By Nicole Levison

A caregiver’s first priority is to provide a safe environment. So it is heart-wrenching to hear about cases of mistreatment and exploitation by caregivers; after all, this is a vulnerable segment of society dependent on the assistance others provide.

Sadly, a 1998 national elder abuse incidence study (funded in part by the Administration on Aging) found that among known perpetrators of abuse and neglect, the perpetrator was a family member in 90 percent of cases.

Assess Your Situation

First, assess your current situation to see if one of your family members might be committing acts of abuse on a loved one. Could YOU be the perpetrator? Be honest with yourself about how you treat your loved one. Several forms of abuse exist: physical, psychological, negligence, sexual, financial—thus the signs and symptoms can vary.

Some noticeable indications of abuse:

• Obvious physical signs such as cuts, bruises, bleeding, welts, hair loss, weight gain/loss, dehydration, poor hygiene, or infections.
• Sudden behavioral changes like flinching, withdrawal from loved ones and usual activities, depression, anger, fear of the opposite sex, agitation, rocking back and forth.
• Refusing visitors, delays in allowing visitors to see the person, or not allowing the care recipient to be alone with a visitor.
• The individual is kept in an overmedicated state.
• Physical restraints are used.
• The person is not taken to the doctor when needed or, on the other hand, seems to frequently end up in the emergency room.
• Personal possessions disappear.
• Unexplained bank withdrawals, checks written, charges on credit cards, or changes in banking practices.
• Abrupt changes to a will or other financial documents.

What if It Isn’t a Family Member?

Sometimes the abuse occurs at home, but isn’t from a family member—be sure to check references and backgrounds of any home health care aide or other support personnel. If your loved one is living at a senior facility and you suspect abuse, take action immediately.

What You Can Do if You Suspect Abuse:

• If the danger is immediate or life threatening, call 911.
• Contact your area’s adult protective services agency.
• Call your state attorney general’s office.
• Telephone the Eldercare Locator at 800-677-1116 for information and referrals on your area's services.

For more information, visit these resources:

• www.ElderAbuseCenter.org
• www.Elder-abuse-foundation.com
• www.ltcombudsman.org

Hiring Help Tips

• Do research and conduct background checks when choosing an aide, nurse, or nursing home.
• Do not allow the care recipient to become socially isolated.
• Get involved and be watchful, particularly if the person suffers from dementia, Alzheimer’s disease, or has dealt with a history of domestic violence.

One Last Thought

If you are a caregiver and are under stress, be aware that support services exist. And sometimes, it’s okay to say “I can’t do this,” and find a reliable nursing home for your loved one. You may commit acts of abuse without even being aware you are doing it if you are under extreme pressure or stress.

When I visit my husband’s grandmother at her nursing home—which she claims is one of the best available and makes her feel safe—I sometimes question a lack of choices (for food, clothing, medical treatments), freedom (her visitors are monitored and she requires permission to leave the grounds), privacy (her room is shared and the dining hall is communal), and control (she must eat at a certain time and even her expenses are automatically deducted from her finances).

But I also realize that the patience and attention her home’s attendants provide is essential to her comfort and well-being. She also has a thriving social life and leads a semi-independent existence.

Grandma feels more at ease in a place where the other residents are nearer to her age and she does not feel herself to be a “burden.” If at any point, I was worried about her or the care she receives, I would not hesitate to address the staff. Not only because our grandmother pays good money to be taken care of, but because these are human beings who have chosen a path that serves their community—they are the first line of contact regarding her health and happiness.

They were also the first to alert us to her love of Cheetos.

Communication really can make all the difference.

So talk to your loved one. And if you are the one receiving care, do not hesitate to express your doubts, desires, needs, wants, or favorite snack choice… because as the incomparable Beatles sang, “And in the end, the love you take is equal to the love you make.”