What is Child Abuse and How Does it Affect Us Long Term?

Child Abuse occurs all the time, but it is hidden behind closed doors and not spoken about unless a young child dies. It is the most hidden of mental illness. Half the criminal population in jails today or alcoholics and drug addicts on the streets today are products of child abuse. Some forms of child abuse are physical, emotional, verbal, sexual, and, as Mackenzie Phillips has written about in her book, Incest.

As a child growing up with a disability, everyday of my childhood I was hit for some reason by my father. At 12 years of age I remember being sent to school crying and upset–just because I had to be there when the doors opened. A friend asked me who hit me–she wanted to beat them up for hurting me. My answer was — my father. Back then it was looked at as a harsh form of discipline, today when this occurs a social worker is sent to the home to find out what is going on and DFAC’s gets involved with the family. Because there are not enough case workers often children fall through the cracks and eventually end up seriously injured or dead. If they survive they become abusers themselves or they turn to drug and alcohol to cope.

I was a child growing up in the ’50’s and ’60’s. The ’50’s was a very conservative era so children with disabilities were hidden away and child abuse was never talked about. Then in the ’60’s you had the Vietnam war. Many of the boys who fought in this war came back drug addicts. They were also the original dealers of drugs. This was when the young started becoming more liberal in their thinking and more active in politics. It was the Kennedy era. Clinton, Bush, and Obama are products of this era. Taking drugs was accepted so no one thought anything of it. It was commonly used by entertainers and hippies of this era. Many of them were runaways from home because of abuse and turned to drugs while on the streets.

Only after the Manson followers killings did law enforcement get involved and the attitudes about drug abuse started to change. In the Mental Health field training for counseling and therapy in hospitals is for drug and alcohol abuse. Today, we know more about why people turn to drugs and alcohol so we talk more about child abuse. But Incest is still the taboo subject. I have a friend that’s a social worker in the school system. Even she says many of the problem students in the schools today are Incest victims.

Only when victims of child abuse open up and talk about their experience can they get beyond the psychological damage and form good relationships both personally and professionally. I talk about communication and its importance in your profession. I often say these skills are learned in the home around the dinner table. When there is emotional and verbal abuse a child who is normally introverted will build fears around speaking out and opening up–eventually to turn to drugs and alcohol because that helps take away inhibitions. Eventually this becomes a crutch that they depend on to open up and express their feeling. That is why in therapy there are many layers to get through before you get to the real truth of their problems.

Depending on your natural behavior patterns you deal with child abuse differently. There have been movies made about multiple personalities–which is often a result of early childhood traumas such as sexual abuse or Incest. Until society understands there is an epidemic around child abuse and the Mental Health field publishes more articles around this subject it will continue to be a taboo subject and we will never be able to control the homelessness of mental health patients who forget to get treatment or take their medication.

People with disabilities will continue to be abused by the system until they begin to demand their rights in employment. In a way, victims of child abuse who seek help for drug and alcohol abuse, can be considered disabled and seek assistance for employment easier than people who were born with disabilities.

For years many of these topics were hidden away and not spoken about. Recently you’ve seen celebrities publish books and openly admit to incest and sexual abuse in the news. What has happened as a result are that many people went through these experiences themselves are now talking about this issue and this has brought this to the forefront. When you face up to and deal with issues that you have hidden away behind closed doors that you can get to the real problems face them and get beyond them to live a full product life knowing you will no longer have to turn to the drugs and alcohol and can have a full productive life in both your personal and professional lives knowing you will not have to worry about falling off the wagon or returning to the addictive behaviors of drug and alcohol abuse.

Our brain controls our thinking but happiness comes from within us. If we learn to dislike ourselves then we sabotage our success; if we love and respect ourselves then we believe we can succeed then we will try every avenue possible to succeed without giving up until we reach our goals. You have to decide for yourself whether you will seek the help to overcome your demons or whether you will give up and stay where you are.

For me, Success is My Only Option! For you, What are your Option?

