This form of abuse manifests itself in the following ways:
- Disrespectful behavior
Behaviors that are unquestionably humiliating in nature are meant to disregard, insult, disrespect, and devalue, demean, defame an elderly person. This can be verbal insults, infantilizing comments, name-calling like publicly calling the older person foolish, stupid, mad, useless, etc.
Repeated behavior that is intentional and is perceived by the older person as coercive, manipulative, and hostile in nature. For example, forcing the older adult to perform actions against their will, to track, follow, and keep a watch, and to make sure that the victim has knowledge of it. Repeatedly making communications like sending letters and emails, making phone calls, which are clearly undesirable to the older person.
Non-verbal or verbal suggestions of intended physical, psychological and sexual mistreatment or harm. Manipulating situations and changing the response of the older person by communicating wish to take harmful actions against the older person if he/she fails to comply.
Threatening to neglect and deny basic amenities, to abandon and never return, destroying prized possessions, to terminate provisions of care and institutionalization, to harm pets, friends, and other family members, with or without any weapon.
Verbal or non-verbal behavior leading to the territorial or interpersonal isolation of the older person. For example, keeping the elderly person in house confinement; restricting communication with the outer world; stonewalling; silent treatment; relocating the person and seclusion from friends, family members, partners, spouses, and other social contacts; withholding assistive devices like hearing aide, walker, wheel-chair, spectacles, etc.
All these actions are meant to isolate and limit the elderly person’s interaction with the outer world.
3. Physical abuse
Physical abuse involves the intentional use of physical force that leads to chronic illness, physical pain, bodily injury, internal hemorrhage, functional impairment, distress, or death. It partially includes (alongside other forms) scratching, poking, beating, pulling, punching, kicking, hitting, biting, slapping, shaking, stomping, shoving, choking, pinching, and burning.
Other forms of physical abuse include inappropriate use of medicines, physical restraint, pinning in place, arm twisting, hair pulling, force-feeding, strangulating, etc.
Different manifestations of physical abuse:
- Inappropriate use of medications
This might lead to extreme distress, physical pain, bodily injury, functional impairment, or death. It involves the misuse of medication to take control over the elderly person at various degrees. Examples include but are not limited to over-administering prescribed drugs, especially over-sedation; administering non-prescribed or wrong drugs; under-medicating; medicating for purposes not intended to, etc.
- Use of physical restraints
Physical restraints refer to the inappropriate use of any device, material, or equipment that is attached to the elder’s body or is kept near the elder’s body to limit free bodily movement and wilful access to his/her body. Such restraints might be used as a punishment when the elderly person fails to comply with the perpetrator. It does not include medically authorized restraints of elderly people to manage violent behavior associated with chronic or acute psychiatric conditions.
- Physical punishment
Actions on the part of the perpetrator which inflicts direct or indirect physical pain and harm, which can lead to acute or chronic physical distress. Punishment is used for one of the following reasons:
1. To prevent behavior undesirable to the perpetrator.
2. To stop repetitive unwanted behavior.
3. On failing to perform a desired, required, or requested activity.
4. Sexual abuse
Sexual abuse encompasses any sexual interaction, either physical or verbal, touching or non-touching with an elderly person.
This includes but is not limited to:
- Forced or unwanted completed or attempted contact between the penis and the vulva or the penis and the anus, involving penetration, however slight.
- Forced or unwanted contact between the mouth and the pens, vulva or anus.
- Forced or unwanted penetration of anal or genital opening of the victim with any body parts of the perpetrator like finger, hand or other objects.
- Forced or unwanted yet intentional touching of the elder person’s body parts directly or through the clothing like genitalia, groin, breast, inner thighs, buttocks, anus etc.
- Forced or undesirable non-contact sexual acts like forcing the victim to watch pornographic materials through pictures or videos, recording sexual content by using the elder person for sexual gratifications.
- Voyeurism, by secretly watching an elderly person undressing or engaging in sexual activities to derive sexual pleasure.
- Sexual harassment through suggestions, advances, requests and threats. These can be both contact and non-contact acts.