Elder Abuse

Page Headings:

Elder abuse is a generic term used to address the problems of older people, some with dementia, who are abused physically, sexually and psychologically, and exploited financially.

Dementia is not a normal part of ageing, but is caused by diseases that affect the brain. As our population ages and larger numbers than ever before are over sixty-five, the prevalence of dementia also increases.

In 1995, there was an estimated 45,600 people with moderate to severe dementia in NSW, with an expected increase to 54,720 in 2000 and 72,960 in 2010.

The NSW Government has responded through the implementation of the NSW Action Plan on Dementia, now in its fourth year of a five year plan. The NSW Government allocated $2.2 million for the first three years and a futher $1.2 million over four years ($300,000 recurrent) in the 1999/2000 budget.

The NSW Action Plan on Dementia is a joint plan between the Ageing and Disability Department (ADD) and Health Department with ADD responsible for co-ordinating and monitoring the Plan. It includes 116 actions to be implemented in seven key focus areas.

Key focus areas include: -

Diagnosis and assessment;
Access to services, including community support, health care and accommodation;
Community awareness; and
Training and planning issues.

Abuse of Older People:

Abuse of older people is any pattern of behaviour which causes physical, psychological or financial harm to an older person. It is not a new phenomenon. However, until recently, it has been largely unrecognised amongst the community or by service providers and professionals. Its very nature means that it is largely hidden and rarely acknowledged, and its extent is difficult to gauge. As with child abuse and domestic violence, abuse of older people is seriously under-reported. However, reliable studies in the USA, UK and Canada have shown that between 3% and 5% of older people living in their own homes are victims of abuse. This is supported by Australian research.

Research also indicates that elder abuse occurs primarily in relationships where one person is dependent upon another. Usually, this is because of frailty, illness or disability. Different kinds of abuse (physical, sexual, psychological, financial, neglect) may require different responses, often by different organisations.

On this understanding, the NSW Government has sought to equip services most likely to come into contact with frail older people as well as those who have a particular role to play in managing abuse, with a greater understanding of how to identify, assess and respond to elder abuse. This has been achieved through the following work: -

  1. Training of health and community care workers, police and a range of other services targeting older people in all regions of NSW:
    This training included the nature and causes of elder abuse, as well as the most appropriate ways of responding to it. The training primarily targeted workers dealing with older people living in their own home, with a secondary target of workers dealing with people with disabilities living in their home. The training included a "train the trainer" component and had a clear focus in inter-agency issues.

  2. Establishing inter-agency protocols for responding to abuse in each region in NSW:
    The protocols are a set of guidelines agreed to by agencies in a local area. They set out agency roles for actions to be taken when abuse is identified, for example to whom a case of suspected abuse should be referred in emergency and non-emergency situations, and then which services will intervene, should it be appropriate. The protocols improve co-ordination between services, as well as the responsiveness of services to abusive situations. They also promote best practice. The protocols are currently being revised and formally adopted in each area of the State.

  3. Development of information resources:
    Resources aimed at improving the awareness of workers about abuse include: -

    • the training video, Behind Closed Doors;
    • the training kit, Abuse of Clients and Their Carers;
    • a Legal Issues Manual;
    • the NSW Inter-Agency Protocol on Abuse of Older People;
    • a series of discussion papers focusing on issues such as dementia and abuse, financial exploitation, mandatory reporting and gender.

    These resources are available from the Ageing Issues Directorate by phoning (02) 9364 6963 during normal working hours.

ADD has also produced resources aimed at improving awareness in the wider community. A community awareness kit aimed at culturally and linguistically diverse communities was produced in January 2000 and may be downloaded from their Web site.

Since the issue of elder abuse began to emerge in the early 1990's, the NSW Government has been seen as the national leader in developing strategies to better understand the causes of abuse, prevent it occurring and to respond appropriately when it does occur. This work has been done through the NSW Task Force on Elder Abuse (1991-1993), and then the NSW Advisory Committee on Abuse of Older People (1993-1996). It is now being managed by the Ageing and Disability Department.

Contact: Merrin Thompson
Phone: (02) 9367 6875
E-mail address: merrin.thompson@add.nsw.gov.au

Click Here to Visit the Ageing & Disability Department Web site.

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Abuse and Neglect of Older Adults:

This is a discussion paper from the National Clearinghouse on Family Violence. This paper was prepared by L McDonald and A Collins for the Family Violence Prevention Unit, Health Canada.

