What is elder abuse?

1.10       Elder abuse may be broadly defined as causing harm to an older person. It usually refers to deliberate harm, such as assaulting an older person or stealing their money, but it may also be harm caused by neglect, such as failing to feed or provide prescribed medications to an older person. Elder abuse usually refers to abuse by family, friends, carers and other people the older person may trust, rather than abuse by strangers. Most elder abuse therefore has ‘similar features’ to family violence.[12]

1.11       While there is no universally accepted definition of elder abuse, a widely used definition is the one put forward by the World Health Organization, describing elder abuse as

a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person.[13]

1.12       This description is used across a range of government and non-government bodies.[14]

Categories of elder abuse

1.13       Commonly recognised categories of elder abuse include psychological or emotional abuse, financial abuse, physical abuse, neglect, and sexual abuse. Using drugs to sedate older people when unnecessary is another type of abuse, sometimes called chemical abuse.

1.14       These types of abuse are considered throughout this paper, with case studies from submissions. A short overview is set out below.

Psychological abuse

1.15       Psychological or emotional abuse appears to be one of the most common types of elder abuse,[15] and includes verbal abuse, name calling, bullying and harassment.

1.16       Over a third of calls that reported abuse to a Victorian elder abuse helpline over two years were related to emotional abuse.[16] Verbal abuse was the most common complaint,[17] followed by ‘pressuring, intimidating or bullying/harassment’,[18] and ‘name calling, degrading, humiliating or treating the person like a child, in private or public’.[19]

1.17       Other examples of psychological abuse include: repeatedly telling an older person that they have dementia; threatening to withdraw affection; and threatening to put an older person into a nursing home.[20] Stopping an older person from seeing family and friends may also be psychological abuse or ‘social abuse’.

1.18       A US national study found that being ignored, humiliated or verbally abused were commonly reported types of ‘emotional mistreatment’ of older people living in the community.[21]

Financial abuse

1.19       Financial abuse appears to be the other most common type of elder abuse, accounting for over a third of the calls that reported abuse to the Victorian helpline.[22] Common types of financial abuse were: someone incurring bills for which the older person is responsible;[23] someone living in the older person’s home for reasons other than for the benefit of the older person;[24] someone stealing the older person’s goods;[25] ‘threatening, coercing or forcing an older person into handing over an asset’;[26] and abusing power of attorney arrangements.[27]

1.20       The US study found that spending money without permission, forging signatures, and forcing someone to sign something, were commonly reported types of financial elder abuse.[28]

1.21       Other behaviours that may, in some circumstances, be financial abuse include: refusing to repay a loan; living with someone without helping to pay for expenses; failing to care for someone, after agreeing to do so, in exchange for money or property; and forcing someone to sign a will, contract or power of attorney instrument.[29] Many similar examples were provided by stakeholders, and are discussed throughout this Discussion Paper.

Physical abuse

1.22       Calls to the Victorian helpline reported a range of physical abuse, including: pushing or shoving;[30] kicking, punching, slapping, biting or burning;[31] and rough handling.[32]

1.23       Australian crime statistics suggest that older people are less likely to be murdered, robbed or physically assaulted than younger people.[33] But some types of physical abuse of older people may not be caught by these statistics—for example, the use of ‘restrictive practices’ in hospitals and residential care facilities, when such practices are not necessary. Examples of restrictive practices include restraining a person with ropes or belts, locking someone in a room, or unnecessarily giving someone a sedative.

Neglect

1.24       Neglect includes failing to provide an older person with such things as food, shelter or medical care. Family members may be responsible for providing such ‘necessities of life’. Some may receive a social security payment for providing care to an older relative. Staff in residential care facilities and others who provide in-home care may also be responsible for providing such care.

1.25       Neglect was the subject of relatively few calls to the Victorian helpline: only four people complained of others failing to provide an older person with the necessities of life, and one person said that someone received the carer’s allowance but didn’t provide care.[34]

1.26       Forms of neglect found by the US study included: failing to clean the house or yard, failing to obtain or cook food; failing to obtain medicine; failing to help the person get out of bed, dressed and showered; failing to make sure the bills are paid.[35]

Sexual abuse

1.27       Sexual abuse includes rape and other unwanted sexual contact. It may also include inappropriate touching and the use of sexually offensive language.

