Elder Abuse

Around 23 percent or more than one-fifth of India’s elderly are known to have experienced abuse in the form of disrespect, verbal abuse, neglect while some have even faced assault, according to the “Elder Abuse 2013” report. How we wish instances like these are fiction. The line separating utopia from reality is painful. World Health Organization and other Academic institutions, around the world, have all substantially contributed to enhancing understanding and raising awareness about such mishaps. United Nations recognize World Elder Abuse Awareness Day, commemorated all over the world on 15^th June every year. Twenty or thirty years ago, societies throughout the world denied the existence of violence against women and child abuse. Then, through research, came the evidence. Why then delay in this aspect?

What is Elder Abuse?

“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”.

In 2002, the work of the World Health Organization brought international attention to the issue of elder abuse.

What is “older”? The concept of old age itself must be understood in broad terms. In many countries and cultures, being considered old is not necessarily a matter of age, but it is rather linked to circumstances such as being a grandparent, or showing physical signs such as white hair. Many people who would be considered relatively young in developed countries are likely to be considered old in other ones. Although the average over-60 population is about 13 per cent worldwide, it is not rare to have up to a quarter of the entire population being considered “old” in a given context. In addition, in many emergency-affected contexts where people live in hardship, many of the conditions usually associated with older age, such as disability and chronic disease, are present at earlier ages. As such, while the UN definition of old age is those aged 60 years and above, using a cut-off point of 50 years and over may be more appropriate in many contexts where humanitarian crises occur.

According to the National Center on Elder Abuse, the number of older adults who are mistreated each year is close to 5 million and is rising This is the case even though incidents of abuse often go unreported. Around 4-6% of elderly people have experienced some form of maltreatment at home. Elder maltreatment can lead to serious physical injuries and long-term psychological consequences. It is predicted to increase as many countries are experiencing rapidly ageing populations.

Scenario in India-

• India is growing old. The economic surveys tell us that the Life Expectancy of an individual has grown by 25 years to 64 years in the past 50 years. 77 million, the number of aged people in the country today is expected to shoot to 177 million in the following 25 years.
• The humungous leap is not bereft of problems. With more old people living longer, not only are the living spaces getting more congested but marginalization, isolationand insecurity are taking root owing to the generation gap andchanges in lifestyles and manifesting themselves as chronic functional disabilities.
• The cliché household scenario wherein the value system was strong enough to ensure elder safetyis now walking a tangent away.With people thinking that elder abuse is a practice of the west, the identification of victims has become difficult.
• Studies have pointed out that the main problems faced bymen in the middle income group in order of decreasing prevalence are “economic” problems, mental health problems (lack of work, facilities for leisure), problems of ‘time’ leading to a general feeling of loneliness, living separate from spouse, health problems that fed on the patience of the caretakers, health problems linked with lack of mobility and economic problems followed by lack of accommodation.
• On the flipside, the problems faced my females gained prominence in the economic aspects, feelings of loneliness, ill-treatment, humiliation and complete neglect from family members.
• However, there are organization such as Help Age India, who hav launched programmes such as Help Unit Generations (HUG) campaigns to raise awareness on the abuse against elders with the aim to sensitise young children and adults on the elder issues and needs.

Root Causes-

a. Generation Gap-

A lot of young people living with their elderly parents often find themselves facing a Generational conflict when their elderly parents don't approve of certain aspects of their lifestyle and/or career. In most cases the elderly fail to keep up with the changing times, thereby antagonizing themselves in their childrens' eyes.

b. Outcome of Child Abuse-

At times elderly abuse can be linked to abuse faced by their children when they were at an age when people are usually dependent on their parents. Parental abuse, as we know, exists in various forms ranging from neglect to excessive parental pressure thereby leaving children with little love or affection for their parents once they grow old.

c. Rise in Materialism and Careerism-

With increasing aspirations of young people, both in their career and material desires, elderly parents are often considered as burden or hindrance to their child's aim and aspirations in life. A young man or woman who is very career oriented might need to devote a lot of hardwork for his or her respective jobs, and at such times looking after one's elderly parents takes a backseat. Also with rise in material desires, a young person may want to spend his hard-earned income on consuming various commodities instead of paying his father or mother's medical bills.

d. Traditional Quasi-Federal Societal Structures-

Traditional norms of our society dictate that parents often choose to have children as a source of old age income. Children have often been treated as investment goods whose job in life had always been to do whatever his parents wanted and look after (or rather) pamper his parents once they retire. But with increasing modernization and liberalization children often attempt to break away from the shackles of conservative societal norms, thereby demonizing their parents altogether and leaving them to rot in neglect.

