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Literature Review

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Literature Review
Introduction
While elder abuse in aged care facilities has existed for ages, only in the most current
years have analysts and literary works started to critically examine the problem. The purpose of
this literature review is to present an exploration and understanding of elder abuse through
uncovering existing literature which tackle pertinent concerns related to elder abuse. As a flow of
new studies and literary works suggest, it is delinquent that the issue associated with elder abuse
be concentrated upon and highlighted.
Definition of Elderly Abuse
Inconclusive data encircling the extent of elderly mistreatment is partially related to
insufficient consensus regarding what make up elderly mistreatment (Corbi et al., 2015). A
number of definitions regarding elderly abuse have surfaced. Nevertheless, an explanation by
the United Kingdom's Action on Elder Abuse appears more well-known. This meaning is
considered to have surfaced from the work carried out in Australia, UK, USA and Canada and
afterwards implemented by the Global Network for the Prevention of Elder Abuse. The
definition suggests that elder abuse refers to one or recurring action, or insufficient proper
measures, transpiring within any relationship in which there exists an expectation of trust that
leads to distress or harm to an older individual (Corbi et al., 2015). Similarly, it has furthermore
been described by the Council of Europe, European Ministers Committee (Soares et. al. 2010)
as any action, or absence of ideal action, perpetrated against an elderly individual and taking
place within an institutional or family configuration, risking his/her life, financial, physical or
mental state, autonomy as well as the progression of his/her personality.
The two definitions appear suitable. However, the first explanation appears to be more
general to some degree. For instance, the phrase “transpiring within any relationship in which
there exists an expectation of trust” does not essentially define the relationship. It may be
couples or two siblings in a conflict while this fight generates a certain amount of stress to the
elderly. For that reason, it could be more concrete if this relationship is well defined.
Furthermore, it merely takes into account a mistreatment happening solely within the context of
a relationship with trust. The second explanation additionally limits the issue to elderly in an
institutional configuration and at home regardless of elderly mistreatment taking place beyond
the institutions and at home.
Types of Elderly Abuse
Abuse of the elderly is an intricate occurrence and comes in different varieties. Presently,
five primary classes of elderly mistreatment have been recognized to incorporate material or
financial abuse, physical, emotional or psychological mistreatment, neglect and sexual abuse
(Soares et. al. 2010). Comprehensive explanations as well as examples regarding these classes
are presented below. The descriptions associated with the different types of elderly mistreatment
for this research as provided below are extracted from the final review of Documented Case
Surveys and Self-Reported Prevalence (Corbi et al., 2015).
Physical Abuse
Physical abuse takes place whenever a care-giver intentionally inflicts an injury or pain
to an elderly individual that is within his/her care (Post et al., 2010). Subsequently, the abuse
may consist of actions not limited to slapping, cutting, beating, pushing, shoving, kicking,
punching and inappropriate restraints of the aged. Therefore, it is essential to be cautious of a
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few indications on the elderly such as bruises, cuts, and black eyes along with abrupt
behavioural change to discern physical mistreatment of the elderly.
Psychological or Emotional Abuse
As outlined by (Corbi et al., 2015), emotional or psychological mistreatment additionally
consists of a deliberate act which triggers psychological and mental discomfort to an elderly
under a person’s care. Instances of these kinds of acts involves intimidating, pointless seclusion
of elderly, disparaging, insulting, verbal abuse and daunting the elderly individual. In view of
this, Corbi et al., (2015) points out that it is crucial to look for behaviours like being distressed
and agitated, lack of interest in interactions, and becoming withdrawn to distinguish and protect
elderly from emotional mistreatment.
Financial or Material Abuse
Material or financial abuse refers to the misappropriation of properties or funds
belonging to an elderly individual by a care-giver (Soares et. al. 2010). In most cases, financial
abuse comprises of falsifying and forging paperwork belonging to an elderly. It can furthermore
entail fraud, stealing along with coercing or forcing an elderly individual transfer funds or
properties into a different account or name.
Sexual Abuse
Sexual abuse pertains to any unacceptable and non-consensual sexual contact happening
between the elderly individual and the care-giver (Soares et. al. 2010). This form of abuse may
consist of coercing or forcing an elderly person to view pornographic films. Additionally, it may
incorporate unwanted touching of the elderly and making forceful sexual actions on the elderly
individual. In consideration of this, Corbi et al., (2015) recognizes indications like bruises
around or on the genitals or breasts, anal and vaginal bleeding as well as bloody undergarments
of elderly individuals to point out sexual mistreatment of the elderly person.
Neglect
Acierno et al. (2010) categorises neglect as a form of elderly abuse into passive and
active. Active neglect takes place whenever a care-giver deliberately neglects to execute his/her
duties or responsibilities. Case in point of this type of neglect consists of globally starving the
elderly or deprivation of food, water, clean clothing, bedding and other basic needs. In contrast,
passive neglect connotes an unintentional inability of a care-giver to execute their caregiving
duties and responsibilities (Acierno et al., 2010). Martins et al. (2014) outlines that passive
forms of neglect may happen as a result of minimal expertise or forgetfulness on the caregivers’
side. According to this definition, the elderly individuals subjected to poor living conditions, for
example soiled bedding, improper clothing, poor heating system, no water and electricity as
well as substandard electrical wiring ought to be properly monitored for neglect (Martins et al.,
2014).
Available materials furthermore recognise a different type of neglect referred to as self-
neglect (Alexa et al., 2011), which emerges whenever an elderly individual displays habits that
poses a risk to his/her safety and health. This could constitute an elderly individual declining or
inability to provide sufficient food, water, shelter, clothing, personal hygiene, safety and
medication as recommended to him/herself (Alexa et al., 2011). It is vital to recognize that the
emphasis of this research is not on self-neglect.
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Risk factors for Elderly Abuse

