5 Red Flags That Could Signal Neglect, Mistreatment, or Abuse

By Judy Speicher, Caring.com author | Last updated: Mar 08, 2017

Have you ever worried whether an elderly person is really all right?

Sometimes it's a loved one we're worried about -- we're concerned about whether she's being treated well by her caregiver, friends, or family members. Sometimes it's just a worry about a senior we know casually -- someone we see around the neighborhood, at church or synagogue, or at local gatherings. We wonder whether we should worry; we wonder whether we should say something.

The fact is, far too many of our elders are not all right. The Senate Special Committee on Aging says there are as many as 5 million victims every year, while the National Center on Elder Abuse cites recent studies that estimate that up to 3 to 5 percent of the elderly population in the U.S. have suffered abuse.

Unfortunately, this type of appears to be on the rise, according to Elizabeth Loewy, former chief of the Elder Abuse Unit in the Manhattan District Attorney’s Office, where she oversaw thousands of elder abuse cases. Despite the prevalence of the problem, Loewy says it remains signicantly underreported.

That may be partly because neglect, mistreatment and abuse aren't always easy to spot. Some signs are obvious, some not so much. The New York City Elder Abuse Center defines elder abuse as an act that causes harm or distress to an individual 60 years or older. It happens most often in relationships based on trust. And it can be intentional or unintentional. Elders with cognitive impairment are particularly vulnerable, both because dementia behaviors can be extremely frustrating to caregivers, and because elders with dementia can lose the ability to recognize abuse and defend themselves.

Here are five signs to look for:

1. Signs of Physical Abuse

·         Bruises

·         Broken bones

·         Burns

·         Abrasions

·         Pressure marks

Hearing odd explanations for injuries -- "Oh, she ran into a wall."

Common signs of physical abuse against an elderly person include unexplained signs of injury such as those listed above, says Anne Sansevero, a registered nurse and member of the board of directors of the Aging Life Care Association.

“Be alert for a history of broken bones, sprains, or dislocations and sudden hair or tooth loss especially if the injuries are unexplained or explanations do not ‘fit’ with the findings,” she says.

Sansevero also advises looking out for behavioral indicators on the part of the elderly person’s primary caregivers. Not allowing you to visit with the elderly person alone, inconsistent explanations for injuries or taking the elder to multiple medical facilities for treatment can all be red flags that abuse is occurring.

2. Signs of Neglect

·         Dirty clothes

·         Soiled diapers

·         Bedsores

·         Unusual weight loss

·         A home that's unusually messy -- especially if it wasn't before

·         Lack of needed medical aids, such as hearing aid, cane, glasses

If the elder is disabled, especially cognitively disabled, and needs help taking medication or getting dressed, it can be considered neglect if their caregiver is not providing assistance. Alternatively, passive neglect occurs when the abuse is unintentional, often as the result of an overburdened or untrained caregiver.

3. Signs of Verbal or Emotional Abuse

·         Withdrawal and apathy

·         Unusual behavior, such as biting or rocking

·         Nervous or fearful behavior, especially around the caregiver

·         Strained or tense relationship between caregiver and elder

·         Caregiver who is snapping or yelling at the elder

·         Forced isolation by the family member/caregiver

Emotional abuse is one of the most difficult problems to spot, since the victim may be unable to convey what's happening because of illness, dementia, or fear of being neglected. "The elderly person is unable to fight back," says Dr. Irene Deitch, professor emeritus of psychology at the College of Staten Island, part of the City University of New York.

Emotional abuse can range from a simple verbal insult to an aggressive verbal attack. It can also include threats of physical harm or isolation.

Deitch says verbal attacks include a caregiver or family member yelling or cursing at the person, or using phrases such as, "I can't wait till you die and I have my life back again."

Often in cases of emotional abuse, Deitch adds, a spouse or adult child will isolate the senior, not allowing calls or visitors, so no one else gets a sense of what's happening in the house.

4. Signs of Sexual Abuse

·         Bruises around the breasts

·         Bruises around the genital area

·         Evidence of venereal disease

·         Vaginal or rectal bleeding

·         Difficulty walking or standing

·         Depressed or withdrawn behavior

·         Flirtation or touchiness by the caregiver

We don't even want to think about it, but it happens. Attackers look for vulnerable people to victimize. Seniors can be perceived as easy to overpower. They may also be less likely to report abuse because of their dependency on others for care.

5. Signs of Financial Exploitation

·         Bills not being paid

·         Money disappearing and unaccounted for

·         Caregiver taking money for a purchase that doesn't arrive

·         Unusual purchases that your loved one didn't used to make

·         Increased use of credit cards

·         More frequent withdrawls of cash

·         Adding someone new to bank accounts or credit cards

Financial exploitation of elders is all too common. Older adults may be particularly vulnerable to this type of abuse for a number of reasons, says Loewy, who now serves as general counsel and senior vice president for industry relations at EverSafe, a financial monitoring service for older adults.

Loewy says it may be that financial exploiters are simply following the money, and seniors tend to have a higher net worth than younger adults. And some older adults are at greater risk of exploitation due to cognitive impairment.