As the decade comes to a close, it has become increasingly clear that abuse and neglect of older adults has come to be recognised as a problem worthy of serious academic inquiry and coordinated social action on the part of all Canadians. The purpose of this paper is to provide an overview of the important developments that have occurred in the field since the publication of the first discussion paper in 1989. Existing problems in defining abuse and neglect, issues surrounding data on incidence and prevalence, the lack of progress on the theoretical front and the related problems of identifying risk factors are revisited. Changes in adult protection legislation, along with advances in the creation of protocols for detection, intervention, and programming are described. We conclude by surveying some of the preventive strategies that have been adopted across Canada in recent years and by offering suggestions for future directions.

In this paper they have also shown that the three major types of elder abuse are physical, psychological and financial.

Click Here to Access the entire discussion paper.

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The Ontario Network for the Prevention of Elder Abuse:

The ONPEA is a non-profit, charitable organisation dedicated to the prevention of elder abuse and neglect. It is managed by a volunteer Board of Directors. Their mandate is to: -

  • Educate professionals and lay persons about elder abuse and neglect.
  • Promote information sharing among professionals and advocates in the field of elder abuse.
  • Develop educational and training programs about elder abuse prevention and intervention for people working with the elderly.
  • Advocate legislative action to meet the needs of victims, perpetrators, and their families.
  • Offer services and support to victims of elder abuse and neglect.
  • Be sensitive to multicultural and aboriginal issues related to elder abuse.

The Bernard Betel Senior Centre is associated with the Ontario Network for the Prevention of Elder Abuse. They have an Elder Abuse Project and with the Heart Health Network employ skits and plays to promote the prevention of elder abuse and neglect; they also promote healthier life styles. These plays are enacted by two to four actors.

The elder abuse play is followed by the cast remaining on stage and in character, with the audience identifying the elder abuse they've seen (e.g., physical, emotional, financial, neglect) and then the audience proposing solutions and, in the process, learning a lot about what resources are available. They also find that the victim often protects the perpetrator and is reluctant to expose the abuse or the abuser.

With the healthy lifestyle plays, they try to get a public health nurse to be present to talk to the audience following the play/skit.

The address of the Bernard Betel Centre is: -
1003 Steeles Ave West
Toronto, Ontario M2R 3T6
Canada
The Co-ordinator, Elder Abuse Awareness Project: Sheila Zane
For the Ontario Network for the Prevention of Elder Abuse: -
Contact: Elizabeth Podnieks
E-mail address: onpea.info@utoronto.ca

Click Here to Visit the Ontario Network for the Prevention of Elder Abuse Web site.

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The International Network for the Prevention of Elder Abuse:

INPEA is an organisation, founded on 1998, which is dedicated to the global dissemination of information as part of its commitment to the world-wide prevention of the abuse of older people.

Acknowledging the diversity of culture, background, and life style of the world population, the International Network for the Prevention of Elder Abuse aims to increase society's ability, through international collaboration, to recognise and respond to the mistreatment of older people in whatever setting it occurs, so that the latter years of life will be free from abuse, neglect and exploitation.

The objectives of INPEA are: -

  • to increase public awareness and knowledge of the issue
  • to promote education and training of professionals and paraprofessionals in identification, treatment and prevention
  • to further advocacy on behalf of abused and neglected older people
  • to stimulate research into the causes, consequences, prevalence, treatment and prevention of elder abuse and neglect.

Click Here to Visit the International Network for the Prevention of Elder Abuse Web site.

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Older - Wiser - Living:

Abuse of an older person, or 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 can include physical, sexual, financial, psychological, social and/or neglect.

Types of abuse:

  • Psychological abuse - occurs when the behaviour causes mental or emotional suffering or harm.
  • Physical abuse - is the infliction of physical pain, injury or force.
  • Sexual abuse - occurs when a person is forced into any sexual activity without their consent.
  • Financial abuse - is the illegal or improper use of property, finances and other assets.
  • Social abuse - is preventing a person from having social contact with friends or family.
  • Neglect - is the failure to provide or allow others to provide the basic necessities of life.

Context of Abuse

Abuse of older people occurs in a range of situations. Some situations involve abuse by family members, friends or neighbours providing direct care to the older person. Other situations involve abuse of older carers (eg. by a spouse), ongoing domestic or family violence, or abuse by family, friends and neighbours who are not providing direct care or support to the older person.

