‘It is like being in a prison and in a dark hole and you cannot see any light. He put me in prison and he kept me there”
"My glasses fell off me and broke, and the button came out. I had a red coat and the button came out of the top of the red coat. This was physical, it had never happened before." (Quotes from victims of elder abuse. Source: Older People's Experiences of Mistreatment and Abuse, NCPOP, UCD, 2012.)
It is estimated that 11,000 older people in Ireland suffer some form of abuse. However, while the rights of the child are enshrined in legislation, the abuse of older people has been recognised only recently as a serious societal issue.
According to the World Health Organisation (WHO): "Even today, elder abuse continues to be a taboo, mostly underestimated and ignored by societies across the world. Evidence is accumulating, however, to indicate that elder abuse is an important public-health and societal problem."
A survey launched last month revealed that more than a third of family carers of older people said they had engaged in some form of potentially harmful psychological or physical behaviour towards the person in their care in the previous three months.
The study, Family Carers of Older People: Results of a National Survey of Stress, Conflict and Coping, was carried out by the National Centre for the Protection of Older People (NCPOP) at UCD. It surveyed 2,311 family carers of older people in Ireland in receipt of a carers' allowance and found that 8 per cent reported behaving in a potentially harmful physical way towards the older person in their care.
The report also found that 3.9 per cent of family carers reported physically harming the older person in the previous three months. This included roughly handling, hitting, slapping, or shaking them.
Overall, 0.9 per cent of carers reported that they handled the older person roughly in other ways and 0.5 per cent admitted to hitting or slapping the older person sometimes in the previous three months.
The report also found that a very small proportion of carers reported that they shook or withheld food from the older person.
Elder abuse has been defined 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 or violates their human and civil rights”.
In Ireland elder abuse refers to the mistreatment of a person over the age of 65 and is divided into five categories: emotional or psychological abuse; financial abuse; sexual abuse; physical abuse, and neglect.
The latest national elder abuse prevalence study was carried out by the NCPOP in 2010. The survey of more than 2,000 older people living in the community revealed that 2.2 per cent had suffered mistreatment in the previous 12 months. This suggests that roughly 11,000 older people in Ireland were abused in the past year.
To date there has been no national study on the prevalence of elder abuse in nursing homes. However a 2012 study by the NCPOP of 64 nursing homes revealed that 57.6 per cent of staff reported that they had observed one or more neglectful behaviours by other members of staff in the preceding year.
According to the report, physical abuse was observed by 11.7 per cent of respondents while 1.8 per cent of nursing-home staff saw another member of staff slap or hit an older resident.
A small percentage (0.6 per cent) said they had seen staff throw something at a resident, and 0.5 per cent said that an older person had been kicked or hit with a fist or an object by staff.
More recently the Health Information and Quality Authority (Hiqa) reported it had been notified of 373 alleged, suspected or confirmed cases of elder abuse in nursing homes in 2013, most of which was reported by relatives or friends.
The NCPOP family carers’ report was launched at a special conference organised to mark World Elder Abuse Awareness Day last month.
The event was addressed by Simon Biggs, professor of gerontology and social policy at the school of social and political sciences at Melbourne University in Australia. He also runs a research team at the Brotherhood of St Laurence, an Australian anti-poverty charity.
Prof Biggs addressed the relationship between elder abuse, ageism and human rights.
He said that in order to understand continuing elder abuse in society it is important to look at it within a wider social context, encompassing both society’s attitude towards older people and the relationship between the older person and the State.
“Elder abuse is an extreme case; the extreme end of the spectrum of behaviours towards older people.
“But nevertheless we still have to ask why do we allow that to happen? Why was it detected much later historically than child abuse? Why are the services much less developed?” he asked.
“Our understanding of the dynamics of abuse are much less developed than they are for children, and to understand that you have to understand the priority that society gives to certain age groups and not to others,” he said.
According to Prof Biggs, society puts a “huge emphasis on productivity and the economic value of people” which means that older or disabled people who can no longer work are “almost automatically devalued”, while children and young people are seen as the future workforce or an investment.
“We underuse our older people: we don’t often allow them the opportunities to contribute to society . . . in a way they may wish,” he said.
According to Prof Biggs, studies have shown that members of the public perceive that elder abuse is happening a lot more than it actually is, particularly in residential care.
“Despite this, the actual pick-up rate of elder-abuse cases by support services is ‘appalling’.
“People assume that it is happening more than it actually is but there is not very much action to stop it happening, so that is the bottom line.
“I think that is why we have to ask the question about social attitudes. Why is that people can assume that elder care and the state of older people in society leaves them open to abuse?”
Prof Biggs said that, rather than considering elderly people as “unproductive”, a “burden” or “a grey tsunami”, as they tend to be perceived in most developed countries, it should be seen as “a great achievement and a great gift . . . that now we have a much longer lifespan, and an active and often productive lifespan, than we had in the past.”