In reviewing the difficulties regarding the risk factors associated with elderly
mistreatment and abuse, Post et al. (2010) states that it is important to consider the occurrence
as an intricate one involved with the abuser and the potential victim along with the framework
in which it takes place. Therefore, it is crucial to comprehend the connection between the
attributes of the victim such as his/her dependency level, status of his/her health or expertise and
those of the perpetrator qualities that might range from the degree of his/her pressure, economic
reliance and level of anxiety. Jackson and Hafemeister (2011)furthermore outlines that it is
equally essential to take note of the contextual risk aspects including the ones associated with
the venue (institution or home), interpersonal relationships (nurse, lawyer, child) as well as the
wider social and cultural framework such as rural/urban location, religion, cultural background,
ethnicity, race, along with social and economic status of both the abuser and the potential
victim.
Thomson et. al. (2011) have presented valuable details concerning the risk aspects
associated with elderly abuse. Among these significant risk elements comprise of cognitive
impairment, behavioural problems and depressive disorders which are directly associated with
the attributes and character traits of the victim while inadequate social network, living alone or
with other people and the burden or stress of the caregiver are linked to the attributes of the
perpetrator or abuser (Thomson et. al., 2011). Additionally, poverty in general is likewise a vital
risk aspect in triggering elderly mistreatment. In view of this, Thomson et. al. (2011) have
remarked that, the aforementioned aspects have been backed by literary works to possess a
strong connection with elderly mistreatment and abuse. They additionally outlined that, research
have generated inconsistent results regarding the relationship of elderly mistreatment and abuse
to elements that have not been mentioned and to some degree they believe their links are
restricted to experts’ views. However, it is paramount to concentrate on these aspects in the
course of policy stipulations to minimize or eradicate elderly mistreatment. For instance,
Pillemer et al. (2016) mentions that it is vital to note that elements associated with the
community, demographics, as well as interpersonal attributes can be beneficial in furnishing
precautionary and intervention exercises in minimising abuse of the elderly.
Burnes et al. (2015) evaluated a number of scientific studies which have supported the
risk factors identical to Thomson et. al. (2011). For instance, according to a cross-sectional
research that was carried out to assess elderly mistreatment and cases of neglect reported to the
County Department of Milwaukee in the United States on Aging between 2006 and 2009, the
authors were able to present a profile of the nation's burden of elder mistreatment by
perpetrator, victim, as well as reporter attributes to compliment a few of the factors presented by
Thomson et. al. (2011).
The findings by Burnes et al. (2015) suggested that 64% of the affected individuals of
elderly mistreatment were above 75 years of age, 71% were frail, 60% were white, 23% had
from Alzheimer’s condition, and 20% furthermore had other coexistence of two or more related
medical conditions. The research additionally uncovered that more than 40% of the self-
neglecters were afflicted by deadly unfulfilled health care demands. Interestingly, their research
pointed out that 44% of the elderly neglect and mistreatment reports were created by health care
professionals and community institutions (Burnes et al., 2015). This disclosure reveals that the
development of recognition concerning elderly mistreatment along with the need to report it
bears a degree of significance among these specialists and could act as a foundation by which
this issue can be eradicated or minimised.
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A study carried out by Tareque et. al. (2015) in Bangladesh, specifically the Rajshahi
district, additionally displays the connection between elderly abuse and poverty. Within their
result, they pointed out that in relative terms, approximately 61% of people from impoverished
homes are susceptible to mistreatment of some sort, as opposed to merely 5% of individuals
from wealthy homes. Dong et. al. (2014) in their analysis have affirmed that reduced levels of
physical functionality were linked to elevated potential for elderly mistreatment such as
emotional abuse, neglect by caregiver and economic exploitation.
Prevalence of Elderly Abuse