Extent of Elder Abuse in Australia

Overseas studies estimate that between 2% and 5% of older people are victioms of abuse. Few Australian studies have been conducted on the prevalence of elder abuse. A study of Hornsby Ku-ring-gai Geriatric and Rehabilitation Service clients in New South Wales who were over 65 years of age and living in the community, found 4.6% had experienced physical, psychological or financial abuse or neglect (1992 figures). Australian studies indicate abuse is experienced by older people across all cultural and socioeconomic backgrounds. Up to two thirds of older people who are abused are women.

Individual Factors

Various factors within our society can foster or ignore the abuse of older people. These include negative attitudes towards ageing, the stereotyping of older people, social apathy towards violence, social isolation of the care-giver and the abused person, materialism and greed in society, and limited community resources.

Preventing Elder Abuse

As abuse of older people encompasses a broad range of situations, a wide range of responses need to be available. Responses that may assist include: -

  • provision of information
  • provision of community support services
  • alternative living arrangements
  • individual support, counselling and support groups
  • increasing social participation and support networks
  • co-ordination of services and specialist teams
  • empowerment and advocacy based responses, and
  • legal interventions including criminal law, domestic violence legislation and substituted decision making processes.

Families, Youth and Community Care Queensland fund the only statewide service in Queensland that responds to the abuse of older people. The Elder Abuse Prevention Unit provides: -

  • Counselling, advice and support to older people who have been abused and their family and friends. This service is available from 9am to 5pm, Monday to Friday from anywhere in Queensland for the cost of a local call. Phone: 1300 651 192.
  • Research into elder abuse prevention.
  • Information and training sessions to raise awareness in the community about the nature and extent of the abuse of older people; and educate service providers (eg. HACC) in identifying, responding to and preventing the abuse of older people.

Staff are provided full-time in Brisbane and part-time in Warwick, Rockhampton and Cairns. Other services in Queensland currently responding to abuse include: -

  • Aged Care Assessment Teams
  • Community Health Services
  • Home and Community Care Program
  • Queensland Police Service
  • Office of the Public Trustee
  • Office of the Adult Guardian
  • Legal Services
  • Domestic Violence Prevention Services.

Contacts

Elder Abuse Prevention Unit
Lifeline Brisbane
PO Box 108 Fortitude Valley QLD 4006
16 Hamilton Place Bowen Hills QLD 4006
Phone: (07) 3250 1956
Fax: (07) 3250 1929
Helpline: 1300 651 192

Families, Youth & Community Care Queensland - Office of Ageing
Families, Youth and Community Care Queensland
GPO Box 806 BRISBANE QLD 4001
Level 4, 111 George Street, BRISBANE QLD 4000
Phone: (07) 3224 2625
Fax: (07) 3224 2019
Freecall: 1800 175 500

References:
Kurrie, S.E., P.M. & Cameron, I.D. 1992 "Patterns of elder abuse" in Medical Journal of Australia, no. 157, pp. 673-676.
Pillemer, Karl and Finkelhor, David 1988 "The Prevalence of Elder Abuse: A Random Sample Survey" in The Gerontologist vol. 28, no. 1, pp. 51-57.
Decalmer, Peter and Glendenning, Frank eds. 1997 The Mistreatment of Elderly People 2nd ed. London:Sage.

Click Here to Visit Older - Wiser - Living Web site on Elder Abuse.

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The Constance Lukaszewski Nursingtellitlikeitis Website:

This is an excellent Website. It covers a wide variety of topics. It is worth visiting this Website just to see the Webpages dealing with the September 11 terrorist attack on the World Trade Centre in New York, USA. The selection of graphics, words and music just blows your mind away. The words for "American Crisis" are by a grandaughter while the words for "To All Those Who Made It Through" are by a daughter when she was sixteen years old.

"A Testimony To Our Elderly" is also an excellent Webpage, well worth a visit. The sentiments expressed in this Webpage are well worth remembering and reminds us of the often very poor treatment that is being received by our senior citizens. It is a wake up call to us all to do something about this sorry state of affairs that is crying out for justice.

Charlton Heston's excellent Harvard Speech "Heston's Harvard Speech" is another Webpage that should not be missed. It is a reminder to us all to stand up for what we have been brought up to believe in and stand firm by our beliefs.

Click Here to Visit The Constance Lukaszewski Nursingtellitlikeitis Website.

Click Here to Visit The American Crisis - The Sept 11 WTC Disaster.

Click Here to Visit A Testimony To Our Elderly.

Click Here to Visit Heston's Harvard Speech.

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