Thursday, 16 April 2009

Elder Abuse finally receives some attention

An unpublished HSE report on elder abuse has been receiving media attention with the headlines highlighting the fact that last year more than 1800 cases of elder abuse were reported to the HSE. The figure for 2008 shows a significant rise on the previous reported period. When broken down into type of complaints the report shows that a quarter of the complaints related to allegations of psychological abuse, a fifth neglect, 16 % involved allegations of financial abuse and 12 % complaints of physical abuse such as slapping. And who were the majority of alleged abusers? The HSE report shows that in about 80 % of cases they were family members. The high level of involvement of family members in abuse should not be surprising given that these are the people most closely involved with the elderly, often acting as carers.

Levels of cases across the country varied dramatically with 47% of the cases being reported in the south. Yet there was a degree of consistency as to who was most likely to report the cases - a public health nurse, hospital or HSE staff member. Referrals from family members accounted for less than 15% of cases.

The reality is that the 2008 report from the HSE, with its finding of a significant increase in reported cases (double that of the previous 9 months), is in fact a reflection of a change in attitude towards acknowledging and responding to the fact of elder abuse. Over the last few months the HSE has published its Elder Abuse Policy and as a result has brought on line awareness raising for HSE staff and the wider population through its “Open Your Eyes” campaign. It also now has in place Senior Case Workers responsible for dealing with elder abuse across all regions of the country.

These, and other changes, have therefore resulted in an increase focus on elder abuse, and an increase in cases. However, the level of reported cases is in fact low compared to similar developed nations. According to a recent factsheet published by the WHO

“International prevalence estimates of elder abuse in community settings (including neglect by caregivers, physical, psychological and financial abuse) from Canada, Finland, the Netherlands, the United Kingdom and the United States of America range from 4-6%.” (more)

Of course we have no similar research yet from Ireland. Indeed, the HSE report, which remains unpublished, is a major step forward in creating official recognition for a significant and ongoing problem of abuse.

So it remains the case that if Ireland is in any way like other developed nations 1800 cases will be a mere fraction of the overall level of abuse currently going on behind the closed doors of elderly peoples own homes. The action taken by the HSE to respond to the problem of this form of abuse is to be welcomed but must be built on, with the development of good practice and effective guidelines. Intervention when needed must be monitored and assessed, protection policies developed and staff fully trained, resourced and supported. The sooner this is done, the better, and it is not as if Ireland has to reinvent the wheel in this area - a raft of International experience available to us to adapt and suit our own particular national needs.

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