FINANCIAL MANAGEMENT AND PLANNING FOR SENIORS 老年人財務管理和計劃

我們為什麼特別關注老人福祉？

Compiled and Edited by Donald Chen. CPA

我們特別關注老人福祉乃基於下列信念：

1.  每一個人，包括所有長者，都享有生存、自由和人身安全的權利。

2. 每一個人，包括所有長者，都有權有尊嚴地獲取生活基本所需。

3. 任何人，包括長者，都不應受到殘忍的、不人道的或侮辱性的待遇。

有關虐待長者的基本認識

1. 虐待長者的定義

每個人都享有生存、自由和人身安全的權利，亦有權獲取生活基本所需。任何人，包括長者，都不應受到殘忍的、不人道的或侮辱性的待遇。基於以上信念，虐待長者的定義如下：

一般而言，虐待長者是指傷害長者福祉或安全的行為，或不作出某些行為以致長者的福祉或安全受到傷害，通常施虐者與受虐長者本身是互相認識，或施虐者是負責照顧受虐長者的。

我們基於社會的標準和專業知識，去衡量這些行為是否對長者造成傷害。在考慮該行為是否虐待長者時，應留意下列情況：

§ 無論長者是否覺得受虐待，虐待行為本身可能已足以構成虐待長者。

§ 虐待長者可能發生在任何地方，包括安老院、住宅處所及公共地方。

§ 虐待長者的行為可能只發生一次或重複發生，或是短暫或是長時間發生；及

§ 即使施虐者不是蓄意傷害長者，若其行為對長者造成傷害，也可構成虐待長者。

廣泛而言，不論是否長者認識的人，都有可能成為施虐者。然而，本指引只針對處理受虐長者與施虐者本身已經是互相認識的個案，或施虐者對受虐長者是有照顧責任的個案。在此指引中，「老人」或「長者」指60歲或以上的人士。

2. 虐待長者的性質

虐待長者包括以下六種性質：

1. 身體虐待

身體虐待是指對長者造成身體傷害或痛苦，而這些傷害乃非意外或由於沒有提供任何預防措施所引致的。

2.  精神虐待

精神虐待是指危害或損害長者心理健康的行為及／或態度，例如羞辱、喝罵、孤立、令長者長期陷於恐懼中、侵犯長者私隱，及在不必要的情況下限制長者的活動範圍或活動自由等。

3.  侵吞財產

侵吞財產是指任何涉及剝奪長者財富或妄顧長者利益的行為，例如在未經長者同意下取用長者的財物、金錢或轉移長者的資產。

4.  疏忽照顧

疏忽照顧是指嚴重或長期忽視長者生活上的基本需要（例如沒有為長者提供足夠飲食、衣服、住宿、醫療、護理等），以致危害長者的健康或生命安全。疏忽照顧亦包括沒有根據醫生的指示給予長者其所需的藥物或輔助器具，使長者身體受到損害。如果正規服務提供者（例如安老院、綜合家居照顧服務隊、醫院等）因沒有遵行照顧長者的責任而引致長者受到傷害，亦可以被視作疏忽照顧。

5.  遺棄長者

遺棄是指在欠缺合理原因下，長者被負責提供照顧或監護者離棄，而對長者身體或心理造成傷害，例如家人故意將患有認知障礙症的長者帶往陌生地方後離去，使他／她不能自

返回住所，或將長者送入醫院時虛報通訊地址／ 聯絡電話，或多次抗拒／逃避接觸，或拒絕提供通訊地址／聯絡電話，以致醫院無法聯絡照顧或監護者，商討有關長者的醫療及福利事宜。

6.  性侵犯

性侵犯是指性侵犯長者，例如施虐者向長者展示自己的性器官、非禮或強迫進行性行為等。

引致虐待長者的危機因素

1.  不良的家庭關係

長者與家人如一向關係欠佳，欠缺溝通，雙方常滿懷敵意，便很容易發生衝突。若日積月累的家庭問題一直得不到解決，加上長者及家庭未能因應基於其年老帶來的轉變（例如因退休而長時間留在家中、長者日漸依賴別人照顧）而作出相應的調適時，長者受家人虐待的機會便會上升。

