The Long Shadow of Childhood Sexual Abuse

I have interviewed thousands of adults about the long-term effects of sexual abuse when they were children but few stories have shocked me as much as one I heard recently from a colleague in another city.  The patient was in the final stages of Alzheimer’s Disease and had not spoken for over two years.  She had lost control of her bladder and wore a diaper that her daughter, with whom she lived, changed regularly.  During a hospital stay, a male nurse changed her diaper and as he began she suddenly said, “No, Daddy, please don’t.”

The inescapable conclusion is that after more than seven decades and despite the dense fog of her mental decline she was reacting to the pain and fear of abuse by her father.  The story made me wonder about the rest of her life.   Did she share the story of her abuse with anyone?  Did she ever receive counseling?  Did anyone in the health care system ever inquire about her past?  How much of a difference to lives like hers could there be if the health care system routinely assessed patients for a history of childhood abuse?

The 21st century offers a real opportunity to make a difference for people like the woman in this story.

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