Elder Abuse and Fear of Crime Among Older People

Report on an Australian Conference and on New Zealand Initiatives

Fleur Keys and Maree Brown
Policy Analysts, Social Policy Agency

Although little research has been done in New Zealand on the prevalence of elder abuse and fear of crime among older people, the literature suggests that they are international concerns. Because of the growing interest in this area, two officials from the Senior Citizens Unit attended the Australian Institute of Criminology conference "Crime and Older People" in Adelaide in February. The focus of the three-day conference was on the issues of elder abuse, victimisation, fear of crime, and crime prevention strategies for older people.

The keynote speaker at the conference, Professor Ezzat Fattah, from the School of Criminology at Simon Frazer University in British Columbia, opened the conference with a provocative speech about the possible link between victimisation and fear of crime among the elderly. He said that international research consistently shows that the elderly are the least victimised group in the general population but that they exhibit a high (and usually the highest) level of fear of crime. However, attempts to reduce this fear of crime simply on the grounds that fear is an undesirable condition is a questionable rationale, according to Fattah. He asserted, to the contrary, that fear may be a positive force which actually contributes to the low rate of victimisation of the elderly. To the extent that fear may cause people to be more cautious, to modify their behaviour or minimise risks, it may reduce their chances of becoming victims of crime.

Fattah acknowledged that research in this area was problematic. For example, it was not necessarily fear which caused older people to stay home at night; lifestyle and routine activity of older people had to be taken into account. Furthermore, while the home might figure in the popular imagination as a haven, it could also become the scene of crime. Thus, home-dwellers minimise certain risks but do not remove themselves completely from crime's orbit. Fattah also problematised the notion of an optimum level of fear. Clearly, too much fear could constrain a person's independence and activity, while too little could lead to complacency and risk taking. However some industries, such as home security and insurance firms, would always have a vested interest in raising public fear of crime.

Elder abuse and neglect - how big is the problem?

It is very difficult to measure the prevalence of elder abuse and neglect, not least because there is no one standard definition of what constitutes abuse or neglect. Paul Sadler, a Senior Policy Officer with the New South Wales Office on Ageing, presented the findings of research on elder abuse conducted at the Hornsby Ku-ring-gai Geriatric and Rehabilitation Service, Northern Sydney. This study was the first in Australia to provide information on the prevalence of elder abuse amongst clients of a geriatric service.

The Hornsby research included a review of the medical records of all clients seen by the Service in the June 1990-91 year. It was found that 4.6% of the 1,176 non-institutionalised clients aged 65 and over were victims of elder abuse or neglect. While acknowledging that the clients of the Service were not a representative sample of the older population in Hornsby and Ku-ring-gai, Sadler concluded that a rate of 4.6% was within the range of most overseas studies into elder abuse. This figure was later brought into question by Dr John McCallum, of the National Centre for Epidemiology and Population Health (The Australian national University).

McCallum's paper offered an interesting discourse on the prevalence of elder abuse and the need for effective intervention. Beginning from a working definition of elder abuse as: "any pattern of behaviour by a person that results in physical, psychological or economic harm to an older person", his basic premise was that as awareness of elder abuse has grown, a debate has developed between those who seek to maximise the issue, and those who seek to minimise it. McCallum described the maximisers as those who look at statistics and use terms such as "the tip of the iceberg" in an attempt to explain the small percentage of people identified as victims, while the minimisers are those who regard elder abuse as a product of "fertile imaginations", and the reality as "a very minor issue".

McCallum went on to argue that the social context in which abuse occurs further complicates the debate surrounding the definition and prevalence of abuse. For example, different levels of conflict are sanctioned in different groups. He asserted that different levels of intervention act as deterrents to elder abuse in different situations. Finding the right mix of formal and informal responses to abuse is important in preventing and minimising the effects of abuse in all sections of the community. He suggested that particular attention needed to be paid to marginalised groups in society, such as substance abusers, who have a low stake in conformity to social norms.

McCallum concluded that the overriding concern of those working in the field of elder abuse should be to work towards improving the accuracy of definition and sensitivity of assessment of elder abuse, with maximisers and minimisers working together to reduce the impact of abusive situations on older people.

