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Abuse, Neglect and Violence against Older Persons Silvia Perel-Levin Social Forum, Geneva, 2 April 2014 Types of abuse 1. Physical characteristics Examples The infliction of pain or Slapping, hitting, kicking, force- injury feeding, restraint, striking with objects. 2. Psychological/emotio Verbal aggression or threat, threats of Infliction of mental anguish institutionalization, social isolation, humiliating statements. nal abuse 3. Financial/material abuse The illegal or improper Theft of cheques or money, coercion to exploitation and/or use of deprive the older person of his or her funds or resources assets, such as forcible transfer of property. Suggestive talk, forced sexual activity, 4. Sexual abuse 5. Neglect Non-consensual contact of touching, fondling with a any kind with an older nonconsenting competent or person incompetent person. Intentional or unintentional Failure to provide adequate food, refusal or failure of clothing, shelter, medical care, designated caregiver to hygiene, or social stimulation. meet needs required for Types of abuse characteristics 6. Societal abuse Ageism, lack of appropriate pensions, discrimination Alternative classification Neglect Violation Deprivation isolation, abandonment and social exclusion of human, legal and medical rights of choices, decisions, status finances and respect WHO/INPEA 2002 Risk factors – ecological model Societal Societal Community Community Relationshi p Individual Relationship Individual Ageism, wide Social isolation Financial Dementia Dependence discrimination Concentration of poverty Emotional Depression dependence Sexism, racismWidowhood Living Experienced arrangements abuse Socio-economicWitchcraft accusationsLong-term Aggression abuse/violence factors/concentration Lack ofofsupport networks Intergenerational Dependence or transmission? disability poverty Erosion of intergenerational Gender relations Inheritance systems/ Age The extent of the problem Latin America and the Caribbean • 6 to 37% prevalence Elder Abuse in India (20 cities) • 31% faced abuse • Over 50% during 4 years in multiple forms • 24% almost daily Helpage India, 2012 The extent of the problem, India 1.67% in Rajasthan to 77% in Madhya Pradesh (Helpage India, 2012) Sexual Violence in Eastern DRC Age Number Percentage < 15 252 5.9 16-24 809 18.8 25-34 841 19.5 35-44 988 22.9 45-54 752 17.4 55-64 211 4.9 > 65 458 10.6 Total 4,311 100 Prevention – ecological model Societal Societal Community Community Relationshi p Relationship Interdisciplinary action Individual Individual Should primary health care workers screen for elder abuse? NICE- Canadian pocket tools Tools for the police • Elder Abuse risk assessment • Assessment and intervention reference guide • Theft by persons holding power of attorney Interventions Safety Autonomy? INPEA International Network for the Prevention of Elder Abuse Established in 1997 • Raising awareness World Elder Abuse Awareness Day (WEAAD) 15 June • Education and training of professionals and paraprofessionals in identification, treatment and prevention • Advocacy on behalf of abused and neglected elders • Promote research into the causes, consequences, prevalence, treatment and prevention of Elder abuse and Neglect Concluding remarks Scientific rigour humanistic model? “Respect is better than food or drink” An older respondent WHO, 2002 Missing Voices