Challenges Faced by Seniors in Assisted Living

The senior living industry has faced unprecedented challenges in the last two years due to the COVID-19 pandemic. There were issues with the rising COVID cases among community-residing seniors, understaffing, low-quality care delivered, and more. Among them, the shortage of staff will create a strong ripple effect on seniors living in communities.

For decades, understaffing has been a problem in senior living and related sectors. When there aren’t enough caregivers in the facility, residents will receive poor and inadequate care, and issues of medication mismanagement and abuse can potentially happen. If the problem of the lack of staff is not addressed, it can snowball into more serious outcomes that can put the residents’ health at risk.

Elder Abuse: A Serious Problem Facing Seniors

Moving into a senior living community isn’t without any difficulty. While family members see that the transition may be the best option, it depends on how safe, secure, and equipped the community is. You may find that some communities lack staff, which is problematic. With a poor staff-to-resident ratio, abuse can happen.

Let’s delve into this top issue that makes family members refuse the idea of moving their senior parents into a community.

What is elder abuse?

The full spectrum of elder abuse includes physical, sexual, psychological abuse, neglect, and financial exploitation.

When your loved one enters a senior living community, you won’t be as updated with their lives as they were at home or living with you. You won’t know what they do during the day, who they are with, or if they’re abused by caregivers or community staff. Unfortunately, elder abuse is common in assisted living, memory care communities, and nursing homes. Your loved one might be experiencing it, but you’re completely unaware.

Types of elder abuse

Knowing the types of abuse, how to spot the signs, and how to stop it can help improve your loved one’s living situation when they’re living apart from you.

1. Physical abuse

According to the National Center on Elder Abuse, physical abuse is the “use of physical force that may result in bodily injury, physical pain, or impairment.”

Physical abuse is likely to happen if the caregiver has been involved in drugs, has a criminal history, was exposed to abuse as a child, or has a mental illness. Management problems, such as high turnover, understaffing, and lack of caregiving training, can also open doors for physical abuse.

Although most residents in independent and assisted living communities only need minor assistance from their caregivers, those who require higher levels of care may get abused. Seniors with moderate to full dependency on their caregivers are likely to experience physical abuse where caregivers hit, kick, shove, slap, or restrain them.

Prominent signs of physical abuse include unexplained bruises, burns, scars, fractured or broken bones, cuts, and more

2. Emotional or psychological abuse

The impact of emotional or psychological abuse has more dire effects on victims and can result in fear, distress, trauma, depression, and serious mental anguish. It’s the most common form of abuse experienced by community-residing seniors.

A caregiver may commit psychological abuse if they feel resentful or has a poor relationship with a senior they cared for. But sometimes, it’s solely because they can't control their temper, especially when caring for a resident with problematic behaviors.

Emotional abuse can be verbal and nonverbal. Some examples include:

• Habitual blaming or scapegoating
• Intimidation through yelling or swearing
• Verbal and nonverbal threats and harassment
• Isolation
• Humiliation and criticism
• Disrespect

Your loved one is possibly psychologically abused if they:

• Feel afraid of their caregiver
• Appear depressed and withdrawn
• Engage in self-harm
• Have low esteem
• Avoid eye contact
3. Sexual abuse

Sexual abuse occurs when a senior falls victim to unwanted sexual contact or interaction, such as:

• Rape
• Unwanted touching
• Forced nudity
• Sexual photography
• Sexual assault
• Being forced to watch pornographic materials

Signs of sexual abuse are:

• Depression and anxiety
• Changes in mood
• STDs and infections
• Bruises in sensitive parts of the body
• Difficulty walking

Typical victims of sexual abuse are vulnerable and weak residents. In community settings, women are at a higher risk of experiencing sexual abuse than men because they're less able to protect themselves.

4. Financial exploitation

Vulnerable seniors also fall prey to financial abuse. It happens when a caregiver extorts money from the residents and spends it for personal use. In most cases, lonely and helpless seniors are likely to get into this problem.

Your senior loved one is a victim of financial abuse if their caregiver:

• Steals their cash and valuables
• Uses their credit cards and checks
• Takes over their power of attorney
• Engages in fraud

Signs of financial abuse include:

• Unauthorized bank withdrawals and transfers
• Forgeries in financial and legal documents
• Missing valuables
• Changes in the power of attorney

If you find evidence that your loved one is financially abused, file a report at the local Adult Protective Services or work with law enforcement to catch the perpetrator.

5. Neglect

In a 2017 review by the WHO, 4.2% of community-residing seniors experienced neglect, which is the third most reported prevalent case following psychological and financial abuse.

Your senior relative is neglected when their caregiver fails to provide adequate care, causing minor or severe physical injuries, like bedsores and open wounds. Neglect also comprises situations where the caregiver delivers a substandard quality of care, resulting in missed medications, poor hygiene, seniors not getting meals on time, and compromised personal safety.

Warning signs of neglect are:

• Bedsores
• Malnutrition and weight loss
• Dehydration
• Poor hygiene
• Unsafe living conditions

Emotional neglect is devastating to community-residing residents as it can elevate the risk of isolation and depression and exacerbate existing health conditions.

Preventing Elder Abuse in Senior Living Communities

There’s a lower risk of elder abuse in assisted living than in nursing homes, memory care, and other settings where the care recipient has a high care need.

Nevertheless, elder abuse cases can be minimized or completely avoided if the family and community staff work together to deliver better care. For example, if the family is straightforward about their senior parent needing constant, round-the-clock care, it’s easier for the community manager to find a more suitable, resilient, and well-trained caregiver to look after them. Working together with the staff can reduce the likelihood of abuse in communities.

More importantly, if you or other family members know how to detect signs of abuse, you can take immediate action and prevent serious problems in the future.

Syed Rizvi

Syed has years of experience dealing with people, understanding their needs, and helping them find solutions to their problems.
As a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), Certified Montessori Dementia Care Professional (CMDCP), Syed is committed to working closely with Senior and their family knowing what is it like for individuals facing a challenging time, at times groping in dark trying to figure what is the appropriate next step or care level for their unique situation.
Syed and Senex Memory Advisors are fully committed to working closely with families in creating a personalized, step-by-step process memory care plan at zero cost.