State of Victoria Responses to Elder Abuse

Justin McDermott from the Department of Health and Community Services in Victoria had a different approach to the definition of elder abuse. He presented the findings of a State of Victoria working party charged with defining elder abuse and developing a strategic response to it.

He said that the term "elder abuse" was borrowed from child abuse in the early 1970s when US researchers suggested that the two phenomena were similar. In both cases, the victim was dependent and vulnerable, and mistreatment usually occurred in private, away from public scrutiny. The Victoria working party found that this link carried with it a certain baggage - it tended to fuel myths that old age was a kind of second childhood, or that most elderly people were feeble-minded, vulnerable, a burden, and therefore at risk of abuse. This description may have some validity in cases where a person with dementia suffers abuse from, or abuses, a caregiver. However, there are many other scenarios of elder abuse where the problem is not a function of age, mental competence or frailty.

The working party concluded that elder abuse does not form a unique or exclusive category of behaviour - it has no one definition. Rather, it is a convenient label for forms of behaviour often described by other names, such as domestic violence, professional malpractice, caregiver stress and fraud. Each of these forms of behaviour has its own validity and can refer to people of all age groups.

Eight typical scenarios: The working party then drew up a list of eight typical situations in which neglect or abuse were known to occur. These scenarios do not amount to a definition of elder abuse but they illustrate what people may have in mind when using the term. McDermott stressed that the following scenarios are not exhaustive, nor mutually exclusive:

• Maltreatment or neglect by caregiver - whether intentional or not;
• Domestic violence - often between spouses and often a function of a long-standing dysfunctional marriage. Alcohol and drug abuse are commonly associated with this kind of violence. Sometimes a role reversal occurs in later life, when a formerly abused partner becomes the abuser of a now dependent spouse;
• Maltreatment or neglect of an elderly parent or parents by a dependent adult son or daughter. One American study suggested that this is the most common form of physical abuse of older people;
• Intergenerational conflict in an extended family situation;
• Financial exploitation; for example, where a younger family member misuses an older relative's assets;
• Maltreatment by a staff member in a residential care situation;
• Professional malpractice/maltreatment by a paid caregiver;
• Self neglect, identification of which can be difficult as it raises ethical questions about the right to self determination. Intervention is usually only possible when the situation involves some danger, such as a health hazard, to other people.

Developing Successful Responses

In demonstrating that elder abuse is used as a label for forms of behaviour often described by other names, McDermott was not just making an academic point. This discourse on definition informed the working party's whole approach to developing successful responses to elder abuse. It concluded that in the State of Victoria there was already a range of services in place to deal with most of these problems. There was no need for a specialised protective service for older adults. However, it was necessary for each agency to re-examine the way its services were targeted, and adopt a broader view of who its client group was. In other words, each agency had to ensure its services were extended to older people. It was acknowledged that extra resourcing might be needed in some cases.

The working party concluded that while it may be relevant to know if the victim is elderly, and that this may affect the range of appropriate solutions available, it should not change the principles of the approach. A successful response also required agencies to develop protocols which defined their respective responsibilities, and improve their own understanding about the range of situations which have come collectively to be defined as elder abuse.

Multi-agency Co-operation

A number of speakers at the conference referred to the need for multi-agency co-operation in the development of effective responses to both elder abuse itself, and to crime against older people in general. A multi-agency approach was promoted not only as an efficient use of existing services and resources, but also as a means of meeting the diverse needs of the older population.

In addressing the issue of crime prevention strategies, Marianne James of the Australian Institute of Criminology (Australian Capital Territory) argued that preventing crime and reducing fear of crime is not just about law enforcement, it is also a community concern. While multi-agency co-operation was seen as important at national and regional level, co-operation at a community level was also vital to the success of programmes. James suggested that the community should be used as a resource, with the skills of a wide range of organisations and people being mobilised to manage and implement programmes. She stressed that older people should be encouraged to participate in their communities, and should be consulted regularly to ensure that they contribute fully in the decision-making process. Developing a multi-agency approach also requires clear agreements between service providers about policy objectives, points of contact and referral, as well as individual areas of responsibility.

