Recognising the signs of abuse in the elderly and the incapacitated

Any number of things can lead to abusive behaviour by professional caregivers or caregiving relatives, including emotional exhaustion or a lack of support. Photo: dpa

Abuse of long-term care recipients can take many forms.

It can be physical, emotional, sexual or financial, or manifest itself as neglect.

A widespread problem, it can stem not only from caregivers, but also from fellow care recipients, such as nursing home residents.

Many instances of abuse likely go unnoticed because their effects often aren’t clearly apparent, and the victims may be unwilling or unable to talk about the abuse, notes the Centre for Quality in Care (ZQP), a non-profit, non-governmental foundation based in Berlin, Germany.

This makes it all the more important that relatives and caregivers be aware of warning signs.

These include minor injuries such as swelling, pressure marks, scratches and bruises.

Dirty clothing or bloody underwear are also signs that should be looked into.

Changes in behaviour can be a clue as well, the ZQP says, e.g. if a care recipient has suddenly become anxious, timid, easily startled, apathetic, agitated, aggressive or confused.

Abuse can range from spitting at a care recipient to manhandling them or restricting their freedom, e.g. by strapping them to their bed, and treating them disrespectfully or like a child, e.g. with regards to their financial matters.

If you suspect that a care recipient is being abused, you should proceed with circumspection and address your suspicion with the person one on one.

Avoid asking “why” questions.

Care recipients who have been abused are often anxious, have trouble sleeping and feel powerless.

Any number of things can lead to abusive behaviour by professional caregivers or caregiving relatives, including emotional exhaustion, a lack of support, a monotonous work routine, inadequate knowledge of illness symptoms or lack of de-escalation strategies, the ZQP says.

This makes it imperative that caregivers recognise signs of excessive strain in themselves, such as irritability, loss of empathy, headaches and difficulty concentrating.

If necessary, they should reduce their workload.

Another way to help prevent abusive behaviour is through further education.

Responsibility for raising awareness about the abuse of long-term care recipients rests mainly with care facilities and their management personnel, the ZQP emphasises, saying they must initiate any changes. – dpa