International Perspectives on Elder Abuse 1st Edition
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Mental Health Services for Vulnerable Children and Young People
Supporting Children Who Are, or Have Been, in Foster Care
Michael Tarren-Sweeney and Arlene Vetere
International Perspectives on
Elder Abuse
Edited by
Amanda Phelan
First published 2013
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
Simultaneously published in the USA and Canada
by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2013 selection and editorial material, Amanda Phelan; individual chapters, the
contributors
The right of the editor to be identified as the author of the editorial material, and of
the authors for their individual chapters, has been asserted in accordance with
sections 77 and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or utilised
in any form or by any electronic, mechanical, or other means, now known or
hereafter invented, including photocopying and recording, or in any information
storage or retrieval system, without permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks or registered
trademarks, and are used only for identification and explanation without intent to
infringe.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
International perspectives on elder abuse / edited by Amanda Phelan.
p. cm. -- (Routledge advances in health and social policy)
ISBN 978-0-415-69405-6 (hardback) -- ISBN 978-0-203-38705-4 (ebook)
1. Abused elderly. 2. Older people--Abuse of. I. Phelan, Amanda.
HV6626.3.I577 2013
362.6’82--dc23
2012036188
ISBN: 978-0-415-69405-6 (hbk)
ISBN: 978-0-203-38705-4 (ebk)
Typeset in Goudy
by Taylor & Francis Books
In memory of my nephew Cian Comerford 1994–2011
Contents
List of tables and figures
Preface
Acknowledgements
Contributors
1 Elder abuse: an introduction
AMANDA PHELAN
2 Australia
SUSAN KURRLE
3 Canada
LYNN MCDONALD
4 Chinese society
AGNES TIWARI, ELSIE CHAU-WAI YAN, MARGARET LEE
5 Ireland
AMANDA PHELAN
6 Israel
ARIELA LOWENSTEIN AND ISRAEL (ISSI) DORON
7 Kenya
ISABELLA ABODERIN AND NESTA HATENDI
8 Latin America
LIA DAICHMAN AND LILIANA GIRALDO
9 Norway
ASTRID SANDMOE
10 Spain
ISABEL IBORRA, YOLANDA GARCÍA AND ESTER GRAU
11 United Kingdom
BRIDGET PENHALE
12 United States of America
JOY SWANSON ERNST AND PATRICIA BROWNELL
13 Concluding thoughts
AMANDA PHELAN
Index
List of tables and figures
Tables
1.1 Elder abuse typologies, possible manifestations and potential
indicators
8.1 Risk factors for elder abuse
8.2 Legislation
10.1 Incidence of older people killed by relatives
Figures
10.1 Prevalence of different types of abuse according to information source
Preface
The idea for this book began while I was completing my PhD. When
reading literature on elder abuse, I became increasingly aware of the
different interpretations and understandings of elder abuse in different
jurisdictions. However, trying to consider the global issue of elder abuse
within a common lens of research, practice, policy and legislation proved a
challenge. Consequently, this book allows the reader to examine current
international perspectives within a cultural and localised context.
The contributing authors are all leaders in their country's research in the
domain of elder abuse and have eloquently articulated indepth insights into
the topic. Each author was invited to generate perspectives under the lens of
research, practice, policy and legislation. However, the function of each
chapter was to provide insights which were not overly superimposed by
prescriptive headings, thus allowing the contributing authors the flexibility
to develop the discussions as parallel to the country's context. In doing so,
the book provides readers with an excellent base in the topic of elder abuse
in an international context.
Acknowledgements
This book was a challenging journey for me and I am indebted to many
people. Within the UCD School of Nursing, Midwifery and Health Systems,
I have received support from many colleagues, but in particular the Dean
and Head of School, Dr Martin McNamara, and my friend, Dr Mary Casey.
My colleagues, Professors Margaret (Pearl) Tracey and Gerard Fealy, Dr
Attracta Lafferty and Ms Nora Donnelly in the UCD National Centre for the
Protection of Older People have also inspired my continuing research and
interest in the area of elder abuse.
I would like to thank all of the contributing authors for giving their time
and craft in each of the chapters. I know academic life has many demands
and each contribution required careful reflection and development.
