Abuse isn’t just about bruises. Not all forms of abuse leave bruises where we can see them,Domestic Violence Groups in South Africa . Although physical abuse is terrifying and needs to be addressed immediately there are other forms of abuse that can cause significant damage. One type of abuse that is very difficult for outsiders to detect is financial abuse. Marriage should be a partnership but when one spouse completely dominates the finances to the point that the other spouse has no control and no options financial abuse may be occurring.
What Are Signs of Potential Financial Abuse?
Every married couple handles their finances differently. In some cases one spouse handles the majority of the finances. They manage the accounts, pay the bills and deal with creditors. That does not by itself equal financial abuse.
Financial abuse occurs when one spouse is treated like an irresponsible child and Substance Abuse Near Me . They are cut off from funds and their knowledge about the couple’s finances is severely limited. Some signs of financial abuse include:
•Strict Allowances. This isn’t an amount that the spouses have agreed to limit themselves to but is instead a set amount that is grudgingly handed out from one spouse to the other and is all that will be given.
Documents, documents, documents. Written evidence is incredibly strong and can range from credit card bills showing that there is a credit card but that you aren’t named on it to emails from your spouse that show the financial abuse.
Other witnesses can be incredibly powerful on your behalf. Financial abuse is hard for people outside the relationship to detect. So when someone credible comes in and tells the judge that it is happening and they can see it the judge will listen and Domestic Violence Group Therapy .
Domestic Violence Groups in South Africa ?
Women and men both commit, and are victims of, crimes but are their perspectives, understandings and interpretations of crime (either as victim or perpetrator likely to be different)? How and why - or even if - is a matter of debate; theorising on these matters is difficult depending on the perspective of the researcher.
Men and women also commit violence but their motivations are likely to be different; men may do so to assert their dominance over a situation, a territory, or person; to ensure that their masculinity is not in doubt. Women may do so in defence of their children, themselves, family, friends and perhaps even their property. However, if women are becoming as violent as men for the same reasons as men, does this mean we are moving in a direction which is irreversible? Would such a trend, if it truly existed, necessarily be a perilous one? More importantly, why does the notion of women becoming violent (or becoming more violent) cause such consternation in society whilst violence by, and towards, men is accepted as part of their masculinity?
Women are statistically less likely to commit crimes, particularly crimes of violence; however, numbers of women being arrested, cautioned and imprisoned for violent offences are rising. Media reports and government statistics all appear to show that women are increasingly involved in crime, particularly violent crime. In England and Wales, the number of females in custody was 4,445 (24 November 2006) with the highest number being attributed to drugs offences whilst violence was second. In Scotland, the figure was 326 (24 November 2006), though ambiguous as it does not specify the gender of (i) 'lifers' who have been recalled (ii) those convicted but awaiting sentence/deportation (iii) those under sixteen years of age. Williams states that, in a nine year period, there was a rise of 140% for female offenders incarcerated (1993-2001) despite the fact that offending rates remained relatively stable. In the United States, figures show that although incarceration rates were rising, violent offences by women were going in the opposite direction; women's involvement in violent offences showed a minimal rise (from 10.8% to 12.3%). This may, however, be reflective of changes in recording, prosecuting and incarcerating female offenders rather than any actual increase in the rate of female offending itself.
Violence is often fuelled by substance abuse, via alcohol or drugs or both and this is the case both for men and women. Males perpetrate the highest numbers of crimes, violent or otherwise, and they also account for the highest number of victims of violent assaults; women, however, as perpetrators of violent crimes in particular are on the however women are apparently working hard to catch up. Certainly, the media portrays young women as being 'as bad as boys' when it comes to violence, particularly when fuelled by alcohol; city centres across the UK have a large problem with violence but this is possibly due to an increasing culture of binge-drinking. Indeed, as recently as December 2006, reports of violence fuelled by alcohol were in the news again; this time, however, the focus was not the violence as such, but that the perpetrators of the violence were female.
A BBC article quotes Dr Jon Cole of Liverpool University who believes that, whilst it does not cause aggression, alcohol stops sensible choices being made "You make the easiest choice, which is often aggression". The same article refers to a study by The Glasgow Centre for the Study of Violence which showed that women were involved in almost half of all the pub fights observed. Further, medical research shows that testosterone levels in women rise by fifty percent in females, but is lower in males when they become drunk.
