You could not think of a better advocate for elder abuse than Mary Twomey, astute, articulate and funny. Yes, we did laugh at our last forum on elder abuse. Mary, who co-leads the Institute of Excellence on Elder Abuse at UC Irvine and also founded the Ageless Alliance United Against Elder Abuse packed the essence of elder abuse in a rap song.

90% of elder abuse is perpetrated by family members. 1 in 10 Americans over 60 are the victim of abuse (people with dementia are not part of this number). Elder abuse comes in the form of physical, emotional, financial and sexual abuse as well as neglect and self neglect. Few people know what to do about it when they see it. Many don’t see it. Knowing about it helps.

Mary demonstrated that nearly everything can be linked to elder abuse. The location and design of the home for example can contribute to isolation or force some people into institutions. The lack in dementia training for the general public – most of us will be caregiver to somebody with dementia, is nonexistent. Many family relationships have a long term abuse history and the balance can tilt when an older person becomes vulnerable. A person has about 150 personal care attendants through a life time. About 44 million Americans are caregivers to family or friends. The potential for abuse happens when relationships are unequal.

Mary raps, “There is no excuse for elder abuse” but understands the complex web of family relationship where the abuser and abused can switch roles when one of them becomes a vulnerable elder and understands that releasing the pressure on care givers through support, training and simply by providing a place for sharing experiences is crucial in preventing elder abuse.

The other side of elder abuse is the quite delicate balance between an older person’s right to self determination and the recognition of their vulnerability together with a society’s responsibility to help. Accepting help is voluntary, nobody can be forced.

How to prevent it? Bring up the topic of aging wherever people come together, such as in faith communities and invite people to share experiences. Prevent isolation among seniors. Create a 24/7 hotline for caregivers. Train people in understanding dementia (1 in 2 people with dementia experience some form of abuse by others). Strengthen the voluntary ombudsmen program in nursing homes. Create a federal budget for Adult Protective Services. Include this question in every medical screening “Are you afraid of anyone in your family?” (part of the Hwaleck-Sengstock Elder Abuse Screen).

How to spot it? Go to The Red Flags and realize how we all tend to relegate some of these signs to the realm of “private matters”.

How to report it? Call 1-800-677-1116 (National ElderCare Locator).

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