Abuse of Aging Caregivers

Abuse of Aging Caregivers

Aims of the Concept

The abuse of the elderly by caregivers has been largely discussed, but rarely is the abuse of caregivers by the elderly. Abuse of the caregivers by the people they care for is not spoken about because it is thought that they have express authority over them. However, it is not the case (Melchiorre et al., 2017). Caregivers have been identified for a long time to be victims of poor treatment by the elderly and also by their family members. More so, abuse directed against caregivers increases with their age (Isham, Hewison & Bradbury-Jones, 2019). Abuse of elderly caregivers, therefore, becomes an issue that is worth discussion. The aims of the concept are identifiable as follows;

1. To establish whether the level of abuse of caregivers by the elderly and by the immediate family members of the caregivers is high to the extent that it needs redress.
2. To determine whether abuse of caregivers affects their delivery of services to the elderly people (Hoffman, 2016). This dimensional need would establish whether older caregivers deliver to their best due to alleged mistreatment.
3. To understand the perception of the elderly caregivers concerning their mistreatment. The aim seeks to establish whether caregivers identify abuse directed to them as part of their job or whether they are agitated and feel demotivated.

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4. To explain whether abuse of elderly caregivers is intentional and opportunistic. This will need an analysis of whether there is a greater likelihood of elder caregivers to be abused than their younger counterparts.
5. To establish whether there are nursing interventions that could be used to stop abuse of elderly caregivers. The protection of caregivers is in the best interest of providing essential care to the needy elderly; hence it is a very basic aim of the concept (Neuberg et al., 2019).
6. To propose the need for future research and redress concerning abuse of elderly caregivers by the people they care for and their families.

Uses of the Concept

Caregiving is a necessary nursing intervention. It relates to the practice where a person takes care of another person. In the nursing dimension, caregiving is more than taking care of the person. It is more about caring for their medical needs as well as their general wellness. Nursing caregivers seek to give the best livelihood for the person to ensure that their health is not negatively affected by the life they live (Abdelmoneium & Alharahsheh, 2016). Most often, caregivers are provided for elderly people. Most of the elderly people need caregivers as they are likely to suffer a lot of chronic conditions such as heart disease, diabetes, Alzheimer’s disease, and dementia, among many others. The need for caregivers thus is necessary because the concerned people need guidance; they need medication and also someone to check on them to ensure that they are in their right states of health. Caregivers could also be provided to people who have medical needs that they cannot fulfill by themselves, hence the need for caregivers.

Since the inception of caregivers, mortalities that could be avoided among the aging population and the needy cases have since reduced. The services of caregivers are necessary because other than just being individuals who can guide the elderly, they have an efficient background in nursing and can direct and make life-saving decisions as well as the best support services for the people they care about. Other than just ensuring that the people they take care heed to the necessary medication, caregivers are expected to be empathetic and offer emotional as well as social support to the people they take care for.

Just like in any field, all caregivers are not necessarily young. Just like other human beings, they grow old. Getting older most often comes with a lot of vulnerability. One may not be viewed as effective as it could be when the caregiver is a bit younger. Elderly caregivers are, therefore, susceptible to abuse (Cooper et al., 2010). The abuse directed to them can be both physical and emotional. Abuse directed to a caregiver by any of the parties, whether they are the client they are intended to take care of or even by any of the family, has a lot of impacts on the care that the caregiver may direct to the client in the latter days.  Indeed, caregiving should be carried out in calm and collected environment since it is not just a medical but also a social process and needful for the wellness of the client.

Observing cases where caregivers have abused the people they care for especially when they are elderly patients, their contract is cut short, and they could suffer more instrumental consequences. However, there is little concern when caregivers are themselves abused. Special considerations in the case of elder caregivers can be made because they have been in the field for long. They understand different dynamics and responses from the people they care for. They understand that the client may have different responses to care and also to depend on the underlying conditions that require them to have caregivers. As nurses age, however, their resilience and persistence for negative attitudes and mistreatment from their clients and their family members could have an impact on them (Özcan, Boyacıoğlu & Sertçelik, 2017).  This group considers itself to have a lot of experience, and hence they could need some formal redress or better treatment from the clients considering that their age difference is also minimal. It is, therefore, necessary to observe what implications come up with abuse of this group by the people they take care of.

