The Silent Cancer of Elder Abuse 

By Oliver Mupila, The Times of Zambia (Ndola)

Zambia

July 22, 2008

Although the nations of the world have over years made serious attempts to curb the abuse of elderly people in society, the problem is still rampant especially in developing countries like Zambia , which have no social security schemes for senior citizens in place.

Various studies have often confirmed the abuse of elderly people as a widespread phenomenon, affecting thousands of vulnerable people across all classes of society.

Being largely hidden, this abuse is difficult for the professional community to address effectively. Only with the support of the public can society ensure that such cases are brought to light and appropriate action taken.

There is growing evidence from a number of communities that elderly people abuse and violence is a major, though hidden, problem in the developing world, since elderly people abuse is closely linked to poverty.

Attacking the causes of poverty could greatly improve the security of older people. Within the family status undergoes an abrupt change.

In Zambia for example, there are numerous cases of widows being forcibly removed from the family home. Elder people abuse in that form is far less likely to be reported than child abuse, which has gained greater public awareness.

This writer a few years, after a survey, established that "while one out of three child abuse cases is reported, only one out of 30 cases of elderly people abuse is reported."

With enhanced public awareness of the problem coupled with improved reporting systems, it is anticipated that reports of elderly people abuse (particularly domestic abuse) would drastically reduce.

For now, however, elder abuse remains one of the most under-recognised, and consequently one of the most under-reported social problems in the country.

But in any case, just what is elder abuse?

Simply put, elder abuse could be looked at as being any form of mistreatment that results in harm or loss to an older person. It is generally divided into physical abuse, sexual abuse, domestice abuse, psychological abuse, financial abuse and neglect.

Elder abuse is a big problem around the world and it is such a serious problem that the personal losses associated with this abuse are devastating. They include the loss of independence, homes, life-savings, health, dignity and security.

In Zambia , elder abuse is often directed at old women, as victims of witchcraft allegations. These accusations are common in a number of our communities in both urban and rural areas

Accusations have often been connected with unexplained local events, such as sudden death or crop failure. A more recent feature, however, is that the huge number of deaths from HIV/AIDS has begun to be blamed on witchcraft.

Where community violence is common, older people often become victims because of their greater vulnerability. Abuse can take a number of forms - physical abuse may include not only injury but also malnutrition by withholding physical care, while psychological abuse may occur in the form of threats, verbal harassment, or isolation. Broadly defined, however, there are three basic categories of elder abuse: domestic, institutional, and self-neglect.

Domestic elder abuse generally refers to several forms of mistreatment of an older person by someone who has a special relationship with the elder (say a spouse, sibling, child, and friend or a caregiver in the older person's own home).

Although the exact legal terminologies and definitions may vary from one place to another, most people recognise five types of domestic abuse. Physical (the non-accidental use of physical force that results in body injury, pain or impairment), sexual (the non-consensual sexual contact of any kind with an older person), emotional or psychological (the willful infliction of mental or emotional anguish by threat, humiliation, and intimidation, or other verbal or non-verbal abusive conduct), neglect (the willful or non-willful failure by the care-giver to fulfill their care-taking obligation or duty), and financial or material exploitation (the unauthorised use of funds, property, or any other resources of an older person).

Institutional abuse, on the other hand, generally refers to any of the above that occur in residential facilities for older persons (for example old people's homes, nursing homes and care facilities).

Perpetrators of institutional abuse usually are persons who have a legal or contractual obligation to provide elder victims with care and protection (say caretakers, staff and professionals).

Most physical, sexual and financial material abuses are considered criminal. In addition, depending on the type of the perpetrator's conduct and consequences for the victims, certain emotional abuse and neglect cases are subject to criminal prosecution.

Available data from past statistics provide a clear picture about the identity of people who are the perpetrators of elder abuse in domestic set-ups. It is estimated that adult children of the elderly are responsible for over 30.0 per cent, grand children 1.9 per cent, spouses 14.8 per cent, siblings 1.7 per cent other relatives 17.8 per cent. Service providers account for 12.9 per cent, friends or neighbours 10 per cent, others 9.4 per cent and persons unknown 1.5 per cent.

By the way, children of the elderly in the developed world are responsible for over 70 per cent of financial elder abuse and 30 per cent in the less-developed world. Grand children, other relatives, friends and neighbours each respectively accounts for roughly 15 per cent and the other 25 per cent is by professionals or service providers.

More than two-thirds of elder abuse culprits are victim's own blood relatives. Given the above facts, it is reasonable to assume that elder abuse can best be understood within the context of "family violence" or "intra-familial conflicts".

As to some of the possible causes, just like any other type of domestic violence, elder abuse is extremely complex and many factors contribute to its occurrence. It is generally assumed that a combination of psychological, illnesses like HIV/AIDS in sub-Sahara Africa , social and economic factors that affect inter-personal and intra-familial relations along with mental and physical conditions of the elderly themselves and their tormentors, are all responsible for any single incident of domestic abuse.

At the same time, other professionals working with victims, their families and perpetrators have formed various explanations of the causes of elder abuse principally based on clinical and social observations.

Some say its is caused by the frustrating behaviour of the elderly which leaves the care giver stressed, while others say it is because of the impairment of the dependency of the elder as most senior citizens have to depend on others for survival.

Still, there are others who say the cycle of poverty is to blame for the rampant cases of elder abuse, while others hold that the elderly (typically adult children) tend to have more personal problems than do the non-abusers

But whatever the case, how can elder abuse be stopped?

Every person can help to protect the vulnerable elderly people from all types of abuse, neglect and exploitation by reporting elder abuse. It is important for people to be on the look-out for such important warning signs in the elderly people as being withdrawn, confused or extremely forgetful, depressed, helpless or angry, hesitant to talk freely, frightened, and secretive.

Abused elderly people may also suffer isolation or lonely with no visitors or relatives with family members or caregivers isolating the elderly person or restricting the person's contact with others.

These signs could be confirmation that some form of abuse has taken place, and concerned people should immediately report such a case to either the police or responsible Government wing for investigations.

(The author is a Malaria & HIV Consultant /Gerontologist and president & CEO for Health Village International Clinics for Malaria Control , USA )

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