1.28       Sexual abuse of older people may be uncommon compared to other types of elder abuse.[36] Sexual assault was also the smallest category of assault found in the US study. However, a 2014 research study stated that, while the ‘idea of older women as victims of sexual assault is relatively recent and little understood … it is becoming increasingly evident that, despite the silence that surrounds the topic, such assaults occur in many settings and circumstances’.[37] Australian crime statistics also suggest that older people are significantly less likely to be the victims of sexual assault than younger people, particularly younger females.[38]

Elements of elder abuse

1.29       In the Issues Paper the ALRC sought feedback on the elements of the WHO definition, namely the elements of: harm or distress; intention; and the issue of payment for services.[39] The other elements concern the kind of relationship involved, defined in the WHO definition as a ‘relationship where there is an expectation of trust’ and the target of the abuse, namely an ‘older person’. Stakeholders offered a mixture of comments with respect to each element, summarised below.

1.30       The ALRC considers that, to obtain a full picture of abuse of older persons, a broad description of elder abuse needs to be used, like the WHO definition. This can serve a range of purposes, including to gain a better understanding of the experiences of older Australians. The Office of the Public Advocate (Qld) expressed this as follows:

The primary consideration in the formulation of a definition for elder abuse is the purpose behind having a definition. If the purpose of defining elder abuse is to reflect the lived experiences of older people who have been victimised on the basis of their age, and to identify and better understand the social problem that is elder abuse to inform strategies to reduce and prevent it, the definition should be appropriately broad.[40]

1.31       The information obtained through using a wide definition can then inform policy responses depending on the particular purposes of those responses, viewed along a spectrum from, at the one end, community education, and on the other, criminal offences.

1.32       In Chapter 2, the ALRC proposes that a national prevalence study of elder abuse be undertaken. In that context attention can be paid to breaking down the description of abuse into its various elements for the purposes of building a detailed evidence base and to inform future data collection and policy responses. As the Older Persons Legal Services Network observed, any definition needs to be ‘illustrative not exhaustive’, and

needs to be broad enough to incorporate all types of abuse, while at the same time identifying a number of different forms of abuse so that this behaviour can be easily recognised by a wide variety of organisations and people.[41]

Older person

1.33       The idea of someone being an ‘older’ person is a relative concept—chronologically, medically and culturally. It does not have a precise definition and specific ages may be used for particular purposes. For example, the Australian Bureau of Statistics groups people into population age cohorts, and differentiates between ‘15–64’, ‘65 years and over’ and ‘85 years and over’. People over 65 are generally classified as ‘older’ for ABS purposes.[42]

1.34       For some purposes, treating all people of over a particular age as warranting special treatment under the law may be appropriate from a public policy perspective. Whether someone may access their superannuation funds or age pension, for example, turns on the person’s age. However, differences in longevity and ageing have also been identified, particularly in relation to Aboriginal and Torres Strait Islander peoples. As Legal Aid ACT observed:

There is a significant gap in the life expectancy of Aboriginal people and other Australians, with many Aboriginal people becoming grandparents at relatively younger ages.[43]

1.35       The national prevalence study of elder abuse proposed by the ALRC could identify the age of the older person in instances of elder abuse that will be relevant, and particularly identifying particular age cohorts—for example, distinguishing between ‘old’ people, 65–84 years; and ‘old old’ people, over 85 years.[44] The Financial Services Institute of Australasia, for example, said that this distinction was a useful one for financial services providers and researchers ‘in identifying differences in financial decision-making capability across the lifecycle’.[45]

1.36       Being over the age of 65 years does not necessarily make someone more vulnerable to abuse. There are no doubt many healthy and effective older people who are much less vulnerable to abuse than most people aged under 65. Furthermore, some people under the age of 65 may be vulnerable to abuse for many reasons, such as ill health, frailty, disability, impaired decision-making ability, poverty or other factors. Legal Aid ACT, for example, while recognising the utility of using the ABS reference point of 65 years and older, said that that ‘the experience of ageing is far from uniform, and that conceptualising elder abuse within a framework of capacity, and not simply age, may be a more useful metric’.[46] NARI asked:

Should age (and what age) be a defining feature, or should the definition focus on frailty, dependence, vulnerability or other similar factors that may contribute to power imbalances between the parties? Advanced age is not, in and of itself, an impairment and some research suggest a definition of elder abuse should concentrate on issues of vulnerability, isolation and dependence rather than age.[47]

1.37       The Queensland Law Society suggested that a focus on chronological age by itself ‘can be misleading’,

because individuals over the age of 60 often continue to enjoy good health and full independence. Retirement is not necessarily an appropriate trigger. However, some Australians experience the characteristics associated with being ‘elderly’ because they are more susceptible to experiencing ill health, disability and death at a younger age (for example, Indigenous Australians).[48]

1.38       Such concerns point to the importance of ensuring that all relevant elements of the dynamics and presentation of elder abuse are identified and captured in research and prevalence studies.

