Elder Abuse: A Haunting Reality in Kashmir

Every year on June 15th, the world commemorates UN World Elder Abuse Awareness Day. This day serves as a painful reminder of a grim reality—elder abuse. Writing about abuse is always distressing, but it becomes even more painful when we speak of abuse directed at our elders. Elder abuse is not just a term; it is a haunting reality, particularly in Kashmir.

Having treated more than 30,000 seniors in both the government and private sectors, I have encountered a heart-wrenching truth through their medical histories: caregiving at home is a significant concern. In the context of Kashmir, caregiving is predominantly done by adult children. While many seniors appreciate the care and attention provided by their families, a staggering 50% have expressed anguish and pain, revealing that they face elder abuse in one form or another.

Understanding Elder Abuse

Elder abuse is the mistreatment or neglect of older adults (Parents), causing them harm or distress. It can take many forms, including physical, emotional, financial, and neglect. It is a serious violation of human rights and can lead to severe deterioration of health and long-term psychological consequences. In Kashmir, the issue is compounded by socio-economic challenges and cultural factors that often leave elders dependent on their families for care.

The Prevalence of Elder Abuse in Kashmir

Through my practice, I have seen firsthand how prevalent elder abuse is in our society. Despite the cultural emphasis on respect for elders, many seniors face mistreatment. This abuse can manifest as neglect, financial exploitation, or emotional and physical abuse. The emotional toll of such treatment is profound, leading to depression, anxiety, and a sense of hopelessness among the elderly.

Caregiving in Kashmir

In Kashmir, the primary caregivers are usually the adult children. While many of these caregivers provide excellent care, the pressures of modern life, economic hardships, and lack of support systems can sometimes lead to elder abuse. The stress of caregiving, combined with inadequate resources and support, often results in unintentional neglect or even deliberate mistreatment.

The most common form of abuse in Kashmir is psychological abuse, also known as emotional abuse. This form of abuse can be particularly devastating for elderly parents, as it can erode their sense of self-worth and well-being. From my experience treating elderly patients, many have disclosed that the primary perpetrators of this abuse are their married sons. When perpetrated by an adult child, the stress exacerbates all physical and mental health problems in seniors.

Here are some examples:

1. Verbal Abuse:

• Insults and Name-Calling: The adult child regularly insults their parents, calling them derogatory names, belittling their abilities, or making them feel worthless.
• Threats: They threaten their parents with harm or abandonment if they do not comply with their demands.

2. Intimidation:

• Yelling and Screaming: The adult child frequently raises their voice, yells, or screams at their parents to instill fear and assert control.
• Gestures: They use threatening gestures, such as raising a fist or making aggressive movements towards their parents.

3. Isolation:

• Preventing Social Interaction: The adult child isolates their parents from friends, family, or community activities, limiting their social interactions and support networks.
• Controlling Communication: They monitor or restrict their parents’ phone calls, letters, or visits from others.

4. Manipulation:

• Gaslighting: The adult child manipulates their parents into doubting their own memories, perceptions, or sanity, often dismissing their concerns as “imaginary” or “overblown.”
• Blame: They constantly blame their parents for their own problems, making them feel guilty or responsible for their difficulties.

5. Humiliation:

• Public Embarrassment: The adult child humiliates their parents in front of others, making demeaning comments about their age, abilities, or appearance.
• Mocking: They mock their parents’ beliefs, opinions, or the way they do things, making them feel foolish or incompetent.

6. Control:

Dictating Decisions: The adult child takes control of all decisions regarding their parents’ lives, such as finances, health care, and daily routines, without considering their wishes or needs.

Withholding Affection: They withhold affection or support as a means of punishing or controlling their parents.

7. Neglect:

• Ignoring Needs: The adult child deliberately ignores their parents’ emotional or psychological needs, refusing to provide comfort or support.
• Refusing Assistance: They refuse to help with necessary tasks or deny their parents access to medical care, leaving them to fend for themselves.

8. Deception:

• Lying: The adult child lies to their parents about important matters, creating confusion and mistrust.
• False Promises: They make promises to take care of their parents or provide certain things and then deliberately break those promises, leaving them disappointed and distressed.

Other forms of Elder Abuse

Physical Abuse

Physical abuse includes any act that causes physical pain or injury to an elderly person. This can range from slapping, hitting, and pushing to more severe forms like beating, burning, or restraining. Signs of physical abuse may include unexplained bruises, fractures, and cuts, as well as a sudden change in behavior, such as flinching or becoming withdrawn.

