Abuse, Neglect and Violence against Older Persons

Silvia Perel-Levin Social Forum, Geneva, 2 April

2014

Types of abuse characteristics Examples1. Physical The infliction of pain or

injurySlapping, hitting, kicking, force-feeding, restraint, striking with objects.

2. Psychological/emotional abuse

 Infliction of mental anguish

Verbal aggression or threat, threats of institutionalization, social isolation, humiliating statements.

3. Financial/material abuse

 The illegal or improper exploitation and/or use of funds or resources

Theft of cheques or money, coercion to deprive the older person of his or her assets, such as forcible transfer of property.

 

4. Sexual abuse Non-consensual contact of any kind with an older person

Suggestive talk, forced sexual activity, touching, fondling with a nonconsenting competent or incompetent person.

 

5. NeglectIntentional or unintentional refusal or failure of designated caregiver to meet needs required for older person’s well-being.

Failure to provide adequate food, clothing, shelter, medical care, hygiene, or social stimulation.

 

Alternative classification

Neglect  isolation, abandonment and social exclusion

Violation of human, legal and medical rights

 Deprivation of choices, decisions, status finances and respect

Types of abuse characteristics

6. Societal abuse

Ageism, lack of appropriate pensions, discrimination

WHO/INPEA 2002

Risk factors – ecological model

Societal Community Relationship

IndividualIndividualRelationship

Community

SocietalDementiaDepressionExperienced abuseAggressionDependence or disabilityGenderAgeIsolation Drug/alcohol dependence

Financial Dependence Emotional dependence Living arrangements Long-term abuse/violence Intergenerational transmission?

Social isolationConcentration of povertyWidowhoodWitchcraft accusations Lack of support networksErosion of intergenerational relations

Ageism, wide discriminationSexism, racismSocio-economic factors/concentration of povertyInheritance systems/WidowhoodMigration of the youngWeak police/criminal Justice

The extent of the problem

Latin America and the Caribbean• 6 to 37% prevalence

Elder Abuse in India (20 cities)• 31% faced abuse• Over 50% during 4 years in multiple

forms• 24% almost daily

Helpage India, 2012

(Helpage India, 2012)1.67% in Rajasthan to 77% in Madhya Pradesh

The extent of the problem, India

Sexual Violence in Eastern DRCAge Number Percentage< 15 252 5.916-24 809 18.825-34 841 19.535-44 988 22.945-54 752 17.455-64 211 4.9> 65 458 10.6Total 4,311 100

Prevention – ecological model

Societal Community Relationship

IndividualIndividualRelationshipCommunitySocietalWhere do we start?

Interdisciplinary action

Should primary health care workers

screen for elder abuse?

NICE- Canadian pocket tools

Tools for the police

• Elder Abuse risk assessment

• Assessment and intervention

reference guide

• Theft by persons holding power of attorney

Interventions

Safety Autonomy?

INPEAInternational Network for the Prevention of Elder Abuse

Established in 1997

• Raising awareness World Elder Abuse Awareness Day (WEAAD) 15 June

• Education and training of professionals and paraprofessionals in identification, treatment and prevention

• Advocacy on behalf of abused and neglected elders

• Promote research into the causes, consequences, prevalence, treatment and prevention of Elder abuse and Neglect

Concluding remarks

Scientific rigour humanistic model?

“Respect is better than food or drink”An older respondent

WHO, 2002 Missing Voices