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The concept of Elder Abuse

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The Concept of Elder Abuse: Breaking the Silence was presented to HelpAge International by Bridget Penhale from UEA, Norwich in May 2011. Bridget is a European Board Member, INPEA

The Concept of Elder Abuse: Breaking the Silence was presented to HelpAge International by Bridget Penhale from UEA, Norwich in May 2011. Bridget is a European Board Member, INPEA

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  • 1. The Concept of Elder Abuse: Breaking the Silence Bridget Penhale UEA, Norwich European Board Member, INPEA
  • 2. Introduction and Background
    • Historical aspects
    • Global phenomenon
    • Recent recognition, increasing concern
    • An under-developed concept
    • Different perspectives involved
  • 3. Contextual matters
    • Community care
    • Demographic changes
    • Medical and technological advances
    • Legal and Rights agenda
    • Advocacy
  • 4. What is Abuse?
    • Definitional issues
    • A taboo topic
    • Need for consensus?
    • Private issue or public concern?
    • Adult protection or elder abuse?
    • Risk, vulnerability and protection
  • 5. The Importance of Naming
    • Silence about the topic
    • Comparative lack of recognition
    • Problems with terminology
    • Naming is essential: what is named….
    • Primacy of the individual and personal
    • Social construction of abuse and violence
    • Importance of professional identification
  • 6. Definitions of Abuse (1)
    • 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
    • Action on Elder Abuse, UK (1995)
  • 7. Definitions of Abuse (2)
    • Abuse is the violation of an individual’s human and civil rights by any other person or persons
    • No Secrets, UK (2000)
    • Abuse, like beauty, is in the eye of the beholder
    • Callahan (1986)
  • 8. Types of Abuse
    • Physical abuse
    • Sexual abuse
    • Psychological abuse
    • Financial or material abuse
    • Neglect
    • Societal abuse
    • Discriminatory abuse
  • 9. Features of Abuse
    • Physical or sexual assault
      • Issues of consent
    • Deprivation
    • Issues relating to medication
    • Involuntary isolation or abandonment
    • Financial abuse and exploitation
  • 10. The Need for Differentiation
    • Different types of abuse
    • Different settings and locations
    • Different participants
    • Different witnesses
    • Different responses and interventions
  • 11. Critical Factors
    • Social and cultural contexts
    • Gender and power relations
    • Not just family and interpersonal relationships
    • Personal, cultural and structural levels
    • Ageism as a master category
  • 12. Barriers to Identification
    • Mistreatment occurs in private
    • Societal views and attitudes:
      • Violence
      • Families
      • Disability
      • Care practices
    • Reluctance to report
    • Failure of professionals to detect
  • 13. The Concept of Elder Abuse (1)
    • An Aging issue?
    • A complication of caregiving?
    • The Family violence perspective
      • Prevention, punishment and protection
    • Apparent tensions
      • service and helping orientation
      • justice and criminalisation orientation
  • 14. The Concept of Elder Abuse (2)
    • Different images of Aging
    • Different systems of policy and practice
    • Are these applicable?
    • What are the views of elders?
    • What of models of empowerment?
  • 15. International Network for the Prevention of Elder Abuse (INPEA)
    • Established at IAG World Congress, 1997
    • Mission Statement and Objectives, 1998
    • Focus on
      • increasing awareness of abuse and neglect
      • promoting education and training
      • advocacy
      • research
    • NGO Status, 2003
    • Website: http://www.inpea.net
  • 16. Research: Missing Voices
    • Partnership with:
      • WHO Ageing and Life Course
      • HelpAge International
      • academic institutions
    • Study of older people in community and primary health care settings in:
      • Brazil India
      • Kenya Argentina
      • Lebanon Canada
      • Austria Sweden
  • 17. Missing Voices: Findings (1)
    • Older people perceive abuse as:
      • Neglect : isolation, abandonment, social exclusion
      • Violation : human, legal and medical rights
      • Deprivation : choices, decisions, status, finances and respect
  • 18. Missing Voices: Findings (2)
    • Key categories of abuse identified:
    • Structural and societal abuse
    • Neglect and abandonment
    • Disrespect and ageist attitudes
    • Psychological, emotional and verbal abuse
    • Physical abuse
    • Legal and financial abuse
  • 19. Missing Voices: Findings (3)
    • Important contextual aspects:
    • Social and institutional arrangements
      • Retirement and social roles of older adults
      • Long-term care institutions
      • Health care professionals as abusers & victims
      • Culture-specific influences as abuse
  • 20. Missing Voices: Findings (4)
    • Two key factors underpinning abuse:
      • Gender
      • Socio-economic status
    • Crucial points:
      • Prevailing view: women, especially poor, widowed or childless most affected
      • Respondents agreed: poor older people suffer most
  • 21. Missing Voices: Findings (5)
    • Direct Quotes:
    • * “He must have needed the money” (Canada)
    • * “Over school holidays, the first thing a family, who has a place to go to in the countryside does, is to grab the elder and put him/her in a hospital” (Brazil)
    • * “One rude word said to an old man is stronger than stabbing him with a knife” (Lebanon)
    • * “People talk down to us- call us ‘sweetie’ or ‘dearie’ - tell us what to do” (Canada)
  • 22. Missing Voices: Findings (6)
    • Direct Quotes:
    • * “Respect is better than food and drink” (Lebanon)
    • * “Older people are a big headache and a waste of scarce resources, the biggest favour you could do to me as an older people’s organisation is to get them out of my hospital” (Kenya)
    • * “To institutionalise an old person is like kidnapping someone” (Argentina)
  • 23. Missing Voices: Conclusions
    • Strategies proposed by the focus group participants:
      • Awareness and education
      • Training of professionals
      • Empowerment of elders
      • Role of the media
      • Recreation facilities
      • Structural solutions
      • Research
  • 24. Missing Voices: Recommendations
    • Key Action points:
    • To develop a screening and assessment tool
    • To develop an education package on elder abuse
    • To develop and disseminate a research methodology ‘Kit’
    • To develop a Minimum Data Set concerning elder abuse
    • To disseminate research findings widely
    • To develop a global inventory of good practice
    • To mobilise civil society through raising awareness of the widespread magnitude and problem of elder abuse
  • 25. Recent developments
    • World Elder Abuse Awareness Day
    • INPEA world environmental scan
    • European level initiatives:
      • Research: DAPHNE III Programme
      • Prevalence studies, specific projects
      • Policy level: MILCEA, EUSTaCEA
      • WHO European region
    • WHO Violence and Injury Prevention
  • 26. The Way Forward?
    • Improve recognition and awareness of abuse
    • Develop standards and systems of accountability
    • Develop strategies to prevent and intervene
    • Promote education and training
    • Improve knowledge and understanding
    • International collaboration to prevent abuse
  • 27. Contact details
    • Bridget Penhale
    • School of Nursing and Midwifery
    • University of East Anglia (UEA)
    • Norwich
    • Tel: +44 (0)1603 597016
    • Email: [email_address]

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