It is a gross act of belittlement to assume that because an individual suffers from cognitive impairment such as dementia, he or she does not experience the same level of trauma and pain during and after an act of sexual abuse as anyone else.
The human brain is shaped and transformed by experiences. Emotional, cognitive, social, and biological forces shape human development. Extreme experiences in life, such as trauma stemming from sexual abuse, can alter memory recall, biological stress modulation, and interpersonal relations. Even an individual with late-stage dementia (with little to no memory-recall) still experiences and feels trauma.
All people have a physical “fight or flight” response to extreme stress. The human body has an elaborate psychophysical response system to traumatic stress.
The physiological response to trauma may include:
- Increased rate and force of contraction of the heart;
- Constriction of blood vessels;
- Dilation of the bronchioles, which alters breathing rhythms;
- Increased metabolic rate; and
- Inhibition of some “non-essential” processes, such as digestion and motor activity.
When in a stressful or traumatic situation, an individual experiences fear, sweats, and an increase in heart rate and blood pressure. Regardless of recall ability, the individual has been traumatized.
When an individual is trapped in a traumatic situation that he or she cannot escape, the body begins has an adverse reaction to the trauma. This reaction is dubbed “trauma learning,” and occurs when the normal fight or flight responses cannot be activated. As a result, the individual becomes immobilized, and as the level of traumatic perception increases, the mind enters a “numbing state” in which the brain is flooded with opiates. This numbing state accounts for the disconnection of the processing and encoding of information.
While dementia alters memory recall, it does not have any effect on the functions of the neurological systems that handle stress management. These systems operate in the primal part of the brain that recognizes danger, regardless of if the individual can recall the memory. People with dementia still experience fear, anxiety, and stress. The effects of dementia do prohibit the individual from being able to accurately describe and report any traumatic event. And as a result, sexual abuse can go unreported for long periods of times. For example, in a study of 284 cases of sexual abuse, only 1 out of 8 elders with dementia were able to report abuse.
This lack of recall or ability to report may further incite predators to continue their sexual abuse. Predators may even believe that the individual does not feel anything at all. However, there is evidence to indicate that people with dementia may in fact experience trauma more acutely than those without dementia. Such victims are not equipped physically, constitutionally, or psychologically to defend themselves against such attacks.
However, there are clues that caregivers can pick up on that may indicate a person with dementia or diminished cognitive abilities has recently undergone a traumatic experience, such as sexual abuse. This includes:
- Offering guarded responses when asked about the abuse;
- Displaying fear or strong ambivalence towards any offenders
- Being resistant to personal care;
- Displaying inappropriate boundaries and behaviors;
- Exhibiting increased anxiety or agitation during care;
- Exacerbation of symptoms related to primary diagnosis;
- Appetite changes or sleep disturbances;
- Reenactment behaviors;
- Sexualized behaviors;
- New onset of behaviors; and
- Other clinical and behavioral chances such as decreased participation in activities, yelling, crying, or deterioration in physical condition.
The Kosieradzki • Smith Law Firm represents clients in cases involving catastrophic injury caused by nursing homes and other care facilities that fail to provide proper care, including the failure to protect vulnerable adults from sexual abuse. If your loved one has been harmed due neglect or abuse in a care facility, take action and contact the Kosieradzki • Smith Law Firm online or call us toll-free at (877) 552-2873 to set up a no-cost, no-obligation consultation