News - Stop Elder Abuse
By Jayne Kendry, Age Concern
Jayne McKendry works for Age Concern New Zealand as the Professional Advisor for Elder Abuse and Neglect Prevention Services. She is responsible for strategic development including monitoring and reporting on issues relating to elder abuse and neglect.
Jayne provides expert advice on elder abuse and neglect and associated matters to service providers, government and other organisations with an interest in this area.
Introduction
"Eat that food. I'm not getting you anything else. You're a baby, whining and grizzling about the food all the time. There's nothing wrong with it. Everyone else eats it ok. What's the problem you stupid old woman. Just eat will you."
"If you don't give me money for the pokies, I'll make sure you never see your grandchildren again."
"You stupid old cow. Why don't you just go to bed. You're a waste of space."
Psychological abuse - sometimes called emotional abuse, or verbal abuse - includes a wide range of behaviour from threatening and intimidating the person to treating the older person like a child and isolating them from family, friends, and regular activities - either by force or threats or through manipulation.
It can also include insults or giving the "silent treatment" - all behaviour that causes fear, mental anguish and emotional pain or distress.
Age Concern New Zealand has been working with older people for many years. Our elder abuse and neglect prevention services work with about 500 older people who have been abused or neglected every year. Over 300 of the people we see have experienced some kind of psychological abuse - it's the most frequently identified type of elder abuse.
And older people tell us that verbal abuse is one of the worst ways of being hurt - it stays with them for a very long time. We know that other organisations also work with older people who are victims of elder abuse or neglect so it is likely that the 300 people we see are just the ‘tip of the iceberg'.
"One rude word to an old man is stronger than stabbing him with a knife"
Psychological abuse is most frequently inflicted by family members. For the people that Age Concern elder abuse and neglect prevention services saw between 2004 and 2006, adult sons and daughters and husbands/wives/partners were most commonly responsible for psychological abuse. In cases where the abuser was the primary carer for the older person (25% of all cases), psychological abuse was most common (63%).
The Prevalence Survey Report published in the UK in 2007 found that partners (57%) and other family members (37%) were the main perpetrators of interpersonal abuse. (The Report defines interpersonal abuse as including psychological, physical and sexual abuse).
What impact does elder abuse have on older persons' mental health?
Respondents to a qualitative study published in the UK in 2007 reported a raft of psychological impacts following experience of elder abuse. These included emotional distress, loss of self-confidence and self-esteem, depression, thoughts of suicide and/or self harm. Some respondents became socially isolated, others experienced a loss of independence. Also evident were negative impacts on physical health, financial loss, and a change to family relationships. (Mowlam et al, 2007)
People that Age Concern elder abuse and neglect prevention services saw between 2004 and 2006 had experiences comparable with these findings. 57% of the people we saw during this period were reported as ‘extremely distressed or angry'. For 51% general health was significantly affected, 50% experienced significant disruption to their life, the economic security of 35% was significantly affected and 19% of clients were relocated (more than two-thirds of them permanently) as a consequence of the abuse or neglect. (Note that any one person may report experience of a number of these consequences.)
What can be done to stop elder abuse?
Age Concern New Zealand believes that to eliminate elder abuse one of the things we need to do is address ageist attitudes so that people of all ages are valued, respected, supported and empowered. This stance has been supported by research published by the Families Commission in January. The authors of Elder Abuse and Neglect exploration of risk and protective factors apply an ecological framework to looking at elder abuse and neglect, considering factors at an individual, family, institutional, community and society level.
"Strong themes emerged about the undervaluing of older people in society as a whole. This was linked to the perceived ‘lack of productivity' associated with people who are no longer in paid employment. Informants in this study overwhelmingly endorsed the need to promote more positive images of older people, and develop a culture of respect that valued the unique contribution of older people." (Peri et al, page 11)
Many forms of abuse are grounded in ageism. Actions that people would likely find offensive and socially unacceptable if they happened to younger persons or other groups are sometimes treated as acceptable if these are happening to an older person. (CNPEA)
In 2007, Age Concern New Zealand produced a DVD, It's all about Respect. The
DVD is an interactive training tool and raises awareness of attitudes and behaviour toward older people. In addition to scripted scenarios for use in training sessions, it contains unscripted comments from older people, carers, members of the public, and professionals working in the area of elder abuse and neglect prevention, all of whom talk about what respect of older people means to them.
