Where the elderly are vulnerable to abuse

A strong rightsbased mechanism providing comprehensive support to victims is required

Recent studies, research by Helpage India and Agewell Foundation, the recently published book Elder Abuse and Neglect in India, to name a few, indicate the increasing number of elder abuse and neglect cases. These numbers are likely to grow with an expanding elderly population.

Elder abuse and neglect, which was until a few years ago seen as a developed world phenomenon, is now visible in developing countries, including in India, where family care and reverence for the elderly is supposed to the norm. Elder abuse is an unacceptable attack on human dignity and human rights. Ignoring the rights of older people makes the senior citizens vulnerable to the risk of abuse, neglect, exploitation and marginalisation.

The World Health Organization (WHO) statistics reveal that around 4-6% of older people experience some form of maltreatment at home, with the numbers being much more in institutional settings. But, there is also acknowledgement by gerontologists and care workers for the aged that elder abuse is often unreported and under- recognised. WHO, in 2002, offered the most consensual definition of elder abuse, being used in many parts of the world since then: “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 India, a universal definition of elder abuse and neglect is missing, but in general those working with in this field classify elder abuse in five broad categories: physical, emotional or psychological, financial or exploitation, neglect, and sexual abuse. It refers to actions against elders perpetrated by someone who is trusted. Frequently, besides these five, abandonment, isolation, intimidation, fiduciary abuse, extortion, unreasonable confinement, active versus passive neglect and coercion are also identified as forms of elder abuse.

Across the world ,it is now recognised that while efforts to address elder abuse and neglect are increasing and more resources are being used towards a societal response to combat it, the realities of a rapidly growing older population, along with prevailing attendant ageism, individualism and breakdown of traditional support systems suggest that older adults will continue to be at risk of being abused and neglected, and potentially at younger ages than in previous generations.

With feminisation of ageing, older women are living longer than men and also sex ratios favouring older women, happening in many countries, including India, puts women are at a greater risk of abuse. Especially ageing widows and frail, disabled older people are at a greater risk to abuse and neglect not only by family members but also by non-family members and unknown people. Widows becoming victims of property grabbing and abandonment is common despite various laws to them.

Initially research on elder abuse and neglect by family members indicated caregiver stress as the cause for the problem, but recent studies reveal many other characteristics of the perpetrators, such as mental health and behavioural problems, drug abuse, family disputes, intimate partner abuse, etc. With regard to non-family abusers, untrained and unscrupulous caregivers, financial exploiters and petty criminals are being recognised as people of whom older people have to be careful. At the community level, prevailing ageism is seen to devalue and exploit older people leading to their abuse in various situations and circumstances.

We need effective preventive strategies to reduce the risk to abuse, and strong laws and policies to address these concerns. In the 21st century, many positive developments in different countries have led to the formulation of legislation to protect older people from abuse. But, despite the rights-based perspective in legal reforms, rights-based action in implementing measures is missing. Most national legal systems stipulate punishment for the perpetrators of elder abuse, but have no adequate legal instruments to detect and report abuse of different forms and, more important, to rehabilitate the victims. Many legislative measures deal with maintenance from family members as a recourse to tackle the problem but do not call for inclusive policies for the elderly or for creating enabling environments for older people.

Significantly, when older people report a case of abuse against them by their children, legal recourse helps in getting a monetary sum from the children for meeting daily financial needs, but overlooks their consequent state of loneliness, lack of available caregivers, threat of emotional insecurity, depression, etc.

Rights-based mechanisms to provide comprehensive support to victims of abuse and neglect are missing from a national action plan. The State’s responsibility to combat elder abuse in ageing societies is not only imperative but also pertinent to older people being able to exercise their right to a life of dignity and respect.

IN GENERAL, THOSE WORKING WITH IN THIS FIELD CLASSIFY ELDER ABUSE IN FIVE BROAD CATEGORIES: PHYSICAL, EMOTIONAL OR PSYCHOLOGICAL, FINANCIAL OR EXPLOITATION, NEGLECT, AND SEXUAL ABUSE