Violence however is a term which can be interpreted in many ways: one particular study shows females' understanding and interpretation of violence is unusual (see Burman below). There are accepted definitions of violence or aggression: crime is "an action which constitutes a serious offence against an individual or...state..."; violence: "behaviour involving physical force intended to hurt, damage, or kill; strength of emotion or of a destructive natural force". Aggression: "hostile or violent behaviour or attitudes; the act of attacking without provocation...".
In the study undertaken by Burman et al, verbal abuse and the spreading of rumours was seen as 'violent' or more aggressive than physical violence (such as being punched). If verbal, rather than physical, violence causes more concern girls, should we take this as an indication that girls consider violence to be a psychological rather than physical problem? Why do some girls have a greater fear of violence which is spoken whilst most people, and particularly boys, are more inclined to class violence as a physical assault?
Fear of violence is often more potent as it is the 'unknown'; the precise time and place of being the recipient of violence is unknown with domestic violence victims, but they are kept on alert because they know it is going to occur at some point. However, from a legal point of view, violence and violent crime, is where physical injury is inflicted and only in recent years was psychological trauma accepted as a 'violent offence' (see Protection from Harassment Act 1997).
Given the low numbers of women who offend, both historically and in recent times, it is unsurprising that studies into female criminality were either ignored or undertaken in relation to their interaction with, and response to, male violence and criminality. It is also unsurprising that female criminologists found the need to fill this gap. In the past, women were classified into two types: mad or bad. Most female offenders convicted of violent crimes were seen as women who fought back against domestic violence or who protected their children; others were considered 'evil' and historically, were considered witches or concubines of the devil. We may now have a better understanding of criminality, but this has not stopped the 'bad' or 'mad' viewpoint from being represented by the media, the public and in some quarters of the criminal justice system when females are involved.
Women are viewed as more deviant than their male counterparts as they have not only offended against the criminal code but also against social convention. Whereas social rules and convention have changed over time, women are still considered to be mothers, wives, lovers and workers but not offenders; rarely do we expect women to commit violent offences. Those who do are vilified for years possibly serving longer terms than male counterparts, particularly when they offend against those they are supposed to protect.
Myra Hindley and Beverley Allit both murdered children; Allit did so as a nurse so could be again seen as doubly deviant as her occupation - as well as her gendered role - was one of carer.
It is difficult of course to do a proper comparative analysis without knowing the details of the 'violence against the person' offences committed by both men and women. There are a number of 'assaults' committed by women which may well not have been prosecuted had they been committed by men; it is impossible to say without knowing more about both the offence and the offender (regardless of gender). Obtaining goods for sale (to provide money to pay bills/food) or obtaining goods - such as shoplifting food/clothing is more common among female offenders than males. Analysis of current statistics shows that the highest number of female offenders committed 'drugs offences' with the second highest being for 'violence against the person' followed by 'theft and handling'. For many, women who commit violence do so mainly in self-defence or protection of a child; females are not seen as inherently violent. But is this perception false or misleading?
Most studies of the culture and phenomenon of gangs tend to focus on males (though some do mention 'girl gangs' or girls in gangs as a peripheral but distinctly intricate part of a predominantly male gang). However, a problem arises which is twofold: firstly and perhaps obviously, not all female offenders - violent or otherwise - are in gangs. Secondly, there is a danger that the study will produce results more likely to provide an insight into gang culture rather than any comparative study of female and male criminality.
Current statistics show the highest number of female offenders committed 'drugs offences' with the second highest for 'violence against the person' followed by 'theft and handling'. For many, women who commit violence do so mainly in self-defence or protection of a child; females are not seen as inherently violent. But is this perception false?
One of the possible reasons behind women committing fewer 'serious' offences could be their role as mother/carer. Given that a large proportion of children are either brought up by single mothers or by mothers due to fathers working longer hours (or being the sole breadwinner) women generally have the main, if not sole, responsibility for child rearing. Therefore, the ability for women commit crimes - unless they left their children elsewhere, or were childless - was severely restricted. The risk of being caught and sent to prison - and violent offences generally attract higher tariffs - meant that any benefit of committing a crime seemed unattractive. Of course, this assumes that women who commit offences chose to do so for pragmatic/rational reasons; classicists will be jumping for joy!
