The International Network for the Prevention of Elder Abuse (INPEA) states that:
‘‘Elder abuse is 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.”
Such abuse is generally divided into the following categories:
Physical Abuse – the infliction of pain or injury, physical coercion, or physical or drug induced restraint. Psychological or emotional abuse – the infliction of mental anguish.
Financial or Material Abuse – the illegal or improper exploitation or use of funds or resources of the older person.
Sexual Abuse – non-consensual sexual contact of any kind with the older person.
Neglect – the refusal or failure to fulfil a care giving obligation. This may or may not involve a conscious and intentional attempt to inflict physical or emotional distress on the older person.
The problem of elder abuse cannot be properly solved if the essential needs of older people – for food, shelter, security and access to health care – are not met. Society must create an environment in which ageing is accepted as a natural part of the life cycle, where anti-ageing attitudes are discouraged, where older people are given the right to live in dignity – free of abuse and exploitation – and are given opportunities to participate fully in educational, cultural, spiritual and economic activities.
Experiencing Elder Abuse: Maggie
Eighty-three-year-old Maggie lives alone in a small apartment which she bought with the proceeds of her house sale some years ago soon after her husband died. She is becoming increasingly frail as time goes on and has given up her driver’s licence so is now dependent on her children to help her in daily living. She has two adult children (Beth and David) who both live within 25 minutes’ drive away.
- Beth has promised her mother that she will take her shopping each week to help her buy groceries and household essentials but over the past 6 months has taken to doing her mother’s shopping with her own family shop and then dropping off the items on her way to her son’s weekly sporting event. She can’t stay for a chat and a cup of tea because she’s always running late. She estimates the cost of the shopping and adds $20 to the estimate as she feels that it’s a small reward for the effort and the petrol costs. Is this elder abuse?
- David has been made redundant from his job. He has a wife and three children and is finding it increasingly difficult to support his family’s lifestyle. To ease his financial burden he has been asking his mother for support. Maggie is becoming anxious as she has already given him several thousand dollars and she can feel that it is causing tension between them. One further aspect of this behaviour is his suggestion that she appoint him with Enduring Power of Attorney which would enable him to access her bank accounts. He has the form already filled in, brings it with him and insists she signs it when he visits her. Is this elder abuse?
- Because Maggie doesn’t know her neighbours very well and rarely sees them, and because she doesn’t want to trouble her children any further, she puts up with her deteriorating health and mobility. Consequently, she is not sleeping well, is losing weight and feels increasingly depressed, largely due to David’s increasingly hostile behaviour and his financial demands. Are these indications of elder abuse?
The answer to all three questions is ‘yes’. Even though Maggie’s children may be, or may have been well-intentioned, Beth is gradually and increasingly neglecting her mother without any awareness that she is doing so and is overtly abusing her financially. David’s abuse is both psychological and financial.
Unintended Elder Abuse
Lack of understanding of elder abuse
“What constitutes elder abuse? People might not understand what they’re doing is elder abuse. If you’re working and you have a family and you can’t be there to take better care, is that elder abuse if everyone is doing their best?”
Members of the community referred to a lack of understanding of what constitutes elder abuse. The line between care and abuse is not always easy to see and can change over time. Questions people caring for older people might ask are: is taking the car keys from an older person an act of care or a restriction of freedom? When does the actions of an adult child ‘doing the best they can’ for their mum while mum lives in increasingly squalid conditions become neglect? Does looking after a father’s money give a son the right to take a few hundred dollars every now and then as compensation? Elder abuse can occur when there is no intent to cause harm to the older person, or the harm results from actions taken with good intentions. The person causing the harm may consider they are doing their best to care for the older person in challenging circumstances.
Often, the experience may not be recognised as abuse by the older person, the person causing the harm or bystanders. This is due to a lack of understanding of what constitutes abuse or deep-seated attitudes that the rights of older people are not as important as those of others.
Despite widespread recognition of the term, there was the view that a lack of understanding what constitutes elder abuse could be a factor in some instances where abuse is perpetrated.
How prevalent is elder abuse?
It is estimated that in WA, there are about 75,000 cases a year although it is recognised that the number is probably far higher due to under-reporting. Maggie, like most victims, is highly unlikely to report her children’s neglect and financial abuse to the WA Police or to Advocare. The Institute of Family Studies in Australia estimates that upwards of 14% of people over 65 experience elder abuse.
How is elder abuse manifested?
The abuse from Beth and David could be described as the following:
- Emotional or psychological e.g. David pressuring Maggie for financial gain; Beth not interacting meaningfully with Maggie.
