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What is elder abuse?

It is the neglect, exploitation or painful or harmful mistreatment of anyone who is 65 or older (or anyone aged 18 to 64 who falls under the legal definition of a dependent adult). It can involve physical violence, psychological abuse, isolation, abandonment, abduction, false imprisonment or a caregivers neglect. It could also involve the unlawful taking of a seniors money or property. In short, elder abuse involves various crimes, such as theft, assault or identity theft, that strike victims of all ages. But when the victim is 65 years old or older (or a dependent adult), the criminal could face stiffer penalties. Source:The state Bar of california(what should I know about elder abuse published in 2007-2008) It is generally agreed that abuse of older people is either an act of commission or of omission (in which case it is usually described as neglect), and that it may be either intentional or unintentional. The abuse may be of a physical nature, it may be psychological (involving emotional or verbal aggression), or it may involve financial or other material maltreatment. Regardless of the type of abuse, it will certainly result in unnecessary suffering, injury or pain, the loss or violation of human rights, and a decreased quality of life for the older person (4). Whether the behaviour is termed abusive, neglectful or exploitative will probably depend on how frequently the mistreatment occurs, its duration, severity and consequences, and above all, the cultural context. Among the Navajo people in the United States, for instance, what had appeared to an outside researcher to be economic exploitation by family members was regarded instead by the tribal elders concerned as their cultural duty, and indeed privilege, to share material belongings with their families (5). Other Indian tribes in the United States viewed elder abuse as a community problem rather than an individual one (6). The definition developed by Action on Elder Abuse in the United Kingdom (7) and adopted by the International Network for the Prevention of Elder Abuse 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 persons

source:elder abuse(Woldreport on violence and health)

Pencetage of old people abused both male and female?


The abuse of older people by family members dates back to ancient times. Until the advent of initiatives to address child abuse and domestic violence in the last quarter of the 20th century, it remained a private matter, hidden from public view. Initially seen as a social welfare issue and subsequently a problem of ageing, abuse of the elderly, like other forms of family violence, has developed into a public health and criminal justice concern. These two fields public health and criminal justice have therefore dictated to a large extent how abuse of the elderly is viewed, how it is analysed, and how it is dealt with. This chapter focuses on abuse of older people by family members or others known to them, either in their homes or in residential or other institutional settings. It does not cover other types of violence that may be directed at older people, such as violence by strangers, street crime, gang warfare or military conflict. Mistreatment of older people referred to as elder abuse was first described in British scientific journals in 1975 under the term granny battering (1, 2). As a social and political issue, though, it was the United States Congress that first seized on the problem, followed later by researchers and practitioners. During the 1980s scientific research and government actions were reported from Australia, Canada, China (Hong Kong SAR), Norway, Sweden and the United States, and in the following decade from Argentina, Brazil, Chile, India, Israel, Japan, South Africa, the United Kingdom and other European countries. Although elder abuse was first identified in developed countries, where most of the existing research has been conducted, anecdotal evidence and other reports from some developing countries have shown that it is a universal phenomenon. That elder abuse is being taken far more seriously now reflects the growing worldwide concern about human rights and gender equality, as well as about domestic violence and population ageing. Where older age begins is not precisely defined, which makes comparisons between studies and between countries difficult. In Western societies, the onset of older age is usually considered to coincide with the age of retirement, at 60 or 65 years of age. In most developing countries, however, this socially constructed concept

based on retirement age has little significance. Of more significance in these countries are the roles assigned to people in their lifetime. Old age is thus regarded as that time of life when people, because of physical decline, can no longer carry out their family or work roles. Concern over the mistreatment of older people has been heightened by the realization that in the coming decades, in both developed and developing countries, there will be a dramatic increase in the population in the older age segment what in French is termed le troisie`me age (the third age). It is predicted that by the year 2025, the global population of those aged 60 years and older will more than double, from 542 million in 1995 to about 1.2 billion (see Figure 5.1). The total number of older people living in developing countries will also more than double by 2025, reaching 850 million (3) 12% of the overall population of the developing world though in some countries, including Colombia, Indonesia, Kenya and Thailand, the increase is expected to be more than fourfold. Throughout the world, 1 million people2002.
CHAPTER 5. ABUSE OF THE ELDERLY . 125

reach the age of 60 years every month, 80% of whom are in the developing world. Women outlive men in nearly all countries of the world, rich and poor (3). This gender gap is, however, considerably narrower in developing countries, mainly because of higher rates of maternal mortality and, in recent years, also because of the AIDS epidemic. These demographic changes are taking place in developing countries alongside increasing mobility and changing family structures. Industrialization is eroding long-standing patterns of interdependence between the generations of a family, often resulting in material and emotional hardship for the elderly. The family and community networks in many developing countries that had formerly provided support to the older generation have been weakened, and often destroyed, by rapid social and economic change. The AIDS pandemic is also significantly affecting the lives of older people. In many parts of sub-Saharan Africa, for instance, children are being orphaned in large numbers as their parents die from the disease. Older people who had anticipated support from their children in old age are finding themselves to be the main caregivers and without a family to help them in the future. Only 30% of the worlds elderly are covered by pension schemes. In Eastern Europe and the countries of the former Soviet Union, for instance, as a result of the changes from planned to market economies, many older people have been left

without a retirement income and the health and welfare services that were provided by the former communist regimes. In the economies of both developed and developing countries, structural inequalities have often been the cause among the general population of low wages, high unemployment, poor health services, lack of educational opportunities and discrimination against women all of which have tended to make the elderly poorer and more vulnerable. Older people in developing countries still face a significant risk from communicable diseases. As life expectancy increases in these countries, the elderly will be subject to the same long-term, largelyincurable and often disabling diseases associated with old age that are currently most prevalent in developed countries. They will also face environmental dangers and the likelihood of violence in their societies. Nevertheless, advances in medical science and in social welfare will ensure that many older people will enjoy longer periods of disabilityfree old age. Diseases will be avoided or their impact lessened through better health care strategies. The resulting large number of older people will be a boon for society, constituting a great reservoir of experience and knowledge
FIGURE 5.1

Projected growth in the global population aged 60 years and older, 1995--2025
S o ur c e : U n i t ed N at i o ns P op ul at i on D i v i s i o n , 20 0 2

Percentmage of old people both male and female in Bangladesh?


