Elder abuse can be defined quite simply as: ‘Any act within a relationship of trust that harms an older person.’
Elder abuse is something that is possibly more prevalent than we think. The abuse can be hidden in mainstream settings, where individuals live independently and in solitude. In the remote indigenous context however, elder abuse may be more visible, although may not always be recognised as such by the community. Additionally, the cultural responsibilities and obligations mean that sometimes coordinators and staff from outside the culture may mistake cultural sharing norms for elder abuse.
To illustrate, let’s look at the following two examples.
Billy is an old man who lives with his extended family on community. Every pension day his family take Billy to the community store where they help purchase food for Billy and the family using his pension money. They also help Billy buy any clothes and blankets he needs. Sometimes they will buy items for other family members when there is enough money to do so. Billy also likes spoiling his grandchildren and will often spend any money he has left on treats for them.
Billy rarely has any money left to buy more food or items after pension day – he has to wait for his next cheque, but his family make sure that he gets his meals on wheels everyday and also share with him when they get paid. Billy is happy with this arrangement as he feels like he is contributing to the family and they are supporting him too.
Janie is an old lady living in the same community. Every pension day her family take Janie to the community store and buy food with her pension money just like Billy’s family – but this is where the similarity ends. Janie’s family purchase food and other items for their own personal needs without thought to what Janie might want or need. Janie rarely has any money of her own to spend as any left over funds are taken by her nephews, using force if she tries to stop them or hide the money.
Janie often goes hungry between pension days and will go hunting to find bush tucker to supplement the meals delivered by the aged care service. Often, her grandchildren will take those meals from her too.
The above two scenarios are examples of situations I have observed on community. The first one describes a socially competent family group where sharing supports the entire group. The second situation is elder abuse.
So what else might elder abuse look like on community?
Some clients might disclose threats of violence against them by family members, others show clear indicators of violence. While the skin colour of an elderly aboriginal person may preclude seeing bruising clearly, the observation of a person protecting any part of their anatomy, such as someone holding their arm, may indicate the person has been hit. Broken bones can also be a key identifier.
Physical restraint may not always be obvious, but may include locking a person with dementia in the house while the rest of the family go off to do the shopping.
Again this may be obvious. In a small community, staff will generally be aware if a family or particular family members are taking an old person’s money and will tell you. The family carer or a family member might have more money to gamble with or spend on consumer items – where are they getting this money?
Indicators of financial abuse in a remote community might be noticing that a person is losing weight, even though the aged care service is providing regular meals or that they are unable to pay for their meals and services due to car loans – even when they don’t drive a vehicle.
Other scenarios are where a family member takes artwork that the old person has created and sells it for personal benefit or where family members take essential items from the old person such as bedding and warm clothes in winter.
Instances of neglect that have been observed on community include withholding water from an older person so that they don’t wet the bed, forgetting to provide water to an older person who cannot mobilise and not changing a person’s continence aids in a timely manner.
Football season rolls around and everyone travels to the location of the match – except for the frail aged. Sometimes, those left behind are unable to care for themselves and are at the risk of hungry dogs that have also been temporarily abandoned.
Psychological abuse on community is often seen where family members or even service providers create a sense of fear within the person that if they don’t comply with a directive or hand over their pension they will be sent away from their home country to die.
Remember the definition above: ‘Any act within a relationship of trust that harms an older person.’ Sometimes, family and carers don’t mean to abuse their relative, but that doesn’t make it okay.
What can you do about it?
Where you observe physical violence, you have an obligation to report this to the police.
Elder abuse comes under the Domestic Violence Act in the NT. This means that there is capacity for the person to take out a restraining order against their abuser. Unfortunately, enforcing the order when there is little or no regular police presence on the ground is more difficult.
Sometimes dealing with situations directly is the way to go on community.
Where you suspect financial abuse or neglect is occurring, talk to the old person and find out how they feel about the situation. They may not like what has been happening but have been unaware of what they could do about the situation.
Talking to the family or carer about what is appropriate and what isn’t may assist, particularly in the case of neglect, as they may not be aware that their acts constitute elder abuse.
Where you need to discuss physical abuse with family members however, a word of caution; take advice from local staff first. If the person who is inflicting the abuse has a violent background you may be placing yourself in danger. If there is a risk of violence to you, defer to the professionals and report to the police.
Elder abuse is not okay. The frail aged have the right to live lives free from harm imposed on them by others. It is up to all of us to be vigilant and uphold this right if they are unable to do so themselves.