Time to face up to reality of elder abuse


OPINION:Ageist attitudes contribute to abuse of older people and its tolerance by society

TODAY MARKS World Elder Abuse Awareness Day. Elder abuse is a societal issue and can occur to any older person, regardless of social class, age or dependency, although increasing age increases risk.

Like child protection and domestic violence, elder abuse remains a difficult topic, shrouded in secrecy, particularly as most abuse occurs within the home environment and by family members. Thus, disclosure is mired in issues of family allegiance, embarrassment, anxiety regarding legal entanglement and if the perpetrator is the main care-giver, forced admission to a nursing home may be a fear.

Defining elder abuse is challenging but there is a professional consensus that it may be perpetrated in many ways, such as physical abuse, sexual abuse, psychological abuse, financial/material abuse and neglect.

Separate research undertaken by the International Network for the Prevention of Elder Abuse, Age Action Ireland and research in both the UK and Sweden indicates elder abuse is perceived by older people themselves as being influenced by societal and political realities, as well as a lack of valuing of the individual older person.

In this regard, ageist attitudes and practices certainly contribute to abuse of older people and its tolerance by society.

One significant response to ageism is the ongoing United Nations focus on consolidating the rights of older people within a dedicated convention, similar to the 1989 Convention on the Rights of the Child. This will underpin a clear focus on protecting older people and ensuring equal rights with other age groups. But such a convention is needed now. There is no time for delay.

In Ireland, much progress has been made in both service provision and societal awareness. Subsequent to the 2007 recommendations of the Irish Government’s policy document on elder abuse, the Health Service Executive established a dedicated service to respond to allegations of elder abuse. Referral figures have been rising year on year, with 2,302 in 2011 alone.

Media campaigns have increased public discourses and emphasised the unacceptability

of elder abuse. The Law Reform Commission has also made recommendations to update legislation to improve protection, most notably within the forthcoming Scheme of Mental Capacity Bill, due to be debated in the Oireachtas in the near future.

Furthermore, the establishment of the National Centre for the Protection of Older People (NCPOP), a multidisciplinary collaboration of researchers led by the School of Nursing, Midwifery Health Systems in University College Dublin, has led to important insights on the issue of elder abuse in Ireland.

In 2010 a prevalence study undertaken by the centre estimated that over 10,000 older people in Ireland were subject to some form of elder abuse in the preceding year.

Consequently, although the HSE has received a rising volume of referrals, a gap in actual elder abuse cases and referrals for intervention remains. In the NCPOP prevalence study, financial abuse was identified as the most common form of abuse of older people. Although the gravity of financial abuse in Ireland is not identified, in 2009, the MetLife Mature Market Institute estimated $2.6 billion was lost each year in the US as a consequence of elder financial abuse.

Older people are particularly vulnerable to financial abuse due to increasing volumes of older people in the population, a greater wealth pattern and a possible dependency on others. Financial abuse includes theft, fraud, pressure to change a will, misuse of income, such as pensions, and misappropriation of money or assets.

Recent changes in banking and technology also present new ways of perpetrating elder abuse; for example, telemarketing, phishing and internet scams. In the UK the focus on individualised care budgets, which were seen to promote personalisation, has the consequence of forcing older people to manage large sums of money, which in turn clearly increased the risk of financial abuse.

The consequences of financial abuse for older people are great as they have limited resources to draw upon and limited ways of generating persistent income, leading to a greater dependency on government welfare systems. Financial abuse causes stress, hardship, depression and compromises personal independence.

To mark World Elder Abuse Awareness Day, the International Network for the Prevention of Elder Abuse, the National Centre for the Protection of Older People and the HSE held an international conference in UCD yesterday.

It was preceded by a symbolic signing of declarations against elder abuse by, amongst others, the mayors of Dublin, Cork County Council, nursing and Garda representatives. Other events are occurring around the country, with a focus on raising awareness and promoting the unacceptability of any type of abuse against older people.

DR AMANDA PHELANis subject head of Older Persons Nursing in the UCD School of Nursing, Midwifery and Health Systems, co-director in the UCD National Centre for the Protection of Older People and national representative for the International Network for the Prevention of Elder Abuse.
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