Opinion

The hidden harm of elder abuse

22 May 2020

A third of UK citizens think that domestic violence directed towards older people isn’t abuse. That’s why the present lockdown for older people looks increasingly concerning, says Veronica Gray of Hourglass.

In the UK, it is estimated that more than a million older people – around 10% of the older population – experience some form of abuse in any given year (Biggs et al, 2013). One in three UK residents don’t believe that acts of domestic violence directed towards an older person count as abuse (Hourglass, 2020a). And we know that assaults and domestic murders surge by as much as 25% during a festive season – a similar time of increased financial strain and closer proximity of family members – so the present lockdown environment for older people looks deeply concerning (Hourglass, 2020a).

Hourglass – the only UK charity dedicated to ending the harm, abuse and exploitation of older people – defines the abuse of older people 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’ (Hourglass, 2020b).

The Hourglass helpline receives daily accounts of financial, psychological, sexual, physical and domestic abuse, as well as neglect. Victims suffer multiple and interacting forms of abuse. For example, the behaviours involved in financial abuse, such as restricting access to a bank account, can be accompanied by or facilitated through psychological abuse, such as undermining the victim’s sense of worth. From April 2019 to April 2020, 58.4% of cases saw financial abuse.

"Assaults and domestic murders surge by as much as 25% during times of increased financial strain and closer proximity to family"

Protection from crime and abuse

Our approach has always been underpinned by a stance of zero tolerance of abuse, by enabling people to understand what it is and what causes it, and by asserting an expectation that services should be sufficiently funded. While it’s our belief that real and lasting change will only be achieved through facilitating a priority shift at the highest level – whereby the rights of older people are protected in legislation – there are practical measures already at our disposal to protect older adults from crime and abuse.

  • Specialised emergency shelters: Older women are often unaware of and thus underuse domestic abuse shelters, which do not normally provide support for men either, and cannot effectively care for those with dementia or other health problems associated with old age. Specialised emergency abuse shelters exclusively focused on older victims offer both a temporary safe environment and a medically effective one.
  • Multidisciplinary teams: These teams can help promote community-wide approaches to the prevention and treatment of abuse of older people. Additionally, informal relationships between members of multidisciplinary teams can help develop professional ties between disciplines and lead to the establishment of ‘elder abuse prevention networks’.
  • Screening: Identifying risk factors for those who may be at higher statistical risk of disease or illness could ensure further testing or treatment. Screening tools should be able to correctly detect those suffering from abuse or neglect, enabling the medical professional undertaking the screening to follow it up with the effective intervention.
  • Educational campaigns: Campaigns aimed at the general public spread information about available services, encourage positive attitudes towards older people in society, outline information about how to prevent maltreatment, and raise public awareness of the abuse of older people. Campaigns focused on those at risk of or experiencing abuse aim to increase awareness of acceptable and unacceptable caregiving behaviours and signpost available organisations and support services for victims.
  • Caregiver support interventions: These seek to alleviate the stress and burden of caring for an older person by providing key services (including meal preparation, housekeeping help or day care, or broader caregiving help through educational, teaching coping strategies or support groups). Caregiver training programmes have been used to develop skills to prevent conflict behaviour with patients, or to learn coping mechanisms in order to manage stress or to deal with difficult patient behaviour.

Resources and guidance for CPs

  • Whatever your concern, you can always call the Hourglass helpline on 080 8808 8141 (9am to 5pm, Monday to Friday) – starting a conversation is at the heart of safer ageing.
     
  • Spread awareness – provide educational campaigns to schools, colleges and universities, and discuss with younger people the issues of ageism and promote awareness of the signs of abuse.
     
  • Have a conversation about practical arrangements for the future – ‘Have you thought about future decision-making for health and financial matters?’ or ‘Do you feel confident managing your money?’ Empowering older people to seek out knowledge to help plan their future can safeguard from abuse. Citizens Advice is an excellent resource to answer any of these questions citizensadvice.org.uk
     
  • Be aware of the new scams targeting older people and talk about the signs to look out for. Friends Against Scams have created online training, so that you can understand more about scams and help protect others from falling victim to them bit.ly/scams_training
     
  • Young carers (under 24) can be directed to support from the Carers Trust carers.org
     
  • Encourage self-care and good wellbeing practices for those who work with older people. Living under the restrictions of social isolation, it is more important than ever to support yourself in your caregiving role. Protecting those providing care protects older people from abuse. There is help and support available for informal carers at Citizens Advice bit.ly/CA_carers_support
     
  • Local councils can be signposted to offer practical help such as advice about benefits such as Carer's Allowance. 