I would also like to thank my family, in particular, my mother Frances,
my sisters Mary, Terry, Evelyn and Caroline and my brother Jimmy. Finally,
this book would not have been possible without my husband, Gary, and
children Aoife and Jack, who patiently tolerated my academic woes!
Contributors
Isabella Aboderin is Senior Research Scientist at the African Population
and Health Research Center (APHRC) in Nairobi, Kenya, where she
leads the programme on ageing and development in sub-Saharan Africa;
and Senior Research Fellow at the Oxford Institute of Population Ageing
(OIA), University of Oxford.
Patricia Brownell is Associate Professor Emerita of Social Service at
Fordham University. Dr Brownell represents INPEA on the CoNGO
Committee on Ageing, UN/New York and also serves on the Executive
Committee of the Board of Directors of the (NCPEA) as well as chairing
the Public Policy Committee.
Elsie Chau-Wai Yan is an assistant professor at the Department of Social
Work and Social Administration. Her research interests include elder
abuse, elder sexuality, dementia care, caregiver stress and women's
health.
Lía Susana Daichman has worked as a Consultant in Gerontology and
Geriatrics at the IADT, Buenos Aires. Lía served as President of INPEA
from 2001–2009 and was elected President to the Buenos Aires
Gerontological Society (AGEBA) 1994 and has been Chair of the LA
Committee for the Prevention of EA (COMLAT – IAGG) since 1995.
Israel (Issi) Doron is the Head of the Department of Gerontology,
University of Haifa, and President of the Israeli Gerontological Society.
He specialises in the fields of law and ageing, social policy and aging,
ethics, ageism and the human rights of older persons.
Yolanda García Esteve is a Professor and the current Secretary-General at
the Valencian International University. She is also the Queen Sofía
Centre's in-house expert in the field of legislation, where she gathers and
comparatively studies legislation on violence from all around the world.
Liliana Giraldo Rodriguez is a researcher in Medical Sciences, Institute of
Geriatrics, Mexico (Instituto de Geriatría, México) and holds a Master's
Degree on Demography, El Colegio de Mexico. Current research
interests are aging, elder abuse, mistreatment, violence, and
discrimination.
Ester Grau Alberola is a Professor at several universities: the Valencian
International University, the University of Valencia and the University of
Salamanca (special courses). She has over 12 years’ professional
experience in gerontology and social psychology.
Nesta Hatendi is HelpAge International Regional Representative for East,
West and Central Africa. Nesta works alongside HelpAge International
country offices and their teams in Kenya, Uganda, Ethiopia, Tanzania and
DRC, and leads on strategic programme development to influence policy
related to older people.
Isabel Iborra is a Professor at the Valencian International University. She
is the current National Representative of the INPEA in Spain, a member
of the National Security Council Working Group on Elder Abuse
(Ministry of the Interior) and the former Scientific Coordinator at the
Queen Sofia Centre.
Susan Kurrle is an academic geriatrician in hospital and community
practice at Hornsby Ku-ring-gai Hospital in northern Sydney, Australia.
She holds the Curran Chair in Health Care of Older People in the Faculty
of Medicine at the University of Sydney.
Margaret Lee is a member of the Young Nursing Academic Programme
(YNAP) at the University of Hong Kong School of Nursing. Margaret is
working with the HKU Domestic Harmony Research team; elder
mistreatment is one of the research foci of the team.
Ariela Lowenstein is Acting President, Yezreel Valley College. Lowenstein
developed and established in 1999 Haifa University's Graduate
Department of Gerontology, heading it for its first five years. In 1990,
she established the Center for Research and Study of Aging, which she
headed until October 2011, creating a wide network of global
collaborations with top researchers and institutions.
Lynn McDonald is a professor in the Faculty of Social Work, where she is
the Coordinator of the social work Gerontology Program and Director of
the Institute for the Life Course and Aging at the University of Toronto.
She is the Scientific Director of a National Centre of Excellence, the
National Initiative for the Care of the Elderly (NICE) dedicated to the
inter-professional knowledge transfer about and for older adults.
Bridget Penhale is currently Reader in Mental Health of Older People at
the University of East Anglia (UEA), UK, and has specialised in work
with older people since 1983. In 2010 she received the International
Rosalie Wolf Award for her work in the field of elder abuse research and
practice.