2.  不能適應家庭結構的轉變

若家庭內發生結構轉變，例如年老配偶去世，或長期分隔的親友（如成年子女或媳婦）於外地／內地移居本港與長者同住，而家庭成員又未能互相適應，容易產生衝突，若衝

化，虐待長者事件便有可能出現。

3. 親友／照顧者自己的身體狀況出現問題

若親友／照顧者本身健康情況欠佳／患精神病／有酗酒等情況，虐待長者的機會便會增加。

4.  長者身體或精神上要依賴別人

若長者身體上要依賴別人照顧，或因精神上無行為能力，經常難以為自己作有效的決定，並執行自己的意願，遇到欺壓時，因為身體或精神上的缺失而難以反抗，便容易成為虐待長者受害者。

5.  照顧的壓力

對部份照顧者而言，照顧體弱或精神上無行為能力的長者的壓力很大，若

要他人照顧的長者因某些原因長期表現不合作，例如要依靠別人餵飯的長者經常不願進食，照顧者如得不到足夠的支援便容易產生不滿的情緒，虐待長者的機會便會上升。

6.  長者社交網絡薄弱

當長者很少朋友，亦很少與外界接觸時，對與其僅有聯繫的親友便會加倍信任和依賴，當遭受虐待時便難以尋求外界的協助。

以上列舉引致虐待長者的危機因素並不概全，只供工作員（註）參考。若發現長者及其照顧者有上述的情況，便須提高警覺，及按個案需要提供適切的服務，以預防虐待長者事件的發生。

4. 長者受虐的表徵

當長者面對虐待處境時，往往會有異於平常的行為表現，例如神情呆滯、退縮、情緒低落、抑鬱或變得被動，又或平日經常參加活動卻突然常常無故缺席。工作員遇有以上情況，便應主動關心長者，並考慮長者是否有遇到虐待的可能。

以下為一系列顯示長者受虐的表徵，包括出現在長者本身的身體表徵、行為表徵，以及在照顧者身上出現的行為表徵及環境表徵，用以協助工作員評估長者是否有受到虐待。

這些行為或跡象，並非一定是虐待長者的證據，但一旦有出現，特別是當多種情況同時發生時，有關部門／單位人員必須注意及警覺，詳細評估發生虐待長者的可能性，並盡可能全面評估長者的情況（包括家庭背景，支援網絡等），以考慮是否需要進一步介入。另外，此處列舉之表徵並不概全，同樣的表徵亦會出現在不同的虐待長者性質，因此，主要作有關人員參考之用。

4. 顯示長者遭受身體虐待的表徵

1. 瘀傷

a. 身體部位（如身軀、手、腳等）有多處地方出現無法解釋的瘀黑，似乎並非由意外受傷造成

b. 面部出現瘀傷，似乎並非由意外受傷造成

c. 瘀傷成簇或顯現物件的形狀，例如杖印、皮帶印、衣架印、手掌印及腳印等

d. 身體上出現多處瘀傷，各呈不同顏色，顯示處於不同時段受傷，或在不同的痊癒階段

e. 重複出現瘀傷

2.  骨折

a. 與骨折或關節錯位相符的四肢腫大或疼痛

b. 多處骨折，並處於不同的痊癒階段

c. 臨床檢驗時發現難以解釋的骨折

3.  肌肉撕裂

a. 無法解釋的撕裂

b. 不同時期的多處傷疤

4.  內臟受傷

a. 無法解釋的臟腑破裂

b. 無法解釋的腦部抑制性血腫

5 燒傷／燙傷

a. 由雪茄／香煙／香燭等造成的燒傷，似乎並非意外造成

b. 長者需要別人餵食，而有燙熱食物造成的口部及食道燙傷傷痕

c. 身體任何部份遭燒傷／燙傷

長者行為表徵

a) 不願接受醫療檢驗

b) 被詢問有關受傷過程時，不願意透露有關資料

c) 重複強調傷勢是因自己不小心造成或說話前後矛盾

d) 受傷後延遲接受所需的醫療服務

e) 不尋常地向不同的醫生尋求醫療服務

f) 企圖自殺

施虐者行為表徵

a) 不尋常地帶長者向不同的醫生尋求醫療服務

b) 被詢問有關長者受傷過程時，不願意透露有關資料

c) 當長者被問及有關受傷的問題時，蓄意或搶快地代替長者回答

d) 長者受傷後，避免或延遲讓其接受所需的醫療服務

老人虐待及忽視

家庭暴力和對家庭成員虐待的事件一直存在著，但是都被隱藏著。從一九六○年代中期開始，虐待及忽視孩童、對孩童性攻擊和摧殘婦女的問題已浮現出來，而成為大眾所關注的社會問題。自一九七八年開始，老人虐待和忽視的問題才受到重視，大家開始覺察到老年人在社會中的數目越來越多，而且有他們獨特的問題存在，因為他們比較沒有能力去抵抗「虐待及忽視」，所以老年人比一般人更可能有失去基本權利和需求的危險。