Empowering older people

Older people face physical and attitudinal barriers that create circumstances of actual or presumed age-related vulnerability – an environment which puts older adults at risk. Our campaign for safer ageing seeks to remove these barriers to empower older people to age securely and live free from abuse.

To empower older people to age safely, it is imperative that the voices of older people are heard and amplified to the greatest possible extent when it comes to identifying these barriers to safer ageing. For example, does the government strategy for tackling domestic violence account for the differences in needs and experiences of older victims? Is the dissemination of vital information surrounding Covid-19 (largely digital) accessible to older people? These are the lessons that Hourglass has learnt from listening to the stories of older people and their families.

We also need to ensure access to knowledge and resources, including providing information and training on the signs of abuse for those working with older people, and securing resources to improve older people’s capabilities, particularly financial and digital.   In the longer term there needs to be more investment in money management programmes for older people. Such programmes could feature daily assistance with monetary matters, for instance – providing help with making deposits, paying household bills, and negotiating with creditors. These should be targeted to those most at risk: older people who are cognitively impaired or suffer from social isolation.

Finally, we believe that a designated commissioner for elderly people is essential in safeguarding and promoting the interests of older people. We can learn from the best practice in Wales and Northern Ireland, both of which already have an independent commissioner for older people. This official can give a voice to older people and provide public leadership on responding to the abuse of older people.


Financial abuse and Covid-19

The wonderful community spirit of helping older neighbours can be seen across the UK: shopping deliveries, prescription collections and phone calls to older people all offer a break from the isolation.

But, sadly, unscrupulous individuals will take advantage of people who are frightened and in need of support. This is our advice for older people who are worried about the safety of their finances during this time of crisis:  

  • If other people do your shopping, keep an eye on receipts and what is spent.  
  • Don’t allow anyone into your home or to take money for shopping unless you can confirm their identity or you have made an appointment for them to visit.  
  • Be aware of phone and internet scams that try to get you to disclose your bank details.  
  • Find out your bank’s security procedures on contacting customers.  
  • Check your bank statements regularly.  
  • Never share your PIN number.  
  • Keep important documents and valuables out of sight.  
  • Don’t lend anyone money unless you are sure you can afford not to have it returned.

Why Hourglass’s work is so vital

Hourglass, previously Action on Elder Abuse, is the only charity dedicated to calling time on the harm and abuse of older people. We’re part of the UK-wide organisation: Hourglass Scotland, Hourglass Wales, Hourglass Northern Ireland.

We are working tirelessly to influence, challenge and educate, listen, advise and support. We commit to working in partnership to deliver positive change for vulnerable older people and all those affected in the UK. We are striving to create an environment where safer ageing is guaranteed for all.

In times of isolation and shielding vulnerable people from Covid-19, the need for a charity like Hourglass is greater than ever. Instances of abuse are on the rise, with the national domestic helplines reporting an increase in call numbers by as much as 125% since the lockdown began (Grierson, 2020). We have seen a 74% increase in calls to our helpline in January 2020 compared with last January, coinciding with the start of widespread news coverage of the pandemic.

Hourglass has touched the lives of tens of thousands of people and shaped government policy. That’s why Hourglass is so vital. wearehourglass.org


Veronica Gray is deputy CEO of Hourglass and has 18 years’ experience in the community and voluntary sector across Ireland. 


Time to reflect

How do we challenge the ageist attitudes that so often create the space for negative and abusive behaviours towards older people? Join in the conversation on Twitter @CommPrac using #ElderAbuse


References: 

Biggs S, Erens B, Doyle M, Hall J, Sanchez M. (2013) Abuse and neglect of older people: secondary analysis of UK prevalence study. See: http://natcen.ac.uk/media/20824/abuse-neglect-older-people.pdf (accessed 23 April 2020).

Hourglass. (2020a) Covid-19 response. See: wearehourglass.org/covid-19-response (accessed 23 April 2020)

Hourglass. (2020b) Definitions. See: wearehourglass.org/wales/definitions (accessed 23 April 2020).

Grierson J. (2020) UK domestic abuse helplines report surge in calls during lockdown. The Guardian. See: theguardian.com/society/2020/apr/09/uk-domestic-abuse-helplines-report-surge-in-calls-during-lockdown (accessed 23 April 2020).

 

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