Kupuna Transitions

Many seniors believe there is safety and quality of care when it comes from those they are closest to. Children are raised to do the right thing and spouses are handpicked, so in a perfect world they are the most qualified individuals to provide TLC. On top of this rationale, news stories of the elderly being abused in care facilities reinforces the idea that we would be better off at home.

According to Hawaii Island Executive on Aging Dr. Kimo Alameda, most of the abuse of our older adults is carried out by family members. When I asked some of the kupuna at my day center about why they believe most financial, physical and emotionally abusing situations are carried out by children and spouses, they had some insightful thoughts.

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One woman in her 90s feels that it might come from their familiarity with the older individual. They know their temper and may think they’re getting them straightened out. Another 89-year- old woman also feels that they don’t mean to abuse, in that sense – they are likely doing these things without realizing what it’s doing to the person on the inside. On the other hand, she has also seen a clearly abusive situation with a neighbor in which the caregiver grandson was on drugs. She noticed the son was blind to the grandson’s ways, so the grandma was stuck.

Occasionally the relative willing to help is the one mostly needing a place to stay rather than the one best suited for care. Even in situations when the family member is stable, control issues can slip in. Although the requests upon the recipient are usually well-intended, they can still feel like demands rather than care. The vulnerability of those needing their help must be treated with the utmost respect and patience.

In fact, impatience is often the first step towards an unstable caregiving situation because a good night’s sleep is highly unlikely. One can become short-tempered with the consistent lack of rest, and fatigue also limits the caregiver’s drive to provide an uplifting environment that stimulates the individual’s mind and body. It often takes a clear head space to get an older adult with ailments to feel motivated to get active.

I personally believe that dementia care is the most at-risk dynamic of all, in terms of abuse. Caring for somebody with memory loss brings a greater need for understanding. A family member may assume the older person is intentionally behaving a certain way and react to their actions rather than seeing past them as a symptom of the disease. Understanding limited capacity may not necessarily keep them safe, though, as those gaps create opportunities for bad behavior to occur which may not be recalled by the victim.

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I absolutely honor family members who step in, and have seen firsthand how challenging it is to maintain tenderness and understanding as weeks turn into months and years. My hope in shedding more light on this topic is to raise our awareness to the importance of looking out for each other. Putting all of the caregiving pressure onto one family member may be a recipe for disaster. We all need support in adult caregiving and work as a team to keep everyone healthy and well cared for.

Karyn Clay is a gerontological specialist who began caring for older adults 23 years ago and earned her B.A. in gerontology from SDSU in 1998. She founded Ho’oNani Day Center in 2002 and Ho’oNani Care Home in 2015, which make up Ho’oNani Adult Care Services, Inc. and are located on the same property in Kamuela. All are invited to join her Caregiver Conversations gatherings at Tutu’s House the first Wednesday of every month.