by Susan J. Reeks

It wasn’t the first time I’d heard screams drift across the yard from next door.  When you live in an old neighborhood, where the houses are barely ten feet apart, there aren’t many secrets you can keep from your neighbors.  Our next-door neighbors have a history of alcohol-induced arguments.  This time, however, something was different.  I could hear Larry crying for help while repeatedly tapping on his window.

Larry had only been home for a week since suffering a serious stroke and spending two months in rehab.  It was 2:00 am when I shuffled into the dining room and stood staring out my window, wondering what to do.  Should I call the police?  Should I go knock on their door? Would that risk the wrath of Nancy? (Larry’s wife had never been friendly and had been borderline abusive to their daughter before she had escaped to college. I didn’t relish the idea of getting in her face.)  But what if she hasn’t fed him?  What if she has hurt him in some way?

What exactly constitutes abuse?

Fortunately, the U.S. Administration on Aging’s National Center on Elder Abuse has a detailed website on the subject.  According to the site, when a caregiver — family or otherwise — knowingly causes harm or serious risk to a vulnerable adult, either intentionally or negligently, it can be defined as elder abuse.  There are basically four types of abuse:  The most common is neglect, which includes failure to provide food, adequate shelter or healthcare for a vulnerable elder;  physical abuse, also common, includes inflicting or even threatening to inflict pain or injury;  sexual abuse is defined as any non-consensual sexual contact; and exploitation occurs when the caregiver misuses funds or assets.

Still, I wondered how the experts determine whether or not abuse is present in their elderly patients.  Scott Davis, a Registered Nurse and Patient Care Coordinator at Willis-Knighton Health System in Shreveport, Louisiana, sees a lot of elderly patients in his emergency room.  “With injuries,” Davis said, “a typical explanation is that they fell at home.  We ask ourselves questions such as, ‘Is this story plausible?  Is an injury more traumatic than it should be?’  We also look for spiral fractures, where twisting of the bone occurred.  Not that an older person with osteoporosis couldn’t fall and break a leg, but sometimes it’s obvious that he or she has been abused.”

Davis and his ER team also look at frequency when determining actual abuse.  “We look at a person who has been in a lot,” he said.  “How many times have they fallen over a certain time-period?  More often it is a neglect situation and we’ll call the relatives and say, ‘Hey, your dad is in here again.  How long has it been since you’ve visited?’   It can be as simple as a person who has power-of-attorney but didn’t go get them their medicine, or a person who has sustained an injury a week ago and the caregiver is just bringing them in today.”

The elderly almost always suffer through their abuse in silence, so it’s important to recognize signs of mistreatment.  When an elderly person suddenly withdraws from normal activities, has a sudden change in alertness, or experiences unusual depression, abuse may be present.  Frequent arguments, belittling comments, and threats from a spouse are also indicators of possible abuse.  Bedsores, unusual weight loss, poor hygiene and unattended medical needs indicate possible neglect, while sudden changes in the elder’s financial situation might indicate exploitation.

Elder abuse crosses all social and ethnic boundaries and affects both men and women, so don’t hesitate to report any suspected cases of abuse.  If there is no immediate danger, you can talk to the elder’s doctor or home health provider and ask them to confirm whether or not abuse is present.  You can also contact Adult Protection Services.  All states have adult protective and long-term care ombudsman programs, family care supports, and home and community care services.  The Eldercare Locator at 1-800-677-1116 can provide information and referrals on services in your area.  The Eldercare Locator is open Monday through Friday, 9 a.m. to 8 p.m. Eastern Time.

As for the night when Larry awakened me crying for help, I decided it was best not to place myself in the middle of a domestic disturbance and to let the professionals handle it.  I called the fire department, and I was pleased to see that a couple of patrol cars accompanied the fire truck and ambulance to the scene.  It turned out that Larry had fallen out of bed and Nancy had never even woken up to help.  After a couple of similar incidents over the next week or two, Larry was placed in an assisted living environment, where he will continue to receive rehabilitation services.

Susan J. Reeks is a freelance writer from Shreveport, Louisiana.

Illustration by Bonnie Branson — artbonnie.com.

This entry was posted on Monday, July 11th, 2011 at 2:26 am and is filed under Be Proactive, Emotional Support. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.