Amanda Phelan is Subject Head of Older Persons’ Nursing in the School
of Nursing, Midwifery and Health Systems, University College Dublin,
and is also a Co-Director in the UCD National Centre for the Protection
of Older People.
Astrid Sandmoe is an Associate Professor at the Department of Health
Studies, Faculty of Health and Social Studies, Telemark University
College, Norway. She is currently working on a multi-disciplinary elder
abuse project in Telemark County to enhance the quality of care to older
people exposed to abuse.
Joy Swanson Earnst Ph.D., MSW, is an associate professor and the
director of the undergraduate social work programme at Hood College,
Frederick, Maryland. Her research focuses on elder neglect and Adult
Protective Services.
Agnes (Aggi) Tiwari is Professor and Head of the School of Nursing, Li
Ka Shing Faculty of Medicine, University of Hong Kong. She has
published extensively on family violence prevention and intervention and
also conducts her faculty practice in three shelters for abused women and
provides consultancy to victim support services.
1 Elder abuse: an introduction
Amanda Phelan
Introduction
Abuse of older people is a growing challenge in all societies. This is
particularly pertinent as demographics demonstrate a global ageing
population. For example, Leeson and Harper (2008) indicate that
approximately 8 per cent of the world's population was aged 60 years and
over in 1950, but by 2006 this figure had increased to 11 per cent, with
projections of a rise to 22 per cent by 2050. Elder abuse can occur in any
setting that includes older people and in any socio-economic group. The
topic of elder abuse has a relatively recent history in public discourse, but
there are challenges in definition, understandings and constituent elements.
As with other forms of interpersonal violence, elder abuse is an unpalatable
taboo subject often shrouded in secrecy and shame and can be considered a
‘hidden problem’ in society (Baker and Heitkemper 2005). However, elder
abuse has serious consequences. Apart from the immediate effects of abuse,
such as possible bruises, fractures, distress and financial loss (Lindbloom et
al. 2007), there are enduring effects such as premature mortality (Lachs et
al. 1998), depression and continued psychological distress (Mowlam et al.
2007, Lafferty et al. 2011) as well as a continued experience of fear (Comijs
et al. 1998).
In order to provide an assessment of perspectives of elder abuse in our
selected countries, this chapter provides a foundation in understanding the
topic of elder abuse. As such, it examines issues of old age, the emergence
of elder abuse in public discourse, terminological and definitional
challenges, prevalence and theoretical frameworks. The reality of elder
abuse can differ due to issues of legislative imperatives, mandatory
reporting, cultural norms, response systems, policy guidelines and so forth,
but this diversity should not be used as a barrier to addressing the topic
through a comprehensive, rights based approach.
Old age
The human life cycle has become increasingly demarcated in terms of age-
related components as to how an individual is categorised (Boyd and Bee
2004). Old age exists as a definite chronological life stage, but the precise
chronological differentiation and meaning of old age can be interpreted
differently (Posner 1996, Katz 1996). Consequently, although chronology
can be the primary reference for old age, ageing theories are also influential
when considering the ageing process itself (WHO 2002a; UN 2004).
The modern classification of older people has reflected Otto von
Bismarck's distinction of ‘the elderly’ from the general population (Carp
2000) by introducing in the late ninteenth century rudimentary pensions for
those over 65 years of age as a reaction to a rising interest in socialism in
Germany. Subsequently, ‘over 65 years’ became acknowledged in many
Western countries as the demarcation of the category ‘older person’. For
example, 65 years of age is frequently acknowledged as the age of
retirement and is employed when calculating age dependency ratios. Older
age dependency ratios are based on the number of older people (generally
65 years and older) compared to the number of people of working age (i.e.
15–64 years of age). Projected population statistics suggest that the old age
dependency ratios in Europe may double in the next forty years (Lanzieri
2006). However, with increasing dependency ratios, the age of retirement
has risen moderately in some countries (WHO 2011, Phelan 2011) with
some commentators lobbying for further increases to 70 years of age
(Economist 2011).
Other age references must also be acknowledged; for example, the WHO
(2002a, 2011) and the UN (2004) both use the standard of 60 years to
describe ‘older people’. The WHO (2002a) argues that, although the marker
of 60 years may appear young, in the developed world and in the
developing world, chronological age is not a precise indicator of the
changes that accompany ageing. In addition, increased complexity has
