A Violation of Older People's Human Rights
Elder abuse can be defined 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". Elder abuse can take various forms such as physical, psychological or emotional, sexual and financial abuse. It can also be the result of intentional or unintentional neglect.
In many parts of the world elder abuse occurs with little recognition or response. Until recently, this serious social problem was hidden from the public view and considered mostly a private matter. Even today, elder abuse continues to be a taboo, mostly underestimated and ignored by societies across the world. Evidence is accumulating, however, to indicate that elder abuse is an important public health and societal problem.
Scope of the problem
A 2017 study based on the best available evidence from 52 studies in 28 countries from diverse regions, including 12 low- and middle-income countries, estimated that, over the past year, 15.7% of people aged 60 years and older were subjected to some form of abuse. This is likely to be an underestimation, as only 1 in 24 cases of elder abuse is reported, in part because older people are often afraid to report cases of abuse to family, friends, or to the authorities. Consequently, any prevalence rates are likely to be underestimated.
Although rigorous data are limited, the study provides pooled prevalence estimates of number of older people affected by different types of abuse:
- psychological abuse: 11.6%
- financial abuse: 6.8%
- neglect: 4.2%
- physical abuse: 2.6%
- sexual abuse: 0.9%
Globally, the number of cases of elder abuse is projected to increase as many countries have rapidly ageing populations whose needs may not be fully met due to resource constraints. It is predicted that by the year 2050, the global population of people aged 60 years and older will more than double, from 900 million in 2015 to about 2 billion, with the vast majority of older people living in low- and middle-income countries. If the proportion of elder abuse victims remains constant, the number of victims will increase rapidly due to population ageing, growing to 320 million victims by 2050.
Addressing Elder Abuse
Elder abuse is a problem that exists in both developing and developed countries yet is typically underreported globally. Prevalence rates or estimates exist only in selected developed countries — ranging from 1% to 10%. Although the extent of elder mistreatment is unknown, its social and moral significance is obvious. As such, it demands a global multifaceted response, one which focuses on protecting the rights of older persons.
Approaches to define, detect and address elder abuse need to be placed within a cultural context and considered along side culturally specific risk factors. For example, in some traditional societies, older widows are subjected to forced marriages while in others, isolated older women are accused of witchcraft.
From a health and social perspectives, unless both primary health care and social service sectors are well equipped to identify and deal with the problem, elder abuse will continue to be underdiagnosed and overlooked.
Financial Abuse of Older People
Recent research findings draw specific attention to financial exploitation and material abuse of older persons as a common and serious problem. Based on available evidence, 5 to 10 per cent of older people globally may experience some kind of financial exploitation. However, such abuse often goes unreported, partly due to shame and embarrassment on the part of the victims or their inability to report it because of cognitive and other impairments, and most prevalence studies are based on self-reported surveys.
Financial exploitation takes many forms. In developed countries, the abuse often encompasses theft, forgery, misuse of property and power of attorney, as well as denying access to funds. The overwhelming majority of financial exploitation in less developed countries includes accusations of witchcraft that are used to justify property grabbing, ejection from homes of and denial of family inheritance to widows. Risk factors for falling victim to financial exploitation range from social isolation and cognitive impairment to emotional or physical dependence on the perpetrator, financial dependence of the abuser on the older person, certain living arrangements, poverty, widowhood and lack of support networks, in addition to ageism and other types of prejudice, discriminatory inheritance systems, as well as weak police and criminal justice systems.