The world is in the throes of a demographic revolution according to the World Health Association (WHO). As the population of seniors 65 years of age increases, a likely outcome is a correlation in the rise of an emerging health and social crisis – elder abuse and neglect. This is an important concern because, as the Administration on Aging reports, an estimated 2.1 million older Americans are victims of elder abuse, neglect or exploitation annually.

Elder Abuse Defined
While there is a lack of uniformity, consistency and standardization of what constitutes elder abuse worldwide, a general description of elder abuse, adopted by The National Center for Elder Abuse and Neglect (NCEA)  is “… the intentional or neglectful acts by caregivers or trusted individuals that lead to harm against a vulnerable elder.”  The WHO broadens this definition as “…a violation of human rights and a significant cause of illness, loss of productivity, isolation , and despair.” The NCEA categorizes the seven types of abuse: (Brian-I can’t get my computer to use dashes-can you change these circles into dashes)

• Physical Abuse
• Emotional (Psychological) Abuse
• Financial and Material Exploitation
• Neglect
• Abandonment
• Self–Neglect
• Sexual Abuse

Risk Factors
Perpetrators are typically adult-family members with issues such as gambling problems; standing to inherit the elder’s estate and want may be rightfully theirs prematurely; or having negative family relationships with either the elder or siblings.  Poor family dynamics is typically at the root-cause of elder abuse and neglect. While caregiver stress may be a contributing factor, this is typically not the main reason for most elder abuse.  As seniors age, the risk for abuse increases—those over 80 and or with dementia are at increased risk. In addition, gender, social isolation, living under the same roof with family, and poor physical health increase vulnerability.

Addiction and Elder Abuse

One of the relevant financial linkages and correlation with the rise in chemical addiction in our state and region is the enforcement of KASPER (Kentucky All Schedule Prescription Electronic Reporting). This is contributing to an exacerbation of what has become a social tsunami.

The Kentucky All Schedule Prescription Electronic Reporting System (KASPER) tracks controlled substance prescriptions dispensed within the state. A KASPER report shows all scheduled prescriptions for an individual over a specified time period, the prescriber and the dispenser.

KASPER is a reporting system designed to be a source of information for practitioners and pharmacists and an investigative tool for law enforcement and regulatory agencies.

Those addicted are seeking alternatives to opiates that are more difficult to obtain than heroin, as an example. Financial elder abuse and material exploitation escalate as desperate addicted relatives (and/or those known to elderly victims) steal and even extort money from older relatives to satisfy this habit. This robs elders, for example, of retirement savings and/or family heirlooms. As well, this wreaks havoc with already pressured and human-capital taxed social service agencies that scramble to pick up the pieces from the family brokenness that contributes to the incidence and prevalence of elder abuse.

Steps to Take

Healthcare professionals and workers can avail themselves of the following action steps to become more engaged and aware of this alarming health and societal trend.  Become aware of the signs and symptoms of elder abuse and neglect (see ncea.aoa.gov). Report suspicions of elder abuse –it is both a moral responsibility and, in Kentucky as in most states, a legal duty. If there is imminent danger to a senior, one should contact law enforcement or call 911, immediately.

Incidence and Prevalence

Below is a sampling of findings that show what is known about the incidence and prevalence of elder abuse and neglect:

• The most recent major studies on incidence reported that 7.6–10 percent of study participants experienced abuse in the prior year.The study that found an incidence of one in 10 adults experiencing abuse did not include financial abuse.
• Available data from state Adult Protective Services (APS) agencies show an increasing trend in the reporting of elder abuse.
• Despite the accessibility of APS in all 50 states (whose programs are quite different), as well as mandatory reporting laws for elder abuse in most states, an overwhelming number of cases of abuse, neglect, and exploitation go undetected and untreated each year.
• One study estimated that only one in 14 cases of elder abuse ever comes to the attention of authorities.The New York State Elder Abuse Prevalence Study found that for every case known to programs and agencies, 24 were unknown.
• Major financial exploitation was self-reported at a rate of 41 per 1,000 surveyed, which was higher than self-reported rates of emotional, physical, and sexual abuse or neglect.

Source:  National Center on Elder Abuse

John (Jack) Rudnick, Jr., EdD, is chief operating officer for Tri-State Gastroenterology Associates, Crestview Hills, Ky.