Aging of population is now a global phenomenon. It is common all over the world that older age range is increasing rapidly on the other hand the number of children and youth population is decreasing. We know from the various sources that in 1950, there were about 200 million persons
Bangladesh.doc

aged 60 and over in the world, constituting 8.1 per cent of the total global population. By the year 2050, there will be a ninefold increase; the worlds elderly population is projected to be 1.8 billion people, about 20 per cent of the total 9.8 billion people. The median age of the world population will jump from 23.5 years in 1950 to 36.2 years in 2050. Bangladesh has same experience. The elderly population of Bangladesh is also increasing in a remarkable rate. The increasing trend of the number of elderly population is explained in the following table: Table form source: Country Statement

on

Seminar on the Social, Health and Economic Consequences of Population Ageing in the Context of Changing Families, Bangkok, Thailand 25-27 July, 2007 Arshad Hossain
Deputy Secretary Ministry of Social Welfare Government of the Peoples Republic of Bangladesh

Source:

Types of elder abuse?


Physical abuse
This is when someone physically hurts you. Physical abuse can be: _ Hitting _ Kicking _ Pulling hair _ Pinching or shaking _ Or giving someone too much medication so they find things difficult to do.
5

Sexual abuse
This is when someone makes you do sexual things that make you sad, angry or frightened. Sexual abuse is being touched where you do not want to be touched _ your private parts _ your bum _ your breasts _ your penis or vagina or being made to touch other people in these places.
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Emotional abuse
This is when people say bad things to hurt your feelings, shout at you or threaten you. Examples of emotional abuse are:

_ calling

you names _ laughing at you _ blaming you for things when its not your fault _ treating you like a child _ ignoring you
7

Financial abuse
This is when someone takes your money or belongings without asking. Financial abuse can be: _ stealing your money _ being forced to pay for other peoples things _ when you dont have a say in how your money is spent
8

Neglect
Neglect is when your care or support is not enough to meet your needs. Neglect can be: _ being cold much of the time _ being hungry much of the time _ having only dirty clothes to wear _ being put in danger
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Discriminatory abuse
This is when people say or do bad things to you, or treat you unfairly because you are different. Discriminatory abuse is being treated unfairly because you: _ have different colour skin _ have a different religion _ are disabled _ are lesbian or gay _ speak a different language

Source:

Say NO to abuse

Easy read version


Printed by SUFFOLK DESIGN & PRINT. Telephone 01473 260600

Physical Abuse Physical abuse is defined as; Inflicting, or threatening to inflict, physical pain or injury to a vulnerable elder. Physical abuse can also include depriving them of basic needs such as food, medicines, or giving too much medication. Physical abuse accounts for 25% of all abuse cases of elder abuse. This type of abuse includes punching, pushing, shaking, pinching, burning, force feeding, and any sort of physical punishment or restraint. Signs of abuse include physical signs as well as sudden changes in behavior or refusal of a caregiver to allow visitors to see an elder alone. Emotional or psychological Abuse Emotional, psychological abuse is defined as; Inflicting mental pain, anguish, or distress on an elder person through verbal or nonverbal acts. Psychological abuse accounts for 36% of all cases of abuse. Emotional abuse can be difficult to detect unless witnessed. People being abused in this way can show changes in behavior, fear when in the presence of the abuser, agitation or withdrawal. Sexual Abuse Sexual abuse is non-consensual sexual contact of any kind. Sexual abuse can be difficult to detect except for those involved in their nursing care. Signs include the physical signs. Always investigate allegations of sexual abuse by a vulnerable adult. Financial or Exploitative abuse Financial or exploitative abuse is defined as the illegal taking, misuse, or concealment of funds, property, or assets of a vulnerable elder. Financial/material exploitation accounts for 30% of all cases of abuse Exploitation includes the unexplained disappearance of funds, valuable possessions, changes to wills or financial documents. Neglect as abuse Neglect is defined as failing or refusing to provide food, shelter, healthcare or protection for a vulnerable elder. Neglect accounts for 49% of cases of abuse.

