What Can Physicians Do About Elder Abuse?

Elder abuse is a serious problem, prevalent in British Columbia and beyond. Reported incidents of physical, emotional, and financial abuse have increased substantially in the province, highlighting the need for action.1

As we observe World Elder Abuse Awareness Day on June 15, we look to outline the problem and address the importance of doctors in combating it. We’ll also provide tips for recognizing elder abuse and provide information about related resources.

Elder Abuse Getting Worse

As the pandemic disrupted our daily lives; increasing isolation, caregiver burnout and financial insecurity created a set of circumstances that worsened the problem.

Isolation puts seniors at risk for abuse.

Even in situations where abuse is suspected, it often goes unreported. According to a survey conducted by the Office of the Seniors Advocate, 90% of British Columbians say that they would report elder abuse if they witnessed it, but less than half of those who have, actually did so.1

The Importance of Doctors in Fighting Elder Abuse

During a patient visit, if a physician finds themselves saying, ‘There is something not right here,’, something is probably not right and they should report it. Doctors, along with firefighters, police, librarians, postal carriers, and delivery people, are uniquely positioned to spot elder abuse and interject. While it’s true that doctors have a small window of visibility and can struggle to make definitive determinations, it’s still important to remain vigilant.

What to Look For: Signs of Elder Abuse

Elder abuse can be physical, psychological, emotional, financial, sexual, or neglectful in nature. Recognizing it can be easier said than done.

The Office of the Seniors Advocate British Columbia Hidden and Invisible Report on Seniors Abuse and Neglect in British Columbia lists the following as possible signs of abuse.1

• Physical signs of abuse such as fractures, bruising or burns including unusual patterns or location of injury
• History of unexplained accidents or injuries
• Behaviours that provoke fear of violence, isolation or diminish a person’s dignity or self-worth
• Lack of money for necessities when income appears to be adequate
• Being agitated, anxious or fearful of being alone with a specific person
• Change in social patterns, interactions and buying habits
• Signs of being unkempt or not well nourished
• Excluded from social gatherings, inaccessible to family members or long-term friends
• Sudden withdrawal of money; unexplained or forced changes to legal documents such as

property titles, wills, powers of attorney or representation agreements

While these signs are indicative, they are only that. Seniors can bruise easily. When people suspect abuse of any kind, they often lean towards reserving judgement, hesitant to place blame that could potentially be unwarranted. Nonetheless, doctors need to trust their instincts, take action, and refer suspected cases through the proper channels.

Self-Neglect in Seniors

Particularly sensitive is the issue of seniors who choose to live at risk. An example would be a senior who is unable to prepare proper meals for themself, but rejects the notion of being provided food by caregivers or external sources. Many seniors see this as their personal choice. Each example is unique, so it’s important to ensure that nuances are looked at, addressed, and considered.

What Should Doctors Do When They Suspect Elder Abuse?

Suspecting elder abuse is one thing, addressing it is another. Physicians often fail to act because they don’t know where to go.

The Division is planning a session for later this year that addresses the issue of elder abuse and neglect. In the meantime, there are resources available to doctors or members of the general public who suspect elder abuse. (Listed below)

On World Elder Abuse Awareness Day and indeed throughout the year, doctors have an important role to play. It starts with acknowledging that abuse is happening and ensuring that we support the victims and promote intervention. While the task is not a comfortable or easy one, it’s fundamental to the wellbeing of seniors and well worth the effort.