Elder Abuse in HIV-Positive People

Abstract

Abuse in a relationship is the infliction of pain, harm or injury or neglect by the care-giver which may cause physical and mental stress. As we move towards greater advancement in disease prevention and screening strategies, there is an inevitable rise in the elderly population. There are and will be more dependants in the population than in the past as we move towards better health-care. Elderly people on Anti Retroviral Therapy (ART) are on the rise and the World Health Organization (WHO) estimates that about 2.8 million people on ART today are more than 50 years old. The presence of disease and associated ageing makes this population vulnerable to abuse by the younger population, especially their own family. There is increased dependence upon drugs, follow-up visits and other associated opportunistic infections in this population. Concurrent diseases and physical and cognitive frailty are all factors which may hamper their ability to respond or protect themselves from abuse. Numerous such cases remain unspoken and go unnoticed. Older people may also have the tendency to refrain from complaining, or resist any such treatment for fear of dependence. Various scores for elderly abuse have been devised and can be used during the routine visit to the ART centre to elicit any mistreatment and abuse which may be present. These scores generally contain questions which are important for predicting the status of the old patient in his/her family, his/her expectations of family members, and the extent to which such expectations have been fulfilled.