In terms of victimisation, women are largely accountable for rape or other sexual assaults but even here the amount of disproportionate statistical analysis is difficult given that male rape and male sexual assault is under-reported and (in some countries) legally ignored. Stigma attached to victims of sexual assault is horrendous for female victims but this is more so when victims are male. This is largely due to men being perceived as (i) the aggressors or (ii) physically able to fight off an assault.
In England and Wales, legislation is quite specific in terms of the crime of rape in that a penis must be inserted into either a vagina or the anal passage (or mouth); so whilst a victim may be either male or female, the perpetrator must be male. In Scots law, the act of rape can only be committed by a man on a woman; male on male sexual assault is just that - sexual/indecent assault but not rape. Where victim and perpetrator are one and the same (e.g. an abused wife retaliates against her husband) there are inconsistencies between the genders. According to CEDAW, women are more likely to 'to be killed than to kill' but the legal system discriminates; women who kill their [often abusive] husbands are convicted of murder whilst men who kill their wives are convicted of manslaughter. Thus, if convicted of murder which women are, the only sentence available is life; even when convicted of murder, men and women are still treated differently with tariffs higher for women than men.
Male perpetrators may be more selfish in their approach to crimes; committing offences which are directly of benefit and which give an immediate sense of gain. In violence, men use violence as a first, rather than last resort, as it on two levels it gets them what they want: the first is the object of their attention, the second is status and self-belief in their own ability. Violence for many men seems to be a way to [re]assert their masculinity. Violence committed by women - on the whole - appears to be a last resort; there was no other way to get either in or out of a situation and thus violence was used.
Of course, there are criminal couples: men and women who work together - though not necessarily in harmony - to make financial and other gains. Prostitutes have for many years used (and been used by) male pimps. The men offer protection, security from harassment whether this is from other working women, volatile clients and other pimps who want to 'muscle in' on the money earned by the prostitute.
The pimp will use violence as a means of asserting his status has being in control of both the woman and the environment within which they work. Of course, the prostitute herself is committing a criminal offence in soliciting on the street and may herself use violence against her client and other working women. The implied consent that women give to men who pimp them is that violence is acceptable: they will not want nor like the violence used against them but most accept it as part of their lives and also want the volatility of the pimp to be known to others as a way of protecting themselves from other females and clients.
Theorising about the motivations which drive offenders, male and female, tends to mean that we encapsulate whole groups of people by defining them on the basis of individual psycho-social profiles. This may be applicable for instances where groups commit crimes on a large scale, over periods of time, such as ethnic cleansing (which often entails the mass slaughter of males and systematic rape and impregnation of females - as seen in Bosnia for example).
Of course, systematic rape of females - and occasionally males - is a form of violence often used by groups of individuals sanctioned by the state (as seen in war situations) and also individuals in a domestic setting (the husband who forces his wife, girlfriend, etc.) and sexual violence is almost unique in that women - particularly in Scots' Law - are not convicted of rape. There are cases where accomplice of facilitation of rape is conducted by a female against another female but these tend to be rare. One example would be the sexual abuse of young women by Fred West who raped and abused women with his wife; even here, however, the case showed that Fred West has systematically abused his wife and thus she may have complied and committed these acts to reduce her own victimisation.
Crime in general, whether violent or otherwise, may be more easily identifiable as a male characteristic in society rather than female simply because of historical social conventions. Women had to care for their homes and families; opportunities for women to offend were minimal in that they had limited access to places which would allow them to commit crimes. Men, on the other hand, were often the workers, the drinkers, the socialisers (women entertained their friends, but this was often in homes rather than public houses, etc.) and thus opportunity was greater for them. If nothing else, in historical times, the clothing a woman wore would make burglary (e.g. entering a house via a window and then removing goods) quite difficult though perhaps not impossible! Even in more recent times, women were seen to steal for 'good' rather than 'bad' reasons: they stole food from supermarkets rather than goods to be sold for hard cash.