"Respect is better than food and drink"
This DVD further supports the key principle behind Age Concern's work since the early 1990s - promoting the rights and wellbeing of older people and those who care for them.
Other findings from the Families Commission research include that:
- Older people are less likely to be abused or neglected if they are aware of their rights and have a strong self esteem.
- Positive relationships within families are a key protective factor. However the authors recognised that social ideologies about family loyalty and personal independence contribute to the silence about abuse.
- Well trained, well paid staff with high staff-resident ratios in residential care situations prevents elder abuse and improves the quality of care in institutions.
- Social connectedness at a community level is a protective factor with many issues recognised as contributors to this, including accessible public transport, community facilities and regular interagency meetings to facilitate sharing of information concerning at-risk older people.
Services that can help
Specialist Elder Abuse and Neglect Prevention (EANP) Services operate in many major cities and provincial areas throughout New Zealand and include a service for Maori and a service for Pacific people, both in Auckland. Contact details for all providers are available at www.ageconcern.org.nz
Elder Abuse and Neglect Prevention Services provide information and advice; they work with older people, their families/whanau/aiga and carers (including residential care facility staff) helping them to change the situation so they can all be safer. Even if there is only potential for abuse, the Services can provide information and advice to prevent abuse in the future, linking with other agencies in the community to help where appropriate.
The EANP Services also raise public awareness of elder abuse and neglect, and provide education for people working in residential care facilities and for other organisations who work with older people. Their work includes advice to older people and their families on actions to take to protect against opportunity for abuse or neglect in the future - for example, encourage positive relationships between generations and ensure that boundaries are openly discussed and agreed. Guidelines for older people, and for families and carers are available online
If you suspect that an older person is being abused or neglected...
Don't let your fear of meddling in someone else's business stop you from speaking out. You could be saving someone's life. Talk to the older person - let them know you care and are worried for them. Encouragement and support is a really important way you can help an older person to take action in the face of mistreatment.
Everyone - no matter how young or how old - deserves to be safe from harm caused by those who live with them, care for them, or come in day-to-day contact with them.
Everyone deserves to be treated with respect and with caring. Our well-being depends on it.
To mark World Elder Abuse Awareness Day on June 15, 2008, Age Concern New Zealand published two information sheets about psychological abuse.
One is for general use with information for older people, their family and friends and people who work with older people. The second is for people who work in residential care facilities.
The information sheets are available free of charge from Age Concern New Zealand Information about the Families Commission research can also be found there or from NZ Families
References
Age Concern New Zealand, Elder Abuse and Neglect Prevention; Challenges for the Future, 1 October 2007. Accessed on 2 May 2008
Canadian Network for the Prevention for Elder Abuse, [cited 25 March 2005]
Glasgow, K (2007) Background Paper for a Workshop to Develop a National Research Strategy on Elder Abuse and Neglect, Families Commission and Age Concern New Zealand (unpublished)
Mowlam,A., Tennant, R., Dixon, J., McCreadie, C., UK Study of Abuse and Neglect of Older People: Qualitative Findings, Kings College of London and the National Centre for Social Research, August 2007
O'Keefe, M., Hills, A., Doyle, M., McCreadie, C., Scholes, S., Constantine, R., Tinker, A., Manthrope, J., Biggs, S., Erens, B., UK Study of Abuse and Neglect of Older People; Prevalence Survey Report, National Centre for Social Research and Kings College London, June 2007
Peri, K., Fanslow, Dr. J., Hand, Dr. J., Parsons, J., Elder abuse and neglect - exploration of risk and protective factors, Families Commission, Wellington New Zealand, January 2008
WHO/INPEA , Missing Voices: views of older persons on elder abuse, Geneva, World Health Organisation 2002