The physical signs of neglect are often easy to see. Dirty surroundings, poor personal hygiene, soiled bedding, smell, untreated cuts or sores, poor dental hygiene. Abandonment To desert a vulnerable elder is abuse when that person has assumed the responsibility for care or custody of them. Source: file:///C:/Users/USER/Downloads/6_types_abuse.htm There are several different types of elder abuse: Physical Abuse: Any act of violence or rough treatment causing injury or physical discomfort. Physical abuse also includes sexual abuse and medication abuse. Physical abuse may include:

Any kind of physical assault such as slapping, pushing, pinching, choking, kicking, punching, burning, or injuring with an object or a weapon It also includes deliberate exposure to severe weather and unnecessary physical restraint Force feeding Rough handling Sexual abuse such as sexual assault or harassment Medication abuse, such as withholding prescriptions over overmedicating

Psychological or Emotional Abuse: Any act that may diminish the sense of identity, dignity, or self-worth of an individual. Psychological abuse may include:

Name calling, yelling, insulting, ridiculing, swearing Threatening abandonment, poverty, withdrawal of love, or institutionalization Intimidating, frightening, humiliating, infantilizing (treating like a child) Isolation, silent treatment Invasion of privacy Excluding from decision making or meaningful events

Financial or Material Abuse: Theft or misuse of a seniors money or property. Financial abuse may include:

Theft of money or possession

Forging a seniors signature on cheques or other documents Misusing power of attorney Use of a seniors money or possessions without authorization Unduly influencing a senior to change his/her will Sale of home or possessions without seniors consent or legal authority

Neglect: The failure to meet the needs of an older adult who cannot meet these needs on his/her own. Neglect may have physical, psychological, and/or financial components, and be: Active: Intentional withholding of basic necessities and/or care; or Passive: Non-intentional, non-malicious withholding of basic necessities and/or care because of lack of experience, information, or ability Neglect may include:

Failure to provide necessary provisions such as food, water, heat, adequate housing, clothing Failure to provide recommended health aids or equipment Lack of attention to needed medical or social assessment treatments Inattention to safety precautions, including the need for supervision Abandonment

Note: A seniors neglect may also be self-neglect meaning the older person is living in an unsafe or unhealthy manner by choice or ignorance. While this may be distressing to see, it must be remembered that a competent person, of any age, has the right to make choices about their lifestyle and to live at risk if he/she is not a danger to others. However, if you have any concerns about a senior not having the means and supports to access basic necessities or if you feel a senior does not understand the implications and risks of his/her lifestyle, it is suggested that you contact your Regional Health Authority
Source: http://www.nlnpea.ca/Types_of_elder_abuse

The National Center on Elder Abuse defines seven different types of elder abuse: physical abuse; sexual abuse; emotional abuse; financial exploitation; neglect; abandonment; and self-neglect. These definitions are based on an analysis of existing State and Federal definitions of elder abuse, neglect and exploitation conducted by the Center in 1995. Physical abuse. Use of physical force that may result in bodily injury, physical pain, or impairment. Sexual Abuse. Non-consensual sexual contact of any kind with an elderly person. Emotional abuse. Infliction of anguish, pain, or distress through verbal or non-verbal acts. Financial/material exploitation. Illegal or improper use of an elder's funds, property, or assets. Neglect. Refusal, or failure, to fulfill any part of a persons obligations or duties to an elderly person.
This Informational report was researched and written by Toshio Tatara, PhD. and Lisa M. Kuzmeskus, M.A. for the National Center on Elder Abuse Grant
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No. 90-am-0660 (Washington, DC: May 1996; update by the National Center on Elder Abuse, March, 1999). Tatara, Toshio and Lisa Kuzmeskus, Summaries of Statistical Data on Elder Abuse in Domestic Settings for FY 95 and FY 96 (Washington, DC: National Center on Elder Abuse, 1997). The National Center on Elder Abuse is a partnership of the National Association of State Units on Aging (NASUA); the Commission on Legal Problems of the Elderly of the American Bar Association (ABA); the Clearinghouse on Abuse and Neglect of the Elderly (CANE) of the University of Delaware; the San Francisco Consortium for Elder Abuse Prevention of the Goldman Institute on Aging (GIOA); the National Association of Adult Protective Services Administrators (NAAPSA); and the National Committee for the Prevention of Elder Abuse (NCPEA). Support for the National Center on Elder Abuse is provided by the U.S. Administration on Aging.
1

Abandonment. Desertion of an elderly person by an individual who has physical custody of the elder or by a person who has assumed responsibility for providing care to the elder. Self-neglect. Behaviors of an elderly person that threaten the elders health or safety.

Highlights of A Study of Domestic Elder Abuse Reports


Presented below are selected findings from a national study of state domestic elder abuse reports, conducted by
2

the National Center on Elder Abuse.

Data were collected from State adult protective service agencies and State units on aging. As noted

above, many incidents are not reported; thus, these numbers may undercount the extent of the problem.

From 1986 to 1996 there has been a steady increase in the reporting of domestic elder abuse nationwide: 117,000 reports in 1986; 128,000 reports in 1987; 140,000 reports in 1988; 211,000 reports in 1990; 213,000 reports in 1991; 227,000 reports in 1993; 241,000 reports in 1994; 286,000 in 1995 and 293,000 in 1996. The 1996 figure represents an increase of 150 percent since 1986. This study estimates that approximately 1.01 million elders were victims of various types of domestic elder abuse in 1996. This figure, however, excludes self-neglecting elders. If selfneglecting elders are added, the total number of elder abuse victims might be as high as 2.16 million individuals. The median age of elder abuse victims was 77.9 years, according to 1996 data that excluded self-neglecting elders. The median age of selfneglecting elders was 77.6 years in 1996.

Neglect is the most common form of elder maltreatment in domestic settings. Of the nonselfneglect reports that were substantiated in 1996, 55 percent involved neglect. Physical abuse accounted for 14.6 percent in the same year, while financial or material exploitation represented 12.3 percent of the substantiated reports. In 1996, 66.4 percent of the victims of domestic elder abuse were white, while 18.7 percent were black. Hispanic elders accounted for 10 percent of the domestic elder abuse
Types of Domestic Elder Abuse (1996)
Physical Unknown Abuse Financial/Material4% 14.6% Exploitation 12.3% Sexual Abuse All Other 0.3% Types 6.1% Emotional Abuse 7.7% Neglect 55.0%

victims in the same year. The proportions of


FOR MORE INFORMATION, please contact the National Center on Elder Abuse at 1201 15th Street, NW, Suite 350, Washington, DC 200052800. Tel (202) 898-2586 Fax (202) 898-2583 E-mail NCEA@NASUA.org. NCEA Web site wwwgwjapancom/NCEA

Native Americans and Asian Americans/Pacific Islanders were each less than 1 percent.