Abuse of aging caregivers could be the reason that most caregivers tend to relegate their duties before they reach their retirement ages. From observation, most of the caregivers are young.  The need for understanding whether once caregivers are abused they tend to be demotivated and leave their jobs is thus necessary. This understanding will create the impression of whether redress is needful. Abuse of elderly caregivers should be addressed because they entail a very informed, experienced, and resourceful lot. Probably by addressing instances of their abuse, there could be a way to retain most of them and offer excellent services to deserving clients.

Defining Attributes

According to Walker & Avant (2005), defining attributes is identifying the critical characteristics that differentiate one concept from the other and clarifies its meaning. In that respect, four defining attributes have been identified as representatives of abuse of elderly caregivers;

1. Lack of respect for them: Caregivers are professionals; hence, they deserve to be treated with the respect they deserve (Erosa et al., 2010). Lack of respect for them can be expressed by addressing them wrongly and refuting to take their advice.
2. Physical assault: Some of the caregivers who take care of the elderly and other burdened individuals could receive physical torture, such as being hit by an object by the people they care for or their members of the family (Erosa et al., 2010).
3. Expressing hate for their age: Emotional abuse directed towards elder caregivers could be expressed when the person they are set to care for and other members of the family express hate towards them on the basis of their age (Cooper et al., 2010).
4. Misplacement of their personal effects: Whereas some of the people that caregivers attend have mental issues, continuous loss of personal items that belong to the caregivers may be an expression of abuse to them.

Model Case and Analysis

Mendi is a 51-year-old nurse who has been assigned to take care of Joleen, who is 64 years old and has diabetes. She complains that Joleen no more listens to her and fails to take the medication with only the intervention of her husband being needed for her to take the medications. She has complained of being hit by Joleen using a cooking stick once. Mendi has also reported that once Joleen told her, “Go away, you old thing!” Also, she once lost a watch and some money while attending Joleen.

The case of Mendi is a model case because it identifies with all the four attributes of abuse of an elder caregiver. She is disrespected, physically abused, attacked emotionally on the basis of her age and also her personal effects are stolen.

Borderline Case

Janet is a 54 years old caregiver who has been assigned to Mercy as 65 years old female who has Alzheimer’s disease. In many instances, Janet reports that Mercy complains that she has a caregiver who is almost her age. Janet has also lost her personal items in the house and once she found her lost purse inside Mercy’s bedroom. However, Janet has not experienced any physical abuse and she identifies Mercy as a believer in the care she gives her and her adherence to the rules that she offers. She stipulates that working with Mercy is sometimes tiresome but she covets her ability to follow the instructions she offers

The case of Janet is a borderline case, Her client and her family respect her and have not expressed physical abuse. Emotional abuse based on her age and stolen personal items have been identified attributes. Nonetheless, the case cannot be full identified to be representative of caregiver abuse.

Related Case

Ivy is 50 years old caregiver who has been assigned to 71 years old Gibson who has vision and hearing problems. In the process of offering him care, Ivy complains that he was once agitated and he threw a water bottle at her. However, there are no other cases on the same and she reports that he respects her advice and follows on medication keenly. He does not abuse her emotionally on the basis of age and never has she ever misplaced her personal effects in the process of offering care to him.

The case of Ivy can be concluded as a related case because there was physical abuse when Gibson threw a water bottle at her. However, there is no other attribute of an elderly caregiver and hence it can only be called a related case.

Invented Case

Jane a 53 years old caregiver provides care to Johnson who is blind and has several comorbidities at 45 years old. Jane does no relate with him and does not provide him with the care he deserves at all. Also, Jane has not complained of any abuse from Johnson.

The case outlined above is an invented case because in real life, a caregiver who does not offer the necessary support to the client can only be recalled as it is against nursing practice.

Illegitimate Case

Passy a 52 years old caregiver who has been assigned to Stevens a 77 years old African-American man, goes to work late. She says that Stevens complains of her tendencies to come to work late. Once, Stevens had told her to quit if she was not in the position to attend to him as he deserved. She believes that Stevens is abusing her and reports that she needs a change of duty.