Harm or distress

1.39       Gadens Lawyers submitted that the phrase ‘harm or distress’ should be defined widely ‘so as to capture all types of conduct or inaction which is harmful to the care recipient’:

Specifically, ‘harm’ should include physical and verbal harm, as well as social, cultural and economic harm. Furthermore, the definition should not be limited. As the elder rights arena expands and the literature becomes more settled, it is likely that more examples of elder abuse will come to the fore. In the light of this, the definition should not be limited as it may pejoratively confine the meaning of elder abuse to certain activities and consequently other activities which should be characterised as elder abuse may not fall within the scope of the definition because it has been drafted in narrow terms.

The term ‘distress’ should again be construed broadly. … We note that in some circumstances, a victim of elder abuse may not realise that they have been abused. Therefore, we consider that the presence or non-presence of distress should not be used to determine whether or not elder abuse has in fact occurred. Perhaps what is more relevant is whether harm has been inflicted.[49]

1.40       The Law Council of Australia distinguished ‘harm’ from ‘distress’:

While harm denotes the direct effect of action or inaction, distress captures the indirect effect in causing ‘extreme anxiety, sorrow or pain’. Distress is subjective: what distresses one person may not distress another.[50]

1.41       The Public Trustee (Qld) said that the aspect of ‘harm’ as an alternative to ‘distress’ was important in the context of older persons with diminished decision-making ability, such as cases of advanced dementia, who may not experience distress ‘in a subjective sense’, although financial abuse may amount to ‘harm’.[51]

1.42       Hervey Bay Seniors Legal and Support Service pointed to situations which may cause harm, but not distress:

This would be the case where the older person is unaware of the harm due to ignorance or where they have no memory, recollection or knowledge of it due to dementia or some other incapacity. This type of abuse can be carried out by a person to whom the older person has entrusted their finances or health and safety including paid carers or institution. It can also be both intentional and unintentional. Often the harm or abuse is insufficient to warrant criminal action but would give rise to some form of civil cause of action.[52]

1.43       Other examples concern situations where the wishes and preferences of an older person are not respected. The Law Council provided a case study of a man who had been an eminent engineer in his working life:

He acknowledged he had high care needs but wanted to travel interstate to attend an annual dinner which was named after him and being held in his honour. He needed assistance with his plans to travel as he was immobilised and could not leave the residence without assistance. The residential care provider refused to allow him to travel and said he needs two people to accompany him and the people were not available. (In fact there were many people who volunteered to do this for him). The residential care facility misinterpreted their duty of care as extending to his absences and refused to take the risk of being liable for his wellbeing during a time of absence.[53]

1.44       Examples of causing distress to an older person by placing them in an aged care facility against their wishes and selling their home against their will were cited by stakeholders.[54] Townsville Community Legal Service said that, on occasions, such actions may be warranted, but this is not always so:

Many older persons find themselves in care because of the decisions of others, including medical professionals and appointed or substitute decision makers. When this occurs, the older person at the centre of the decision making process can be confused, angry and the process can have elements of elder abuse or even be a manifestation of elder abuse. In most cases care is warranted but in some it isn’t—it is simply a way of removing an older person from an asset base.[55]

1.45       Similarly the Office of the Public Advocate (Qld) referred to the ‘practice in Australian society of moving older people against their will from their homes and into residential aged care’—decisions ‘often made by family members and supported by medical professionals’.[56] The Office of the Public Advocate (Vic) provided an example of where this was done to facilitate personal gain, concerning

an older woman whose younger relatives supported her premature placement in aged care in order to gain control of her house through fraudulent use of a power of attorney.[57]

1.46       Distress caused to transgender people by not acknowledging their gender identity was another example provided by stakeholders, as in this illustration by ADA Australia:

Amy is a transwoman, aged 70. Amy was placed in an Aged Care Facility after a stroke by her children as joint Enduring Power of Attorneys. Her family consists of two sons, one daughter and 4 grandchildren. 