Source:

NATIONAL CENTER ON ELDER ABUSE,published in


1995

Examples of elder abuse?


Your caregiver or a new friend persuades you to sign a power of attorney so she can handle your affairs for youonly to sell your home and steal the cash. Neglected and hungry, you lie stranded in your bedroom while your adult son empties your bank accounts. A home repairman persuades you to pay cash on the spot for a great home improvement dealthen never does any work.

3 2
3

You forget to take your medication and a


nursing home staff member slaps you in the face. You pay fees to claim a free vacation or winnings from an international lotteryonly to deplete your savings and get nothing in return.

Whom abuses old people?


An abuser can be a spouse, partner, relative, a friend or neighbor, a volunteer worker, a paid worker, practitioner, solicitor, or any other individual with the intent to deprive a vulnerable person of their resources. Relatives include adult children and their spouses or partners, their offspring and other extended family members. Children and living relatives who have a history of substance abuse or have had other life troubles are of particular concern. Perpetrators of elder abuse can include anyone in a position of trust, control or authority. Family relationships, neighbors and friends, are all socially considered as relationships of trust, whether or not the older adult actually thinks of the people as "trustworthy". Some perpetrators may "groom" an older person (befriend or build a relationship with them) in order to establish a relationship of trust. Older people living alone who have no adult children living nearby are particularly vulnerable to "grooming" by neighbors and friends who would hope to gain control of their estates. The majority of abusers are relatives, typically the older adult's spouse/partner or sons and daughters, although the type of abuse differs according to the relationship. In some situations the abuse is "domestic violence grown old," a situation in which the abusive behaviour of a spouse or partner continues into old age.

In some situations, an older couple may be attempting to care and support each other and failing, in the absence of external support. With sons and daughters it tends to be financial abuse, justified by a belief that it is nothing more than the "advance inheritance" of property, valuables and money. Within paid care environments, abuse can occur for a variety of reasons. Some abuse is the willful act of cruelty inflicted by a single individual upon an older person. In fact, a case study in Canada suggests that the high elder abuse statistics are from repeat offenders who, like in other forms of abuse, practice elder abuse for the Schadenfreude associated with the act. More commonly, institutional abuses or neglect may reflect lack of knowledge, lack of training, lack of support, or insufficient resourcing. Institutional abuse may be the consequence of common practices or processes that are part of the running of a care institution or service. Sometimes this type of abuse is referred to as "poor practice," although it is important to recognize that this term reflects the motive of the perpetrator (the causation) rather than the impact upon the older person. With the aging of today's population, there is the potential that elder abuse will increase unless it is more comprehensively recognized and addressed.

Source: http://en.wikipedia.org/wiki/Elder_abuse

Characteristics of abuser?
The abuser is usually a relative of the victim. Because of the close relationship, elders find it difficult to report abuse. The abuser may also be a caregiver or friend hired by the elderly person to assist him or her with household tasks, food preparation and the management of financial resources. The following characteristics profile the abuser: Usually relative of the victim, most often son or daughter Often has alcohol or drug abuse problem, chronic medical condition or financial crisis Financially dependent on victim for home, car or food Under stress History of violence in family

Symptoms of elder abuse?


Elder abuse and neglect can be very difficult to notice. You might not recognize signs as being abuse immediately. They may appear to be symptoms of dementia or signs of the elderly persons frailty or caregivers may explain them to you that way. Many of the signs and symptoms of elder abuse do overlap with symptoms of mental deterioration, but that doesnt mean you should dismiss these warning signs. The following are a few warning signs that could indicate some form of elder abuse:

changes in personality or behaviour in the elder; fear, anxiety, depression or passiveness in relation to a family member, friend or care provider; unexplained physical injuries, such as brusies, sprains, or broken bones; behaviour that mimics dementia, such as rocking, sucking, or mumbling to oneself; dehydration, poor nutrition or poor hygiene; improper use of medication; confusion about new legal documents, such as a new will or a new mortgage; sudden changes in elders finances, such as significant withdrawals; and reluctance to speak about the situation.

Source: http://canadasafetycouncil.org/campaigns/preventing-elderabuse

Number of old people abused?


More than 200,000 old people suffer abuse and neglect from those close to them, the care standards watchdog said yesterday. In more than seven in eight cases the victims were maltreated by family members, the Commission for Social Care Inspection found. The number of elderly people being starved, denied medicine, routinely humiliated or beaten up is likely to be far higher as the figures do not cover abuse in care homes, the CSCI warned in its Government-backed report.

More than 200,000 elderly people are said to suffer some form of maltreatment (file picture) Using figures from a Department of Health survey, the CSCI estimated that 227,000 older people 'have experienced neglect or abuse by persons they should have been able to trust'. This equates to more than one in 40 elderly Britons who live independently. The survey questioned 2,100 people over 66 who were living in their own homes. Many who said they had been abused or neglected named more than one person as responsible. Some 51 per cent said they had been maltreated by a spouse or partner, and 49 per cent named another family member. Around one in eight, 13 per cent, said they had been mistreated by a care worker providing home help. If incidents such as abuse from neighbours and other acquaintances are included in the figures, just under 350,000 elderly Britons are reckoned to have suffered mistreatment, the report found. More than four in ten said they had suffered neglect, more than one in seven said they had been suffered physical abuse or attack, and just over a quarter complained of financial abuse. The CSCI warned of 'uneven' and 'variable' efforts by local authorities to stamp out abuse or act on complaints. It called for further research into abuse of the old in hospitals and care homes.

