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Professor Brahim Boulassel recommends the creation of geriatric services at hospital level
Prevention and fight against elder abuse
The former head doctor of the Forensic Medicine department at the Nédir Mohamed University Hospital Center (CHU) in Tizi Ouzou, Professor Brahim Boulassel, talks about the mistreatment of the elderly. “We are well aware of the signs that can identify mistreatment even if no systematic screening grid is currently used.” “However, we see that reports of this mistreatment remain rare in comparison with the scale of this phenomenon,” he laments.
Noting that all types of abuse have a serious psychological impact, dominated by anxiety and depression. “Only the abused elderly people seen at the medico-legal consultation benefited from medico-legal recognition,” he said.
Abuse, he said, is mistreatment, occasional, long-term or reputed, inflicted on a person who is treated with violence, contempt, or indignity. It is an act committed or omitted, in which case we usually speak of negligence which is either intentional or involuntary. Abuse can be physical or psychological, with verbal attacks in particular. It can also involve financial or material mistreatment.
“Abuse involves a relationship of power or domination between the perpetrator and the victim, who is therefore often dependent and defenseless. It happens that a caregiver and a caregiver find themselves in the shoes of the attackers,” observed Professor Boulassel. Noting that whatever the type, abuse will certainly result in unnecessary suffering or pain, loss or violation of the victim’s rights and a deterioration in their quality of life.
Recommending the creation of geriatric services at hospital level, for the prevention and fight against abuse of elderly people, Professor Boulassel noted that abuse is a frequent, underestimated and complex phenomenon which must be treated on a case-by-case basis.
“There is neither a typical patient profile nor specific clinical signs,” he continued, recalling that the reporting of this phenomenon which is part of the implementation of certain provisions of Law No. 10-12 of December 29, 2010, relating to the protection of the elderly, in particular its article 11 which stipulates that any natural or legal person can inform the competent authorities of cases of mistreatment or neglect against the elderly, is one of the exemptions professional secrecy.
For this university hospital, ethical questioning is inseparable from geriatric practice for all professionals who work with the elderly. “All professionals are concerned, because ethics will compare the decisions to be made at the moment they must be taken with the values to which the members of a team who share the same responsibility towards the patient refer,” added Professor Boulassel, affirming that fragility, which is characterized by a decline in reserve and adaptation capacities, is common among the elderly.
From there, he further indicated, their vulnerability arises and from this vulnerability arise many ethical questions regarding the interventions or, on the contrary, the non-interventions of professionals.
“Vulnerability naturally leads to the ethical desire to protect these elderly people, but we very easily slip from protection to prohibition or obligation. ”For the good of the old person”, families or professionals decide for them what is good for them. How can we respect the principles of dignity?”, he concluded.
Rabah Mokhtari