Lifespan stage and counseling-related problems.
As part of being a human being, we are born and we grow old as time passes and then we die as life comes to an end. Part of human development is the stage of late adulthood. From the book “Human Behavior in the Social Environment,” by Jose B. Ashford and Craig Winston LeCroy, the years from age sixty until death are considered late adulthood. At this stage of life, there are many challenges that the elderly people face. Aging comes with the loss of being independent, age discrimination and diminished physical ability. During the aging process, there are also biological, emotional, intellectual, social and spiritual changes. Beside two other big challenges such as poverty and ageism, one of the biggest problems that elderly people face is elderly abuse when they are at the point in their lives where they are dependent of someone to provide supports for them.
According to the American Psychological Association, an estimated 4 million older Americans are victims of physical, psychological or other forms of abuse and neglect. Many people who hear “elder abuse and neglect” think about older people who live in nursing homes or older relatives who live all alone and don’t have visitors. Being part of the counseling program, it is important for counselors to know that majority of incidents of elder abuse do not happen in nursing homes or other residential settings, but rather takes place at their own home with their own spouses, children, siblings or relatives. Forms of elderly abuse to be aware of are physical abuse, verbal/psychological/emotional abuse, sexual abuse, financial exploitation and neglect. Elder abuse is often a very complex problem that is caused by many reasons such as cultural issues, stress, society and other factors. Elder abuse affects both older men and women from all socioeconomic groups, cultures, races and ethnicities. Bio-psycho-social developmental themes
Bio-psycho-social developmental themes affecting late adulthood is crucial in understanding elderly abuse. During this developmental stage, there are lots of changes in the biological systems among this age group. Problems related to elderly physical health include gradual loss of bone mass, joints are more restricted, variety of foot problems, and arthritis which is known to affect many elderly people. Power and speed of muscle decrease as well as strength and endurance. There is a decline in hearing and vision impairment. Skin gets thin and dryer which make the skin more easily bruised and injured. Maintaining independence and health is very important in the success of someone who is in this stage of development. With the biology of aging, the elderly become physically frail which cause others to care for them sometimes resulting in mistreatment and abuse.
Forms of elderly abuse that affect the individuals biologically are physical abuse and sexual abuse. Physical abuse ranges from getting slapped, shoved, beatings, kicking, pinching, burning, and getting restrained with ropes or chains. Giving inappropriate medications is also part of physical abuse. Sexual abuse among this age group ranges from inappropriate touching, forcing sexual contact, rape, sodomy and coerced nudity. It is the least reported type of elderly abuse. Sexual abuse also includes taking pictures and forcing an individual to look at pornography. These two forms of elder abuse usually cause physical problems such as signs of body bruises, bruises around genital areas, unexplained sexually transmitted diseases, untreated wounds, sprains, broken glasses and bloody underclothing. There are changes in the psychological system of this developmental stage that contributed to elderly abuse and mistreatment.
Alzheimer’s disease is the most common form of dementia for aging individuals. Alzheimer is literally having memory loss which is common among individuals that are in their sixty and above. Cognitive impairment increases with age and dementia is usually one of the biggest problems that often refer to irreversible cognitive impairment that affects an individual’s memory, personality, and functioning. According to the Alzheimer’s Association, cognitive impairment can sometimes be discovered early in individuals. When individuals are not able to recall names, forgetting words, misplacing things, having memory loss, getting lost in own street or neighbor, not knowing or forgetting chore needs to be done, they may possibly be showing Alzheimer’s disease or other forms of dementia. Behavioral and emotional changes occur in people with Alzheimer’s disease.
As the disease gets worsen, those with the disease will experience symptoms that include delusions, agitation, aggression and uncooperative with care. Alzheimer is a commonly known dementia disease in which there is no cure and it gets worse as it progresses. The risk of abuse increases in people with health issues such as dementia (Kohn and Verkoek-Oftedahl 2011). Verbal, emotional and psychological abuses are the common abuses that elderly individuals suffered from. Signs of emotional and psychological abuse are being upset, withdrawn, and unusual dementia-like behavior such as rocking and sucking. Name calling, intimidation, threatening, isolating the individual from families and friends are forms of verbal, emotional and psychological abuse. In late adulthood, the social dimension or support system becomes smaller.
Majority of older adults have some family, while others do not. Family is the first line of support for older adults when they need care and assistance. Some older adults or elderly individuals often live with their children including grandchildren, while others live with their spouses. It is important to know that elderly abuse is often caused by family members and the least likely to be reported. For those that do not have family and are dependent for care, they are often live in adult residential homes or care facilities where they only people they interact with are the staffs within those settings. Elderly abuse is sometimes caused by individuals working at the care homes. Some individuals of this population experience loneliness and isolation. When an individual is isolated for no apparent reason, it is sometimes can be part of elderly abuse.