- Social e.g. both children not ensuring that Maggie is taken out and seeing the few friends she has left or even inviting her to family gatherings.
- Financial e.g. Beth feeling entitled to over-charge her mother for services rendered; David’s behaviour resulting in a considerable amount of money already being given to him, coupled with his insistence on having access to her savings.
Who is at risk?
- Persons, aged 80 years and older, suffer abuse and neglect two to three times the proportion of the older population.
- Among known perpetrators of abuse and neglect, the perpetrator is a family member in 90 percent of the cases.
- Two-thirds of the perpetrators are adult children or spouses.
- The offender is most commonly a close relative, especially a grown child, spouse, or sibling.
- Less often, the abuser is a son or daughter-in-law, grandchild, niece, nephew or friend and neighbour.
- The typical target is a frail, ailing woman more than 70 years old.
- In most cases, the victim and the abuser live in the same household in social isolation from friends, neighbours, and other kin who might otherwise informally deter the wrongdoing. When parents are physically abused or financially exploited, sons are the most likely culprits.
- When daughters and daughters-in-law are abusive, their maltreatment usually takes the form of emotional and physical neglect.
- Abuse may occur through mistreatment by home health aides and residential aged care staff members.
- Older persons who are mistreated can suffer from severe emotional distress, especially depression, and are likely to die more quickly
What are the common signs of elder abuse?
- Withdrawing and/or acting fearfully.
- Anxiety, stress or depression.
- Physical injuries including bruising
- Not paying normal bills or having unpaid bills.
- Weight loss which can be sudden or more gradual.
- Difficulty in sleeping at night and/or sleeping excessively during the day.
Support for Elder Abuse
Elder abuse itself takes many forms, and the issues that surround it, such as financial insecurity, mental health, isolation can all be supported to mitigate its impact. Reaching out for help, or finding information to help others, is the best start.
SUPPORT AND ADVOCACY
|Provides advocacy, information and education. Employs advocates and volunteers to create brochures and run the Elder Abuse Helpline 1300 724 679|
|Compass: National Action on Elder Abuse
|A national website for navigating elder abuse, includes an online support directory for WA.|
|Support for mental wellbeing providing online chat, forums and a helpline. 1300 22 4636|
|Represents carers with support and education for carers including respite care, education and referral. 1800 242 636|
|Specialist advice relating to Dementia and elder abuse, provides the National Dementia Line. 1800 100 500|
|Elder Abuse Action Australia
|National peak established to respond to and prevent elder abuse. Contains resources and factsheets.|
|Every Age Counts
|Advocacy and pledge campaign against Age Discrimination.|
|Independent Living Centre WA
|Information, training, funding and hire services for people to live independent lives.|
|Provides telephone online chat and counselling for a range of issues for men, relationships and their families. 1300 78 99 78|
|Older Persons Advocacy Network
|Allows you to request an advocate from your state or territory. Provides further education and webinars on elder abuse, complaints and supports.|
|Provider of relationship support services for individuals, families and communities. 1300 364 277|
|Support for complex mental health issues, including online chat. 1800 18 7263|
|Anonymous and free LGBTI peer support and referral online or by phone. 1800 184 527|
|National sexual assault, domestic and family violence counselling service. 1800 737 732|
|Australian Banking Association
|Campaigns on financial elder abuse, provides a range of factsheets and contacts.|
|Help and advice for carers including respite and financial assistance.|
|Online support for financial decision-making.|
|Community Legal Centres
|Legal information, referral and advice for people who may be ineligible or unable to afford legal aid.|
|Citizens Advice Bureau
|Concession support for a range of legal and community issues including Power of Attorney, Guardianship and Wills.|
|Legal Aid WA
|Legal aid for Western Australians, including an Infoline. 1300 650 579|
|Northern Suburbs Community Legal Centre
|Assists with a range of legal and financial issues, including the Older People’s Rights Service.|
|Office of the Public Advocate
|Assistance with decision making, investigation, guardianship and information sessions.|
|Focuses on the prevention of financial elder abuse, including the ‘WA Will Bank’.|
HOUSING AND AGED CARE
|Aged Care Quality and Safety Commission
|National regulator of Aged Care services, handles complaints and is the primary point of contact for consumers and providers in relation to quality and safety.|
|My Aged Care
|Help around the house or accessing aged care services. 1800 200 422|
|Seniors Housing Advisory Centre
|Information on housing, rental and accommodation support and services for Seniors.|