and strong.
Where we can fall down is assuming that trip to the movies to see your favourite Marvel film will be a great outing for your vintage classic loving Dad. Or providing the spicy Indian the whole family eats on a Thursday is going to agree with Mum’s stoma care regime in the days after.
The person you love is still there. The values they hold and the wishes, dreams, tastes and wants they always have are unlikely to change too drastically.
Remember to share the choice of activities and ideas with the person you are caring for and allow them input, too!
Understanding and acceptance comes in the form of asking someone for their input. Make space for compromise and look for the opportunity to find common ground. That doesn’t mean sacrificing everything to the whims and wants of a demanding elderly parent. But it does mean you have to remember to include them in the decision-making process.
Want more advice on how to identify what matters most in a care environment? Check out the hierarchy of values. It’s a great tool for helping you uncover the needs of your person!