Abuse of the Elderly

The Jamaica Observer, Bishop Howard Gregory

February 11, 2008

Jamaica

One measure of a state's well-being is the way in which it treats its elderly and the vulnerable within its borders.

Our history has been one in which the grandmother as a primary symbol of nurture and bedrock of the family has been revered and treated with the utmost respect.

Like many features of our national life, this situation no longer holds, and the elderly, whether male or female, are now the subject of the violence, abuse, and crime which pervading the society.

It was heartening to see that the lead article of the Sunday Observer two weeks ago exposed the experience of abuse experienced by residents in the George Abrahams Home for the aged in August Town. While citing instances of verbal abuse and sexual harassment, it has not really made the society aware of the depth and scope of the problem.

In fact, it has presented the nature of the abuse of the elderly as one in which some perverse men are involved but, if looked at in its wide-ranging manifestations, it will be observed that it is something in which operators of facilities for the elderly, paid care-givers in the home, and even family members are involved.

The abuse of the elderly is becoming one of the major sources of manifestation of the indiscipline, violence, and criminal behaviour which have overtaken us.
Motorists on our roads, especially drivers of licensed and unlicensed taxis, seem to believe that once a person has started to grow grey hairs or show any sign of ageing, that person does not have a right to be driving on the roads of Jamaica. So they seek to intimidate them by blowing their horns at them if they are not as impatient or simply don't display "road hog" tendencies.

Should they find themselves in the unfortunate position of having an accident, these users of the road, regardless of whether they are the ones at fault, immediately begin to abuse and seek to intimidate the elderly. It takes a very firm and self-assured elderly person to stand up to such assault.

Should they confine themselves to the boundaries of their homes, these elderly are at times unable to even reap the fruits from their trees as they are chased back inside and threatened if they say anything to intruders on their property. Indeed, elderly farmers have been known to have been told to go back to their beds while praedial thieves load their vehicle with their livestock.

There are, however, manifestations of abuse of the elderly, which are less public and are less the subject of public knowledge because they are too embarrassing for the elderly to share with others or in any open fashion. I speak of the rape of the elderly which takes place with far more frequency than many Jamaicans would care to admit.

In instances with which I have had pastoral involvement, that aspect of the experience of the elderly is usually played down and kept from reports concerning the experience.

I vividly recall the literal "wilting" of the elderly spinster in her 80s who was attacked and raped by an intruder in her home, and how she became a shadow of the person she was prior to the experience.

The targeting of returning residents, which has been a reprehensible feature of our national life for several decades, represents an attack on and abuse of persons who for the most part are elderly and therefore perceived as vulnerable and easy targets of those with intentions to exploit and abuse. Sexual abuse and rape of these persons are also areas of their experience which are often kept quiet.

Allied to abuse is neglect. Neglect has a more benign ring to it and yet is just as dangerous as its more active companion, abuse.

Here, the person who is guilty of neglect deliberately or intentionally withholds the care and support which is necessary for the well-being of an individual, whether child or adult. There are persons who see the operation of a home for the aged as an opportunity to make some good money, but who do not understand the investment, competence, and love and care for persons, which make for the successful operation of such an undertaking.

While the government has been placing greater spotlight on the operations of these institutions, there are still instances in which the elderly are not receiving due attention and may fall from their beds or be the subject of other accidents because they have been left unsupervised. There are also instances of dietary deficiencies, which have been spotted in such residents because of inadequate nutritional support. These dynamics may also be present in situations in which the elderly are being left in the care of an employed person in the family home.
Neglect may also be the result of the failure of adult children to see to the welfare of their parent(s). The laws of Jamaica make it mandatory for children to take care of parents who may be in need. What is extremely disturbing to some of us in the pastoral office who have to visit and exercise pastoral care of these elderly persons is to see the squalor and level of deprivation in which some have to live. And when they die, the children come forward to bury their parents in the most expensive caskets in order to impress their friends and the community.

The physical and emotional abuse of the elderly is something which takes place at various levels and in various contexts. Most of us would be quick to identify the homes for the aged as the place where this kind of abuse takes place, and yet it is far more frequent in the context of family and the home.

Elderly persons are subject to verbal abuse, neglect such as withholding of meals and leaving the person for long periods in his or her urine and excrement, as well as slaps and beatings, which can leave serious bruises or even broken bones.

Unlike other age groups and persons in other situations of abuse, the elderly usually are dependent, often have limited mobility, and have no alternative to the prevailing situation.

One of the things I have always taught ministerial students is that, when visiting the sick and shut-ins, they should always try to get time alone with the person. The reason for this is that, if abuse is taking place, the family member or caregiver will not want anyone to be alone with the elderly in case he or she should report the abuse.

It is tempting to immediately label those who abuse as wicked persons and the scum of the earth. Unfortunately, it is not quite as simple as that. Those who abuse can be the most dutiful and diligent children and family members.

Caregivers of elderly persons who require total care need to be aware of their limits. It is not unusual to find abuse taking place in a situation in which a caregiver who has changed the bed linen and Pampers several times for the day, and who discovers that the elderly parent has had another "accident" just after the last change for the night, may slap the person out of frustration.

This kind of situation is complicated when the caregiver is the only child of the siblings who has stayed home to take care of an elderly parent while the others are off making life for themselves, even as they send home instructions as to what must be done for the elderly parent.

The situation is complicated by the elderly parent who never really expresses appreciation for the one staying at home and doing everything, but spends waking moments talking about those who are away and wondering what fate may be befalling them at this time.

The point is that abuse of the elderly is not excusable but much of it is avoidable if we can educate persons, especially caregivers, concerning the care of those in their charge and the need for self-care on their part.

I have always challenged groups of laypersons within congregations to look out for persons who have to take care of elderly or shut-in members of the family, and to offer themselves to be available for some relief moments from time to time when the caregiver can have some "down time."

The dreaded disease, Alzheimer's disease, is making the situation even more complicated. As the disease takes greater hold of the person, there are often personality changes, which can make the victims difficult to handle. So it is possible for one's mother who has been the most gentle and loving soul all her life to become violent and belligerent and generally difficult to handle. If you have never heard a "bad word" come from the mouth of your mother but now find that she is shouting them out for the whole community to hear, then it becomes most unnerving.

Not only may the caregiver have a difficulty seeing Mom in this condition, but the adult child may believe that becoming physical with the parent is the way to control and bring about compliance. The church as a community can be just as challenged by the situation. If this elderly parent has been a member of the choir and officer of the church, and now begins to manifest these things, it is seen to be a scandal by the body, and so some members would rather the family member not bring such a person to church but keep her locked up at home.

The point of it all is that abuse of the elderly is not just something which some few perverted men conjure up and execute. It is a social problem, which we must constantly address. It is not just strangers and irreligious persons who engage in such activities, but even family members and members of the church and other communities of belonging.

We have a responsibility as a society to educate persons in an ongoing way about the nature of abuse. We have to educate and support caregivers so that they understand their roles, what they demand, and the limits to what they can offer, and the need for self-care if they are not to overstep those boundaries in destructive ways.

We also have to do everything in our power to identify and stamp out abuse of the elderly wherever it takes place.

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