Older Adults

• ​​In Michigan, it has been estimated that 73,000 older adults become victims of abuse per year. 50% of these incidents were forms of financial abuse. (Elder Abuse, 2019). Exploitation usually occurs from someone who is well trusted. Literature states that older adults are less likely to report financial exploitation. (Acierno et al. (2010) National elder abuse survey). Financial arrangements within a skilled nursing facility can be informal, and can be unknown until repeated wrongdoings are caught (Consumer Financial Protection Bureau, 2014). ​​

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• Social participation

• Financial exploitation is often occurs within a relationship that is built on trust (Consumer Financial Protection Bureau, 2014). This relationship leaves an older adult vulnerable and has confidence in the trusted individual. The relationship between the victim and the perpetrator can become damaged from the mistrust. Within the skilled nursing facility, the older adult may become socially isolated from removing the perpetrator(s) from his or her life.  

• Health management

• Older adults who become victims of financial exploitation can obtain negative mental health symptoms. These symptoms can include depression, anxiety, and loneliness. Negative mental health symptoms can impact healthy routines. A change in health routine can cause a lack of physical activity, decreased nutrition, and an increase in unhealthy activities. 

• Marginalization occurs in the nursing home when a resident is “expelled from useful participation or socialization” (Young, 1990, pp. 53). 

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• Social Participation

• Older adults in skilled nursing facilities are denied engagement in social situations when they are placed in isolation due to behavior that is perceived by staff as inappropriate. Isolation can be dangerous for the residence mental health and they are often unaware of why they were placed in isolation. 

• Leisure Participation

• Older adults in skilled nursing facilities are often left out of available leisure activities due to a perceived lack of ability. Staff members often hold ageist views of older adults and thus deny them specific leisure opportunities. Denying the opportunity for older adults to participate in leisure is a form of marginalization. 

​Older adults in nursing homes lack authority, status, and the sense of self that professionals tend to have. 

Health Management and Maintenance

Developing, managing, and maintaining healthy routines for physical fitness, nutrition and medication can be difficult when living in a skilled nursing facility. The residents health routines are scheduled for them and they have very little say in when they are allowed to exercise, take their medications and what they eat. They lack authority over their health management and maintenance.

Meal preparation and cleanup

As mentioned before, residents at skilled nursing facilities often lack the authority and status to have control over the planning, preparation, choices of food and what time they eat. Residents are often give a few choices of food options and if they prefer to eat in their room rather than in the dining hall. It is important to note that this may not be seen as a form of oppression for all of the residents, but some residents feel a great sense of loss over the ability to cook meals for themselves and loved ones. 

• ​​An individual who is a victim of violence will “fear random, unprovoked attacks” onto themselves or their property (Young, 1990, pp.61). Violence is not only a matter of physical harm but also social injustice. The social context around violence makes violent acts possible and even acceptable (Young, 1990). Young (1990) described violence as systemic in character because individuals are targets merely because they are members of a particular group. Older adults are frequently victims of physical and social violence solely because of their age and the perceived weakness and worthlessness. 

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• ADLs

• The ability to care for one’s own body is often negatively affected by violence. Older adults who are the victims of violence may be unable to physically complete their ADLs such as dressing, bathing/showering, toileting, grooming and sexual activity. Zhang et al., found that Michigan residents who are unable to complete their ADLs have a higher risk for caregiver neglect than those who are independent in their ADL routines. 

• Sleep participation

• Sleep is also negatively affected by violence. Residents who are victims of physical violence may experience fear and anxiety that will prevent the individual from resting. Victims of physical violence may experience reduced sleep participation due to pain as well.