Those who were caught may cry and reduce themselves to the 'helpless desperate female' and an invariably male security guard or store manager, may find himself torn between chivalry or sympathy towards the woman and his job. If a man was caught in the same act of theft, it is possible that (if denial did not work) then aggression would result in a negative reaction from staff and thus prosecutions of males were more likely.
Given that males generally appear to be more confrontational - and this may be anthropological in origin - whereas woman appear to take the path of least resistance, it is possible that perpetrators of crimes (particularly non-violent crimes) are likely to find that their gender reflects their culpability in the eyes of the law and any enforcement officers.
Over the last few years, and in particular in relation to younger offenders, females are less likely to be able to use their gender to escape punishment (though there may be some instances were this still applies, for instance speeding in cars). Whereas historically women might have been viewed as immoral, but not necessarily criminal, recent years have seen a shift so that they are not only immoral but most definitely criminal and thus should be treated equally by the criminal justice system. Inevitably, however, the public will view the criminal female as more criminal or more deviant than her male counterpart.
Women may also have a more pragmatic approach to criminal activity, violent or otherwise. It might be that they are more careful about exposing themselves to temptation for certain crimes (such as theft, fraud, etc.) or are so careful that they may go undetected. Men may well approach crime with a more arrogant attitude and feel their ability to escape detection is greater than male or female counterparts.
What theories therefore can be applied, if any whether partially or wholly, to violence and the men and the women who use it? It is difficult to state which 'criminological theory' can actually be applied completely to criminality without being considered either aligned to one discourse or another even if the intention is to avoid this. It may be impossible to apply the same theories of criminality for men and women given that attempts thus far have failed to provide any conclusive answer into the causation of criminality in female or male crimes.
The problem with analysing the comparison between male and female offenders is that whilst their motives might appear different, this is not necessarily the case. Influences such as biology, psychology, economic and education as well as society in general will have an impact on each individual's behaviour and their understanding of what is acceptable. Violence is so often used as a means for dispute resolution - particularly in the younger generation - that we may be on an irreversible path.
As seems common within criminology, in order to explain criminality, attempts are made to encompass causation with one particular ideal or theory; it is due to this attempt to treat theories as mutually exclusive which results in failure.
Women are different in terms of their responses to crime and in particular violence, their use of violence against others and their understanding of violence and crime in general. Women have been dominated for so long and now they choose to fight back, they are regarded as more dangerous. They are altering perceptions held over a long period of time; that is not to say women will turn into Amazonian women ready to dominate the world and make men submissive creatures! However, if we - as women - want equality, it seems we have to fight twice as hard (even if that fight turns physical).
The criminal justice system now deals with far more women offenders than previous decades, but this is also likely to be in part attributable to the medicalisation of female offenders in the past. Now that this is no longer the case, women are identified as criminal not [mentally] ill and thus greater numbers are being included in criminal offending statistics. Greater reporting to the police, due to insurance requirements among other things, means that whereas those offences which may have been overlooked for being petty no longer are treated as inconsequential.
Whether one looks at the lack of implementation of equality for women, or whether men's masculinity is eroded by women's empowerment, whether abuse victims abuse others so they can gain control and power over another, many individuals commit crimes for reasons understood only by them - and perhaps not even then. Theories of crime, causation and criminality will be at ever increasing odds as elements of classicism, positivism, strain theory or a 'pick-and-mix' approach to all three are rejuvenated depending on the year or decade.
Advances in sciences (natural and social) may also play a part in the future of how criminality is considered; genetic or even social predisposition for criminality is not something which is seen on the movie screen, it is a reality which will be hitting us very soon if indeed it has not already done so.
Indeed, September 2006 saw the Labour Government publish their plans to improve families' potential for achievement by the possible local or even governmental intervention for 'problem families'. Critics were reported as fearing that the Government was entering the dangerous field of eugenics (so fatally but effectively seen during the Holocaust) or by creating ASBOs for children who were yet to be born on the basis of their parents' socio-economic status.
Where does this leave the field of criminology? Governments may look to criminologists and other social scientists to address the question of crime and criminality and causes thereof but they may give limited terms of reference for research projects.
