Isolation as the Unifying Indicator In Older Adult Abuse[1]

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It has been noted time and time again that the single largest factor contributing to abuse of older persons is isolation.  Isolation implies a lack of physical contact with the outside world.  It also manifests itself in emotional isolation – lack of contact with supportive persons, and often constant verbal putdowns that result in low self-esteem.

"It has been noted time and time again that the single largest factor contributing to abuse of older person is Isolation." 

As a society, we have inadvertently contributed to the isolation of older adults.  Some of the factors that interfere with people gathering together easily include: closure of rural community buildings; the layout of our urban areas and reliance on the automobile, and the fact that families often live at great distant.  To off set this, programs that link older adults, such as Telecare, Wheels to Meals, Friendly Visiting, reassurance calls; various faith and seniors groups, adult day programs, all play an important role in reducing isolation and the risk of abuse for older adults.

Indicators and Contributors to Isolation

One of the most significant means of active engagement in society is the telephone, particularly for older adults who may not have the transportation or mobility needed to connect with others. Isolation can result when the older person lacks access to the telephone. 

The following are some things that may indicate that the older person is restricted in their access to the telephone:

·        The older adult never answers the phone

·        The older adult cannot access the answering machine

·        The telephone is placed out of reach of the older adult

·        The ringer is turned down or phone jack pulled out of the wall

·        Call screen is in place and family, friends, etc. are being screened out.

Other indicators that the older person’s access to others is being restricted include:

·        Appointments are frequently cancelled

·        Necessary appointments (i.e. medical, renewing medications at the pharmacy) are not made

·        Someone talks over the older adult.

·        Necessary health-care aids are denied or not in easy reach (e.g. hearing aid, glasses, false teeth, cane, walker, and wheelchair.)

Isolation can result when the older adult speaks a different language or has speech or hearing difficulties that interfere with communication

In some cultures, lack of access to the remote control to see TV programs in the language of choice are factors in isolation and abuse.

Assessing for Isolation

Some questions that might indicate whether or not isolation is contributing to abuse of an older person are:

·        Are you alone a lot?

·        Has anyone ever refused or not been there to help you take care of yourself, if you needed it?

·        Do you get to see your friends and family often?

·        Do you feel isolated?

·        Are you allowed to make decisions for yourself?

·        Are you being deprived of contact with others?

·        Does anyone accuse you of things that are not true?

·        Do you have access to a phone?

·        Do you have access to transportation?

·        Can you phone anyone you want to phone?

Source: American Medical Association. (1992); Manuel (2004); Clinical experiences at Family Service Association of Toronto.

July 7 2005

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