Elder abuse – what it is, who is at risk and what to do about it
The Australian Network for the Prevention of Elder Abuse offers this definition: “Elder Abuse is any act occurring within a relationship where there is an implication of trust, which results in harm to an older person. Abuse may be physical, sexual, financial, psychological, social and/or neglect.”
British researchers believe that elder abuse should be viewed as a spectrum of behaviours rather than an all-or-nothing phenomenon. In a recent survey, led by a psychiatrist at the University of London, researchers asked family caregivers how often in the past three months they had acted in various abusive ways towards their care recipient; more than half reported at least occasionally screaming, insulting, cursing, threatening, swearing, or actual physical abuse.
This helps us see there are many types of abuse being experienced by a great many older people. In many situations it may be subtle, or intentionally hidden, so that it may not be evident to a casual observer. The abuse is perpetrated by someone close to them, with whom they have a relationship implying trust, and may include family members such as a son, daughter, spouse, brother, grandchild, niece or friend. (Any staff member of a nursing home or hospital, regardless of position held, may also behave or act in an abusive manner. Such behaviour is not the focus of this article, but is a serious problem and should be reported.)
Risk factors
Risk factors contributing to abuse have been identified as: mental health and/or alcohol abuse by the abuser, the dependency of the person experiencing abuse, domestic violence, carer abuse and financial dependence. Frequently more than one kind of abuse is being experienced. Dependency can involve either the older person or the abuser, or both and can be physical, emotional, psychological and/or financial. Either the older person or the abuser (or both) may feel powerless or fearful that their needs will no longer be met if things change. Given all these variables it is obvious that the problem of elder abuse is exceedingly complex and interwoven with previous family dynamics.
Statistics
Who is affected by abuse? During 1998-1999, 354 people sought assistance from the Aged Rights Advisory Service in South Australia regarding abuse. Of these: 69% were female, 10% were from a Non English Speaking Background, 21% had a diagnosis of dementia, 53% experienced abuse from their adult child, 21% by other family members, 8% from their spouse, 6% friends, 11% from multiple family members. A typical victim then is an elderly female migrant, with dementia, who is abused by family members. But elder abuse can, and does, happen to people of all backgrounds.
The Human Rights of Older Persons. Following is from the International Federation of Ageing Declaration on the Rights and Responsibilities of Older Persons.
Independence – Older persons have the right:
1. To access to adequate food, water, shelter, clothing, and health care through the provision of income, family and community support and help;
2. To work and pursue other income generating opportunities with no barriers based on age;
3. To retire and participate in determining when and at what pace withdrawal from the labour force takes place;
4. To access education and training programs to enhance literacy, facilitate employment, and permit informed planning and decision making;
5. To live in environments that are safe and adaptable to personal preferences and changing capacities;
6. To reside at home as long as possible;
Participation – Older persons have the right:
7. To remain integrated and participate actively in society, including the process of development and the formulation and implementation of policies which directly affect their well-being;
8. To share their knowledge, skills, values and life experiences with younger generations;
9. To seek and develop opportunities for service to the community and to serve as volunteers in positions;
10. To form movements or associations of the elderly.
Care – Older persons have the right:
11. To benefit from family support and care consistent with the well being of the family;
12. To access health care to help them maintain or regain the optimum level of physical, mental and emotional well-being and to prevent or delay the onset of illness;
13. To access social and legal services to enhance capacity for autonomy and provide protection and care;
14. To utilise appropriate levels of institutional care which provide protection, rehabilitation and social and mental stimulation in a humane and secure environment;
15. To exercise human rights and fundamental freedoms when residing in any shelter, care and treatment facility including full respect for their dignity, beliefs, needs and privacy and for the right to make decisions about their care and quality of life.
Self – fulfilment – Older persons have the right:
16. To pursue opportunities for the full development of their potential;
17. To access the education, cultural, spiritual and recreational resources of society.
Dignity – Older persons have a right:
18. To be treated fairly regardless of age, gender, racial or ethnic background, disability or other status, and to be valued independently of their economic contributions;
19. To live in dignity and security and to be free of exploitation and physical or mental abuse;
20. To exercise personal autonomy in health care decision-making, including the right to die with dignity by assenting to or rejecting treatment designed solely to prolong life.
Summary
Reading the Rights of Older Persons is very worthwhile but our simply reading it, saying it or wishing it were so does not accomplish anything. We all need to be more aware of the people in our communities who may be at the receiving end of abuse and be ready to call the authorities to assist them. And we need to be aware that under extreme stress we ourselves may be capable of such behaviour. If we are carers we need to seek help before we take our frustrations out on our elderly charges. With increased awareness and ongoing education of the public we should all work to reduce elder abuse in our communities.
In Sydney, the Aged-Care Rights Services offers free and confidential advice about such issues on 02 9281 3600. NSW country callers can phone toll-free 1800 424 079. For more information, please contact: Carers NSW, Seniors Information Service, The Older Women’s Network.