The Attorneys instructed the Aged Care Facility that only family were able to visit and everyone else was to be turned away or told that the resident was not at the facility. Amy’s telephone was to be removed from her room and Amy was to be dressed as a man and no assistance was to be provided for Amy to dress as a woman. Amy was only to be referred to by her birth name and gender.[58]

1.47       The ALRC supports taking a broad view of the ‘harm or distress’ element in the WHO definition. However, with respect to particular kinds of elder abuse, if specific causes of action arise, or are to be defined, more precision is required. As the Law Council commented, for example, it is ‘difficult to envisage how distress can helpfully be incorporated into a legal definition’.[59]

Intention

1.48       The WHO definition of elder abuse does not address specifically the question of intention to cause harm or distress to an older person.[60] Elder abuse guidelines in Tasmania and Victoria note that abuse may occur as a result of ignorance or negligence, or it may be deliberate.[61] The importance of including unintended abuse was noted by the Office of the Public Advocate (SA):

If intent must be present, then more subtle or evolving abuse may not be detected.  Often, people including family members do not understand the rights of older persons and/or believe that they have a right or entitlement to an older person’s assets, finances or decisions through the relationship they have with the older person.[62]

1.49       The Office of the Public Guardian (Qld) observed that

There may be multiple factors leading to abuse. While abuse may in some instances be deliberate neglect, or abuse, there may also be situations where the carer lacks the ability, knowledge, skill or support to manage the increasing burden of care. Therefore, any proposed legal definition of elder abuse should recognise that elder abuse may be intentional or unintentional in nature.[63]

1.50       The Tasmanian guidelines also suggest that for the purposes of identifying and defining abuse of older persons, ‘the focus should be on the effects on the older person, rather than the intention of the perpetrator’. A similar view was expressed by the Northern Territory Anti-Discrimination Commission (ADC):

The ADC’s experience in the area of complaint resolution and advocacy for equality of opportunity for vulnerable groups across the Northern Territory is that the impact of the conduct is far more relevant than the intention of the person or family member perpetrating the abuse. It is important in an area where attitudes need to change to ensure society’s condemnation of financial abuse, neglect and psychological abuse of older Australians. It is the impact on these vulnerable people rather than the intention of those abusing that should be the focus. Proving intention moves the focus away from the vulnerable older person to the perpetrator.[64]

1.51       The Law Council of Australia also said that, while intention is important, ‘what is essential is the impact of the behaviour’; and that what is critical is changing attitudes to behaviour—‘particularly when some may not regard it as abusive’.[65]

1.52       Seniors Rights Victoria observed that

Abuse of older people can be subtle or extreme, intentional or unintentional, made up of one act or many acts and change or escalate over time. The impact of the abuse is exacerbated by the relationships of trust which involves a heightened level of vulnerability for the older person.

Despite the ultimate consequences for the older person, … there can be significant differences in the ongoing relationship with the perpetrator if the abusive act occurred through an intentional as opposed to unintentional or ignorant circumstances. However, where abuse has occurred unintentionally, the focus should be directed to the consequences experienced by the older person and not the perpetrator’s intention.[66] 

1.53       An example of conduct that may cause distress, but which is not necessarily intended to cause harm, was provided in the submission from Alice’s Garage, with respect to LGBTI older people:

family members who perpetrate homophobic or transphobic abuse may not be aware that their behaviour is abusive because they believe their responses are aligned with societal norms. Recent debates about LGBTI people have included homophobic and transphobic comments being made by high profile community leaders. These comments influence broader community values and beliefs. When families emulate these views in their responses to LGBTI family members—they may not see their behaviour as abusive. The absence of intention to cause harm here should not excuse abuse.[67]

1.54       Intention may be particularly relevant to developing appropriate responses to elder abuse. In responses involving the criminal law, matters of intention may be crucial—in offences such as assault, fraud, theft or criminal neglect.[68] In others, where the abuse arises for example through ignorance rather than, say, malevolence or greed, the response may be to provide better understanding to those undertaking roles—like carers or those acting under enduring powers of attorney.