Read more: http://www.dailymail.co.uk/news/article-1083132/The-abuse-old-age-200-000-maltreatedrelatives-says-care-watchdog.html#ixzz1s37owIEI

Source: http://www.dailymail.co.uk/news/article-1083132/The-abuse-old-age-200-000-maltreatedrelatives-says-care-watchdog.html

'Half a million old people suffering abuse'


By Sarah Womack, Social Affairs Correspondent 12:01AM GMT 07 Feb 2007 Abuse of the elderly must be treated with the same seriousness as child abuse, with police receiving special training to protect older people from what has become a "national scandal", a charity said today. Help the Aged said half a million older people were neglected or abused at any one time physically, sexually, or psychologically but a third of people had not heard of "elder abuse" and almost a quarter had no idea what the signs were. As The Daily Telegraph reported last week, the largest proportion of abusers are related to the person being abused (46 per cent), with 64 per cent of abuse occurring in the homes of victims. However, almost a quarter of people surveyed by the charity were under the impression that professional care workers were the ones most likely to carry out abuse. Only 17 per cent of those surveyed thought that sons and daughters would be most likely to abuse their parents, even though figures show that a quarter of abusers of the elderly are sons or daughters. Paul Cann, the director of policy at Help the Aged, said: "These figures signal a 'Not In My Back Yard' public attitude, fuelling myths that abuse of older people is largely carried out in professional settings and never close to home.

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"We know this isn't the case. Elder abuse can happen anywhere and by anyone, and is more likely to occur within the family home, by someone in a position of trust. "If more people understood what elder abuse is and its impact on those affected, instead of treating it as a taboo, we'd be one step closer to tackling this national scandal." Research suggested that up to 90 per cent of people would want to report abuse if they knew it was taking place, he said.

Help the Aged is today publishing a booklet giving information on "tell-tale signs of abuse" and ways to help. It says signs may include the person becoming unusually withdrawn or depressed or changes in appearance. The television personality Esther Rantzen, who is leading the campaign, said: "Elder abuse not only has a devastating effect on older people, it shocks and appals their loved ones and the whole nation. What kind of country allows older people to suffer, and looks away? Older people must be protected, abusers must be brought to justice, and it's up to all of us to make sure this happens. "We must all be vigilant, recognise the signs and act upon them to protect our vital asset, our older population." Help the Aged and Action on Elder Abuse want training in the prevention and recognition of elder abuse to be a mandatory element of all staff training for anyone working with older people, such as doctors, nurses, social workers, and council staff. The charities also want elder abuse to be treated with the same degree of seriousness and priority as child abuse and adult protection to be a compulsory part of police training. Help the Aged is raising money to help fund the Action on Elder Abuse response line, a free helpline for anyone worried that an older person is at risk. Source: http://www.telegraph.co.uk/news/uknews/1541787/Half-a-million-old-people-sufferingabuse.html

UK Call for action on sexual abuse of elderly

The sexual abuse of elderly people may not be openly acknowledged

The sexual abuse of elderly people is one of society's last taboos and needs to be confronted openly if it is to be stopped, a conference has heard. The charity Action on Elder Abuse believes 5% of older people - some five million people - have been abused. It estimates from calls to its helpline that about 10,000 to15,000 have been sexually abused.

Ginny Jenkins, the charity's director, told its national conference on Thursday that the first step to tackling the problem was to acknowledge its existence so that victims could talk about it: She said: "The idea that someone could rape or indecently assault a frail elderly person is so shocking that people often prefer not to think about it at all. "But sadly it happens far more than anyone would like to believe. "As a society, we have faced up to the appalling facts about abuse of children and people with learning difficulties and now we must begin to open our eyes to the reality that some people target and abuse vulnerable elderly people." National register Wendy Greengross, a patron of the charity, said another problem was that elderly people may not feel comfortable talking sexual matters. She added that, as with all forms of sexual abuse, some might think they were partly responsible for their abuse. Ms Jenkins told BBC News Online that there was a lack of appropriate services to support elderly people who had been abused. She said social services and women's aid organisations were not geared up to deal with it. "Social services tends to concentrate on child protection. It may be right for the nation to look to children as the nation's future," she said. "But in terms of each individual member of the nation we should be looking to older people as they are our own future." Action on Elder Abuse, set up six years ago, supports proposals in the government's Social Services Bill to create a national register to be created for all staff working in the social care field, including those working in old people's and nursing homes and community care services for the elderly. Ms Jenkins said that there was currently nothing to stop care staff who had abused elderly people moving from care home to care home. Learning difficulties The conference also heard from Tom Burgner, who headed an inquiry into the sexual abuse of people with learning difficulties. He called for much tighter regulation of residential and nursing homes for elderly people. He said: "It is far easier not to give permission to set up an establishment than to close it down afterwards." He also called for elderly people to be offered the same protection as children in care and for prison sentences for those found guilty of abusing the elderly to be increased. Source: http://news.bbc.co.uk/2/hi/uk_news/481465.stm

Every year at least 4 million older people in the European region are estimated to suffer physical abuse: being slapped, punched, kicked, burned, wounded with a knife or locked in their rooms, says a UN report.

