June 15th was World Elder Awareness Day; a topic that doesn’t get nearly enough attention considering how wide spread of a problem it is. In a previous post we spoke about the prevalence of elder abuse and what some of the warning signs are1. Please take the time to read the post if you haven’t already, it contains a number of links with more information that everyone should know. But rather than rehashing what has already been said, in this blog we will be talking about what is at the heart of so much of that abuse: the removal of dignity.
When someone says abuse, our brains automatically go to a few places. Physical abuse is punching and kicking, sexual abuse is assault and forceful, emotional and verbal assault is name calling and slurs. But these are manifestations of abuse rather than the root of it. At its core, abuse is about removing a person’s dignity and treating them as less than a person. We all talk about the rights we all have; the right to education, the right to a fair trial, the right to bear arms if you live in the only truly free country according to them. These rights are an expression of how a society is supposed to treat each individual person. They change depending on where in the world you are because unfortunately, who is afforded the privilege of being considered a person is geographically relative. All this is to say that what we are trying to do by affording rights is to maintain the dignity of a person; by virtue of existing, a person deserves to be treated as a person. The philosopher Immanuel Kant went so far as to say that we should “Act in such a way that you treat humanity, whether in your own person or in the person of any other, never merely as a means to an end, but always at the same time as an end.”
When dealing with the elderly and/or dementia patients, it is unfortunately very common for those that work with them to begin to forget that they are dealing with people. They become a job, a chore, in extreme cases, a tool. Dealing with them becomes a task to fulfil in order to get paid; in other words, they become a means to an end. When this happens, the care provided to the patient naturally begins to wane and this is when abuse can begin to occur. To circle back to what was said at the beginning of the post, abuse isn’t just the extremes we think about and it always begins with removing a person’s dignity. When we forget that the patient standing in front of us is a person with a life, hopes, dreams and experiences, we begin to treat them as less than ourselves.
Physical abuse can be simply leaving a patient alone for hours in a bed without checking on them. Sexual abuse can be refusing to give the patient privacy to change or cover their bodies. Verbal abuse can be snapping at them as though they are a miss-behaving child instead of an adult who has lost control of some of their faculties. If any of these signs are present in a care-worker or guardian, consider intervening or having a serious heart to heart about what is appropriate care.
Working with elderly and cognitively impaired patients is no small task and it takes a very special sort of person to do the work. Everyone has a fuse that may end at some point, particularly when dealing with “difficult” patients. But no matter how much someone may decline or how much they differ from what is considered “the norm”, a person remains a person and as such they should be afforded dignity as far as is possible.
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