1.55       The Caxton Legal Centre identified the importance of intention in some contexts:

Intention to cause harm may be relevant to any criminal sanction associated with elder abuse, however for the purposes of identifying and responding to the societal problem of the mistreatment of older people, intention to cause harm should not be a necessary pre-condition. Aside from the difficulty in proving intent, there have been many occasions where perpetrators of harm have started out with the best intentions however have inadvertently mistreated older people (including by neglect) in response to extenuating circumstances.[69]

1.56       Gadens Lawyers referred to the complexity of an element of intention for the purposes of defining elder abuse:

The term implies that an individual has a degree of awareness that their actions will result in a particular outcome. … In many cases, the perpetrator of elder abuse will possess an intent to cause harm or distress to the older person. Having said this, it may also be the case that the perpetrator of elder abuse does not intend to cause distress to the older person.

That is, elder abuse may occur in situations where the carer has acted out of frustration towards the elder person. Or, in some circumstances, carers may not even realise that their actions have resulted in harm or distress to the elder person. In circumstances such as this, the carer may not possess the requisite ‘intention’ and therefore the abuse complained of may not be caught by the definition.[70]

Expectation of trust

1.57       The WHO definition of elder abuse refers to abuse occurring within any relationship where there is an ‘expectation of trust’. Some stakeholders wanted the definition of elder abuse widened beyond situations involving trust relationships, to catch abuse by strangers, such as telemarketing scams. Alzheimer’s Australia, for example, said that the inclusion of the concept of ‘expectation of trust’ may be problematic:

as it will exclude abuse that occurs outside of trusting relationships, such as in the case of a sales person or telemarketer who does not necessarily have a relationship of trust with the vulnerable individual. [71]

1.58       Hervey Bay Seniors Legal and Support Service raised similar concerns, where an older person ‘is taken advantage of because, due to their age or frailty, they are unable to stand up for their rights’, including in dealings with telemarketers.[72]

1.59       The ALRC acknowledges that problems with intrusive telemarketing may cause distress to many people, and that older persons may be particularly affected.[73] In collecting data on abuse of older persons, such situations may also be identified, in addition to those otherwise captured a definition of elder abuse. Addressing such situations may require specific policy solutions.

1.60       Gadens Lawyers suggested that rather than ‘expectation of trust’, the focus should be on ‘implication of trust’, as used in the Victorian Department of Health’s Elder Abuse Prevention and Response Guidelines for Action 2012—2014.

The term ‘implication’ is not as restrictive as ‘expectation’. The ‘trust’ element can therefore be implied into most relationships that a care recipient has, specifically, with family, friends, carers and facility providers.[74]

Payment for services

1.61       Should abuse by doctors, nurses, carers and others who are paid to provide a service to older people be considered ‘elder abuse’? The WHO definition does not specifically refer to the issue of payment for services, only that the relevant abuse occurs within a relationship where there is an expectation of trust. The Terms of Reference for this Inquiry refer to abuse by ‘formal and informal carers, supporters, representatives and others’. The inclusion of ‘formal’ carers and others, means that abuse by paid carers has been considered in the Inquiry, for example in relation to aged care. In the Issues Paper the ALRC invited comment on the extent to which payment for services should be taken into account in describing or defining elder abuse.[75]

1.62       Seniors Rights Victoria noted that neither the WHO definition nor the one used by the Australian Network for the Prevention of Elder Abuse identified payment for services as a ‘key determinant’ in elder abuse cases.[76]

1.63       The Law Council said that it considered the definition of elder abuse should not include harm caused by a person who is in receipt of payment for services:[77]

Whilst this behaviour is abusive, the Law Council submits that the term ‘elder abuse’ should be limited to personal relationships and not extended to relationships which have an economic basis. A tighter definition will ensure accurate data collection of the specific phenomenon of abuse within families and in other trusting relationships.[78]

1.64       While not supporting the inclusion of ‘payment for services’ in a definition of elder abuse, Advocare added that ‘older people should be adequately supported when they find themselves victims of “payment for services” type abuses’.[79] The Office of the Public Guardian (Qld) submitted that definitions should be ‘focused upon the victim’: whether or not the person who perpetrated the abuse is paid, or not paid for the service provided, ‘should be irrelevant in determining whether abuse has occurred’.[80]

1.65       In contrast, Relationships Australia commented that the definition should be consistent ‘for informal and formal relationships, regardless of payment for services’;[81] and N Smith said that:

Payment for services should definitely be considered as an element.  This is definitely an area where there should be an ‘expectation of trust’ as people are paying for services.[82]

‘Elder abuse’ in particular contexts

1.66       While ‘elder abuse’ is a recognised shorthand phrase, and a useful descriptive starting point, it is not without difficulty, both in terms of the use of the word ‘elder’ and in the composite expression ‘elder abuse’. Older people are not homogenous and the experiences of different communities bring different dynamics into play.