Intervening When Elder Abuse Is Suspected

There are many complex factors related to elder abuse. Combinations of psychological, social and financiall factors contribute to the problem. Mental and physical conditions of both the victim and their abuser are also strongly related to abuse of the elderly. The following factors are the causes that researchers list as important:

  • Caregiver stress: Many times the caregivers are not prepared for the responsibility of caring for the mentally or physically impaired older person. Increased stress leads to abuse and/or neglect.
  • Impairment of dependent elders: Researchers document that elders in poor health are more likely to be abused than those in primarily good health. In addition, caregivers who rely on the elder’s financial income are more likely to initiate abuse.
  • External stress: External stress such as financial problems, job pressures, and family situations increase the risk for abuse among the elderly.
  • Social isolation: Families that experience social isolation can be an indicator for potential abuse or a factor that causes the abuse among the elderly population.
  • Intergenerational transmission of violence: Violence is learned behavior in childhood as a response to anger and/or conflict. In many cases the abuse is a continuation of the abuse that has been occurring within the family.
  • Personal problems of the abuser: Caregivers who suffer from such problems as alcoholism, drug addiction and/or emotional disorders are more likely to become abusers themselves.
  • Cultural issues: Certain cultural factors, such as language barriers, make certain situations difficult to assess for abusive behavior. It is important not to overlook abuse due to cultural differences.

When abuse or neglect is suspected, action must be taken. It is important to follow state,and local requirements when dealing with elder abuse and neglect in your specific area. The following guidelines are general considerations to be taken:

  • Intervene immediately when you witness or suspect abuse and neglect. The primary concern should be in protecting the victim.
  • Witnessed abuse must be documented and investigated accurately. The sooner it is documented, the more accurate the information will be.
  • The incident must be reported to the appropriate state and local authorities.
  • Assessment of the elderly victim must be conducted in a way that is not threatening or judgmental.
  • It should be documented in detail, using quotations whenever possible.
  • A health assessment should be completed in accordance with policy and according to state specific laws governing cases of elder abuse and neglect.

Remember that abuse can take many forms and have many causes. The more alert you are to signs of abuse, the more readily you will be able to take the appropriate action.

The Cost of Child Abuse

The U.S. Department of Health and Human services estimated 906,000 children were victims of child abuse or neglect in 2003. While physical injuries may or may not be immediately visible, abuse and neglect can have consequences for children, families, and society that last lifetimes, if not generations.

The after affects of child abuse and neglect is discussed in terms of physical, psychological, behavioral, mental, behavioral, spiritual and societal consequences. In reality, however, it is impossible to separate them completely. Physical consequences (such as damage to a child’s growing brain) can have psychological implications (cognitive delays or emotional difficulties). Psychological problems often manifest as high-risk behaviors. Depression and anxiety compel a person more likely to smoke, abuse alcohol, use illegal or prescription drugs and/or eating disorders. High-risk behaviors, can lead to long-term physical health problems such as sexually transmitted diseases, cancer-vaginal, ovarian or breast in women; prostate, testicular in men, MS, chronic fatigue, lupus, etc.

Physical or sexual abuse can weaken survivors’ immune systems according to Dr. Frank Putnam of the National Institute of Mental Health and Dr. Martin Teicher of Harvard Medical School. Putnam conducted studies on 170 girls, age 6-15-half had been abused, half had not-for seven years. The abused girls displayed symptoms such as:

o Abnormal high stress hormones, which can kill neurons in brain areas crucial for thinking and memory

o High levels of an antibody that weaken the immune system.
Teicher completed a series of brain studies on 402 children and adults, many of whom had been sexually or physically abuse. His findings revealed that sexual or physical abuse creates:

o Arrested growth of the left hemisphere of the brain which can hamper development of language and logic

o Growth of the right hemisphere of the brain (the site for emotion) at an abnormally early age

Physical Health after effects:

The immediate physical effects of abuse or neglect can be relatively minor (bruises or cuts) or severe (broken bones, hemorrhage, or even death). In some cases the physical effects are temporary; however, the pain and suffering they cause a child needs to be addressed. Meanwhile, the long-term impact of child abuse and neglect on physical health is just beginning to be explored.

