…abusers of the elderly include the relative or caregiver who denies access to regular food, hospital visits, drugs and general care, the in-law who constantly belittles and taunts the older adult living in her/his child’s home, to the government official who is in charge of disbursing fund for that aged pensioner.
Old age is a phase in life associated with changes in social roles and capabilities. Lax muscles, memory loss and other aging processes set in, not forgetting the elderly’s predisposition to health challenges. Nevertheless, everyone hopes for long life in good health. Plans for this golden age differ from person to person, but generally most people just hope for a peaceful retirement or aging process. While this may occur in other climes, it remains largely aspirational in these parts.
However, elder abuse, is one unspoken blight of the aging process. How much of our transition from a people with a culture of strong social support systems to an increasingly individualistic society contributes to the gradual neglect and abuse of a vulnerable section of our population? The context for this question was recently provided by reports on social media of a young man who flogged his grandmother, whose witchcraft he believed was responsible for his perceived misfortune.
As bizarre as the recent case may appear, it is not an isolated occurrence. Over the years, there have been cases of the elderly being accused of witchcraft and in dire cases lynched. Europe’s witch hunts of the 16th and 17th centuries easily come to mind. Mental illness has been implicated by researchers in the latter period as cause for the gruesome execution of tens of thousands of people, following claims and suspicions of witchcraft. One might argue that these events occurred when mental illness was poorly understood and insist that such actions no longer occur in societies.
It is deeply disturbing when acts that remind us of man’s inhumanity to man still occur in the 21st century. Prevailing levels of ignorance of the needs of and disregard for the elderly, makes it necessary to shed some light on elder abuse. Perhaps, it is important to be reminded that they are at a phase in life when their health deteriorates, cognition declines and common mental health conditions, such as depression or dementia, may manifests.
Dementia is a mental illness characterised by progressive, usually irreversible affectation of memory, intellect, personality and behaviour. The individual experiences worsening forgetfulness, usually of recent information. As the condition progresses, memories of older things and events are forgotten and sufferers often appear confused. They struggle to remember names of familiar people, things or landmarks, and wandering tendencies may ensue.
Sufferers may experience situations where they erupt violently from the frustrations of not being able to carry out their previously routine activities, such as dressing up or feeding. As the illness worsens, defecating and urinating on self become the norm. All these may manifest as bizarre and worrisome behavioural patterns perceived by caregivers as being deliberately stubborn, mischievous and inconsiderate. Thus, providing the platform for abuse of the elderly.
It is not uncommon to see a depressed, elderly woman confess to events which she knows nothing about. However, before we get machetes and sticks out, excited over catching another witch who has been exposed, it helps to consider that such “confessions” might be the effect of feelings of guilt or delusional beliefs arising from depression…
Depression is another condition which the elderly struggle with and has been described as common in this age group, considering that this stage is fraught with losses (loss of loved ones, social roles, certain body functions) and major upheavals. Interestingly, depression in the elderly does not usually present itself with sad moods, as seen in younger adults. It is usually characterised by vague body pains and aches. Some researchers have postulated that the recurrent complaints suggestive of arthritis might just be symptoms of depression. Memory problems, changes in sleep and appetite, social isolation, increased dependency and thoughts of death are a few of the symptoms associated with depression.
It is not uncommon to see a depressed, elderly woman confess to events which she knows nothing about. However, before we get machetes and sticks out, excited over catching another witch who has been exposed, it helps to consider that such “confessions” might be the effect of feelings of guilt or delusional beliefs arising from depression and its consequent cognitive distortions.
Certainly, the snippets of a confused, dementing aged woman confessing to atrocities must portray a fascinating view. But may we continue to choose to disregard the reality of someone suffering from impairment of brain functions resulting in the gradual inability to carry out major, yet presumed simple routine activities? Perhaps, if all these were viewed from the perspective of the brain being erased gradually, one will empathise better and begin to push for better treatment of the elderly.
These symptoms are however not comprehensive symptoms of dementia or depression but only give a glimpse of the helplessness of the elderly when coping with mental health challenges in our society.
Now, back to the young man’s action, I daresay that anyone who flogs a vulnerable, helpless elderly woman, regardless of blood ties reveals a great deal of the individual’s personality traits or the possibility of an underlying disorder in the abuser. However, before I get on my high horse and begin to castigate the young man who might actually need an evaluation beyond legal justice for assault, let us attempt to understand the phenomenon referred to as “elder abuse”.
Noteworthy is that neglect of the elderly, whether deliberate or accidental, has been identified as a form of elder abuse. Can I then assume that types of neglect include: failure to regularly check on my aged ones in the village or countryside as it is now referred to; not calling regularly…
Going by the WHO’s definition, elder abuse can be a single or repeated act or lack of appropriate action, occurring within a relationship, where there is an expectation of trust which causes harm or distress to an older person. This can take financial, physical, psychological or/and sexual forms. Elder abuse can also be a function of intentional or unintentional neglect.
Noteworthy is that neglect of the elderly, whether deliberate or accidental, has been identified as a form of elder abuse. Can I then assume that types of neglect include: failure to regularly check on my aged ones in the village or countryside as it is now referred to; not calling regularly; perhaps leaving the shores of Nigeria for perceived greener pastures while my aged parents depend on relatives who have also relocated to urban cities or on children of old friends? While I attempt to explain it away with the conviction that I need to hustle and send money for their upkeep.
Going by Eriksson’s stages of psychosocial development, the concept of comfort for the elderly revolves around integrity and despair. Wherein they reflect on life and either regret or are fulfilled by the conclusions they reach. Perhaps, it might make it a better pill to swallow, if one considers that there are varying degrees of severity of forms of elder abuse. However, simple neglect could lead to physical, psychological, financial and/or sexual abuse.
In other words, abusers of the elderly include the relative or caregiver who denies access to regular food, hospital visits, drugs and general care, the in-law who constantly belittles and taunts the older adult living in her/his child’s home, to the government official who is in charge of disbursing fund for that aged pensioner. Pensioners wait on long queues braving health challenges and unfavourable weather conditions hoping to get their entitlement. Confident that after serving their nation, their golden years will be blissful. Alas, news filters that “not today, come back after another verification process”. Whereas, some already financially buoyant young official laughs to the bank, enjoying the cursed profits of these vulnerable groups’ monies!
Elder abuse is definitely more common than previously imagined. May we then ask that, “she who is without sin should cast the first stone”?
Margaret Uddin-Ojeahere, is a psychiatrist and Fellow of the West African College of Physicians.
Also Published on Premium Times Newspaper – https://opinion.premiumtimesng.com/2020/03/14/the-rarity-of-elder-abuse-in-nigeria-a-misconception-or-reality-by-margaret-uddin-ojeahere/?tztc=1