Elderly abuse is a widespread concern throughout the world. Nevertheless, as a result of

aspects linked to variations in culture, definitions and perceptions of the phenomenon, there
exists different data concerning the prevalence of the issue making it challenging for global
contrast. Fortunately, following a rise in awareness of the concern, several studies have shed
light on the incidence of this silent problem.
Data regarding the prevalence of elderly mistreatment appears sparse in the African
continent. Nevertheless, Bigala and Ayiga (2014) present a huge finding through their cross-
sectional research carried out in South Africa. Their analysis showed that in total 65% of elderly
males and 61% of elderly females were subjected to mistreatment. In Nigeria, a few analyses
have displayed an increased rate of prevalence of numerous kinds of elderly abuse. For instance,
Akpan and Umobong (2013) pointed out in their research that approximately 43% to 46 % of
the elderly were subjected to health care physical abuse, bed sores, neglect, lack of visitation
and uncomfortable living conditions. Although these are only few researches, they present an
apparent image of the degree of elderly mistreatment in Africa.
A more extensive literature review carried out by Akpeniba (2016) which concentrated
on calculating the incidence of elderly mistreatment through the use of 49 analyses additionally
give a substantial insight into this issue. They identified a standard rate of mistreat ranging from
3% to 28% in studies on general populations. Their exploration additionally presented several
attributes associated with elderly mistreatment. For example, it was identified that within an
interval of 12 months, 5% of caregivers admitted physically mistreating their customers that had
dementia. Furthermore, 15 % of home care personnel admitted of emotionally abusing their
elderly clients (Akpeniba, 2016). These statistics offers a chilling impact whenever one comes
to terms with specialised caregivers mistreating their clientele. Interestingly, merely 2% of
mistreatment was documented to adult protective service or at home administration suggesting
that abuse of the elderly is a concealed concern.
In recent times, global prevalence regarding elderly mistreatment has depended primarily
on surveys conducted in the UK, Canada, Australia, the Netherlands and the United States under
community settings. These analyses took into account physical, psychological and financial
abuse along with neglect. They discovered that with a sample of 7000 older individuals, 5% of
the older people were mistreated (Soares et. al., 2010; Akpeniba, 2016). This figure indicates a
reduced level of elderly mistreatment within the general populace. Nevertheless, as indicated by
Burnes et. al. (2015), these low figures, as portrayed by the available data, may be as a result of
lack of by the elderly opportunity to report or fear to report along with several other factors. An
Australian research on the other hand offers supporting facts by documenting that economic
mistreatment was the most stated by interviewees as well as most noted by aged care facilities
within their results (Clare et. al. 2011).
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Elderly Abuse in Australian Institutional Care

Elderly abuse within Australian care agencies is additionally widespread. The degree of
elderly mistreatment and abuse in Australian care agencies is highlighted by an extensive
systematic review carried out by (Hempton et. al. 2011). Information in the report indicates that
10% of family members record that their elderly relatives have been abused by means of
neglecting or silencing by the employees of the care centre (Hempton et. al. 2011). The study
additional shows that mistreatment perpetrated by elderly care personnel within these
establishments in many cases are emotional and unintentional. It is furthermore observed that
financial and physical abuses are uncommon but neglect is prevalent in elderly care
establishments.
Other statistics as presented by Sandmoe (2011) reveals that 33% of employees ignored
the oral along with other cleanliness of the aged, 61% was unable to provide the elderly privacy
privileges, 23% disregarded the individual wishes and hopes of the aged, 21% ignored elderly
self-determination, 20 % addressed elderlies as though they were children while 12% man-
handled them (Sandmoe 2011). In a different research, 93% of residents reported of employees
getting into their rooms without knocking or utilising the doorbell while 42% lamented of
unneeded usage of sedative on them (Chesterman, 2020).
Conclusion
Elderly mistreatment which is a public health issue has been evidently established in this
literature review to be rampant in across the globe and Australia. Therefore, it is crucial to
identify approaches to reduce or stop this challenge. The international aging populace which is
ascribed mainly to low rates of birth as well as elevated life expectancy displays the positive
aspects connected with better health care and technological innovation. Inversely nonetheless,
the aging populace might be a bane to contemporary society through raising the unwelcome
possibility of elderly mistreatment and abuse in nursing homes or other settings in case
appropriate measures are not established. This emanates from the fact that oldest individuals are
afflicted with ill-health making them more handicapped and reliant on other people for their
activities of daily living. Secondly, elderly people depend on pension which is often insufficient
to sustain them therefore raising their monetary reliance on other people which could subject
them to the dangers and possibilities of being mistreated.