以下就老人虐待及忽視問題的原因、類型和治療方式分別加以探討。

1.原因：最常見的原因是老人的照顧者在承受長期缺乏睡眠、心理壓力、身體勞動的情況下而鞭責老人，其他的理論則是強調受虐者對外界的過分依賴、世代沿襲下來的家庭暴力特質，及提供照顧者的個性等，以及某些提供照顧者有精神方面的障礙，如精神失調、老年失智、藥物濫用等，亦為重要因素之一。

2.類型：

(1)身體的虐待及忽視：會導致瘀傷、割傷、骨折、脫水、營養不良、褥瘡、體溫過低及死亡等情況的發生.

(2)經濟上的虐待：包括限制金錢、蓄意誤理其資金及財產等。經濟上的虐待除發生在老人身上外，也可能發生在家庭其他成員中，在老年人有自己的財產、房子、存款及其他財物的情況下，會變得比較單純.

(3)基本權利的侵犯：最常見的是不允許個人的宗教參與，或拆閱私人的信件.

(4)心理上的虐待：通常伴隨著其他種類的虐待而來，常發生在被遺棄的老人身上，如言語虐待及隔離。

3.治療：在美國，老人虐待及忽視的治療一直受到爭議，直到一九八六年有三十七個州政府制定法律，明定老人受虐事件應呈報政府主管單位。在老人虐待及忽視的治療方面，首先要意識到此現象的存在，並學習探查的方法，其次要體認治療工作必須多樣性，而設法停止老人被虐待及忽視是首要目標，需要藉由許多相關的機構及人員參與，如社會服務系統能提供管家或建立送餐到府的服務，醫師能治療進行性的慢性疾病，諮商協調人員能夠進行受虐者及施虐者的協調（如：分析虐待及忽視的性質、協調並提供醫療照顧及社會服務等）。 　　老人虐待及忽視的發生與其家庭的相關性很大，臨床的治療著重在找出家庭中發生的原因，而研究及治療技術的快速發展、政府的回應、法律的制定及特殊計畫的執行等，都是未來亟待發展的方向。

虐待老人 (也稱「高齡人虐待」、「不盡孝」)是「在本應相互信任、期待的關係中，他人對老年人作出不合適的行為，此類行為會對老年人造成傷害和痛苦。」這一來自不列顛的反對虐待老人行動組織的定義被世界衛生組織採納。有國家出台法律保護老年人，防

他們受到虐待。

虐待老人的核心元素是老年人信任當事人，但是後者成為了施虐者。因此，這包括老年人熟知的人或與他們有關係的人，例如愛人、同伴或家庭成員、鄰居，或老年人所依賴為生的服務人員。虐待老人有許多形式，它可以被認定是家庭暴力。

雖然各種形式都可以被算為虐待老人，但是這不包括對老年人的普通犯罪活動，例如入室搶劫，當街「摸兜」，或「趁其不備行竊」。

贍養人虐待老人是一個全球性問題。2002年，世界衛生組織在全球範圍內呼籲關注老年人虐待。多年來，政府機構和社區專業組織，都將虐待老人視為社會問題。]

2006年，國際預防虐待老人網絡(INPEA)將6月15日定為世界虐待老人警示日(WEAAD)，當天，全球會舉辦更多的活動來警惕虐待老人，關注相關挑戰。

形式

雖然各國在虐待老人上都有共同問題，但是歷史、文化、經濟和社會都存在獨特的問題，即在國內對老年人的認識問題。最基本的共性在於使用權力控制個人來影響其它老人的幸福和地位。

虐待老人有幾種形式，包括：

物理虐待:

精神虐待:

經濟虐待:

詐騙:

性虐待:

怠慢:

混合經濟剝削:

此外，美國有的州郡法律規定下列也是虐待老人：

遺棄:

