memory loss
14Jun, 2021

Elder abuse – recognise confusing signs and symptoms

By: | Tags: | Comments: 0 | June 14th, 2021

Elder Abuse is everyone’s business. If you suspect that an elderly person may be the victim of physical, mental or financial abuse, please contact Tafta without delay.

At Tafta, we hear about cases through face-to-face contact, telephone calls and emails, often anonymous, where abuse is either suspected, alleged or witnessed. All suspected and reported cases are investigated immediately, and prompt action taken to protect vulnerable elders or remove them from abusive situations.

Signs and symptoms of elder abuse can be confused with the natural ageing process

Unfortunately, elder abuse is not always easy to identify. Old people bruise easily and may be covered in cuts and bruises if they are unsteady on their feet and bump into furniture, doors and walls. Those affected by memory loss or the onset of Alzheimer’s may be confused about what happened to them. In cases like this, it’s all too easy for abusers to deny wrongdoing … and to be believed.

Even worse, they may convince the victim that he or she is mistaken, adding to their feelings of doubt and helplessness. Elders may also be afraid to speak up if they are being abused by care givers or family members, because they’re worried about retaliation or making the situation worse.

To mark World Elder Abuse Awareness Day, Melaine Pillay, Social Work Supervisor at Tafta, shares a recent case history, which illustrates the challenges.

Financial abuse

Mrs. John is a 77 year old widow. She was living with her three adult children and totally dependent on them. Her only source of income is R1860 which she receives from her old age pension.

On Tuesdays and Thursdays, Mrs John used to visit her neighbour, Sally. They would share an afternoon cup of tea and watch their favourite soap opera together. During her last visit, Mrs. John mentioned that she had lost her SASSA card and could not remember where she had left it. The two laughed at Mrs. John’s ageing and possible memory loss. Sally volunteered to talk to Mrs. John’s daughter about the missing card.

She phoned the following day to ask the daughter to please help her mum find the card, as Mrs John seemed very worried that her memory was failing. The daughter’s response both surprised and concerned Sally. She became angry and snapped, “My mum’s financial affairs are none of your concern!” After that, Mrs. John’s visits to Sally stopped abruptly.

Causing trouble in the family

Sally didn’t want to cause any further trouble within the family, but she felt that someone should help Mrs John. She called Tafta Head Office to share her concerns, but wanted to remain anonymous. We immediately arranged for our area Social Worker to visit the home to assess the circumstances. She gave Mrs John a Mini Mental State Examination (MMSE) which indicated that Mrs John has a mild degree of impairment, resulting in some memory loss.

The old lady confirmed that her SASSA card had been missing for almost 4 months and she had asked her children to help her find it, without success. Mrs. John could not provide an accurate recollection of events and felt as though she was losing her mind. Our Social Worker was able to confirm that, owing to the onset of the mild cognitive impairment, Mrs. John’s children had taken her SASSA card and were using her pension for their own needs.

Physical health at risk

Her health had also deteriorated because she was not receiving adequate meals on time. Nor was she taking her chronic medication or visiting the hospital for her regular check-ups – a cycle often associated with older people who lose their autonomy owing to the onset of mild cognitive impairment.

Mrs John seemed to be afraid to speak openly as she did not want to upset her children. Her general demeanour was one of sadness and despair. Apart from feeling confused, she felt that she could not depend on her children and was now questioning her safe space.

Mrs. John’s children refused to meet with us and denied any knowledge of where her card was, but SASSA confirmed that the money was being withdrawn from the card immediately after each payment. Our social worker accompanied Mrs John to SASSA where the card was stopped and she was able to arrange for her pension to be paid directly into her bank account.

Thereafter,we arranged a formal assessment at Addington Hospital to ascertain the level of cognitive impairment and to ensure that Mrs. John receives the necessary medication and treatment to delay the progression of her condition.

Charges dropped

Mrs. John refused to press criminal charges, saying: “They are my children, I cannot punish them.” But she did agree that in order to feel safe and secure, she would like to live within the protected environment of a Tafta facility.

She now receives her meals and medication on time, is escorted to hospital for check-ups and participates in the programmes held at the wellness centre. She also participates in activities recommended by the attending Psychiatrist, aimed at stimulating her brain to continue functioning for as long as possible.

She has made many friends at Tafta and now has a bright smile whenever the Social Worker visits her to monitor her progress. She continues to enjoy her soap opera with new friends. Her old neighbour Sally often visits too.

Because Mrs. John misses her children, the Social Worker has reached out to them to visit her when they can. We will continue to reunify the relationship with them and provide the much-needed aftercare and reconstruction services the family require. It is also important for Mrs. John’s children to be educated on dementia and how this has adversely affected their mother, and how the disease will progress as she ages.

Act on suspicions

We are so grateful for caring neighbours like Sally, who act on their suspicions. Even if these turn out to be unfounded, it’s much better to be safe.

All suspected and reported cases are investigated immediately by our Social Workers in line with the Protocol on Management of Elder Abuse issued by the Department of Social Development.

The first step is for the Social Worker to visit the (alleged) victim in his or her
home to assesses the circumstances and living conditions. Based on this assessment, the following actions may be taken:

  1. Medical assessment of the elder by a medical practitioner.
  2. The victim, accompanied by the Social Worker, is encouraged to report the incident to the South African Police Services for criminal investigation.
  3. If the perpetrator lives with the victim, arrangements are made to either remove the perpetrator with the assistance of SAPS, or alternate accommodation is secured for the older person.
  4. The older person is assessed through the DQ98 (a Dependency Questionnaire) which indicates if the older person can live independently, requires Assisted living, or requires Frail care.
  5. Based on the score of the DQ98, options regarding suitable facilities are explored with the older person.
  6. The older person is placed in the relevant facility.
  7. The Social Worker monitors the older person either in their home in the community or at the placement facility to ensure that he/she receives effective services to reduce the effects of the trauma and prevent any additional trauma.
Awareness programmes

As a preventative measure, Tafta also regularly runs awareness programmes on elder abuse in all communities, creating awareness and educating people about the referral structures and services available to both victims and perpetrators.

The Older Persons Act (Act 13 of 2006) stipulates in Section 26, that any person who suspects that an older person is abused must immediately notify the Director-General or a police official of his/her suspicion. Failure to do so is a criminal offence.

All suspected cases are lodged with the Department of Social Development, and forwarded to the Director-General, accompanied by a comprehensive Social Work report. Within 6 weeks, a supplementary Social Work report is submitted on developments that occurred since the initial investigation, the outcome of the investigation, and the interventions needed to protect the older person. Records are kept of all reported cases – to ensure continuity of services and the continued protection of the older person. These records also serve as a research tool to monitor trends that occur incidentally and geographically, and guide both future awareness campaigns and our intervention alternatives for any future cases.