Not only should professionals receive training, but also the community should be sensitized and older people should be informed about their rights, in par- ticular in relation to abuse, neglect and exploitation.
Effective solutions need to include the perpetrator of abuse.
e role of nurses needs to be re- viewed. In some countries, nurses may have more capacity than physicians to deal with elder abuse.
e following categories could be added:
Abandonment and institutionalization;
Family and gendered violence, e.g.
continuation of violence against women in later life;
iii. Decision-making by family members on behalf of the older person when this is not desired by the older person or is not necessary;
It was considered that a manual with basic information on elder abuse for profession- als dealing with the issue was necessary. Participants discussed the usefulness of the PAHO manual29 and its applicability in their respective countries. Participants agreed that the following points should be modified or added:30
Definition of elder abuse
Sexual abuse, abandonment, neglect and self-neglect should be separate catego- ries.
Financial motivation and family greed;
Using fear of abuse, neglect, isolation or abandonment to con trol the older person.
e risk indicators are portrayed as an individual rights-based approach.
is may not be suitable for societies that place more emphasis on familial rights than on individual rights, such as Singapore.
2. Basis of the diagnostic
Physical abuse should include “forced medical treatments or intervention”.
Emotional abuse could be separated from psychological abuse. Emotional abuse focuses more on the outcomes for the victim, such as anxiety, depression, sadness and loneliness; psychological abuse also includes “limiting the re- sources of a person”.
a. Under “Risk factors in the family”, it was suggested that one main set of missing factors were various types of vulnerabil- ity in the older person such as disability, illness or frailty, high care needs and dementia (or other behavioural issues that could trigger abuse). Another area
e relevant section of the manual, discussed here, can be found in Annex 3.
Numbers refer to specific sections of the PAHO manual.