Criminology seeks to provide a definitive, exact answer to an inexact and (at times) inexplicable question: why do people (whether male or female) commit crime? Perhaps this is its failure and why, despite a growth of writers on the matter, nobody has arrived at an answer (which I argue is not possible in any event). Sociological, economical, psychological and biological factors all have to be considered and taken into account when dealing with any offender, male or female. Many treat criminal causation theories as mutually exclusive.
Criminological theory - even when considering all the elements therein - seeks to find a definitive answer where it is likely that none exist. Lack of a definitive answer, however, does not necessarily mean criminology has failed; it needs to evolve again. Perhaps for criminological theory, answers to questions are as fluid as the times in which they are considered. Evolution of criminology and the theories therein mean criminologists will have to choose the most logical and pragmatic elements, and discard elements which are obviously flawed (whether in whole or in part). This may be the way forward.
Word Count: 3613
"Textbook on Criminology" Fifth Edition. Williams, K: Published by Oxford University Press: 2004
"Race, Gender & Class in Criminology: The Intersections". Edited by Milovanovic D & Schwartz M D Published by Garland Publishing in 1996. Chapter 7: "Sentencing Women to Prison" by Chesney-Lind, M
Concise Oxford English Dictionary: 11th Ed. Revised. Oxford University Press (2006).
"'Taking It To Heart': Girls and the meanings of violence.' The Meanings of Violence" Burman, M, Brown, J & Batchelor, S. Published by Routledge in 2003.
England & Wales Official Prison Statistics: HM Prison Service: October 2006 Official Population Figures
Sexual Offences Act 1956; Criminal Justice & Public Order Act 1994; Sexual Offences Act 2003. Produced by HMSO.
"Violence Against Women in the UK" Kelly, L; Humphreys C; Sen, P & Womankind Worldwide. CEDAW Thematic Shadow Report. Published in 2003.
BBC News Website: http://news.bbc.co.uk/1/hi/uk_politics/5312928.stm dated 5th September 2006
BBC News Online Magazine: 'On The Lash' by Megan Lane & Tomiko Newson (see link: http://news.bbc.co.uk/1/hi/magazine/6213686.stm) dated 8th September 2006.
Violence and Violent Crime - The Gender Consideration
No one thinks about ABUSE until it rears its ugly head... and usually after it has been going on for a while. And no one wants to think it can happen to their parents. After all, they are in a reputable nursing facility where it is well maintained and has a very friendly staff. It does. And the more you know the "warning signs" the faster you will be able to stop it from happening to your loved ones. Allow me to share a story with you of one such incident that will hopefully make you more aware of what to look out for and how to avoid it.
Emma's story is not unlike that of many seniors who fall prey to abuse from care givers and facilities. I wanted to share her story, and that of her children, to give you a better understanding of how something like this can happen... innocently and without others being aware. Her story, as with many others, started out very subtle. Emma had the onset of Alzheimer's... a slow moving yet very tragic and disabling disease. I want to share some details about her condition since it is something I see quite often with older couples and their families. Hopefully this will help increase your awareness of how easily abuse can happen to a loved one.
Susan and Bill are in their mid-60s. The other day they expressed some very serious concerns about Bill's mother. A couple of years ago they told me they suspected Bill's 87-year old mother, Emma, was starting to suffer from Alzheimer's disease. We had a long discussion about Alzheimer's and how it is an irreversible, progressive mental deterioration that can occur in middle or old age. Fortunately, Bill's mother did not start showing signs of Alzheimer's until her mid to late 80s.
Susan had been doing some research on the Internet and learned it is the most common form of dementia. Those of us who have had to watch a friend or family member suffer through Alzheimer's know it targets and destroys memory and thinking skills. The causes and symptoms vary from one person to the next, as does the progression of the disease. Being educated about the disease and the various care options is the key to helping a loved one with Alzheimer's disease.
When Emma first started to exhibit the onset of Alzheimer's, she exhibited mild symptoms which included increasing forgetfulness and mild confusion. From all their research, Susan and Bill knew that in the late stages a person with Alzheimer's is unable to carry out even the simplest tasks.
They decided to take Bill's Mom to a geriatric specialist for an examination. Following her exam, Dr. Hawkins explained that Alzheimer's disease is complicated and getting to a diagnosis is a long process. He told Bill it was wise for him to bring Emma in for an exam because it is important to understand that there will be many steps and visits with doctors to determine whether or not Emma had Alzheimer's.