剝奪權益:

自我疏忽:

制度性虐待 指代當對受贍養老人應當得到照顧和贍養時遭到權益剝奪，受到物理和心理的傷害。

健康後果

虐待老人的健康後果十分嚴重。虐待老人可以摧毀老人的生活治品質，例如：

功能性能力下降

增加依賴性

增加絕望感

增加壓力

心理狀況變差

過早死亡或發病

抑鬱或痴呆

營養不良

褥瘡

死亡

相對於其他老人來說，受到虐待的老人在死亡率上要高出三倍。

衍生虐老的危機因素（Risk Factors）

有研究或統計數字顯示，受虐長者與施虐者的某些特質或處境，往往較易引發虐待長者的事件產生。一般來說，它們會被視作導致虐老的危機因素，而其中值得各方留意的危機因素如下：

高危長者（Elders at risk）

年齡：長者年齡愈高，受虐危機愈大。

夫婦年齡差距：長者夫婦之間年齡差距愈大（例如老夫少妻），年長一方受虐機會愈大。

健康轉差：若長者身體及精神健康轉差（例如患上老年痴呆症等疾病），需要依賴別人照顧，受虐危機愈大。

居住安排：受虐長者較多是與他人同住（例如與自己的配偶、成年子女家庭等），其人際關係又較為疏離甚至陷於孤立。

缺乏資源：受虐長者較多為資源睏乏者，須依靠他人照顧。

新近喪親：新近喪親的長者，生活起居若需要依賴他人照顧，又或缺乏經驗獨立處理私人財產者，往往較易成為被虐的對象(例如財產被侵吞等)。

施虐者的特質

年齡：施虐者多較受虐長者年輕。

性別：普遍來說，男性施虐者較女性為多。

精神或行為問題：若為精神病患，又或有酗酒、吸毒、暴力、反社會等不良行為，則較易成為傷害長者的施虐者。

與受虐者的關係：大多數的施虐者為受虐長者的家人，尤以其成年子女、媳婿及配偶為甚。

依賴者：長者的成年子女若為失業者或未婚，而在財務支出、居住照顧及其他生活層面上，需要依賴其年長父母者，則較易成為傷害長者的施虐者.

SOURCE OF REFERENCE:

(1) Guidelines on procedures for handling cases of elder abuse- Government of Hong Kong

(2) Government of Canada website

Why are we paying special attention

to the well-being of the elderly?

Compiled and Edited by: Donald Chen, CPA

We pay special attention to the well-being of the elderly because of our  beliefs that:

1. Everyone, including all elders, has the right to life, liberty and security of person.

2. Everyone, including all elders, has the right to dignified access to the basic necessities of life.

2. No one, including the elderly, shall be subjected to cruel, inhuman or humiliating treatment.

Basic understanding of elder abuse

1. Definition of elder abuse

Everyone has the right to life, liberty and security of person, as well as to the basic necessities of life. No one, including the elderly, should be subjected to cruel, inhuman or humiliating treatment. Based on the above beliefs, elder abuse is defined as follows:

In general, elder abuse refers to acts that harm the well-being or safety of the elderly, or that the well-being or safety of the elderly is harmed by not doing certain acts, usually when the abuser and the elderly are themselves aware of each other, or the abuser is responsible for caring for the elderly.

We measure whether these behaviors cause harm to the elderly based on societal standards and expertise. When considering whether the act is abusive to the elderly, the following should be noted:

Regardless of whether the elderly feel abused or not, the abuse itself may be sufficient to constitute elder abuse.

Elder abuse can occur anywhere, including homes for the elderly, residential premises and public places.

 Elder abuse may occur only once or repeatedly, or for a short or long time; and

 Even if the abuser did not intentionally harm the elderly, if his or her actions caused harm to the elderly, it can constitute elder abuse.

Broadly speaking, people known to the elderly or not are likely to become abusers. However, this guideline only addresses cases where the elderly and the abuser already know each other, or where the abuser has a responsibility to care for the elderly. In this guideline, "elderly" or "elderly" refers to persons aged 55 or above.

2. The nature of elder abuse

Elder abuse includes the following six natures:

1. Physical Abuse

Physical abuse is the infliction of physical injury or suffering on an elderly person that is not accidental or caused by the failure to provide any preventive measures.