Financial exploitation can also happen when a professional caregiver takes advantage of the elder. Both family caregivers and paid caregivers are in a unique position to perpetrate this crime, Loewy notes. This is why background checks are especially important when hiring a professional caregiver.

What to Do if You Suspect Elder Abuse

The National Center on Elder Abuse (NCEA) recommends calling 911 immediately if you believe an elderly friend, relative, or neighbor is in immediate, life-threatening danger.

If the danger is not immediate but you suspect that abuse has occurred or is occurring, relay your concerns to the local adult protective services agency, long-term care ombudsman, or police.

To find the right helpline, hotline, or elder abuse resources in your local area, visit the NCEA webite.

Reprinted from: https://www.caring.com/articles/signs-of-elder-abuse

Eat well, drink lots of water, exercise and socialize for brain health

In my last column, I wrote about Brain Health Awareness month. The brain, the most complicated system in our bodies is often the most overlooked. When most of us think of health we may think of overall health or we may think of heart health but how often do we think in terms of brain health?

I would speculate that many of us change habits or behaviors based on the fear factor. We wait until there is a health crisis to take notice and adopt healthier patterns. For many of us it may be stepping on the scale that provides the impetus to eat better or healthier. Most of us don't think in terms of brain health unless we are fearful of developing Alzheimer's disease or one of the related dementias.

As a part of normal aging our brains change. Our brains begin the gradual process of decreasing in volume as we age. Short-term memory may decline, reaction time increases, cognitive processing time increases, cognitive inflexibility increases, and the filter between our thoughts and words can become less inhibited. While these may be normal effects of aging we can try to minimize the progression of the effects of normal aging and potentially ward off the effects of "abnormal" brain changes such as the effects of dementia.

According to brainhealth.gov, brain health refers to the ability to remember, learn, plan, concentrate and maintain a clear, active mind. How do we achieve brain health? Maintaining overall health is the best way to protect the brain and minimize the overall effects of normal aging.

Improving overall health, minimizing risk factors and following simple steps can keep the brain active and sharp. Following a heart healthy regime also contributes to a healthy brain. Nutrition and eating smart, exercise, staying social, managing stress and continuing to learn and discover new interests are important to maintaining a healthy brain.

Here are some interesting facts about the brain that may help keep things in perspective: The brain is made up of 77-78 percent water, 10-12 percent fats and 8 percent proteins.

So here is where we begin to keep our brains as healthy as possible — water! Most of us are walking around chronically dehydrated and it takes its toll on our brains. In fact, as we age, dehydration may in fact cause confusion and memory loss. In a person living with dementia the effects of dehydration can be devastating.

Diet contributes a huge part in keeping a healthy brain. Our brains need healthy fats to function. However, maintaining a balance is so important. If you consider what is good for the heart is ultimately good for the brain, then eat a diet high in antioxidants found in fruits and vegetables and moderate in lean proteins and carbohydrates. The brain needs fats so some fat in the diet is therapeutic.

There is an ongoing debate about the use of cholesterol lowering drugs and the effect on the brain. The conundrum is to that to protect the blood vessels from plaque build-up that causes heart disease there may be some adverse effect on the brain. People are living longer due to the control of heart disease — although it is still the No. 1 killer of both women and men — thus living to the age when Alzheimer's disease and related dementias typically become obvious. Keep in mind the greatest risk for Alzheimer's disease is age. Also keep in mind the biggest risk associated with vascular dementia is hypertension, stroke and heart disease. So I am not advocating for anyone to stop their cholesterol-lowering medications because who wants to weigh those odds of a heart attack at a younger age versus an unhealthy brain at an advanced age?

The bottom line is to eat well and in moderation! And here comes the bombshell … just adding 30 minutes of exercise (like taking a walk) to drinking plenty of water, and eating reasonably well can significantly contribute to overall brain health.

While eating well, drinking plenty of fluids and walking are hallmarks of good overall health, the effects of socialization on the brain are undeniable. Those who are socially isolated and have very little contact and stimulation through relationships are known to have an increase in cognitive decline. Laura Carstensen, professor and founding director of the Stanford Center on Longevity, reported in 2009 that our social arena "influences not only our happiness in everyday life but the ways in which our brains process information, the levels of hormones circulating in our bodies and our physiological responses to stress."

Stress, the other culprit adversely affecting brain health, leads to increased levels of cortisol, which essentially kills brain cells, decreases the production of new brain cells and can lead to shrinking of the brain, which leads to cognitive impairments. Controlling stress comes in the package with eating well (including foods high in antioxidants), exercising and socializing.

Finally, add something new and fun to your routine. Changing it up and learning something new has been found to be great for the brain. Try a new activity such as ladder ball, add knitting to your bucket list of things to learn or go buy a new, grown-up coloring book and don't worry about staying in the lines!

Eat well, drink your water, go take a walk with a friend, and come home to relax with a new activity and your brain will thank you! I'm on vacation and I'm going to the front porch to color!

Jill Rosner is a registered nurse, certified geriatric care manager and owner of Rosner Healthcare Navigation. She provides patient advocacy and care management services to clients with health and aging issues. Contact her at JillRosnerRN@aol.com.

Reprinted from: http://www.carrollcountytimes.com/columnists/ph-cc-nav-health-0717-20160716-story.html