Vulnerability and ageing: recognising elder abuse

The Australian Government recently announced a national plan would be developed to address elder abuse in Australia. Many organisations in the sector have welcomed the announcement, which was one of the key recommendations of the Australian Law Reform Commission’s 2017 report on the issue, Elder Abuse: a national legal response.

Elder abuse is widely seen, rightly so, as an abhorrent crime. But sadly, the World Health Organisation (WHO) report that 15.7% of people aged over 60 have reported abuse, which means that
75 000 people in Western Australia are potentially affected. It is estimated that many cases go unreported. Most cases are forms of financial abuse; however, there are many different types of abuse. WHO defines elder abuse as “a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person.”

As well as financial, reported types of abuse also include psychological, social, physical, neglect and sexual.

As we age and become more reliant on others, the reality is that we become more vulnerable to abuse in its many forms. A huge 83% of elder abuse perpetrators are family members of the abused.

Diedre Timms, Chief Executive at Advocare, a not-for-profit organisation in WA protecting the rights of older people, explained some of the complexities around elder abuse.

“I’m absolutely of the belief that a lot of abuse goes on that’s not reported,” Diedre said. “It’s really challenging for older people because the main perpetrators of elder abuse are family members. “So it’s often a son or daughter and that is very difficult in that relationship. You have to first of all admit that it is your son or daughter that’s not doing the right thing. Then to try and do something about it and also preserve the relationship is really challenging. Sometimes, that’s the only relationship that they’ve got left in the family.

“I think we’ve got a bit of a myth really about families being all fabulous – and they’re not necessarily.”

Diedre added that the stress placed on underfunded carers is complicating this issue. Carers of elderly people in the community, often their life partners or adult children, may look after their  loved ones at the cost of their own health. They can receive a government funding package to support the care, but often this is not enough.

“Often the person being the carer is the older person’s partner. So they’re of an increasing age as well,” said Diedre. “A carer can get really stressed and then they might abuse the person they’re looking after just because they’re simply too tired and too stressed to be able to function appropriately.

“There are over 100 000 people on the waiting list for packages of care now. So anyone in the sector is desperately hoping that the new Commonwealth Budget is going to be addressing some of  that.”

David Fisher, Executive Manager Business Services at Juniper, a Uniting Church WA agency providing aged care, also sees carer fatigue as a large contributor to elder abuse. As well as residential care, Juniper also provide aged care support – or home care packages and services – to people who live in the community. David believes that in some cases, looking after an elderly person who needs 24-hour care is too much for some people, who may only receive funding for a limited number of hours of support a week from community services like Juniper.

“How does a care recipient’s needs in a limited budget be met to the interests of the care recipient as opposed to the carer who they live with?” he asked. “We’re only funded to provide a number of hours of home care per week. What happens to the resident for the rest of time?

“Elder abuse in the community is a growing area that needs to be addressed and this is what part of the current reform is looking at. The funding doesn’t keep clients safe and it does put strain on families.

“We know that society wants to stay in their own home, but you can’t stay in your own home as you age and your care needs are higher, unless community is there to support you and to actually provide that care.

“The loneliness of the carer is an abuse that’s not being recognised, the stress of it and physical strain. It is a burden to have to look after somebody when you’re not capable of looking after that person.”

David said that abuse also often happens when family members of an elderly person begin being responsible for that person’s finances. Some might start using money for themselves, rather than for the best care of the elderly person, either for selfish reasons or they may be having their own financial struggles to provide the care. These kinds of situations can be complex, however Juniper’s role is to always look after the person receiving the aged care service.

“It’s a challenge for a church based organisation to balance the residents needs against the family requirements,” David said. “As an organisation, our duty of care is to the residents.”

Diedre Timms explained that elderly people in minority groups are even more vulnerable to elder abuse than the general population. In Indigenous communities, many people are already untrusting of institutions and government organisations, due to past trauma from racism and abuse. People affected by the Stolen Generations are more likely to feel this distrust.