Financial or Material Exploitation

Financial abuse occurs when someone illegally or improperly uses an elder’s funds, property, or assets. This can involve stealing money or possessions, forging signatures, coercing the elder into signing documents, or misusing guardianship or power of attorney. Indicators of financial abuse include sudden changes in bank accounts, unexplained withdrawals, and missing belongings.

Neglect

Neglect is the failure to provide necessary care, assistance, or attention to an elderly person, leading to harm or distress. This can be intentional or unintentional and includes failing to provide food, water, clothing, shelter, hygiene, or medical care. Signs of neglect include poor personal hygiene, untreated medical conditions, malnutrition, dehydration, and unsafe living conditions.

Abandonment

Abandonment occurs when a caregiver or responsible party deserts an elderly person, leaving them without necessary care or support. This can happen in public places or in the elder’s own home. Signs of abandonment include the elder being left alone in unsafe conditions, lack of basic necessities, and reports from the elder about being deserted.

Self-Neglect

While not always classified as abuse by others, self-neglect is a significant issue where an elderly person fails to attend to their own basic needs. This can include neglecting personal hygiene, health care, or living conditions.

Symptoms of Emotional Abuse

1. Behavioral Changes:

• Withdrawal: The elderly person becomes socially withdrawn, avoiding interactions with family, friends, or community members.
• Fearfulness: They exhibit signs of fear or anxiety, especially around certain individuals or in specific situations.
• Depression: The elder shows signs of depression, such as persistent sadness, hopelessness, and loss of interest in activities they once enjoyed.
• Mood Swings: Sudden and unexplained changes in mood, including anger, agitation, or tearfulness.

2.Verbal Indicators:

• Self-Blame: The elder may frequently apologize, make self-deprecating comments, or express feelings of worthlessness.
• Hesitation to Speak: They may seem hesitant or afraid to speak openly, particularly in the presence of the abuser.

3. Physical Signs:

• Sleep Disturbances: Changes in sleeping patterns, including insomnia or excessive sleeping, often due to anxiety or depression.
• Appetite Changes: Noticeable changes in eating habits, leading to weight loss or gain.

4. Psychosomatic Symptoms:

• Unexplained Aches and Pains: The elder may complain of physical ailments that have no apparent medical cause, often linked to stress and anxiety.

Symptoms of Neglect

1. Physical Appearance:

• Poor Hygiene: The elder appears unkempt, with unwashed clothes, body odor, and unclean hair or nails.
• Inadequate Clothing: Wearing clothing inappropriate for the weather, indicating neglect in providing suitable attire.

2. Health Indicators:

• Untreated Medical Conditions: The presence of untreated or poorly managed health issues, such as infections, bedsores, or chronic illnesses.
• Malnutrition and Dehydration: Signs of malnutrition, such as weight loss, dry skin, and sunken eyes, along with indications of dehydration.

3. Living Conditions:

• Unsafe Environment: The elder lives in unsanitary or hazardous conditions, with clutter, pests, or lack of basic amenities like heating or cooling.
• Lack of Accessibility: The home lacks necessary modifications or aids for mobility, making it difficult for the elder to move around safely.

4. Emotional State:

• Apathy: The elder shows a lack of interest in their surroundings, appearing disinterested or detached.
• Despair: Expressing feelings of helplessness or despair, often verbalizing a sense of abandonment or isolation.

Voices of the Seniors

During consultations, many seniors have shared their distressing stories. One senior recalled how his son neglected his health needs. The house belongs to the senior, and his married son lives with him, leading to confusion about who is actually dependent on whom. Another senior spoke of financial exploitation, where family members took their pension, leaving them with nothing for their own needs. An elderly widow lived with her daughter and relied on zakat despite having two sons. Another elderly couple was abandoned in 2016 and has had no contact with their children since then. These stories are not isolated incidents but reflect a broader issue that needs urgent attention.

The Way Forward

Addressing elder abuse requires a multifaceted approach. Awareness and education are crucial. Families must be educated about the signs of elder abuse and the importance of treating seniors with dignity and respect. Support systems for caregivers are also essential. This could include providing holistic health support, respite care, financial support, and counseling services to help alleviate the pressures that can lead to abuse.