Budapest, Copenhagen and Rome, 16 June 2011

European report on preventing elder maltreatment

Image by WHO
Research also indicates that as many as 2500 older people may die at the hands of family members. These are the main findings of the new European report on preventing elder maltreatment, released today by WHO/Europe at the 3rd European Conference on Injury Prevention and Safety Promotion, in Budapest, Hungary. The report gives the first description of the size, causes and consequences of elder maltreatment, and provides an overview of good practice in prevention. This is very shocking, says Zsuzsanna Jakab, WHO Regional Director for Europe: This abuse is destroying the lives of older people, and affecting their mental and physical well-being at a time when they are very vulnerable. The European population is ageing rapidly and governments need to act urgently to halt this growing health and social problem. This report will help. In 2050, a third of the Regions population will be aged 60 years and older, due to a combination of increased life expectancy and a decline in fertility. More resources will be needed to pay pensions and to provide health and social care. Having more old people dependent on younger carers will place extra strain on economic, social and family structures, particularly at a time of financial constraint. This may in turn increase the numbers of old people who are abused. The new report, covering the 53 countries in the European Region, looks at physical, sexual, mental and financial abuse; along with neglect, such abuse comprises elder maltreatment in both private settings and residential and nursing homes. In addition to the estimated 4 million older people physically abused each year:

29 million are subjected to mental abuse (insults or threats); 6 million to financial abuse (stolen money or fraud); and 1 million to sexual abuse (sexual harassment, molestation, rape or exposure pornography)

Old people who suffer from dementia and disability are more likely to be abused. This leads to increased dependence, and the victim may live in the same household as the perpetrator. Abuse is also more likely to occur in low- and middle-income countries and in the poorest sections of society. Elder maltreatment is still a social taboo, and much of it is ignored or underreported in many countries. Nevertheless, the problem is gaining increasing public and political attention, as a common challenge across government departments and sectors. Health systems can play a key role in providing services for people for whom maltreatment leads to physical, sexual and/or mental harm. They are also central in advocating and coordinating preventive action. The WHO/Europe report, overseen by an international group of experts from the health, justice, social and other sectors, provides guidance for policy-makers, practitioners and development agencies on using evidence-based approaches to prevent elder maltreatment. Proposed actions include:

developing and implementing multisectoral national policies and plans to prevent elder maltreatment and to address equity and ethical issues; improving data collection, surveillance and research; implementing prevention and control strategies; strengthening services for victims, including investment in staff training; and raising awareness, with a special emphasis on protective factors.

Notes

The 3rd European Conference on Injury Prevention and Safety Promotion is a major event bringing stakeholders in preventing injuries and violence from across Europe to exchange and discuss the latest results of injury research, policies and practices. It is coordinated by Eurosafe, the European Association for Injury prevention and Safety Promotion. The WHO European Region covers over 880 million people in 53 countries, stretching from the Arctic Ocean in the north, the Mediterranean in the south, the Atlantic Ocean in the west and the Pacific Ocean in the east (http://www.euro.who.int/en/where-we-work).

For more information, please visit the web sites of Eurosafe (http://www.eurosafe.eu.com) and WHO/Europe:

European report on preventing elder maltreatment (http://www.euro.who.int/en/what-wepublish/abstracts/european-report-on-preventing-elder-maltreatment) Violence and injury prevention (http://www.euro.who.int/violenceinjury).

Source; http://oneworldgroup.org/2011/06/16/10000-old-people-abused-every-day-in-europe/

Characteristics of abused persons?

The elder abuse and neglect victim can be described as follows: Usually female 75 years old or older Widowed/divorced Lives alone or with abuser Dependent on the abuser Physically or mentally impaired Frail or chronically ill Isolated Source; Preventing Abuse and Neglect Of The Elderly Anna Mae Kobbe, Assistant Professor Family Life

Preventing elder abuse?


The United States House of Representatives Select Committee on Aging estimates 5 percent of all elderly in America are being abused, neglected or exploited annually. The National Committee for Prevention of Elder Abuse estimates that one million older individuals are abused or neglected each year in the United States. The Tennessee Department of Human Services indicates 5 percent of the elderly population in the state is approximately 40,000 people. Currently, the Department of Human Services works with 2,000 cases per month. If these estimates are accurate, many cases of elder abuse and neglect are going unreported in Tennessee. Instead of enjoying their later years, many older citizens are forced to live in fear in their own homes, suffer pain and neglect or die from injuries inflicted by others. Elder abuse often goes unreported because victims are ashamed, unaware of how to report abuse or fearful of retaliation if they report the abuse. Elder abuse and neglect can be prevented or stopped if family members monitor the well-being of elders and report known or suspected abuse and neglect to the Tennessee Department of Human Services. Tennessee law requires that any person (family member, friend, neighbor, doctor, dentist, etc.) who has reasonable cause to suspect that an adult has suffered abuse, neglect or exploitation must report it. Contact the local office of the Tennessee Department of Human Services in writing, by telephone or in person. Check the telephone directory for the telephone number of the local county office of the Department of Human Services. All 95 Tennessee counties have a local office of the Department of Human Services Elder abuse and neglect can be prevented. Frequent contact with the elderly can help family members evaluate their health status, living