2.  Emotional Abuse

Emotional abuse refers to behaviors and/or attitudes that harm or impair the mental health of the elderly, such as humiliation, swearing, isolation, prolonged fear of the elderly, violation of the privacy of the elderly, and unnecessary restrictions on the range or freedom of movement of the elderly.

3.  Misappropriation of Property

Misappropriation of property refers to any act involving the deprivation of the elderly's wealth or the pretense of the elderly's interests, such as taking the elderly's property, money or transferring the elderly's assets without their consent.

4.  Negligence of Care

Neglectful care refers to the serious or long-term neglect of the basic needs of the elderly in life (e.g., failure to provide adequate food, clothing, accommodation, medical care, nursing care, etc.) for the elderly, thereby endangering the health or life safety of the elderly. Neglect also includes failure to give the elderly the medications or assistive devices they need as directed by the doctor, causing physical damage to the elderly. Regular service providers (e.g., homes for the elderly, integrated home care teams, hospitals, etc.) who cause harm to an elderly person by failing to comply with their duty to care for the elderly can also be considered negligent caregiving.

5. Abandonment of the Elderly

Abandonment means that, in the absence of a reasonable reason, the elderly are responsible for providing care or guardian abandonment, causing physical or psychological harm to the elderly, such as the family deliberately taking the elderly with dementia to an unfamiliar place and leaving, so that he/she cannot return to the residence on his or her own, or falsely declaring the mailing address/contact number when sending the elderly to the hospital, or repeatedly resisting/evading contact, or refusing to provide a mailing address/contact number, so that the hospital cannot contact the caregiver or guardian to discuss the medical and welfare matters related to the elderly.

6.  Sexual Assault

Sexual assault refers to the sexual assault of an elderly person, such as the abuser showing his sexual organs to the elderly, indecent or forced sexual behavior.

3. Crisis factors leading to elder abuse

1.  Poor family relationships

If the elderly and their families have always had a poor relationship, lack of communication, and the two sides are often hostile, they are prone to conflict. If the accumulated family problems remain unresolved and the elderly and their families fail to adjust accordingly to the changes brought about by their old age (e.g., staying at home for a long time due to retirement, the elderly becoming increasingly dependent on others for care), the chances of elderly abuse by their families will increase.

2.  Inability to adapt to changes in the family structure

If there is a structural change within the family, such as the death of an elderly spouse, or a long-term separation of relatives and friends (e.g., adult children or daughters-in-law) who migrate to Hong Kong to live with the elderly in Hong Kong/ mainland, and the family members fail to adapt to each other, conflicts are likely to arise, and if the conflict worsens, elder abuse incidents may occur.

3. There is a problem with the physical condition of the relatives, friends/caregivers

If a relative/ caregiver is in poor health/mental illness/alcohol abuse, the chances of elder abuse increase.

4.  The elderly is physically or mentally dependent on others

If the elderly is physically dependent on others to take care of them, or because they are mentally incapacitated, it is often difficult to make effective decisions for themselves and carry out their own wishes, and when they encounter oppression, it is difficult to resist because of physical or mental deficiencies, they are vulnerable to elder abuse.

5.  Care for stress

For some caregivers, there is a lot of pressure to care for frail or mentally incapacitated elderly people, and if the elderly who need the care of others are uncooperative for some reasons, such as the elderly who rely on others to feed are often reluctant to eat, the caregiver is prone to dissatisfaction if they do not have enough support, and the opportunity to abuse the elderly will increase.

6.  Weak social networks for the elderly

When the elderly has few friends and little contact with the outside world, they will increase their trust and dependence on their relatives and friends who have only contact with them, and it will be difficult to seek outside help when they are abused.

The above list of crisis factors leading to elder abuse is not exhaustive and is only for the reference of staff (Note). If the elderly and their careers are found to have the above-mentioned circumstances, they should be vigilant and provide appropriate services as needed on a case-by-case basis to prevent the occurrence of elder abuse.

4. Signs of elderly abuse

When faced with abusive situations, the elderly often behaves differently than usual, such as sluggishness, withdrawal, depression, depression or becoming passive, or when they regularly participate in activities but are suddenly absent for no reason. In the above situation, staff members should take the initiative to care for the elderly and consider whether the elderly may encounter abuse.

