Elderly people with cuts and bruises, in need of food or water, unwashed or in a dirty bed - it’s often down to abuse. Friday is World Elder Abuse Awareness Day 2012. Being aware of the problem is the first step.

Just like children, old people are often dependent on others. Just how much they rely on other people depends on what condition they are in: how well they can - or can't - look after themselves. So, just as there is child abuse, there is also abuse of the elderly. It’s estimated that 10 percent of the world’s elderly suffer abuse.

The issue has been on the agenda since the 1990s. The International Network for the Prevention of Elder Abuse was set up in 1997. It comprises representatives from around 60 countries and from the United Nations.

Least recognised
Mirjam van Dongen is the Netherlands’ INPEA representative:

“Most countries are working on combatting abuse of the elderly. Japan and Australia are doing well for instance, but many countries haven’t got that far yet. Most of them are still working on assessing the problems and raising awareness. Abuse of the elderly is the least recognised and recognisable kind of domestic violence.”

Street violence, for example during a robbery, or a conman swindling old people who answer the door - in some countries, this is listed as abuse of the elderly but not in others. The Netherlands works with broadly the same definitions as the World Health Organisation.

Relatives
Abuse of the elderly falls into six categories: physical and psychological abuse, neglect, financial exploitation, sexual abuse and violating the rights of people over 65. The abused person is almost always dependent on the abuser. This can involve a professional relationship, for example with a carer or a nursing home staff member. Relatives or people sharing accommodation with the elderly person can also be guilty. Van Dongen:

“A distinction is made between active and passive abuse. An important criterion is that the elderly person suffers harm, that their integrity is eroded."

There are cases of relatives stealing from bank accounts but, often, the abuse is unintentional. For instance, someone who cares for a relative at home, slapping them out of frustration or not managing to wash or feed them. 

Things can go wrong even in cultures in which the elderly are highly respected, explains Van Dongen:

“The way we view elderly people is important, but there are still all sorts of other risk factors. Poverty and bad healthcare can increase the risk of abuse.”

Action plan
Abuse figures range from 5 to 10 percent of the elderly population, depending on the country. The lack of uniformity can be explained not only by different definitions of abuse, but also by different levels of awareness of the problem within society.

A lack of awareness may cause initial statistics to surge. The Dutch society against abuse of the elderly (LPBO), which Van Dongen chairs, this week published abuse figures for 2011. There were 994 recorded cases of abuse of elderly people in the Netherlands, an increase of 16 percent compared with 2010. The reason for the rise is unclear.

In March 2011, the Dutch government launched an action plan, with awareness and prevention playing a crucial role. Educating professionals and volunteers can also help. Draft legislation will make it mandatory for healthcare and education staff to report and deal with abuse. Persistent problems can be referred to the national network of domestic violence helplines. The law has not yet been passed. There have also been calls for tougher sentencing for abuse of the elderly.

Healthcare cuts
The Netherlands has earmarked 10 million euros to implement its action plan. Van Dongen hopes the incoming Dutch government won’t cut these funds. Cuts to the healthcare budget already in the pipeline may lead to an increase in the abuse of the elderly. People providing care need time and professional help to do their work properly.

(mw/ae)