conditions, quality of care and emotional well-being. In some cases, daily telephone contact or personal visits may be required. The following are suggestions to help prevent elder abuse and selfneglect: You can help prevent elderly abuse and neglect. Learn the facts about elder abuse. Promote the elderly's involvement in activities that require social contacts with others. Encourage elderly persons to develop a social support network. Elderly people should have daily contact with family, friends or neighbors. Develop a neighbor-to-neighbor program. A daily telephone call can help monitor the well-being of seniors. Report needs to family, church or community social service organizations. Establish a Widow-to-Widow program in the community. Adopt an elderly person. Keep in touch with them throughout the year. Visit them, provide food or small gifts and help them be involved in the community. Encourage participation in Meals on Wheels, the Senior Citizens Center, the Nutrition Site, Extension Homemakers or civic/community/religious groups. Home-delivered meals and programs for senior citizens can reduce isolation. Transportation can help prevent isolation. Help provide transportation to senior citizens. If you know or suspect that an elderly or disabled adult is being abused, neglected or is not receiving the proper care, report the abuse to the county office of the Tennessee Department of Human Services; Adult Protective Services. You can protect yourself from elder abuse and neglect. Develop a social support network. Contact family, friends or neighbors daily. Be willing to accept changes. Be willing to accept help from others. Be willing to ask for help. Enhance assertiveness skills and self-esteem. Elders have rights. Ask for help. Report abuse even if the abuser is a family member. Call the county office of the Tennessee Department of Human Services. Check local telephone listings for the number. For additional information on elder abuse prevention, contact the following resources: National Committee for the Prevention of Elder Abuse c/o Institute on Aging The Medical Center of Central Massachusetts ll9 Belmont Street Worcester, MA 06l05 508/856/00ll The program of the National Committee for the Prevention of Elder Abuse

includes research, advocacy, public awareness and information and training for professionals in gerontology and related fields who work to prevent abuse.
Source: Preventing Abuse and Neglect

Of The Elderly Anna Mae Kobbe, Assistant Professor


Family Life HOW CAN ELDER ABUSE BE PREVENTED? on: May 18, 2009, 11:27:33 AM

HOW CAN ELDER ABUSE BE PREVENTED?

Educating seniors, professionals, caregivers, and the public on abuse is critical to prevention. On an individual level, some simple but vital steps to reduce the risk:

Take care of your health. Seek professional help for drug, alcohol, and depression concerns, and urge family members to get help for these problems. Attend support groups for spouses and learn about domestic violence services. Plan for your own future. With a power of attorney or a living will, health care decisions can be addressed to avoid confusion and family problems, should you become incapacitated. Seek independent advice from someone you trust before signing any documents. Stay active in the community and connected with friends and family. This will decrease social isolation, which has been connected to elder abuse. Know your rights. If you engage the services of a paid or family caregiver, you have the right to voice your preferences and concerns. If you live in a nursing home or board and care home, call your Long Term Care Ombudsman. The Ombudsman is your advocate and has the power to intervene. Please visit our Help for Elders and Families section to learn more.

All states have adult protective and long-term care ombudsman programs, family care supports, and home and community care services that can help older adults with activities of daily living.

Source: http://jerichoroadministries.org/board/index.php?topic=163.0
What you can do as a concerned family member or friend:

Watch for warning signs that might indicate elder abuse. If you suspect abuse, report it. Look for any discrepancies in the elders medications. Watch for possible financial abuse. Ask the elder if you may scan bank accounts and credit card statements for unauthorized transactions.

Call and visit as often as you can. Help the elder consider you a trusted confidante. Offer to stay with the elder so the caregiver can have a break on a regular basis, if you can.

If an elder is experiencing abuse they may feel ashamed or embarrassed to tell anyone in fear of retaliation or punishment. It is essential that elders have access to information and are aware of available help. Make sure to listen to your elderly parents, friends, or other family members and take their concerns seriously. If you suspect abuse, report it immediately to health care providers, social services, police, legal professionals and/or members of faith communities.

Source: http://canadasafetycouncil.org/campaigns/preventing-elderabuse

Preventing elder abuse in south asian region?


Education and public awareness campaigns: conducting campaigns on elderly abuse have been vital for informing people in industrialized countries. Public education, awareness building as well as training workshops, continuing educational programmes, scientific meetings and conferences can help change the attitudes and behaviour of caregivers and practitioners in various disciplines medicine, mental health, nursing, social work, criminal justice, researchers, educators, policy-makers and decision-makers. These activities need also to be conducted in SEAR countries to bring out the hidden aspects of elderly abuse. However, no official action at the policy level or programmes have been formulated for prevention of elderly abuse.6 Active ageing is the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age. Policies based on active ageing ensure fewer disabilities associated with chronic, old age diseases, giving the elderly a chance to participate in all aspects of life, lowering costs of medical treatment and burden on health services.7This framework is valuable for SEAR countries to adopt when formulating policies or designing a campaign on prevention of elderly abuse

source;

Department of Sustainable Development and Healthy Environment World Health Organization, Regional Office for South-East Asia New Delhi, 2003
SEA/Injuries/2 Distr: General

Prevention of elder abuse according to Bangladesh?