Below are some outcomes researchers have identified:

o Shaken baby syndrome. The immediate effects of shaking a baby (child abuse in infants) can include vomiting, concussion, respiratory distress, seizures, and death. Long-term consequences can include blindness, learning disabilities, mental retardation, cerebral palsy, or paralysis (Conway, 1998).

o Impaired brain development. Child abuse and neglect have been shown, in some cases, to cause important regions of the brain to fail to form properly, resulting in impaired physical, mental, and emotional development (Perry, 2002; Shore, 1997). In other cases, the stress of chronic abuse causes a “hyperarousal” response by certain areas of the brain, which may result in hyperactivity, sleep disturbances, and anxiety, as well as increased vulnerability to post-traumatic stress disorder, attention deficit/hyperactivity disorder, conduct disorder, and learning and memory difficulties (Perry, 2001; Dallam, 2001).

o Poor physical health. A study of 700 children who had been in foster care for 1 year found more than one-quarter of the children had some kind of recurring physical or mental health problem (National Survey of Child and Adolescent Well-Being). A study of 9,500 HMO participants showed a relationship between various forms of household dysfunction (including childhood abuse) and long-term health problems such as sexually transmitted diseases, heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease (Hillis, Anda, Felitti, Nordenberg, & Marchbanks, 2000; Felitti, Anda, Nordenberg, Williamson, Spitz, Edwards, Koss, & Marks, 1998).

Psychological after effects:

The immediate emotional effects of abuse and neglect-isolation, fear, and an inability to trust-can translate into lifelong consequences including low self-esteem, depression, and relationship difficulties. Researchers have identified links between child abuse and neglect and the following:

o Poor mental and emotional health. In one long-term study, 80 percent of young adults who had been abused met the diagnostic criteria for at least one psychiatric disorder at age 21. These young adults exhibited many problems, including depression, anxiety, eating disorders, and suicide attempts (Silverman, Reinherz, & Giaconia, 1996). Other psychological and emotional conditions associated with abuse and neglect include: panic disorder, dissociative disorders, attention-deficit/hyperactivity disorder, post-traumatic stress disorder, and reactive attachment disorder (Teicher, 2000).

o Cognitive difficulties. The National Survey of Child and Adolescent Well-Being recently found children placed in out-of-home care due to abuse or neglect tended to score lower than the general population on measures of cognitive capacity, language development, and academic achievement (2003).

o Social difficulties. Children who are abused and neglected by caretakers often do not form secure attachments to them. These early attachment difficulties can lead to later difficulties in relationships with other adults as well as with peers (Morrison, Frank, Holland, & Kates, 1999).

Behavioral after effects:

Not all victims of child abuse and neglect will experience behavioral consequences; however, child abuse and neglect appear to make the following more likely:

o Difficulties during adolescence. Studies have found abused and neglected children to be at least 25 percent more likely to experience problems such as delinquency, teen pregnancy, low academic achievement, drug use, and mental health problems (Kelley et al., 1997).

o Juvenile delinquency and adult criminality. A National Institute of Justice study indicated being abused or neglected as a child increased the likelihood of arrest as a juvenile by 59 percent. Abuse and neglect increased the likelihood of adult criminal behavior by 28 percent and violent crime by 30 percent (Widom & Maxfield, 2001).

o Alcohol and other drug abuse. Research consistently reflects an increased likelihood that abused and neglected children will smoke cigarettes, abuse alcohol, or take illicit drugs. According to the National Institute on Drug Abuse, as many as two-thirds of people in drug treatment programs reported being abused as children (2000).

o Abusive behavior. Abusive parents often have experienced abuse during their own childhoods. It is estimated approximately one-third of abused and neglected children will eventually victimize their own children (Prevent Child Abuse New York, 2001).

Societal after effects:

While child abuse and neglect usually occurs within the family, the impact does not end there. Society as a whole pays a price for child abuse and neglect, in terms of both direct and indirect costs.

o Direct costs. Direct costs include those associated with maintaining a child welfare system to investigate allegations of child abuse and neglect, as well as expenditures by the judicial, law enforcement, health, and mental health systems to respond to and treat abused children and their families. A 2001 Prevent Child Abuse America report estimates these costs are $24 billion annually.

o Indirect costs. Indirect costs represent the long-term economic consequences of child abuse and neglect. These include juvenile and adult criminal activity, mental and emotional dysfunction, substance abuse, and domestic violence; loss of productivity due to unemployment and underemployment; the cost of special education services, and increased use of the health care system. Prevent Child Abuse America recently estimated these costs are more than $69 billion per year (2001).

Summary

Of the research that has been done about the after effects of child abuse and neglect, the effects vary depending on the circumstances of the abuse or neglect, personal characteristics of the child, and the child’s environment. Consequences whether mild or severe lasts a lifetime, unless there is emotional and spiritual healing. Ultimately, due to related costs to public entities such as the health care, human services, and educational systems, abuse and neglect impact not just the child and family, but society as a whole. Total estimated Direct and Indirect cost to society for child abuse–verbal, physical/ sexual and neglect is $103 billion annually.