As Emma's disease progressed, her symptoms worsened. The medication was unable to significantly slow down the damage that Alzheimer's disease was causing to Emma's brain cells. Initially the medicine did stabilize Emma's condition, but only for a short time.
The doctors also treated Emma's behavioral symptoms with medication, along with some other methods to address her symptoms. Dr. Hawkins told Susan and Bill that they needed to watch for triggers. By knowing these triggers, they could employ a variety of coping strategies. Some of these included avoiding confrontation and making sure Emma got adequate rest. They needed to monitor her comfort and maintain a calm environment. Susan asked about herbal remedies, dietary supplements, and "medical" foods as possible treatments to enhance Emma's memory. Dr. Hawkins said there was no conclusive evidence that these things work.
But, as the disease progressed, Emma's memory loss increased, especially her recent memories. Emma, like many with Alzheimer's disease, experienced severe changes in behavior. She started to do things out of character. She became aggressive, agitated, and irritable. She became depressed and had wild mood swings. She also had difficulty sleeping, another common symptom. Emma's ability to think and reason became so impaired that even performing familiar tasks became impossible. The deterioration of her brain caused her to change in ways that were difficult and trying for Susan and Bill to watch and to deal with.
The progressive nature of the disease brought Emma to the point that Bill and Susan could not care for her any longer in their home. So, about six months ago, they admitted her to a nursing home specializing in caring for Alzheimer's patients. It had a good reputation and everyone seemed very friendly and helpful.
Shortly after admitting Emma to the facility, Susan and Bill created their Estate Strategy. Bill told us he was concerned about whether he had a genetic predisposition to the disease. His comment led us to a discussion of the contributing factors, including genetic, lifestyle, and environmental factors. There are a variety of factors that put Bill at risk for Alzheimer's disease. Age and genetics are risk factors. Fortunately, Bill had not then experienced any signs of the disease. But as Bill aged, his mother's history of Alzheimer's put him at a greater risk of the onset of the disease.
Being aware of the importance of lifestyle and heart health, Bill pledged to avoid stress and fatty foods. Women, like Bill's mom, are more likely to be diagnosed with Alzheimer's than men. Some causes and risk factors for Alzheimer's disease are impossible to change or control. However, lifestyle and heart health are things Bill promised to control. Happily, Bill said he was sticking to his healthy diet and exercise routine.
You might wonder what all this had to do with Emma? The key is to not only recognize it early in your loved ones but when you do, to get yourself checked out to catch any signs early. As with any disease, the earlier it can be discovered, the better chance you have of beating it or knowing how to deal with it.
But there was another issue that was weighing on their mind... and it involved the nursing facility Emma was living in. Bill and Susan were feeling that something was going on with Emma besides her Alzheimer's. They were seeing some signs that led them to suspect Emma was being abused and neglected in the nursing home facility. They knew Emma well and there were enough signs that showed them something just wasn't right at the facility.
If this was true and she was being abused or neglected, they wanted us to explain their legal remedies since they had signed a year-long contract with the home. I started with a definition of what nursing home abuse would be considered. It is generally defined as any action, or failure to act, that causes unreasonable suffering, misery, or harm to the patient. It can include such things as the assault of a patient or it can also include withholding necessary food, medical attention, or physical care from the patient.
It was wonderful that Bill and Susan had stayed involved in Emma's life while she was in the nursing home. This is absolutely the best way to recognize or prevent abuse from happening or continuing to happen.
Since they were suspicious something was happening, I took the opportunity to explain what I consider to be the five main categories of abuse and how to recognize their warning signs. Since this was so helpful for Bill and Susan, I wanted to share these 5 things with everyone. The more we are all aware of these signs, even if it isn't for one of our loved ones, the more we can prevent abuse from happening. Here's the list of the 5 categories of abuse...
1. NEGLECT - Neglect can be intentional or unintentional on the part of the nursing home facility. Neglect, in its simplest of terms, happens when a patient's needs are not being met. This would include such things as not providing appropriate food, water, medical, and personal care for the patient. This can be an intentional choice on the part of the staff or it can be unintentional due to the lack of adequate staffing in a nursing home facility.