1.67       For example, the National Aboriginal and Torres Strait Islander Legal Services said that in the Aboriginal and Torres Strait Islander community, in addition to referring to the age of a person, ‘elder’ is also ‘a title of respect’.[83] Legal Aid ACT commented, similarly, that

The way that we conceptualise elder abuse is problematic in respect to Aboriginal and Torres Strait Islander (ATSI) communities. The concept in itself is contested—‘eldership’ is often associated with community contribution, authority, or knowledge.’[84]

1.68       In the 2005 report by the Office of the Public Advocate (WA) into elder abuse in Aboriginal Communities, it was observed that ‘[t]erminology plays a huge part in the defining and understanding of concepts’ and that some Aboriginal people were concerned that the term ‘elder abuse’ was ‘too confrontational’.[85] Two factors were identified as having particular implications for developing an understanding of elder abuse: cultural obligations and the circumstances of grandparents.[86]

From a cultural perspective, Aboriginal norms in relation to reciprocity, the expectations that resources will be shared and kinship, where a wide variety of relationships are involved in familial and community networks, were dimensions that complicated understandings of whether and how elder abuse was occurring. The position of grandparents caring for grandchildren and the extent to which calls on grandparent resources were culturally reasonable or unreasonable were also highlighted by the research.[87]

1.69       Kaspiew, Carson and Rhoades urge that ‘[s]ubstantially more work is required to understand and conceptualise elder abuse in the Aboriginal context, especially among different communities in different circumstances given the diversity among Aboriginal and Torres Strait Islander communities’.[88]

1.70       With respect to culturally and linguistically diverse (CALD) communities, the Ethnic Communities’ Council of Victoria noted the difficulties of ‘translating the term “elder abuse” in different cultural contexts and languages’:

There is no direct translation for ‘elder abuse’ in some languages, and can connote primarily physical violence. Using it as an umbrella term may deter discussion within certain communities and provoke feelings of shame or stigma. The approach of this project has to be to consider this with the different communities we work with and adapt the language accordingly. For example the ECCV project has used language such as ‘mistreatment of older people’ or focussed on the message that everyone deserves respect and dignity.[89]

1.71       A study undertaken on elder abuse in Victoria, demonstrated that ‘financial management practices and expectations of future care and support are culturally bound’; and that there were ‘identifiable differences between language and cultural groups, including rural older people, in their family patterns and expectations of relationships, and in the rules about managing money within families’.[90]

1.72       A number of factors have been shown to heighten vulnerability in CALD communities, especially ‘language difficulties for those whose primary language is not English, social dependence on family members for support, and the potential conflict caused by cross-generational expectation in relation to care’.[91]

1.73       For people living in rural and remote areas there are also distinct dynamics at play in the context of elder abuse. ‘Any discussion of Australian rurality’, however, ‘must avoid the assumption of homogeneity’.[92] As summarised by Kaspiew, Carson and Rhoades, particularly relevant issues include

the complexity of assets held by families resident in rural areas such as farming properties; lack of access to services that may assist with asset management arrangements and responses to situations where elder abuse is occurring or expected; and the dynamics involved in reporting or disclosing elder abuse in rural communities, where shame and concern to protect the family name potentially play an inhibiting role.[93]

1.74       Other features identified the ‘complex and potentially conflictual dynamics around farming properties with the multi-generational interests involved where the farm is the family business’:

These included complications about the treatment of farms as inheritance, and the balance between providing for children and maintaining the family business, placing one child in a different position from the others, and the treatment of labour and other contributions to the improvement of the farm in estates.[94]

1.75       Understanding the dynamics of elder abuse in particular contexts will be a crucial aspect of developing informed policy responses.[95] Research undertaken as specific actions under the proposed National Plan, as well as the instigation of a national prevalence study of elder abuse, will assist towards this goal