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Agencies raise concerns over response to worsening elder abuse

The failure of successive federal governments to invest in a national elder abuse strategy means that authorities are in the dark as to the scale of the issue or which prevention and intervention strategies work best, researchers and support agencies have warned.

A national approach to elder abuse is urgently needed, consolidating the various work being done by state-based agencies, as the scourge of elder abuse will likely escalate with the ageing population and the Federal Government’s expansion of home-based care services, they said.

In submissions to a NSW Parliamentary inquiry into elder abuse, aged care providers, peak bodies, consumer groups and researchers have criticised the lack of national coordinated response to the issue.

The Australian Association of Gerontology (AAG) told the inquiry that more funding for research was needed as there were significant gaps in knowledge of elder abuse, the risk factors and how best to respond to it.

“In the absence of clear definitions and improved data collection, comparing the results of different studies, measurement of trends over time or across jurisdictions is impossible,” the AAG warned in its submission.

Research indicated that financial and psychological abuse were the most prevalent forms, which was also the experience of frontline agencies providing support to seniors. The variety and complexity of elder abuse meant that strategies had to be tailored to the particular circumstances of the victims and their family context, the AAG said.

Elder abuse expert Professor Sue Kurrle told the inquiry that the true prevalence of elder abuse in Australia was unknown.

“It is important for the future that we are more aware of how often elder abuse occurs in the older population generally, what forms it takes, in whom it occurs, and what actions are taken to address it,” said Professor Kurrle, Curran Chair in Health Care of Older People at the University of Sydney.

What the research was clear on was that most perpetrators of elder abuse were relatives of the older person, Aged & Community Services NSW & ACT told the inquiry in its submission.

And with the move to more control for seniors within community aged care, “an unintended consequence may offer increased opportunity for family members, acting as the person’s representative, to exclude service providers from oversight of aspects of the older person’s care, thus removing protections that previously existed,” said ACS.

Calls for national strategy

Many submissions reiterated calls for government to fund a national elder abuse strategy.

As Australian Ageing Agenda has reported, the various agencies working to prevent and respond to elder abuse are funded by their respective state governments. As a result, there is little collection of national data on the prevalence of the types of abuse, or sharing of programs or resources. It also means the level of support services varies across the country.

“There is a need for a national approach to elder abuse, building on and consolidating the work being done in the states and territories,” said ACS.

Leading Age Services Australia NSW-ACT said that the Commonwealth could take “a more active role” in collating the resources and best-practices of state agencies responsible for identifying and addressing elder abuse, and applying a national approach.

National Seniors said it strongly supported the development of a national response. “A national elder abuse strategy would focus attention on this growing yet largely hidden problem and enable coordinated and consistent responses across jurisdictions. This can only happen through the active participation and collaboration of governments in each jurisdiction,” said the seniors group.

“As part of this national strategy, National Seniors recommends that each jurisdiction commit funds to develop a national research effort to clearly evaluate the prevalence of elder abuse and to gain a better understanding of the circumstances in which it is most likely to occur. This would help to address gaps in understanding and could be used to develop more targeted and effective prevention strategies,” it said.

Criticisms of mandatory reporting

Many groups were highly critical of mandatory reporting of suspected elder abuse as a possible means of combating the issue.

The AAG noted that the evidence to support the effectiveness of mandatory reporting was “not strong” and it strongly cautioned against going further down that path.

“The introduction of mandatory reporting of suspected abuse of residents of aged care facilities to the Commonwealth Government and the police has introduced significant administrative burden for little demonstrable benefit to older people,” the AAG said.

ACS said it was important not to take away the right of the older person to make their own decisions, which could further disempower them at a time when they may already be feeling vulnerable.

Training for staff, community services

There was widespread agreement on the need for significantly greater training for aged, community and health professionals.

Professor Kurrle said medical professionals had generally been slow to be involved in the identification and management of elder abuse.

“This may relate to a lack of awareness of elder abuse, and a lack of scientific knowledge in this area with no evidence-based guidelines on interventions and treatment available,” she said.

Professionals in acute hospitals, particularly medical and nursing staff in emergency departments, were at the frontline of elder abuse identification and it was important they were aware of how it may present, she said.

“Appropriate funding for education and training about elder abuse… is necessary to improve knowledge and confidence in managing this difficult area,” said Professor Kurrle.

The NSW Elder Abuse Helpline & Resource Unit (EAHRU) called for all employees of organisations that serve older people to participate in mandatory education on elder abuse, for clinical training on indicators to be developed for healthcare professionals and yearly screening for elder abuse to be conducted by GPs.

LASA NSW similarly noted that GPs, nurses and pharmacies all had a role to play in identifying and reporting abuse, and additional resources and information for them should be considered.

The AAG said that with the introduction of consumer directed care, and the greater involvement of new businesses in care provision, it was important that that all paid carers had adequate education and training in how to identify signs of abuse and respond to it appropriately.

Community awareness

Beyond targeted education and training for professionals, many groups called for a broader public awareness campaign to educate the public on elder abuse.

ACS said that raising community awareness and tackling ageism would help create an environment that discouraged elder abuse.

Council on the Ageing (COTA) NSW said that the first step in a prevention strategy must be a government-funded education and awareness-raising campaign to enable the community to recognise elder abuse.

“Once such a campaign occurs, then the community can be engaged in the process of preventing elder abuse,” said COTA.

National Seniors similarly said it supported the development of a public awareness campaign, “which outlines the risks of abuse and highlights the mechanisms that can be used to minimise this risk.”

The committee recently began its public hearings, which will continue early in 2016. A final report is due by May 2016.

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