When Home Isn’t Safe: Talking About Elder Abuse

An elderly mother sits quietly in a lounge chair, slightly hunched over, a cardigan hiding bruises on her arms caused by the rough handling of her daughter – her carer.

An old man sits in the dark, hungry. His power is cut off because he can't afford to pay his power bill; his nephew, his authorised representative, has been draining the man's bank account.

A visitor to an elderly lady's home notices that a valuable painting, one the lady cherished because of the memories it held, has disappeared off the wall. They ask “What happened to it?” The lady sadly shakes her head. Her son wanted his inheritance, and she was afraid he would get angry if she refused him. He took the painting and sold it.

Elder abuse is ugly, it’s harmful, and it’s happening to those who are some of the most vulnerable in our community.

Unpacking the Reality of Elder Abuse

Elder abuse is a pressing issue that demands our attention. Did you know that elder abuse increases mortality risk by 40%? An estimated 1 in 10 older adults experience some form of abuse, with the majority of these cases occurring within the home environment. Unfortunately, many cases go unreported due to fear, shame, or lack of awareness.

These statistics highlight the urgent need for action and intervention. The prevalence and impact of elder abuse on seniors is something we should all be concerned about.

Elder abuse can have severe physical and emotional consequences, leaving long-lasting effects on an individual's well-being and quality of life. It erodes trust, diminishes self-esteem, and increases social isolation.

Most of us in the aged care industry know what elder abuse is, but to quickly recap: the legal definition of elder abuse in Australia is “any act occurring within a relationship where there is an implication of trust, which results in harm to an older person.”

This does imply that elder abuse can be unintentional, such as when a family carer inadvertently causes harm to their family member – for example, not changing a continence pad often enough or not drying the person properly so that the person ends up with sores simply because they weren't trained or informed on how to care for the person properly. This would be considered unintentional neglect – it’s still serious, but often can be addressed through education.

Unfortunately, however, a lot of elder abuse is intentional, and that is what we are focussing on here.

Elder Abuse is often defined under the categories of physical, emotional, financial, or neglect.

• Physical abuse involves any intentional harm or injury inflicted on an older person
• Emotional abuse includes psychological torment, manipulation, or isolation
• Financial abuse occurs when someone misuses or exploits an older person's financial resources
• Neglect refers to the failure to provide necessary care and support

It's important that support workers recognise indicators of elder abuse as early detection and intervention can help prevent further harm to older individuals experiencing abuse. So what should you be looking for?

Recognising the Red Flags of Elder Abuse

Support workers might come across several common indicators of elder abuse as they work with older people. These may include:

• Unexplained bruises, injuries, or fractures.
• Sudden changes in behaviour, such as increased anxiety, withdrawal, or depression.
• Apparent financial difficulties or disclosed unexplained transactions in a person’s bank account.
• Poor personal hygiene or lack of appropriate clothing or personal care products.
• Social isolation or restricted access to visitors.
• Malnutrition, dehydration, or inadequate medication management.

As someone who is in a unique position to regularly evaluate the health and well-being of an older person, support workers should pay attention to anything that appears to be out of the ordinary. This includes physical and behavioural changes, financial discrepancies, social isolation, and neglect indicators.

Reporting and Documenting Your Concerns

It is important that support workers document their observations and report any concerns that relate to elder abuse or indicators or incidents that might indicate abuse. Documenting and reporting your concerns supports client safety and well-being and enables timely intervention and appropriate measures to be taken.

Reporting concerns to the appropriate authorities, such as supervisors, managers, or local protective services, helps to ensure that steps are taken to address the potential elder abuse and protect the client from further harm.

Along with reporting, well-written documentation helps provide an accurate timeline of events, observations, and actions taken. By documenting incidents, support workers create a valuable resource for future investigations or interventions.

Documentation also supports ongoing monitoring and assessment of the person. It helps the care manager develop a comprehensive understanding of a client's physical, emotional, and mental state and identify any concerning changes or indicators of elder abuse.

Trust and Connection: A Foundation for Addressing Elder Abuse

But elder abuse is something that older people may have difficulty discussing. Whilst support workers need to work within professional boundaries, it's also important to establish a relationship of trust and respect with the older person. When support workers promote an environment where the person feels safe, valued and empowered, they are more likely to share concerns about elder abuse.