Regardless of how it occurs, it is important to know the warning signs of neglect. A neglected patient may be dehydrated or malnourished. Bed sores and other skin conditions can also be signs of neglect. A decline in personal hygiene can be a sign of personal care being neglected. Weight loss is also a sign consistent with neglect. I asked Bill and Susan to keep an eye out for any of these signs and to see if they currently recognize any of them. If any of these are present, Emma may be the victim of neglect.
2. PSYCHOLOGICAL ABUSE - Psychological abuse in nursing homes is one type that can be very hard to identify because it can be subtle and hard to notice. An early warning sign is when the person feels extreme sadness, fear, and/or anxiety. This type of abuse occurs when there is excessive yelling, humiliation, criticizing, or shaming the patient. It might also involve threatening and intimidating the elderly patient. Often time's psychological abuse is accompanied by other forms of abuse.
Because of Emma's Alzheimer's disease, determining psychological abuse is extremely difficult. Elderly people who experience psychological abuse will often become timid and withdrawn. Depression is a sign of psychological abuse, but it's also experienced by Alzheimer's patients. Some victims of psychological abuse will become more angry, agitated, and aggressive... like Alzheimer's patients. Changes in behavior are common in patients who experience this type of abuse. Due to depression, there may be sudden weight loss and loss of appetite. These patients may even refuse to eat or take medications. Bill and Susan are aware of these warning signs and pledged to be on guard for changes in Emma's behavior.
3. PHYSICAL ABUSE - Physical abuse in nursing homes is abuse that involves physical harm to the elderly resident. It involves intentionally inflicting physical harm, such as hitting, kicking, or pinching. Physical abuse can also come from the overuse of restraints, bed injuries, or from physical neglect.
While physical abuse seems to be easier to identify, that is not always the case. Some signs of physical abuse are hidden by clothing or false stories of falls or stumbles. Bruises and abrasions, as well as falls, fractures, or head injuries, can be signs of physical abuse. Injuries requiring emergency treatment or resulting in broken bones should be red flags to the family. Often times the staff who is in charge of an abused resident will refuse to leave when the family is present. This may be a warning sign that something negative is going on with the resident. We advised Bill and Susan to be present and observant when visiting Emma to help ensure her proper treatment and care. It would also be a good idea to get her isolated from her care givers if even for a short period of time so she could be more open to sharing her feelings and insights into her care.
4. SEXUAL ABUSE - Sexual abuse is another form of abuse that takes place in nursing homes. This type of abuse involves any unwanted sexual attention or sexual exploitation. This can happen with any patient and is especially hard to detect in patients who are cognitively impaired or have memory loss, like Emma.
While sexual abuse can be hard to identify, there are some warning signs. Pelvic injury or bruising in the genital and inner thigh area can be warning signs of elder sexual abuse. Newly contracted STDs is a major red flag. Sexual abuse may cause the elderly person to have unexplained difficulty standing or walking. There may also be changes in behavior or mood, including unusual sexual behavior.
5. FINANCIAL ABUSE - This type of abuse takes place when the caregiver takes advantage of access to the elderly person's financial matters and steals or compromises the victim's finances. This can be stealing from the person, or their accounts, applying for credit, or incorrectly billing for services paid by Medicare or Medicaid.
Although Emma had limited access to money, we told Bill and Susan to watch for these top 3 warning signs of financial abuse: 1) A caregiver demanding money or taking money or possessions as gifts from her; 2) Unknown charges to credit cards or sudden mismanagement of personal finances; 3) Forcing Emma to sign financial documents or forging her name on documents.
If any of these types of abuse are suspected, it is important to ask questions of the facility and to investigate. Despite the year-long contract, Bill can remove Emma from the facility because abuse and neglect would be a breach of the contract.
Unfortunately, many of elder abuse crimes go unreported. Now Bill and Susan feel much more empowered now that they know what to watch for and what to do to take the appropriate legal action to protect Emma and others who are victims of abuse. The more you know and the more we all share our insights and stories, the higher likelihood we can eliminate the abuse of our senior loved ones in a nursing facility. Let's all work together and look for the warning signs for our loved ones and others.