The case of Passy is an illegitimate case because it entails a caregiver who goes to work late and does not provide care to the client in the way that he deserves only to complain of being abused when she is questioned. Her case thus is illegitimate.

Antecedents and Consequences

Abuse of elderly caregivers arises from the fact that they are elder. Different events or at least antecedents can be identified prior to actual abuse happening. Some of the antecedents are complains about the age of the caregiver. Another antecedent may be reluctance to take their orders but taking them in the end (Ho et al., 2017). Lastly, indications of preference for a younger caregiver when communicating with the family members or the person being offered the help can be a way of identifying impending abuse of an older caregiver.

Possible consequences of abuse of older caregivers is their demotivation. Demotivation may fuel them to consider resigning before they are due to retire. It may also make them to offer inadequate care, thus affecting the quality of help they offer to the client. These consequences apparently have an effect on nursing care, and therefore more in-depth research is needed concerning the same.

Empirical Referents

Since abuse of older caregivers cannot be measured, there cannot be established empirical referenced addressing the same. Three ways of establishing whether abuse of caregivers is present can be identified as follows;

1. Optimism concerning patients health; when elder caregivers express optimism on the improvement of the health of the client, it would be an indication of satisfaction and absence of abuse. Lack of optimism would dictate they are abused.
2. Self-Esteem; Elder caregivers who are abused are expected to have low self-esteem. Evaluation of the self-esteem of an elder caregiver is thus necessary.
3. Quitting before retirement time; the proposition to quit before the time for retire comes would be an essential way to conclude that an elder caregiver is being abused.

Conclusion

Abuse of older caregivers is a concept that needs more research than theoretical definitions. Understanding how elder caregivers are abused is essential and will offer grounds for offering a better working environment for older caregivers. An understanding of several ideals such as their propositions to quit, poor self-esteem and pessimism concerning the health of the patients will be used as expressive ways of identifying older caregivers who are abused. Both qualitative and quantitative research approaches need to be used in establishment of the concept.

References

Isham, L., Hewison, A., & Bradbury-Jones, C. (2019). When older people are violent or abusive toward their family caregiver: A review of mixed-methods research. Trauma, Violence, & Abuse, 20(5), 626-637.

Melchiorre, M. G., Di Rosa, M., Barbabella, F., Barbini, N., Lattanzio, F., & Chiatti, C. (2017). Validation of the italian version of the caregiver abuse screen among family caregivers of older people with Alzheimer’s disease. BioMed research international, 2017.

Hoffman, A. (2016). Elder abuse in informal care settings: Literature review of prevalence and best practices for prevention.

Neuberg, M., Meštrović, T., Ribić, R., Šubarić, M., Canjuga, I., & Kozina, G. (2019). Contrasting Vantage Points between Caregivers and Residents on the Perception of Elder Abuse and Neglect During Long-Term Care. Psychiatria Danubina, 31(Suppl 3), 345-353.

Abdelmoneium, A. O., & Alharahsheh, S. T. (2016). Family home caregivers for old persons in the Arab region: perceived challenges and policy implications. Open Journal of Social Sciences, 4(01), 151.

Erosa, N. A., Elliott, T. R., Berry, J. W., & Grant, J. S. (2010). Verbal and physical abuse experienced by family caregivers of adults with severe disabilities. Italian journal of public health, 7(2), 76.

Özcan, N. K., Boyacıoğlu, N. E., & Sertçelik, E. (2017). Reciprocal abuse: Elder neglect and abuse by primary caregivers and caregiver burden and abuse in Turkey. Archives of psychiatric nursing, 31(2), 177-182.

Ho, C. S., Wong, S. Y., Chiu, M. M., & Ho, R. (2017). Global prevalence of elder abuse: A metaanalysis and meta-regression. East Asian archives of psychiatry, 27(2), 43.

Cooper, C., Selwood, A., Blanchard, M., & Livingston, G. (2010). Abusive behaviour experienced by family carers from people with dementia: The CARD (caring for relatives with dementia) study. Journal of Neurology, Neurosurgery & Psychiatry, 81(6), 592-596.

Walker, L.O., & Avant, K., (2005). Strategies for theory construction in nursing (4th ed.). Upper Saddle River, NJ: Prentice Hall