Trust is the foundation for effective communication and intervention. So how do you actively encourage trust and open communication?

• Practice active listening: Pay attention to what the person is saying, maintain eye contact, and show genuine interest in their thoughts and feelings. This helps them to feel that their voice is heard and respected. There are many resources to help you be an active listener; this link will take you to ‘Independence Australia’, which has a guide on active listening for disability workers.
• Show empathy: Put yourself in the other person’s shoes, trying to understand their emotions and experiences. Empathy helps promote a sense of connection and compassion, allowing for more meaningful interactions.
• Maintain a non-judgmental attitude: Avoid making assumptions or passing judgment on the person's situation. Creating a safe and non-threatening space encourages open dialogue and enables clients to share their concerns more freely.

Privacy and Confidentiality

Privacy and confidentiality are essential when discussing sensitive issues related to elder abuse. People must feel reassured that the information they disclose will be kept confidential.

As an aged care worker, maintaining confidentiality is essential to building trust and respecting clients' privacy. However, when there are concerns about an older person's safety and well-being, particularly in situations where their life might be in danger due to elder abuse, you have a duty of care to report your concerns; the well-being and safety of the individual takes precedence over confidentiality. This is outlined in the Aged Care Code of Conduct.

If you have serious concerns, it is vital to escalate them in a timely manner with your supervisors, managers, or relevant authorities who can intervene and ensure the immediate safety of the older person.

Breaking the Silence Barrier: Helping People to Speak Up About Elder Abuse

Empowering older clients to voice their concerns and report elder abuse is important. The more we can get older people to understand their right to live safely and without abuse and to speak up when their rights are infringed upon, the better our society will be. While encouraging clients to speak up is essential, it is important to acknowledge potential barriers they may face. Fear, shame, and concerns about retaliation are common reasons why older adults may hesitate to report elder abuse.

Support workers can play a critical role in encouraging clients to understand their rights and speak up when violated.

Along with actively listening to and validating a person’s concerns, support workers can:

• Educate clients about their rights, empowering them with the knowledge and resources to address elder abuse.
• Pass on the details of advocacy and support services that can help the person.
• Help others in the person's family understand the older person's rights or what constitutes elder abuse, perhaps by leaving brochures or information at the home.
• Encourage the older person to involve trusted individuals, such as family members or close friends, in the reporting process who can provide additional support and advocacy.

Working Together to Combat Elder Abuse

Of course, the support worker can’t do everything. Sharing relevant information with supervisors, relevant colleagues, and appropriate professionals ensures the organisation can provide the best support possible to the older person.

Educate yourself

If you work in the care industry, you should further educate yourself on elder abuse. The National Ageing Research Institute has a great resource for understanding how to respond to elder abuse or suspected elder abuse in people living with dementia.

You should also familiarise yourself with your organisation's policies and procedures relating to elder abuse and any reporting responsibilities. Make sure you understand the processes that need to be taken that help ensure that appropriate steps are taken in a timely manner, safeguarding the older person's well-being and minimising the risk of further harm.

Let’s Create a Safe Future for Older Australians

The reality of elder abuse is a stark reminder of the challenges faced by older adults in our society. All of us are responsible for taking action and positively impacting the lives of those experiencing elder abuse. The stories, statistics, and indicators all point to the urgency of addressing this issue head-on.

Now is the time to step up and be the change that older Australians need. By recognising the signs of elder abuse, building trust and connection with our clients, and empowering them to speak up, we can break the silence barrier and create a safer, more supportive environment for older individuals living in their homes.

Remember, every action counts. By educating ourselves, communicating openly, and supporting older individuals experiencing elder abuse, we can contribute to a society where all individuals, regardless of age, can live with dignity, respect, and safety. Let's create a future where elder abuse is a thing of the past.

Need to update your resources on elder abuse?

If you need updated policies and procedures on elder abuse, or if you have any questions or concerns about accessing support and resources, we are here for you. Book a call with us; the CDCS team are committed to staying up-to-date on aged care reforms and addressing the pressing issues that affect providers.

Book a call with us today, and let's make a difference together.