Recognising, Responding & Preventing Elder Abuse in

Aged Care

ACSA Leadership, Quality & Transformation Symposium

Adelaide

8 November 2019

Geoff Rowe

Chief Executive Officer

Aged & Disability Advocacy Australia

The Paul Tys Churchill Fellowship to access world’s best practice in preventing and responding to Elder Abuse in aged care and the community

USA, Canada, United Kingdom, New Zealand

What do we know about

elder abuse?

The abuse of older people is a complex health and social problem that can have devastating physical, emotional and social consequences for older people, their families and their communities. The abuse of older people occurs within a complex interplay of individual, interpersonal, community and social factors. It can be challenging to identify abuse when it occurs, as there is no single type of older person who is at risk, and no single type of person who may cause harm.

What do we know about

elder abuse?

Elder abuse is described by the World Health Organisation 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’

What do we know about

elder abuse?

Elder abuse can take many forms, including:

• physical abuse,

• psychological or emotional abuse,

• financial abuse,

• sexual abuse, and

• neglect.

What do we know about

elder abuse?

• abuse of older people affects between 2% and 12% of older people, and it affects both women and men. It has been estimated that as many as 185,000 older people in Australia experience some form of abuse or neglect each year.

• NYEAC & Weill Cornell Medical Centre research found that only 1 in 24 instances of elder abuse were reported.

• Abuse of older people can happen both inside and outside the home.

What do we know about

elder abuse?

In the context of aged care, the perpetrator may be:

• Family member

• Power of Attorney

• Staff member

• Another resident/client

• Facility/service

Responding to elder

abuse

• As a community, our response to elder abuse is where our response to domestic violence was twenty years ago.

• As a society we have little, or at best a poor understanding of elder abuse, often viewing it as a family issue rather than a criminal or systemic matter.

• We have failed to count the cost of elder abuse, the emotional, social and financial – to the older person and the community more broadly.

National Plan (2019-2023)

The National Plan to Respond to the Abuse of Older Australians has put forward a road map for commonwealth, state and territory governments to work together. The National Plan has outlined five priority areas for action by governments in the period 2019 – 2023:

– Enhancing our understanding

– Improving community awareness and access to information

– Strengthening service responses

– Planning for future decision-making

– Strengthening safeguards for vulnerable older adults

Responding to elder

abuse

Adult Safeguarding Unit (SA)

Strong focus on safeguarding the rights of adults at risk of abuse.

Key functions of the ASU includes:

• responding to reports of suspected or actual abuse of adults who may be vulnerable

• providing support to safeguard the rights of adults experiencing abuse, tailored to their needs, wishes and circumstances

• raising community awareness of strategies to safeguard the rights of adults who may be at risk of abuse.

Responding to elder

abuse

• SA Elder Abuse Prevention Phone Line: 1800 372 310 (free call)

• ARAS is a key referring partner –currently finalising MoU with the Unit and provide information, education and advocacy https://www.sa.agedrights.asn.au/

• Ph: 82325377 or 1800 700 600

Responding to elder

abuse

• Alliance for Prevention of Elder Abuse: https://www.apea.org.au/

National Elder abuse phone line

• 1800 ELDERHelp (1800 353 374) -automatically redirects callers seeking information and advice on elder abuse with the existing phone line service in their jurisdiction.

Elder Abuse Prevention in

Aged Care

• Leadership

• Human Rights and Ageism

• Client engagement

• Staff Recruitment and screening

• Education and Awareness – video resources

• Complaints & Concerns processes

• Vigilance

Fellowship Observations…….

The standout observation of most concern is Australia’s failure to recognise that older people have the same Human Rights as the rest of the community. Our legislative and service responses do not operate from a rights base. Too often we see older people being required to check in their rights when they check into aged care. Ageism is alive and well in Australia.

Observations……

• Collaboration – the importance and power of collaboration in preventing and responding to elder abuse at the systemic and individual level was a common observation across the many places visited. Collaboration saw government and community change the way that it responded to abuse and it gave vulnerable groups a voice.

• Mandatory Reporting – while not operating in every jurisdiction visited, it was identified by many as an effective way of safeguarding their most vulnerable citizens. Training of mandatory reporters resulted in an increased awareness and understanding of elder abuse right across the community.

Observations…….

• Decision Making and Choice – there is an observed move globally towards supported decision making, ensuring that the person with impaired capacity is involved in the decision-making process that they have historically been excluded from.

• Legal / Law Enforcement – Elder abuse is a crime and must be treated as such. While statutes exist in some jurisdictions to deal with elder abuse as a crime, others are lobbying for change. In countries where laws only protect the most vulnerable, less vulnerable victims with capacity are unable to access justice under the law. There is a need to develop robust laws which allow elder abuse to be treated as a crime, while also respecting the rights of older people to make decisions that may not always be in what others see as their best interest.

Observations…….

• Rural and Remote Responses – The response to elder abuse in rural and remote communities appears to be limited across all jurisdictions visited. While there were some strategies identified such as using meals on wheels providers as contacts, my Fellowship highlighted there is much work yet to be done in this area.

• Indigenous Responses to Elder Abuse –The response to elder abuse within Australia’s indigenous community can at best be described as poor. There are few responses, and little in the way of education and community awareness.

Closing Remarks

• As a society we have failed to count the real cost of elder abuse, the emotional, social and financial cost – to the older person and the Australian community more broadly.

• My Fellowship exploration affirms the understanding that elder abuse is under-reported, and our response inadequate.

• Investment by government is required, in the short, medium and long term. Elder abuse occurs in all communities and does not discriminate.

• Preventing and responding to elder abuse is not just the responsibility of government it is the responsibility of all Australians.

Questions?

Useful Links

Adult Safeguarding Unit

• https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/department+of+health/office+for+the+ageing/adult+safeguarding+unit

Phone: 08 8204 2420

Email: stopelderabuse@sa.gov.au

Useful Links

• churchilltrust.com.au

• ag.gov.au/RightsAndProtections/protecting-the-rights-of-older-australians/

• opan.com.au

geoff.rowe@adaaustralia.com.au

www.adaaustralia.com.au