Barriers to Detecting Abuse
Barriers to Detecting Elder Abuse of Older People
In some situations it can be difficult to recognise or verify abuse, as some forms of abusive behaviour against an older person are often subtle or intentionally hidden.
Making a person feel safe may assist them to raise their concerns about an abusive situation. There are many reasons why older people, or others, may not be raising the issue of abuse. Being aware of why abuse is being kept a secret will assist the Director of Care to raise the issue with sensitivity. Note if the older person is assessed as not having the ability to make decisions in relation to the abuse, staff will have a responsibility to report and take action.
Abuse may not be reported because:
- Unwillingness to disclose that the abuse is occurring and/or has occurred
- The older person is unable to disclose the abuse due to lack of mental capacity
- Health professionals, care staff or the public being unaware that abuse of older people needs to be a consideration
- Signs and symptoms of abuse may be difficult to detect. Many of the signs of abuse are wrongly attributed to changes associated with ageing or physical or mental illness
The older person may be reluctant to discuss the abuse:
- Due to denial, or not wanting to admit to themselves that there is a problem
- Due to wanting to protect the alleged abuser eg from perceived punishment, loss of standing in the community or embarrassment
- Due to feelings of shame or guilt at being judged as "bad" for allowing the abuse to happen to them
- Due to a fear of retaliation or punishment from the alleged abuser, or a fear of harming others ie family or experiencing further abuse, change to the abuse, loss of contact
- Due to fear of not being believed or of being accused of lying
- Because they have doubts about confidentiality being maintained, or believe that there is no one in whom they can confide
- Because they consider the abuse to be normal behaviour
- Because they believe they need to resolve matters by themselves and not involve "others"
- Because they believe that nothing will change
- Or they are unable to communicate or express what is happening to them due to confusion, language difficulties, depression, physical or mental illness.
- Because of different cultural perceptions
- As they are unaware of the law, changes to the Aged Care Act (1997) and Compulsory Reporting requirements of and approved provider
- As they are unaware of their rights, or where help is available
- As they have sought assistance in the past and the response has been unsuccessful or caused further harm
Why others may be reluctant to report abuse
Family members, staff, banking officers, GPs, friends, visitors to the home or other residents may suspect abuse of an older person, but may be reluctant to raise their concerns:
- Due to not wanting to interfere
- That the older person may lose trust and/or not confide in them any further
- As they are unaware of services, who they can to talk to, or what action they can take in relation to the abuse
- For they believe that they lack the knowledge to intervene, particularly about successful strategies
- As they believe that nothing will improve the situation
- As they believe that any action will be heavy handed, insensitive and lead to further harm to the older person
- As they may be unaware that older people do take action to stop abuse, if appropriately supported