This paper addresses two related topics in victimology and elder justice. The first section examines theories of elder abuse causation, focusing on how caregiver resentment arises from behavioral changes in elderly patients, physical caregiving demands, financial hardship, and unresolved personal history between caregiver and patient. The second section considers the ethical and practical challenges of involving a young child — specifically, a five-year-old sexual assault survivor — in the preparation and delivery of a victim impact statement, exploring adapted methods such as drawings, emotion-identification forms, and guided non-verbal expressions that can preserve the child's voice without retraumatizing her or removing her sense of personal control.
There are multiple theories of elder abuse causation, which makes sense because not all elder abuse is attributable to the same factors. The circumstances that lead one person to engage in elder abuse may not exist for another caregiver, or may differ from the circumstances that would lead to abuse in a different caregiving relationship. Caregiving, even for the most compliant patient, can involve significant challenges for the caregiver.
One of the issues caregivers face is changes in the patient's behavior. In many instances, the caregiver is experiencing some type of loss of companionship, particularly if the patient had previously been an integral part of the caregiver's support network.
Some patients may also engage in behavior that increases caregiver stress beyond what is inherent in the caregiving role itself. Elderly patients with dementia, for example, may be unable to follow caregiver instructions. Others may exhibit emotional difficulties that make them unwilling to follow instructions. Both situations can significantly elevate the stress experienced by the caregiver and contribute to feelings of resentment.
Physical changes in the patient can also make caregiving increasingly difficult. Patients may be frail, and because most caregivers are themselves older, the physical demands of providing care may literally cause injuries and pain to the caregiver. When additional physical challenges are factored in — such as incontinence or loss of bowel control — the day-to-day work of caregiving becomes even more demanding.
Another significant source of resentment is the financial distress that caregiving can create. Caregivers may need to expend substantial sums of money on the patient's care. Beyond direct expenditures, the financial strain is compounded when caregivers must leave their jobs or make other major financial sacrifices in order to fulfill their caregiving responsibilities.
A further factor that may contribute to caregiver resentment is the personal history between the caregiver and the patient. Any prior history of domestic violence, marital infidelity, or other harmful treatment by the patient toward the caregiver may intensify the resentment the caregiver feels at now being required to provide that person's care.
Consider the following scenario: Christina, a five-year-old girl, was sexually assaulted by a neighbor who was arrested and convicted of the offense. Christina cannot yet write and is too frightened to speak in an open courtroom. The question is what measures, if any, might be devised to encourage and/or facilitate her participation in the preparation and/or delivery of a victim impact statement.
"Risks of child participation and loss of personal control"
"Drawings, emotion forms, and guided questions for child victims"
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