ABUSE, MALTREATMENT IN OLD AGE. ARE YOU ABUSED OR ABUSED?

According to the World Health Organization (WHO) in the last year 1 in 6 people over 60 years of age suffered some type of mistreatment, abuse, at the community level, being greater in geriatric residences and community care centers. Two out of every three workers in these institutions indicate having carried out mistreatment in the last year.

Elder abuse is defined (WHO) as the action, single or repeated, or the lack of the appropriate response, which occurs within any relationship where there is an expectation of trust and where such action produces damage or emotional distress to the elderly. ‘. The abuse can be: physical, psychological / emotional, economic, sexual, also reflect an act of intentional negligence or by omission. It is necessary to highlight, and in an important way, the structural violence translated into those situations in which there is damage in the satisfaction of human needs, such as adequate, timely and favorable health care. According to J Galtung’s scheme, unlike direct violence that is visible, structural and cultural violence are generally invisible.

This social problem, which goes almost unnoticed, exists in high- and low-income countries and is not sufficiently reported. The increase in the older adult population, especially in Latin America and Asia, highlights the importance of June 15, a day assigned by the United Nations as ‘World Day of Awareness of Abuse and Maltreatment in Old Age’, a date to promote awareness and awareness.

Now facing an unparalleled health crisis globally, older people have become one of its most visible victims. The crisis, in any order, generated by the COVID-19 pandemic has highlighted the limitations of access to essential health services, reducing in the elderly population the reduction of critical services not related to the pandemic, increasing risks for the lives of older adults.

Not only that, but for those who pass through old age and have associated comorbidities, the decision regarding medical care to save lives has been and is difficult, prioritizing the ‘younger’, ‘healthier’ population. This generates the urgency to review the rights to life and health that older adults have and that they should be the same as for everyone else.

RISK FACTOR’S

• Poor physical and mental health of the victim. Disabled people, with dementia and other limiting conditions.

• Mental disorders, alcohol and other substance abuse in the case of the aggressor. Those problematic, borderline, psychopathic, narcissistic, paranoid, passive-aggressive personalities stand out.

• Female gender, particularly from the cultural perspective where women may be devalued, considered as of a lower social status, simply because of gender.

• Sharing a home with the aggressor. In the case of children and direct relatives, consider the previous relationship with the older adult, be careful if it was dysfunctional; also, the economic dependence of the elderly (economic abuse); acts of negligence in care, considering a burden of care for a greater disability.

• Fear of the elderly to complain or report abuse.

• Weak, absent intergenerational family ties.

• Isolation and lack of social support.

• Lack of training, education, caregivers and disadvantageous remuneration for those paid.

• Poor primary care, not comprehensive, not adequate.

• Absence or lack of adaptation, application, of legal norms.

• Lack of participation from multiple sectors of society including the group of older adults who need and should be empowered.