Though, a number of initiatives have been taken for the welfare of the elderly people but, most of them are fail to reach large segments of the elderly population. Neither an inclusive nor a comprehensive understanding in association with national policy agenda of Bangladesh. From the foregoing discussion it has been observed that even though Bangladesh is experiencing the increasing trend of elderly population, but it will be difficult to manage this situation unless the efforts are accelerated. It is high time that Bangladeshi policy makers give due importance to the forthcoming age wave. There are many lessons that can be learnt from the experience of industrial societies who are facing the problems associated with an increase in their ageing population. However, the programmes for the welfare of the elderly population should be prioritized as: - increase the amount of money and the number of beneficiaries under Boyoshko Bhata Karmashuchi, and financial support for the family care-givers;

- the traditional joint family system should be strengthened in order to provide basic needs and psychosocial support to the elderly; - the elderly should be given the opportunity of providing community based services with their active involvement in their care and in the effective utilization of their potentials in development; - access to treatment facility should be available and cheap for elders and special emphasis on care of geriatrics should be taken every health center, medical college, community clinic in both rural and urban areas; - separate programmes (financial and health care) for the welfare of the elderly women (especially, for widows and husband deserted women) should be established; - accelerating implementation of nutrition programmes should be prioritized; 12 | P a g e

- government, NGO and all their organizations have to build care home and available recreational facilities there for elders; - programmes for the welfare of the elderly have to be broadcasted through the medias; and - government should be tried to achieve the targets of Millennium Development Goals (MDG). Source: Unnayan Onneshan Policy Brief on Present Social Context and Elderly Population in Bangladesh Author K. M. Mustafizur Rahman Acknowledgement:
The manuscript is an output of a research programme of Social Policy Unit, undertaken by the Unnayan Onneshan-The Innovators, a center for research and action on development, based in Dhaka, Bangladesh. I cordially thank Mr. Rashed Al Mahmud Titumir for his constant support, careful supervision and uninterrupted encouragement to carry out this research work. I am grateful to Mohammed Abdul Baten and Jayanta Kumar Basak for valuable inputs during this study. I am also thankful to A. Z. M. Saleh for his efforts in developing and editing the report.

Copyright: Unnayan Onneshan-The Innovators


The content of this publication may be reproduced for non-commercial purposes with proper citation (please send output to the address mentioned below). Any other form of reproduction, storage in a retrieval system or transmission by any means for commercial purposes, requires permission from the Unnayan Onneshan-The Innovators.

For orders and request please contact: Unnayan Onneshan-The Innovators House: 16/2, Indira Road, Farmgate, Dhaka-1205, Bangladesh. Tell: + (880-2) 815 82 74, 911 06 36; Fax: + (880-2) 815 91 35 E-mail: info@unnayan.org; Web: www.unnayan.or Population ageing has been seen to result in increasing neglect and abuse of older persons. Elder abuse is defined by WHO as a single or repeated act, or lack of appropriate action, occurring in any relationship where there is an expectation of trust that causes harm or distress to an older person (WHO 2002). The growing number of older persons traditionally expected to be taken care of is contributing to increasing stress in joint and extended families. The faster pace of lifestyle changes has resulted in a quicker widening of the generation gap making it difficult for both the younger and older persons to adjust to each others attitudes. The youth fail to understand the values cherished by the elderly while older persons are virtually bewildered at the rapidly changing attitude and lifestyles of the

younger persons. Neglect and abuse of the elderly has come to be recognized as a universal phenomenon as reflected in the establishment of the International Network for the Prevention of Elder Abuse (INPEA) in 1997 and the designation of 15th June as World Elder Abuse Awareness Day (WEAAD) in 2006.26 Abuse can be physical, psychological, emotional, financial or social. Data on elderly abuse are not available for most countries as discussion of elderly abuse in South Asia remains a taboo. The incidence of neglect and verbal abuse of the elderly is reportedly much higher than that of physical abuse though it is not unknown particularly cases of violent crime targeting older persons. Generally, like domestic violence elderly abuse goes unreported as victims prefer to remain silent to avoid bringing shame to their own family as well as for fear of retaliation. So deeply entrenched is the psycho-cultural barrier preventing elders to report abuse that the tendency is still to be found among the South Asian diaspora in North America (Gupta & Chaudhuri 2008). However, various types of elderly abuse are known to exist and to be on the increase in all countries of South Asia. Like domestic violence, abuse and neglect of the elderly are also gradually coming out more into the open as a result of awareness creation campaigns (INPEA 2008). A study on elder abuse in India based on focus group discussions involving older persons showed that the elderly suffered abuse, neglect and emotional distress but by and large were reluctant to complain and even tried to justify their maltreatment by offspring and other younger family members (Soneja nd; Shah, Veedon & Vasi 1995). In Bangladesh, elderly abuse, typically neglect and abandonment, particularly in the rural areas is reportedly on the increase (Hossain, Akhtar & Tajuddin 2006). In Pakistan, the elderlys traditional place of honour in the family has been eroding and the Government is planning to use legislation - Senior Citizens Welfare Bill - to protect the older population from neglect and abuse and make it
Section 4: Emerging Ageing-Related Issues

37

mandatory for the offspring to provide care and support to their elderly parents (GAA 2009).

Elderly abuse is not confined to the home. The elderly can also be faced with abuse in the institutional setting such as discrimination, neglect and maltreatment by caregivers and service providers 27. Moreover, elder abuse is a gender issue as generally older women are more vulnerable to abuse and neglect (Shankardass 2003). In addition to abuse, older persons are also becoming increasingly vulnerable to violent crime. As population ageing progresses, the growing preference for the nuclear family continues and an increasing proportion of older persons choose (or are forced) to live on their own. Older persons living on their own become an easier target for criminals. Priority needs to be attached to provide the elderly with protection against abuse and crime as these pose a serious threat to the dignity and safety of the older population
source: Papers in Population Ageing No. 6, DEMOGRAPHIC PROGNOSIS FOR SOUTH ASIA: A future of rapid ageing,

Ghazy Mujahid

K.A.P. Siddhisena,UNFPA Asia and the Pacific Regional Office


Bangkok, July 2009.