Speech for Minister Áine Brady TD for the launch of the Report on the National Study of Elder Abuse and Neglect
Good evening everyone, and welcome to the National Centre for the Protection of Older People (NCPOP). I am delighted to be here again, to speak about the latest developments in tackling and preventing abuse of older people. I would like to thank Professor Maurice Boland, UCD Life Sciences, for his kind invitation to launch the National Study of Elder Abuse and Neglect. It would not have been possible to carry out this study without the contribution of over 2,000 men and women who were prepared to speak about their experiences. As we talk about statistics on elder abuse this evening, we also remember there are people behind the numbers. And so I would like to commend those who were prepared to share aspects of their lives with us. Their insights will greatly assist in developing the elder abuse service into the future.
As you know elder abuse is a complex issue and difficult to define precisely. It may involve financial abuse, physical abuse, psychological abuse, sexual abuse or a combination of these. Current policy on elder abuse is outlined in the 2002 Report of the Working Group on Elder Abuse Protecting our Future and the review of that Report in 2009. Protecting Our Future defines elder abuse 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 or violates their human and civil rights.” That Report recommended that a clear policy on elder abuse be formulated and implemented at all levels of governance within the health, social and protection services in Ireland. I am very pleased that substantial progress has been made and continues to be made, especially in the health services, in implementing the recommendations of these reports.
Elder abuse in any form is totally unacceptable and I can reiterate my full commitment to tackling all forms of elder abuse. However elder abuse is a societal as distinct from a health problem and therefore requires us, as a civic society, to recognise elder abuse and to report it if we come across it. Significant progress has been made in the last few years in developing the structures needed to tackle this abuse. The indications are that these structures are working. It is imperative that this progress continues, that any gaps are identified and addressed in full and, that older people are emboldened to report their anxieties to a social worker, a public health nurse, a GP, a member of the Garda Siochána, or to someone they trust.
Review of Protecting our Future
As I mentioned earlier current policy on elder abuse is derived from the 2002 report Protecting Our Future and the Review of that Report in 2009. In commissioning the Review, we were particularly anxious that any gaps in policy be identified, and that research on areas not covered in the original report be carried out. These included financial abuse, institutional abuse and self-neglect. I was pleased that the Review Report found that “progress was most evident and pronounced in the health sector”. It did, however, acknowledge that significant issues, such as financial abuse, were not being addressed in a sufficiently coherent and comprehensive way. The Review continued to make recommendations around three main areas:-
(a) strengthening existing institutional arrangements
(b) accelerating progress on existing recommendations in Protecting our Future, and
(c) addressing emerging areas of concern.
An Action Plan has been developed, in conjunction with the HSE, to implement the recommendations in the Review Report. In addition Performance and Activity Indicators on elder abuse were developed in 2009. These measures together with evidence based research, such as the study being launched today, play a key role in monitoring and planning for a sound service into the future.
National Centre for the Protection of Older People
The establishment of the National Centre on the Protection of Older People was a significant development. The principal function of the Centre is to create a knowledge base of Irish and international research on the occurrence, prevalence, detection and response to abuse of older people. The objective of the Centre is to place elder abuse in the wider social context, which is essential for the development of a sound service. Financial abuse, ageism and discrimination are key issues which cannot be resolved solely within the HSE. Therefore the opportunity to inform policy across a wide range of departments and agencies is being strengthened by a Centre that has an inter-agency mandate.
The Centre has completed a number of reviews and studies, and this latest study provides us with additional evidence on the prevalence of elder abuse in Ireland.
National Study of Elder Abuse and Neglect
Statistics on elder abuse do not make for easy reading. Until now we could only assume that the prevalence of elder abuse in community settings in Ireland, was not unlike that in other developed countries. Abuse and Neglect of Older People in Ireland found that 2.2% of the study population experienced abuse or neglect in the last 12 months. This means that approximately 10,000 people living in the community were found to have suffered abuse, neglect or maltreatment.