How To Prevent Elder Abuse

As our population ages and more stress is placed on families to care or both parents and children at the same time, there is a potential for Elder Abuse by caregivers whether family members or service providers. To understand how Elder Abuse happens we must first define what Elder Abuse is, what are the indicators, who are the perpetrators, what the signs of elder abuse and who is at risk of being a victim.

Elder abuse is defined as any form of mistreatment that results in harm or loss to an older person. It is generally divided into the following categories:

Physical Abuse

Physical abuse is physical force or violence that results in bodily injury, pain, or impairment. It includes assault, battery, and inappropriate restraint.

Who are the perpetrators?

Perpetrators may be acquaintances, sons, daughters, grandchildren, or others. Perpetrators are likely to be unmarried, to live with their victims, and to be unemployed. Some perpetrators have alcohol or substance abuse problems. Some are caregivers for those they abuse.

Who is at risk?

As a group, victims of physical abuse do not differ significantly from seniors who are not abused.

What are the indicators?

Indicators are signs or clues that abuse has occurred. Physical indicators may include injuries or bruises, while behavioral indicators are ways victims and abusers act or interact with each other. Many of the indicators listed below can be explained by other causes (e.g. a bruise may be the result of an accidental fall) and no single indicator can be taken as conclusive proof. Rather, one should look for patterns or clusters of indicators that suggest a problem.

Physical indicators

* Sprains, dislocations, fractures, or broken bones

* Burns from cigarettes, appliances, or hot water

* Abrasions on arms, legs, or torso that resemble rope or strap marks

* Internal injuries evidenced by pain, difficulty with normal functioning of organs, and bleeding from body orifices

* Bruises. The following types of bruises are rarely accidental:

o Bilateral bruising to the arms (may indicate that the person has been shaken, grabbed, or restrained)

o Bilateral bruising of the inner thighs (may indicate sexual abuse)

o “Wrap around” bruises that encircle an older person’s arms, legs, or torso (may indicate that the person has been physically restrained)

o Multicolored bruises (indicating that they were sustained over time)

o Injuries healing through “secondary intention” (indicating that they did not receive appropriate care)

o Signs of traumatic hair and tooth loss

Behavioral indicators

* Injuries are unexplained or explanations are implausible (they do not “fit” with the injuries observed)

* Family members provide different explanations of how injuries were sustained

* A history of similar injuries, and/or numerous or suspicious hospitalizations

* Victims are brought to different medical facilities for treatment to prevent medical practitioners from observing a pattern of abuse

* Delay between onset of injury and seeking medical care

Sexual Abuse

Sexual abuse is any form of non-consensual physical contact. It includes rape, molestation, or any sexual conduct with a person who lacks the mental capacity to exercise consent.

Who are the perpetrators?

Perpetrators of sexual abuse include attendants, employees of care facilities, family members (including spouses), and others. Facility residents sometimes assault fellow residents.

Who is at risk?

* The majority of identified victims are women, however older men have been sexually abused in both domestic and institutional settings.

* Persons with physical or cognitive disabilities

* Persons who lack social support and are isolated

What are the indicators?

Indicators are signs or clues that abuse has occurred. Physical indicators may include injuries or bruises, while behavioral indicators are ways victims and abusers act or interact with each other. Some of the indicators listed below can be explained by other causes (e.g. inappropriate or unusual behavior may signal dementia or drug interactions) and no single indicator can be taken as conclusive proof. Rather, one should look for patterns or clusters of indicators that suggest a problem.

Physical indicators

* Genital or anal pain, irritation, or bleeding

* Bruises on external genitalia or inner thighs

* Difficulty walking or sitting

* Torn, stained, or bloody underclothing

* Sexually transmitted diseases

Behavioral indicators

* Inappropriate sex-role relationship between victim and suspect

* Inappropriate, unusual, or aggressive sexual behavior

Domestic violence

Domestic violence is an escalating pattern of violence or intimidation by an intimate partner, which is used to gain power and control. Several categories of domestic violence against the elderly have been identified:

“Domestic violence grown old” is when domestic violence started earlier in life and persists into old age

“Late onset domestic violence” begins in old age. There may have been a strained relationship or emotional abuse earlier that got worse as the partners aged. When abuse begins or is exacerbated in old age, it is likely to be linked to:

* Retirement

* Disability

* Changing roles of family members

* Sexual changes

Some older people enter into abusive relationships late in life

Who are the perpetrators?