Classification of Elder Abuse-

a) Physical-

For example, hitting, punching, slapping, burning, pushing, kicking, restraining, false imprisonment/confinement, or giving excessive or improper medication

b) Psychological/Emotional-

A perpetrator who identifies something that matters to an older person and then uses it to coerce an older person into a particular action. It may take verbal forms such as name-calling, ridiculing, constantly criticizing, accusations, blaming, or non-verbal forms such as ignoring, silence or shunning.

c) Financial abuse-

Also known as financial exploitation e.g. illegal or unauthorized use of a person’s property, money, pension book or other valuables (including changing the person's will to name the abuser as heir). It may be obtained by deception, coercion, misrepresentation, undue influence, or theft. This includes fraudulently obtaining or use of a power of attorney. Other forms include deprivation of money or other property, or by eviction from own home.

d) Scam by strangers-

 Worthless "sweepstakes" that elderly persons must pay in order to collect winnings, fraudulent investment schemes, predatory lending, and lottery scams.

e) Sexual-

For example, forcing a person to take part in any sexual activity without his or her consent, including forcing them to participate in conversations of a sexual nature against their will; may also include situations where person is no longer able to give consent (dementia)

f) Neglect-

For example, depriving a person of food, heat, clothing or comfort or essential medication and depriving a person of needed services to force certain kinds of actions, financial and otherwise. The deprivation may be intentional (active neglect) or happen out of lack of knowledge or resources (passive neglect).

g) Abandonment-

Deserting a dependent person with the intent to abandon them or leave them unattended at a place for such a time period as may be likely to endanger their health or welfare.

h) Rights abuse-

Denying the civil and constitutional rights of a person who is old, but not declared by court to be mentally incapacitated. This is an aspect of elder abuse that is increasingly being recognized and adopted by nations

i) Self-neglect-

Elderly people neglecting themselves by not caring about their own health or safety. Self-neglect (harm by self) is treated as conceptually different as abuse (harm by others).

j) Separation from family-

Older people may be left behind as families are displaced by conflict or natural disasters – because they are unwilling or unable to travel, or are left to guard family property and belongings. Isolation in the form of fragmentation and dissolution of their families and communities may lead to the loss of support mechanisms on which they had relied.

k)  Caring for children-

If they were not doing so already before the crisis, many older people find themselves looking after young dependants whose parents are dead or absent. The elderly by default of tradition end up becoming the caretakers of the grand children which takes a toll on their physical and mental wellbeing unless done out of love otherwise.

l) Having housing, land and property rights ignored-

In a ‘survival-of-the-fittest’ environment, the already difficult issue of housing, land and property rights may become intractable  if the rightful holder is an older person.

m) Unequal share within the family and Lack of basic necessities-

Older people may be unable to consume some items because they lack the physical ability they once had. Furthermore, there is a meager circulation of goods designed particularly for the old.

n) Susceptibility to ill health and difficulties accessing health services-

Poor health and reduced mobility increase the risk of serious injury and illness in crisis situations. Even normal physical changes associated with ageing that may not greatly impair daily functioning, such  as reduced mobility and failing eyesight, can become significantly disabling during an emergency.

o) Choosing not to report abuse-

Victims of elder abuse and neglect may feel ashamed of their abusive experiences. Those who consider reporting abuse often choose not to because, in the majority of cases, they are abused by a family member, loved one, or trusted caregiver. It can be extremely difficult to tell others that someone you trust and love is abusing or neglecting you. Making matters worse, abusers often blame their victims, telling them that the abuse is their “fault,” and threatening them if they reveal

the abuse to anyone. If the older person is dependent on the abuser for care, he or she may feel as if he or she has no option but to live in fear and pain.

p) Traditional Rituals-

For example, a village in Tamil Nadu where they perform euthanasia on elderly individuals, who are incapable of performing productive labour.

by Navneet Kaur, Volunteer, Agewell Foundation