“The challenges are first of all getting older people to speak up,” she said. “That’s not just Aboriginal people, that’s across the board, but often more so in Aboriginal communities because of the history of abuse by institutions,” Deidre said. “So why would they ask for help now when they couldn’t trust the institutional care that they’ve been provided in the past?”

GRAI (Gay, Lesbian, Bisexual, Trans and Intersex Rights in Ageing Inc) is a support network for ageing LGBTI people. LGBTI people are more prone to suffering abuse. Added to this, as June  Lowe, Chair at GRAI said, while the wider community thinks of older people of having no sexuality, this is absolutely not the case.

“Part of the invisibility [of older LGBTI people] is that the wider community thinks of older people as being asexual, therefore isn’t considering their sexuality identity and gender identity,” June  said.

Many elderly LGBTI people have hidden their sexuality their whole lives and to risk losing relationships with family and friends by ‘coming out’ is not something they are prepared to do. This  burden places a high level of stress on a person’s wellbeing and mental state – especially over a lifetime.

“There is a genuine ongoing fear that if people do out themselves that they’ll be treated less well – and very often that’s founded,” June said.

While June agrees this is a subtler, systemic type of abuse, the symptoms and effects of the abuse are the same.

“It may not look as graphic and shocking but the ongoing effects actually are. It’s an erosion of self-worth and confidence. It doesn’t encourage people to lead good and whole lives.

“LGBTI people routinely behave differently in public and when you’re talking about aged care space, it’s all public; you’ve lost your private space. So you’ve very much lost the capacity to be who  you are and for your friends to be who they are.”

June said there are many things an organisation can do to help LGBTI people feel safe, including not assuming the sexuality or gender of aged care residents, making forms inclusive, having inclusive policies and training staff on the issue, holding LGBTI celebratory events, and having connections with LGBTI groups in the wider community. If people feel safe to be themselves, they are more likely to shed the burden of hiding who they really are. She said that if done right, in some cases aged care providers could turn out to be the safest environment a LGBTI person has  experienced.

“To me that’s a very powerful motivator to engage aged care providers with LGBTI inclusivity because they might make this the happiest time of somebody’s life,” June said.

As with any form of abuse there are so many complexities surrounding elder abuse, but with its ageing population, churches are well placed to be a support in this issue. Deidre Timms said there are a number of behaviours, which can be a sign someone is being abused.

She said that in cases of physical abuse sometimes the signs are quite obvious, but in other cases, people may become withdrawn, their behaviour changes significantly, they suddenly don’t have any money or are suddenly not able to get out and about.

David Fisher believes church congregations and other community groups have a vital role to play in supporting people suffering elder abuse – and preventing it from happening in the first place by looking after carers.

“That’s where the wider network of community is important – congregations knowing who or what that person is going through,” David said. “And often congregations, church groups and social groups will pick it up quicker than the family. It’s the community who sees that person isn’t interacting anymore or not returning calls.

“It’s not only about elder abuse, it’s about being able to stop the abuse happening. It’s too late when elder abuse is happening. It’s about supporting a community to be able to live in their own  homes.”

Inspired?

If you or someone you know is being affected by elder abuse, contact Advocare for support. The Advocare hotline is open Monday to Friday, 8.30am to 4.30pm and provides free, confidential support. Call the hotline on 1300 724 679 or visit advocare.org.au for more information.

Juniper has over 450 volunteers who help provide respite care and a range of other support in aged care. For more information or to become a volunteer visit juniper.org.au/volunteering.

For more information about the work of GRAI, visit grai.org.au.

To find out more about elder abuse in the Australian context, download the 2017 report from the Australian Law ReformCommission, Elder Abuse: a national legal response at alrc.gov.au/inquiries/elder-abuse.

The Uniting Church WA Safe Church Policy addresses elder abuse in our congregations and how Uniting Church members can help keep older people safe. Uniting Church WA Safe Church Awareness Training also presents information and scenarios on how to handle situations of elder abuse. For more information visit unitingchurchwa.org.au/uniting-church-centre/safe-church.

Heather Dowling

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