The following is a series of manifestations of elder abuse, including physical and behavioral representations that appear in the elderly themselves, as well as behavioral and environmental representations in caregivers, to assist staff in assessing whether the elderly have been abused.

These acts or signs are not necessarily evidence of elder abuse, but once they occur, especially when multiple situations occur at the same time, the personnel of the relevant department/unit must pay attention and be vigilant, assess in detail the possibility of elder abuse, and assess the situation of the elderly (including family background, support network, etc.) as comprehensively as possible to consider whether further intervention is needed. In addition, the representations listed here are not exhaustive, and the same representations may appear in different natures of elder abuse, so they are mainly used for reference by relevant personnel.

4. Characterization of physical abuse of the elderly

1.  Bruising

a. Unexplained bruising appears in multiple places on body parts (e.g., body, hands, feet, etc.) that do not appear to be caused by accidental injuries

b. Bruises appear on the face that do not appear to have been caused by accidental injuries

c. The shape of the bruise in clusters or revealing objects, such as staff prints, belt prints, hanger prints, palm prints and footprints

d. Multiple bruises on the body, each of different colors, showing that the injury is at different times or at different stages of healing

e. Recurrence of bruises

2.  Fractures

a. Enlargement or pain in the extremities consistent with fractures or joint misalignment

b. Multiple fractures and in different stages of healing

c. Unexplained fractures found during clinical testing

3.  Muscle tearing

a. Unexplained tearing

b. Multiple scars at different times

4.  Internal organ injuries

a. Unexplained rupture of the internal organs

b. Unexplained brain suppressive hematoma

5.  Burns/burns

a.   Burns caused by cigars, cigarettes, candles, etc., do not appear to have been caused by accidents

b. The elderly needs to be fed and have burns to the mouth and esophagus caused by hot food

c. Burns/burns to any part of the body

Elderly Behavior Characterization

a) Reluctance to undergo medical examination

b)  When asked about the injury process, they are reluctant to disclose relevant information

c)  Repeat that the injury was caused by one's own carelessness or contradictory speech

d)  Delay in receiving required medical services after injury

e)  Unusually seek medical services from different doctors

f)  Attempted suicide

Abuser Behavior Representations

a) Unusual area elders seek medical services from different doctors

b)  When asked about the injury process of the elderly, they are reluctant to disclose relevant information

c)  When an elder is asked a question about an injury, deliberately or preemptively substitutes for the elderly in answering

d)  After an elderly person is injured, avoid or delay receiving the required medical services

Environmental Characterization

It is suspected that the abused elderly has unusual restraints/instruments of torture in their residences, indicating that the elderly may have been subjected to unnecessary restraints and injuries

Characterization of emotional abuse of the elderly

Signs of Elderly Behavior

a)  Very passive

b)  Attempted suicide

c)  Have a tendency to be depressed

d)  Often acting in panic

e)  Fear of caregivers

f)  Avoid contact with people

g)  Mood swings

h)  Hysteria

Abuser Behavior Characterization

a)  Restrict the range or freedom of movement of the elderly in unreasonable circumstances (e.g., frequently locking the elderly in their dwellings or not allowing the elderly to return to their dwellings, etc.)

b)  Extreme nagging, repulsion and indifference to the elderly

c)  Frequently spit, denigrate, blame or insult the elderly

d)  Disregard for the privacy of the elderly (e.g., forcing the elderly to bathe with others)

e)  Elderly persons are not allowed to participate in family or social activities

Environmental Characterization

a)  Elderly persons are segregated and deprived of items for contact or contact with the outside world (e.g., deprivation of elderly persons' telephones, radios, etc.)

b)  The relationship between the caregiver and the elderly is clearly sparse or long-term bad

Signs showing neglect of care for the elderly

Physical characterization of the elderly

a)  Weight loss/extremely low weight

b)  Dehydration

c)  Malnutrition

d)  Long-term growth of pressure sores

e)  Frequent illness

Elderly Behavior/Condition Characterization

a)  Often dirty

b)  Wandering around unaccompanied for a long or long time

c)  It is clear that the diet is irregular and unattended

d)  Apparent lack of appetite and neglect

e)  Representation of abuser behavior

f)  Do not give the elderly the necessary daily necessities

g)  Do not give the elderly the necessary medication/medical care

h)  Do not give assistive devices (e.g., glasses, canes, dentures, etc.) required by the elderly

i)  Do not visit elderly persons who lack self-care ability for a long time and do not contact them at all

j) Environmental Characterization

a)  Elderly accommodation does not have the required security measures or equipment (e.g., handrails)

b)  Lack of basic facilities at work and rest (e.g., electric lights, drinking water, beds, etc.)