New Zealand Initiatives

Many New Zealand organisations are already adopting a multi-agency approach towards elder abuse and crime prevention. Three such New Zealand initiatives are discussed below, including one, the Safer Community Council initiative, which was presented at the Adelaide Conference.

In its Resource Kit about Elder Abuse and Neglect, Age Concern New Zealand states that "a multi-agency/multi-disciplinary approach to planning and service delivery means that resources are used efficiently and effectively. This approach also provides support for service providers and an opportunity to share knowledge, experience and skills which enable new approaches to be tried and tested." With the assistance of funding from the Lottery Aged Committee, Aged Concern has launched four pilot projects throughout New Zealand in which the issues of elder care and protection will be addressed at a local level. There are two further pilot projects which have not received Lottery Age funding, but which are proceeding in close liaison with Age Concern. In setting up these pilot projects, Age Concern has acknowledged that the differing needs and resources of each community must be addressed, and as a result, each pilot project will be unique.

Staff of the Senior Citizens Unit have assisted with these projects by providing policy input to those establishing the pilot projects. An independent Advisory Group has been established to monitor and maintain a general overview of the pilot projects, and the Unit will maintain an ongoing advisory role through membership in this group.

In addition, the national office of Age Concern will act as a clearing house for information about elder abuse and, through funding from the Public Health Commission, will develop a computerised system for compiling statistical information about the incidence and types of elder abuse cases being dealt with by each of the pilot projects. This will be the first time that such information about elder abuse in New Zealand will be collected in a systematic way.

Age Concern New Zealand has also obtained Lottery Aged funding to produce a quarterly newsletter, through which information about elder protection and care issues will be disseminated nationally. It is hoped that the distribution of this newsletter will provide the impetus that is needed to ensure that progress is made in this area.

The Safer Community Council (SCC) initiative offers another example of a co-operative approach to developing programmes to promote the safety of older people. Four pilot projects have been successfully completed in different locations throughout New Zealand.

According to Karena Shannon, co-ordinator of the Christchurch SCC, the primary role of the SCC "is to develop an effective partnership between central/ local government and community groups, whose focus is to identify areas of need, plan local strategies, and in turn co-ordinate and target resources to address these." The Christchurch SCC includes a representative for older people who is responsible for consulting with older people on their safety concerns. In addressing the Adelaide conference, Ms Shannon noted that the results of the survey were quite surprising to the younger members of the Council:

"The issues raised did not relate so much to crime and violence as to everyday problems on their local streets, e.g. street lighting, footpath repair, pedestrian crossing locations, dogs, and inconsiderate use of cycles and skateboards."

The findings from this survey also underline the importance of seeking input from older people themselves, when attempting to identify and address their needs.

The Police have also adopted a co-operative approach in their current drive to address issues related to crime in New Zealand. The primary goal of the five year strategic plan recently released by the Police is to reduce the incidence and effects of crime on victims and communities. This goal cannot be achieved without the assistance of communities, government, and other social services and organisations. To this end, the Police have adopted the motto "Safer Communities Together".

The Police are particularly interested in utilising the skills and wisdom of older people by encouraging them to participate in neighbourhood crime reduction through Neighbourhood Support groups, citizens in police stations, and Neighbourhood Crime Watch patrols. Staff of the Senior Citizens Unit have been meeting regularly with the staff of Police National Headquarters to examine ways in which community police stations, in particular, can effectively engage older people in a voluntary capacity. Members of the Unit have met with a group of older people working as volunteers in Hamilton community police stations, and were impressed by both the enthusiasm of the volunteers and the valuable work they did for the local community.

It is now hoped that a number of pilot programmes can be set up at Community Police Stations, with the aim of establishing how older volunteers can most usefully be recruited to work programmes that are of benefit to the wider community. Senior Citizens Unit officials and staff of the Age Concern National Office have met with the Police with the aim of working together to establish guidelines and objectives for the projects.

In dealing with elder abuse and fear of crime, the Senior Citizens Unit supports the principle of multi-agency co-operation on which the initiatives described above are based, and seeks to facilitate further work in this area.