* Perpetrators are spouses or intimate partners

* The majority are men

* Some perpetrators abuse drugs or alcohol.

Who is at risk?

* Older women whose relationships with their spouses or intimate partners were abusive or strained when they were younger.

* Older women who enter into intimate relationships late in life

What are the indicators?

Indicators of domestic violence are similar to those associated with physical abuse and/or sexual abuse (see physical abuse and sexual abuse). The following additional patterns are also characteristic:

* The frequency and severity of injuries are likely to increase over time

* Victims often experience intense confusion and disassociation

* Violent incidents are often preceded by periods of intensifying tension and followed by periods of apparent contrition on the part of perpetrators

Psychological abuse

Psychological abuse is the willful infliction of mental or emotional anguish by threat, humiliation, or other verbal or nonverbal conduct.

Cultural values and expectations play a significant role in how psychological abuse is manifested and how it affects its victims.

Who are the perpetrators?

Perpetrators may be family members, caregivers, or acquaintances.

Who is at risk?

Persons who are isolated and lack social or emotional support are particularly vulnerable.

What are the indicators?

Indicators are signs or clues that abuse has occurred. Physical indicators may include somatic changes or decline, while behavioral indicators are ways victims and abusers act or interact. Some of the indicators listed below can be explained by other causes and no single indicator can be taken as conclusive proof. Rather, one should look for patterns or clusters of indicators that suggest a problem.

Physical indicators

* Significant weight loss or gain that is not attributed to other causes

* Stress-related conditions, including elevated blood pressure

Behavioral indicators

The perpetrator:

* Isolates the elder emotionally by not speaking to, touching, or comforting him or her

The elder:

* Has problems sleeping

* Exhibits depression and confusion

* Cowers in the presence of abuser

* Is emotionally upset, agitated, withdrawn, and non responsive

* Exhibits unusual behavior usually attributed to dementia (e.g., sucking, biting, rocking)

Financial Abuse

Elder financial abuse spans a broad spectrum of conduct, including:

* Taking money or property

* Forging an older person’s signature

* Getting an older person to sign a deed, will, or power of attorney through deception, coercion, or undue influence

* Using the older person’s property or possessions without permission

* Promising lifelong care in exchange for money or property and not following through on the promise

* Confidence crimes (“cons”) are the use of deception to gain victims’ confidence

* Scams are fraudulent or deceptive acts

* Fraud is the use of deception, trickery, false pretense, or dishonest acts or statements for financial gain

* Telemarketing scams. Perpetrators call victims and use deception, scare tactics, or exaggerated claims to get them to send money. They may also make charges against victims’ credit cards without authorization

Who are the perpetrators?

1. Family members, including sons, daughters, grandchildren, or spouses. They may:

* Have substance abuse, gambling, or financial problems

* Stand to inherit and feel justified in taking what they believe is “almost” or “rightfully” theirs

* Fear that their older family member will get sick and use up their savings, depriving the abuser of an inheritance

* Have had a negative relationship with the older person and feel a sense of “entitlement”

* Have negative feelings toward siblings or other family members whom they want to prevent from acquiring or inheriting the older person’s assets

2. Predatory individuals who seek out vulnerable seniors with the intent of exploiting them. They may:

* Profess to love the older person (“sweetheart scams”)

* Seek employment as personal care attendants, counselors, etc. to gain access

* Identify vulnerable persons by driving through neighborhoods (to find persons who are alone and isolated) or contact recently widowed persons they find through newspaper death announcements

* Move from community to community to avoid being apprehended (transient criminals)

3. Unscrupulous professionals or business persons, or persons posing as such. They may:

* Overcharge for services or products

* Use deceptive or unfair business practices

* Use their positions of trust or respect to gain compliance

Who is at risk?

The following conditions or factors increase an older person’s risk of being victimized:

* Isolation

* Loneliness

* Recent losses

* Physical or mental disabilities

* Lack of familiarity with financial matters

* Have family members who are unemployed and/or have substance abusers problems

Why are the elderly attractive targets?