Counseling Practice: Assess and Strategy
Elderly abuse is often the result of certain societal attitudes that contribute to the violence and discrimination against older people. From the American Psychological Association, such factors that contribute to elderly abuse include the devaluation of and lack of respect for older adults and the society’s belief that what goes on in the home is a private “family matter.” When societal views regarding older people as insignificant, it results in failure to recognize the importance of assuring support, dignity and nonabusive life circumstances for every older individual. When people outside of the family observe or suspect abuse, they may fail to intervene because they believe that it is a family problem and is none of their problems or they might be afraid that they are dealing with a private matter. Also, the feeling of shame and embarrassment might often make it difficult for older persons or even family members to report and reveal the abuse because they don’t want others to know that such events are occurring in their families.
Counselors need to take into consideration of certain cultural values, beliefs and traditions that influence the family dynamics and intergenerational relationships. These differences can make the situations difficult to distinguish from abuse or neglect. One big problem is older individuals from ethnic minorities or immigrants that do not speak English and have language barriers, financial or emotional dependence that prevent them from seeking or willingness to report abuse. It is important that anyone who works with older people in potentially abusive situations need to be sensitive to cultural differences and intervene accordingly as well as not to ignore signs of abuse. To prevent elderly abuse, counseling for behavioral or personal problems in the family can be helpful.
Treating family members with substance abuse can prevent violence against aging adults in the households. In some cases, it may be a best interest to have the older individuals move to a different safer setting or having the older individuals live in nursing home if adult children are not equipped emotionally and physically to support and handle the responsibility of caring for an elderly person.
When suspected of elderly abuse, counselors or any other related mental health professionals are mandated to report elderly abuse to adult protective services as required by laws. It is also important not let fear prevent you from reporting any suspicions of abuse taking place. It is important to know that someone’s life can be saved from further harms including death. People in their late adulthood deserve to be treated with respect and dignity. They are our parents, grandparents and love ones who deserve good care and love as they have reached the full stage of their lives.
Ashford, J. B., LeCroy, C. W., & Lortie, K. L. (2010). Human behavior in the social environment: a multidimensional perspective (4th ed.). Australia: Brooks/Cole, Cengage Learning. Elder Abuse and Neglect: In Search of
Solutions. (n.d.). http://www.apa.org. Retrieved November 16, 2013, from http://www.apa.org/pi/aging/resources/guides/elder-abuse.aspx Kohn, R., & Verhoek-Oftedahl, W. (2011). Caregiving and Elder Abuse. Medicine & Health Rhode Island, 94(2), 47–49. OpenStax College. (2013, July 29). Challenges Facing the Elderly. Retrieved from the Connexions Web site: http://cnx.org/content/m42880/1.4/
Two Current Book References
Glicken, M. D. (2009). Evidence-based counseling and psychotherapy for an aging population. Amsterdam: Academic. This book is a practical guide for advanced students, social workers, clinicians or anyone in the mental field that work with elderly clients. It covers the most effective evidence-based practices for assessment and treatment of elderly clients. Each chapter of the book directly addresses different range of conditions and disorders that are the most common for the elderly population such as social isolation, elder abuse and neglect, depression, anxiety disorders, terminal illnesses, dementias and so forth. It also prepares readers for conditions that they will encounter in the real world even working with or interacting with the elderly population.
Wilson, G. (2000). Understanding old age critical and global perspectives. London: Sage. This book is about understanding old age or the elderly population. It gives readers a wide range of issues and policies on ageing. It provides many theoretical perspectives on ageing in different societies, the trends involving aging adults and what roles should be taken by older people including those who interact with this population. The book explores migration, different health issues, pensions, the structure of family and institutional care as well as it also touches based on elderly abuse. This book is essential for students, nurses, social work, counselors and those who want further understanding of the older population in our society. Journal Article
Thompson, H., & Priest, R. (2005). Elder Abuse and Neglect: Considerations for Mental Health Practitioners. Adultspan Journal, 4(2), 116-128. According to the authors, elder abused is largely an unrecognized problem in the United States and is often untreated. Elder abuse and neglect is so prevalence, that not all incidents are reported. By 2030, the elderly population of late adulthood will double and it is important for mental health practitioners to be aware of intervention, different strategies, consequences, laws and the risk factors that contributed to elder abuse when working with clients. The article addresses the different types of elderly abuse and states real life problems that mental health practitioners including counselors will encounter when working with the population.
Educational Internet Website
National Center on Elder Abuse (NCEA)
The National Center on Elder Abuse or NCEA is directed by the U.S. Administration on Aging. According to the mission of The National Center on Elder Abuse, it is a resource for policy makers, social service and health care practitioners, the justice system, researchers, advocates, and families. The site has prevention strategies and different intervention partners that are good for different work fields such as for those working with older people in the social services, APS, Ombudsman and etc… It provides many different practices that are utilized in different states throughout the United States. Local Referral Source
Department of Health and Human Services, Ombudsman Program
7001 A East Parkway
Sacramento, CA 95823
Telephone: (916) 875-2000
The Office of Ombudsman provide information, answer questions and resources to address issues. The Office of Ombudsman protects and defends a citizen’s rights.
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