1 in 6 people over 60 years of age –nearly 141 million people globally– suffers from abuse, according to World Health Organization (WHO) estimates.
The World Elder Abuse Awareness Day (WEAAD) (June 15th), aims to raise awareness and eradicate this problem that affects both developing and developed countries.
WHO defines elder abuse as “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.” It can take various forms: physical, psychological or emotional, sexual, financial abuse or neglect.
The lack of accurate data is one of the symptoms of this problem, but a 2017 review of 52 studies in 28 countries from diverse regions provided the pooled prevalence of different types of abuse:
– Psychological abuse: 11.6%
– Financial abuse: 6.8%
– Neglect: 4.2%
– Physical abuse: 2.6%
– Sexual abuse: 0.9%
The abusers
This violence happens at home and at institutions such as nursing homes and long-term care facilities. A staggering fact: 90% of abusers are family (adult children, spouses and partners).
But anybody can fit the abuser profile: relatives, strangers, friends, health care providers, public and private institutions… Whoever interacts with older people, especially with those who suffer a severe disability (i.e. dementia), can easily become abusers.
Why is that?
HelpAge International points out ageism. “Stereotypes about older people can be used to justify elder abuse or minimise its impact. In many ways, elder abuse is the most harmful expression of societal ageism”.
The normalization of this violence is a mask that makes it invisible or even an accepted or necessary conduct. So, how can we even identify it? Here are some examples:
Physical abuse: hitting, pushing and restraining by physical (tying them to furniture) and chemical means (medication). Also sexual abuse.
Emotional or psychological abuse: use of hurtful words, yelling, threatening or repeatedly ignoring the older adult. Isolation, infantilization and victimization are also forms of emotional abuse.
Neglect occurs when the caregiver does not try to respond to the older adult’s physical, emotional and social needs (housing, food, medication or access to adequate health care, including aspects such as therapeutic cruelty and therapeutic nihilism).
Abandonment (leaving an older adult who needs help alone without planning for his/ her care) is also a type of neglect.
Financial abuse happens when someone steals money or belongings from an older adult (retirement, Social Security benefits, etc.), uses his/her bank accounts or credit cards or changes names on a bank account, insurance policy, house title or will without permission.
Longevity and inequality
Inequality determines the way we age and is also in the roots of elder abuse.
According to a 2008 report of the Organization for Economic Cooperation and Development (OECD), “the increase in life expectancy” was concentrated “in populations continuing on to higher education” and diminished “in the groups having high school diplomas or less”.
In the OECD countries, a 25 year male with a university degree may live 7,5 years more than another male with lower education level. For women, the difference is 4,6 years. It goes without saying that inequality in education and any other development indicator is worse in the “emerging economies”.
Gender is also an inequality and abuse trigger, especially at old age. In 2015, 54% of people above 60 were women (61% within those aged 80 or more). Although female life expectancy is higher, their life quality is worse because of poor health and higher rates of abuse.
During their lifetimes, women suffer marginalization and poverty. Income inequality, differences in education, health services and job market explain why many women have no retirement benefits or lower ones. Moreover, they are the principal caregivers to children and other old people, often without any compensation.
The gap between the narratives and the facts
The United Nations expects an increase in elder abuse because of the ageing populations: the global population of people aged 60 years and older will more than double, from 900 million in 2015 to 2 billion in 2050.
During the COVID-19 pandemic rates of elder abuse have increased. Both the poor access to adequate health services and the restriction on social interactions have severely affected the elderly.
Neither population ageing nor elder abuse are new. There are countless initiatives, campaigns, plans and organizations around the globe trying to bring ageing into the public agenda, but real transformations are yet to come.
This year, WEAAD coincides with two important events. The first is the United Nations Decade of Healthy Ageing (2021-2030), aimed to align the goals of the 2030 Agenda and the ageing agenda.
The Decade addresses four areas for action:
– Change how we think, feel and act towards age and ageing;
– Ensure that communities foster the abilities of older people.
– Deliver person-centred integrated care and primary health services responsive to older people.
– Provide access to long-term care for older people who need it.
The second event is the 20th milestone of the Second World Assembly on Ageing and the fourth review and appraisal of the implementation of the Madrid International Plan of Action on Ageing (MIPAA).
UN believes that “an international legal instrument for older persons would advance the implementation and accountability of MIPAA”, and admits the “uneven progress” in its implementation and “the absence of an international standard on the rights of older persons, gaps between policy and practice, and the mobilization of necessary human and financial resources”.
When the conquest becomes the problem
Between 2015 and 2030 the world population aged 60 or over is expected to grow by 56%, reaching 1.4 billion people in 2030 (16,5% of the total population).
By then, “older persons are expected to account for over 25 percent of the population in Europe and Northern America, 17 percent in Asia and in Latin America and the Caribbean, and 6 percent in Africa” (UNDP).
The mainstream narrative that labels groups of population as a nuisance —migrants, women, indigenous people, the elderly… the list is open— denying their humanity and emphasizing that they put “the system” at risk, makes it possible for this violence to be perpetuated.
Moreover, in the current context of questioning the role of the State and the public sector, it is worth asking whether it is possible to guarantee good treatment of the elderly when what is at stake is no longer the viability of the systems of health and social protection necessary for a long-lived population, but even its mere existence for anyone.
María Isabel Cartón is a Spanish journalist, specialized on ageing issues. She is an active member of Asociación Jubilares, an NGO that promotes the social participation of senior citizens, and works within the WHO Global Network for Age-friendly Cities and Communities.
