Report of a Survey Conducted for
The Department For Community Development – Seniors’ Interests
Professor Duncan Boldy
Mr Mathew Webb
Ms Barbara Horner
Ms Margaret Davey
And Ms Beth Kingsley
Freemasons Centre For Research Into Aged Care Services
(incorporating the TG Smith Dementia Research And Development Unit)
When asked why they thought abuse might be unreported and what they thought were the main causes of abuse, responses can be grouped under three perspectives, namely that of:
the older person being abused;
those abusing; and
The older person abused
Loyalty to the family and fear of the consequences, were seen as major reasons for nonreporting by those abused, with some respondents referring to fears of being abandoned or “put into a home”. The dependency of the older person on the abuser(s) came through as a strong theme, related to both non-reporting and the main causes of abuse. One respondent stated “Specifically – has no other alternative to avoid the situation”. There were comments suggesting that the person abused was unable to make decisions or voice their needs because of dementia, poor self image, or even felt that “I deserve this, I am a burden”. Other comments referred to the reluctance of an abused person to change the situation, and the likelihood that such a person might ‘renege’ on any changes that were instigated.
Comments highlighted the lack of social and network support for abusers, lack of more suitable alternative accommodation, ‘family culture’, and in one case that there was an “obligation to care with no understanding of dementia or services”. Respondents felt that the main cause for abuse from the abuser’s perspective was due to the stress of caring.
Other causes mentioned included greed, financial difficulty and lack of support. One response maintained that it was a “punitive response to ageing and disease”. A lack of supervision and a feeling that the caring was all too much, came across strongly with one respondent giving as an example that the “carer was trying to do it all – a martyr”.
Several stated that intergenerational conflict was a factor, with a controlling element being identified in some cases.
The reasons given as to why health professionals fail to report elder abuse included such cynical comments as “Does it matter – money will eventually be the daughter’s”, “look the other way, it’ll go away” and “too hard basket”. Some were considered to be frustrated by the lack of anonymity for the reporter and because it was hard to pin down the variables related to abuse. There was felt to be a concern that it was unsafe to report abuse because there would be repercussions for the person being abused, or that the agency may actually cancel services. There was considered to be a reluctance to be involved with legal issues or with reporting suspicions only. It was noted that staff members were not trained to assess abuse.
2. Future efforts/funds are targeted at activities aimed at gaining an increased understanding of why elder abuse occurs and, particularly, what are the most cost effective primary preventions and interventions, bearing in mind the extent of multiple abuse identified. As regards the kinds of primary preventions needed, respondents rated all kinds of education as particularly important, education of both professionals and the general public in recognising elder abuse, and education of older people to assert and protect their rights. Interventions rated as particularly important were respite care (also considered an important contributor to primary prevention), advocacy and counselling services. It is recommended that:
3. Any existing relevant education programs (targeted at professionals, the general public and/or older people themselves) are appraised as to their adequacy and cost-effectiveness, and new programs developed as needed and evaluated.
Although the above study was done in 2002, I believe the findings still apply. Public education on this important issue has not been taken up by our politicians. The 'head-in-the-sand' attitude cannot be tolerated any longer. In an ageing population, it is obvious that seniors make up a big group of voters. It would be prudent of politicians to take note and do something before Aged Care and Elder Abuse issues, escalate into unmanageable problems.
Visitors to this and other related sites should support any call for better funding in this very important but neglected area in our country.