Bring elder abuse into the light so we can help

The problem of elder abuse – physical, psychological and financial – isn't immediately apparent unless you or your closest have endured it; unless you have worked in aged care and seen it.

As we live longer, we hope for a peaceful existence with our loved ones or at least in a place that feels like home. Most of us will find that.

But with longevity can come loneliness, vulnerability, and worse.

The problem of elder abuse – physical, psychological and financial – isn't immediately apparent unless you or your closest have endured it; unless you have worked in aged care and seen it.

The NSW Upper House inquiry into elder abuse is a welcome opportunity to try to assess the extent of the problem and to bring it to public attention. They are the prerequisites for fine-tuning laws and protocols surrounding aged care inside and outside the home.

Submissions to the inquiry closed this month. Many rang alarm bells.

"When staff in aged care stop caring, there is a huge potential for abuse," wrote one nurse who has been registered since 1982. "But it is so hard for them to keep caring when there is no support given and no respect from management! Something needs to be done. The average age of a worker in aged care is 48, well above other industries. There is often high staff turnover, as the job satisfaction and rewards are not there when there is no support for staff and no time to care!"

Decisions about where and how to spend your final years used to be purely about money as well as the availability of family and health support. They are becoming increasingly about safety as well. This is not the old-style "panic" where the elderly were warned to stay off the streets as crime soared. Indeed, most street and house crime has dropped considerably.

The threat of elder abuse emerges far more often from those who care for us as we become less able to fend for ourselves: our family, our friends, care workers, financial advisers and even lawyers. More of us will become dependent on these people as the number of sufferers of dementia in particular increases. There are 342,000 Australians living with dementia and this will rise to almost 900,000 by 2050 without a major medical breakthrough. NSW has about 112,000 people living with dementia, with this number to reach 272,000 by 2050.

"Lawyers are central to the process of older people appointing substitute decision makers, often family members," Macquarie University law lecturer Lise Barry says in her submission. "Under the current law, these appointments give the attorney almost unfettered access to an older person's property, finances and legal decisions, highlighting how vulnerable some older people may be to abuse … If called upon to witness these appointments, lawyers should take the opportunity to screen for abuse."

Remember, we talking here about a very small minority who are abusers – but the opportunity for them to act will keep increasing without action.

In part the problem is cultural. The elderly must be afforded the respect of a healthy life in safety so they can contribute as much and for as long as they want, with appropriate safeguards against exploitation. Likewise, every single person who chooses a life of helping the aged deserves support. When it is missing, things can go wrong.

Reportable assaults in nursing homes have increased 86 per cent since 2009, even though the number of residents rose only 20 per cent over that period.

Without community support, many in their own homes also feel vulnerable. A submission from the Older Women's Network highlights that older women may be exposed to abuse by a broad range of family members and carers. Older women living alone are less likely to be physically or psychologically abused, but may be more at risk of financial abuse by an adult child after the death of a partner. Social isolation of both victim and abuser is a common feature of violence against older women.

Certainly, as Professor Susan Kurrle​ from the Faculty of Medicine at the University of Sydney says in her submission, recognition of abuse risks has improved. She cites a 1989 instance where health professionals missed the signs that a 78-year-old man was being physically abused by his daughter. A 2010 case involved an 81-year-old man whose son moved in with him after divorce. The early signs of abuse were detected by asking, "Are you afraid of anyone?" and "Has anyone hurt you recently?"

The Australian Longitudinal Study on Women's Health shows women who have experienced abuse "tend to be less educated and have more difficulty managing on their available income ... Compounded by the impacts of abuse, women may suffer stress, depression, reduced confidence, restricted activities, feelings of insecurity and forced changes to living arrangements."

The issues are complex and the solutions even more so. As a significant step, the public needs to understand these concerns are real, not just for the elderly but for those who care from them too.

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Bring elder abuse into the light so we can help