In the main, the trends identified in the study repeat those identified in the analysis of the referrals of allegations of elder abuse to the Health Service Executive, with one or two exceptions. The study found that overall women reported higher levels of abuse than men. With regard to age, the highest levels of abuse were reported by men aged 80 years and older and by women in the 70-79 years age group. It continues to be a key concern that the persons most frequently causing anxiety are those that have the closest relationship to the person i.e. son/daughter (50%), partner/ husband/ spouse (20%), and other relative (24%). Financial abuse was the most frequent type of abuse reported, followed by psychological abuse, physical abuse and neglect. The study also examines perpetrator characteristics, socio-economic, health service and social support characteristics of people who reported mistreatment. We are dealing with a complex set of issues here.
Central to the HSE’s elder abuse programme, is the identification of issues for the client, and the tailoring of interventions and supports to meet their needs. 2009 saw a more comprehensive range of supports on offer to clients which included day care, advocacy and conflict mediation.
I won’t go into great detail but it is worth mentioning the increase in referrals from 1,840 cases in 2008 to 1,870 in 2009. Paradoxically, any increase in referrals is a good thing, as we know that under-reporting of elder abuse, is a global issue, of concern to us all. Any increase in the number of referrals shows that the programmes, and structures in place for reporting the incidence of elder abuse, are working.
HSE Public Awareness Campaign
As we all know many older people may be reluctant to report abuse, particularly because elder abuse, by definition, occurs within a relationship in which there is an expectation of trust. If an older person is being abused by a close family member, the older person may not wish to upset that relationship. Similarly, if the abuse is perpetrated by a carer, the older person may be reluctant to report it. Sometimes neither the abused nor the abuser may recognise the actions as abuse. This may be particularly true in cases of financial or psychological abuse. Either of these forms of abuse can be more insidious, and less easily recognised, than any other type of abuse.
In 2009 the HSE developed a comprehensive public awareness campaign aimed at raising awareness of elder abuse in community settings, which also included a focus on financial abuse. As part of the campaign the HSE produced training DVDs, leaflets and legacy cards to equip people with the skills and knowledge to enable them to recognise, and respond appropriately to suspicions of elder abuse. It is important that we continue to create awareness of the elder protection services provided by the HSE and other agencies.
The potential abuse of our older people – including financial abuse – is of concern to us all. The Department of Health and Children will continue to work closely with the HSE and other agencies until the best possible measures are in place to protect our vulnerable older people.
The main goal of any response to elder abuse is prevention. There are two types of prevention – primary prevention, i.e., stopping elder abuse from happening in the first place, and secondary prevention, i.e., when it does happen, taking steps to ensure that it does not happen again. The added value of this Report will assist in developing the appropriate responses needed to tackle elder abuse.
Some types of abuse, for example financial abuse, require action from agencies other than the HSE and this will be a priority focus from now on. In addition, negative attitudes towards, and perceptions of, ageing and older people can lead to intolerance and acceptance of abuse. We have to be ever mindful to eliminate ageism and ageist attitudes. These are not the only factors contributing to elder abuse but can give rise to a culture or an environment in which elder abuse can develop, leading to age discrimination, and devaluing and disempowering older people.
Strategy for Positive Ageing
We must plan ahead now to make Ireland an ‘age-friendly’ country in which every individual, regardless of their age, can access the kinds of services and supports that enable them to live healthy, fulfilling and independent lives in their own homes and communities for as long as possible. As Minister for Older people one of my main priorities is to develop a National Positive Ageing Strategy which will set out a common framework for the development of operational plans by Government Departments. They will clearly set out their objectives relating to older people, as well as the development of ongoing mechanisms designed to monitor progress and identify challenges facing older people in the future.
I intend to have a very broad-ranging Positive Ageing Strategy, which will have a much wider focus than on health and personal social services. Of course, health and social services are vitally important, but it is my belief that all services and all sectors are relevant to older people and the Strategy that I am developing will reflect that broader focus in setting the direction for all future policies, programmes and services relating to older people. I do of course envisage that the Strategy will include a recommendation on the evaluation of the approaches and responses needed to prevent and tackle elder abuse.
In conclusion I would like to thank the research team and all in the National Centre for the Protection of Older People for their work on the Report being launched here today. I know that this is a difficult piece of research to capture. The findings will play an important role in developing the appropriate mechanisms to detect and tackle elder abuse.