how to recognize subtle forms that generate a lot of damage

Robert Collins

Global Courant

Infantilization, contempt, humiliation, ageism. Psychological violence against older adults can be so subtle to the point of being naturalized, both by the person who suffers it and by the person who exercises it.

Precisely for this reason there is a particular day to remove this issue from the domestic sphere, to be able to contextualize it and offer ways to denounce a condition suffered by 1 in 6 older adults, which in our country is equivalent to 290 thousand people.

Although the complaints are growing, they believe that the figures do not fully represent the magnitude of the problem, which constitutes a taboo that is difficult to talk about, and even more so to denounce.

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The mistreatment or abuse can come from a spouse who is also older and the care is beyond him. Photo Shutterstock.

As José Ricardo Jauregui, president of the International Association of Gerontology and Geriatrics, explains, it is difficult to denounce a bond that cannot be abandoned, such as when it comes to a family member, a common source of abuse.

It is in this context that on June 15, designated by the United Nations (UN) as the World Day for Awareness of Abuse and Maltreatment in Old Age, various talks and conferences are held to warn about this problem.

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From the LeDor VaDor home, they explain that violence is understood as an event -single or repeated- that causes harm or suffering to an elderly person. And they clarify that both violence and abuse can be of various types: physical, psychological, sexual, economic and institutional.

Psychological abuse

It is the most frequent, the most difficult to denounce and even to treat. “Psychological abuse is the most common, it can be very subtle and some do not recognize or report it,” says Romina Rubin, a geriatrician, medical director of LeDor VaDor and vice president of the Argentine Society of Gerontology.

And it clarifies what this type of abuse refers to: “Today, infantilization, the removal of autonomy and the different ageist prejudices that generate suffering and limit the well-being of the elderly are recognized as abuse.”

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However, there are others, among which Rubin highlights humiliation, manipulation, control of social networks, isolation, the fact of embarrassing them, permanent criticism, among others.

Psychological abuse is difficult to detect and many do not report it. Photo Shutterstock.

“There are prejudices that become abuse, such as infantilization, like combing them with pigtails, talking to them as if they were children; ageism, telling them ‘because of your age you are not for this or that, you cannot work, desire, have projects’; overprotection and lack of autonomy, such as “don’t go up the stairs because you might fall, don’t cook because you’re going to burn yourself”; believing that they do not understand, such as when they talk to their children and not to them when talking to doctors, ”he lists.

The doctor points out certain issues that increase the risk of older people suffering this abuse, such as suffering from functional dependency or disability, physical or cognitive deterioration, low income, and lack of support networks.

A difficult situation to deal with

The prevalence of psychological abuse is not less: according to estimates by the World Health Organization (WHO), between 4% and 6% of older people suffered some form of abuse or mistreatment. Within this number, 33.4% correspond to psychological abuse, 14.1% to physical abuse, 13.8% to economic abuse, 11.6% to negligence and 1.9% to sexual abuse.

Rubin believes that there are certain characteristics of the person they care for that can somehow increase the risk of mistreating the elderly, such as the dependency, often financial, that they may have on the victim.

Between 4 and 6% of older adults suffered some type of abuse. Photo Shutterstock.

However, as Jauregui reflects, the scenario in which these abuses occur makes it not often an easy situation to address: “Psychological abuse is the most difficult, in general it has to do with a relationship between the caregiver and the subject of care, in which there is a kind of absolute dependence or an impossibility to avoid it, because it is a close relative”, he describes.

In general terms, it is not about situations without nuances: “Many times this abuse occurs in a context that I like to call a double victim, because it is usually the spouse, who is another older adult, who also has his problems and that he is totally overwhelmed, he is exhausted and in this way he begins to care badly, but it is not something active, but rather the situation overwhelms him and then the mistreatment and ill-care begin,” he says.

“What do I mean by this?”, he wonders, to avoid misinterpretations: “That the reaction of the health team or whoever intervenes in this, which is generally a psychosocial team, is not necessarily a justiciable situation, but that there is to work on the environment, because the cause is usually there. It is a complex issue, ”he sums up.

How to realize if an older adult is mistreated

Physical abuse is the most evident, as Jauregui mentions: “they tend to be older adults who are more vulnerable, more disabled or with more cognitive deterioration and, therefore, cannot defend themselves, either by rejecting physical aggression or telling it ”.

In these cases, the health system plays a central role by noticing signs of abuse or aggression, such as bruises, signs that become elements to suspect that this is happening.

As for psychological abuse, it can be more difficult to notice. “This goes hand in hand with what we were saying before, of a caregiver on whom they depend, who can become a relative, and therefore, they may consider that if they say something, they will treat them worse, because there is a relationship that cannot be broken”, he states.

How to report

Since 2017, Argentina has a law (27360) that urges respect for the rights of older people.

The Inter-American Convention for the Protection of the Human Rights of Older Adults was ratified in our country and has constitutional rank. The State is hereby urged to consider older adults as subjects of law.

In this sense, the following rights must be respected:

Equality and non-discrimination for reasons of age, Right to life and dignity in old age, Right to independence and autonomy (the right of the elderly person to make decisions, to develop an autonomous and independent life, to choose their place of residence and where and with whom to live), Right to community participation and integration, Right to security and a life without any type of violence, Right not to be subjected to torture or cruel, inhuman or degrading and Right to accessibility and personal mobility.

More and more older adults

From LeDor VaDor they emphasize that issues related to old age are gaining space on the public, local and international agenda, at the rate of a sharp increase in this elderly population in the world. So much so that the UN declared the decade 2020/2030 as that of Healthy Aging.

In this context, they indicate that it is estimated that by the end of this decade the number of people aged 60 or over will have increased by 34%, from 1 billion in 2019 to 1.4 billion in 2030. In 2050, the world population of older people double the current one, reaching 2.1 billion.

Since 2020, for the first time, there are more people over 60 than children under 5. And it is estimated that by 2050 it will surpass the adolescent segment, they suggest.

For this reason, they point out the opportunity to take advantage of this date to recognize that this population has the same fundamental rights and freedoms as other people, including not being subjected to discrimination based on age or suffering any type of violence, stemming from dignity and equality that are inherent in every human being.

On June 22 at 4:00 p.m., LeDor VaDor will organize a gerontological conference, free of charge and by Zoom, entitled “Abuse of the elderly: strengths, obstacles, and challenges for detection and an intersectoral and interdisciplinary approach.”

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how to recognize subtle forms that generate a lot of damage

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