* Persons over the age of 50 control over 70% of the nation’s wealth

* Many seniors do not realize the value of their assets (particularly homes that have appreciated markedly)

* The elderly are likely to have disabilities that make them dependent on others for help. These “helpers” may have access to homes and assets, and may exercise significant influence over the older person

* They may have predictable patterns (e.g. because older people are likely to receive monthly checks, abusers can predict when an older people will have money on hand or need to go to the bank)

* Severely impaired individuals are also less likely to take action against their abusers as a result of illness or embarrassment

* Abusers may assume that frail victims will not survive long enough to follow through on legal interventions, or that they will not make convincing witnesses

* Some older people are unsophisticated about financial matters

* Advances in technology have made managing finances more complicated

What are the indicators?

Indicators are signs or clues that abuse has occurred. Some of the indicators listed below can be explained by other causes or factors and no single indicator can be taken as conclusive proof. Rather, one should look for patterns or clusters of indicators that suggest a problem.

* Unpaid bills, eviction notices, or notices to discontinue utilities

* Withdrawals from bank accounts or transfers between accounts that the older person cannot explain

* Bank statements and canceled checks no longer come to the elder’s home

* New “best friends”

* Legal documents, such as powers of attorney, which the older person didn’t understand at the time he or she signed them

* Unusual activity in the older person’s bank accounts including large, unexplained withdrawals, frequent transfers between accounts, or ATM withdrawals

* The care of the elder is not commensurate with the size of his/her estate

* A caregiver expresses excessive interest in the amount of money being spent on the older person

* Belongings or property are missing

* Suspicious signatures on checks or other documents

* Absence of documentation about financial arrangements

* Implausible explanations given about the elderly person’s finances by the elder or the caregiver

* The elder is unaware of or does not understand financial arrangements that have been made for him or her

Neglect and Self-Neglect

“Active” neglect refers to behavior that is willful – that is, the caregiver intentionally withholds care or necessities. The neglect may be motivated by financial gain (e.g. the caregiver stands to inherit) or reflect interpersonal conflicts.

“Passive” neglect refers to situations in which the caregiver is unable to fulfill his or her care giving responsibilities as a result of illness, disability, stress, ignorance, lack of maturity, or lack of resources.

“Self neglect” refers to situations in which there is no perpetrator and neglect is the result of the older person refusing care.

Who are the perpetrators?

* Perpetrators may be paid attendants, family members, employees of long- term care facilities, or others

* Caregivers who lack adequate skills, training, time, or energy

* Caregivers who are mentally ill, or who have alcohol, substance abuse or other mental health problems

* In self-neglect cases, there are no perpetrators

Who is at risk?

* Persons with physical or mental disabilities who depend on others for care

* Persons with high care needs. The literature on care giving suggests that certain conditions are particularly stressful to caregivers. These include fluctuations in the older person’s need for care, disturbed sleep, incontinence, and lack of support from other family members.

* Self-neglect is often associated with mental health problems, including substance abuse, dementia, and depression.

What are the indicators?

Indicators are signs or clues that neglect has occurred. Indicators of neglect include the condition of the older person’s home (environmental indicators), physical signs of poor care, and behavioral characteristics of the caregiver and/or older person. Some of the indicators listed below may not signal neglect but rather reflect lifestyle choices, lack of resources, or mental health problems, etc. One should look for patterns or clusters of indicators that suggest a problem. Signs of neglect observed in the home

* Absence of necessities including food, water, heat

* Inadequate living environment evidenced by lack of utilities, sufficient space, and ventilation

* Animal or insect infestations

* Signs of medication mismanagement, including empty or unmarked bottles or outdated prescriptions

* Housing is unsafe as a result of disrepair, faulty wiring, inadequate sanitation, substandard cleanliness, or architectural barriers

Physical indicators:

* Poor personal hygiene including soiled clothing, dirty nails and skin, matted or lice infested hair, odors, and the presence of feces or urine

* Unclothed, or improperly clothed for weather

* Decubiti (bedsores)

* Skin rashes

* Dehydration, evidenced by low urinary output, dry fragile skin, dry sore mouth, apathy, lack of energy, and mental confusion

* Untreated medical or mental conditions including infections, soiled bandages, and unattended fractures

* Absence of needed dentures, eyeglasses, hearing aids, walkers, wheelchairs, braces, or commodes

* Exacerbation of chronic diseases despite a care plan

* Worsening dementia

Behavioral indicators:

Observed in the caregiver/abuser

* Expresses anger, frustration, or exhaustion

* Isolates the elder from the outside world, friends, or relatives

* Obviously lacks care giving skills

* Is unreasonably critical and/or dissatisfied with social and health care providers and changes providers frequently

* Refuses to apply for economic aid or services for the elder and resists outside help

Observed in the victim:

* Exhibits emotional distress such as crying, depression, or despair

* Has nightmares or difficulty sleeping

* Has had a sudden loss of appetite that is unrelated to a medical condition

* Is confused and disoriented (this may be the result of malnutrition)

* Is emotionally numb, withdrawn, or detached

* Exhibits regressive behavior

* Exhibits self-destructive behavior

* Exhibits fear toward the caregiver

* Expresses unrealistic expectations about their care (e.g. claiming that their care is adequate when it is not or insisting that the situation will improve)

FAQ On the Health Effects of Alcohol and Substance Abuse – You Might Be Surprised

The effects of alcohol and substance abuse are not only serious, but are also often terminal. For example, excessive drinking can cause and increase the risk of certain cancers such as, colon cancer, liver cancer, rectum cancer, and even kidney cancer. However, regrettably, it appears that most people are not fully aware of this information. To help you understand the health effects of excessive drinking, take a look at some of the most frequently asked questions about alcohol and substance abuse.

1. Can excessive drinking really damage my liver?

Yes, as a matter of fact, excessive drinking can cause several liver related diseases. One of the most common liver related diseases caused my excessive drinking, is alcoholic hepatitis. Alcoholic hepatitis can easily be recognized by the following symptoms:

-Abdominal pains
-Abnormal yellowing of the skin and eyeballs
-Fever

If a person continues with excessive drinking, alcoholic hepatitis can be fatal. Another common liver related disease is cirrhosis or scarring of the liver. Once again, if left untreated and excessive drinking continues, cirrhosis can be fatal.

2. Why does alcohol damage the liver?

As far as medical research is concerned, alcohol acts as a food as well as a poison. As for the liver, the liver’s primary function is to remove poison and toxins. As the liver does exactly this with alcohol, it is turned into yet another poison, eventually damaging the liver cells. In simple terms, alcohol produces toxins and the liver removes toxins. However, the toxins produced by alcohol, usually outstrips the defenses produced by the liver.

3. Can I get cancer from excessive drinking?

Yes, long term drinking and excessive alcohol and substance abuse can most certainly increase your risk of getting certain cancers. Some recorded cases of cancers due to alcohol abuse, is colon cancer, throat cancer, rectum cancer, liver cancer, mouth cancer, and even kidney cancer. Moreover, women who drink excessively can increase their chances of developing breast cancer. Developing cancer is most certainly possible and one of the many long term effects of alcohol and substance abuse.

4. Is it possible to develop heart disease due to excessive alcohol and substance abuse?

In fact, heart related diseases are one of the most common long term effects of alcohol and abuse. According to a recent study, however, drinking in good moderation can also be beneficial to your heart – especially with people who are great risk to heart attacks. In the long run, excessive drinking can cause several heart related diseases such as strokes and high blood pressure.

5. Is it true that excessive drinking can cause pancreatitis?

Yes, this is very true. Long term and excessive alcohol and substance abuse can most certainly cause pancreatitis. Just like the liver, excessive drinking will cause inflammation of the pancreas. Pancreatitis can be a life-threatening disease. Symptoms may include abdominal pains and weight loss.

6. Alcohol Poisoning – Is, this a myth or is it real?

Alcohol poisoning is everything but a myth. Excessive drinking can often lead to alcohol poisoning, which causes the person to go into an unconscious state. This can even lead to death.

7. What other health problems can alcohol and substance abuse cause?

There are several other health related issues connected to excessive drinking. However, not all of these are long term health effects of alcohol and abuse. Some of which you may see below, are also short term health effects of alcohol and substance abuse.

-Loss of brain cells
-Stomach ulcers
-Irritated stomach and bowel
-Sexual problems
-Personal problems
-Muscle diseases
-Vitamin deficiency
-Nerve damage
-Epilepsy
-Obesity
-Skin problems
-Infertility
-Erectile dysfunction
-Bleeding in the esophagus
-Brain damage

As you can see, alcohol and substance abuse can cause negative health effects on the short and long run. Alcohol and abuse puts you at great risk for health related diseases, and it can also shorten your life by 10 years or much more.