c)  The dwelling is filled with debris and blocks the passage

Signs showing the misappropriation of property by the elderly

Signs of Elderly Behavior

a)  Disclosure or discovery of loss of property/money/assets/buildings, etc. originally owned

b)  In the case of economic well-being of the elderly, they lack basic daily necessities (e.g., food, clothing, etc.) and are unable to cover basic daily living expenses (e.g., utilities)

c)  The elderly transfers their bank accounts, building deeds, etc. without cause

d)  Seniors open joint accounts without cause

e)  The elder suddenly sets up a peace note and leaves all or most of his or her possessions to persons who have no relationship with him or her.

Abuser Behavior Characterization

a)  Require or compel the elderly to open a joint account with a bank

b)  Privately collect, request or force the elderly to hand over documents of their personal data, such as identity cards, passports, stamps, etc., to the abuser for safekeeping

c)  Put away and privately store the bank statements of the elderly account so that the elderly does not have the opportunity to know the records of their account

d)  A sudden undertaking to take care of the elderly, but requesting or arranging for the transfer of all the elderly's property to his name

e)  Theft of money, comprehensive social security assistance or pensions from the elderly

f)  Impersonate the signature of an elderly person on a pension cheque or legal document

g)  improper use of power of attorney, enduring power of attorney or trustee's authority, e.g., forcing an elderly person to sign such documents to take control of his or her property

h)  Without the knowledge of others, take the elderly to the lawyer to make a safety note

Environmental Characterization

a)  The elderly has irregular transaction records in their bank accounts

b)  The elderly's personal valuables are lost for no reason

c)  Seniors have never received a bank statement

d)  The elderly is isolated for long periods of time and are unable to contact any relatives or friends

Show Signs of abandonment of the elderly

Elderly Behavior Characterization

a)  Long-term solitary stays on the street/park/mall, etc.

b)  Long-term dirty

Abuser Behavior

a)  Deliberate abandonment of the elderly in hospitals or homes for the elderly

b)  Deliberate abandonment of elderly persons in public places (e.g., parks, shopping malls, etc.)

Environmental Characterization

No one visited or arranged to leave the hospital after the elderly were admitted to the hospital

Showing Signs of sexual assault in an elderly person

a)  Physical characterization of the elderly

b)  Bruises on the chest/genital organs

c)  Unexplained STDs

d)  Unexplained urethritis

e)  Unexplained bleeding from the external genital area, vagina, anus, etc.

Representation of Elderly Behavior

a)  There has been a significant shift in sexual attitudes/behavior

b)  Excessive masturbation

c)  Panic at the sight of a suspected abuser

Environmental Characterization

Underwear was torn, stained or stained with blood

How can we prevent elder abuse?

There are a number of factors that may increase or decrease the risk of perpetrating and/or experiencing elder abuse. To prevent elder abuse, we must understand and address the factors that put people at risk for or protect them from violence.

1. Listen to older adults and their caregivers to understand their challenges and provide support.

2. Report abuses or suspected abuses to local adult protective services, long-term care ombudsman, or the police. Use the National Center on Elder Abuse Listing of State Elder Abuse Hotlines external icon to find your state’s reporting numbers, government agencies, state laws, and other resources.

3. Educate oneself and others about how to recognize and report elder abuse.

4. Learn how the signs of elder abuse differ from the normal aging process.

5. Check-in on older adults who may have few friends and family members.

6. Provide over-burdened caregivers with support such as help from friends, family, or local relief care groups; adult day care programs; counseling; outlets intended to promote emotional well-being.

7. Encourage and assist persons (either caregivers or older adults) having problems with drug or alcohol abuse in getting help.

The older adult population is growing faster in the U.S. and Canada than are younger populations. Many older adults require care and are vulnerable to violence perpetrated by a caregiver or someone they trust. More research is needed to uncover the causes for, and solutions to, violence against older adults.

SOURCE OF REFERENCE:

(1) Guidelines on procedures for handling cases of elder abuse- Government of Hong Kong

(2) Government of Canada website