Components of a National Plan

2.10       The National Plan to Reduce Violence against Women and their Children 2010–2022 could be used as an instructive model.[8] It sets a ‘framework for action’ over a 12 year horizon to be implemented through four three-year plans, called ‘Action Plans’: to bring together ‘the efforts of governments across the nation to make a real and sustained reduction in the levels of violence against women’.[9]

2.11       A principal goal of the National Plan to address elder abuse should be promoting the autonomy and agency of older people. Using the Family Violence approach as a guide, the National Plan could be developed to address, among other matters, additional strategies with goals such as:

  • promoting respectful intergenerational relationships;

  • making systems work together effectively;

  • improving responses to elder abuse; and

  • improving the evidence base.

2.12       Such goals are not completely discrete areas. Strategies may well address a number of goals at the same time.

2.13       In developing the National Plan, national consultations should be undertaken to provide opportunities for contributions by individuals and relevant organisations. The consultation and National Plan should take into account the different experiences and needs of older persons, including across gender, sexual orientation, disability, cultural and linguistic diversity; and those who live in regional and remote communities.

2.14       The National Plan should identify a range of strategies and actions towards supporting older persons in exercising their rights and stopping elder abuse.

Promoting respectful intergenerational relationships

2.15       Stakeholders identified a range of attitudinal problems concerning older persons that a strategy of promoting respectful intergenerational relationships might focus on. As the Law Council of Australia observed, ‘changing attitudes to behaviour’ was critical.[10] ‘Ageism’ was identified as an underlying issue that contributes to abuse.[11] Common manifestations of ageism include ‘stereotyping, prejudice, discrimination, harassment and vilification as well as abuse, exploitation, neglect and violence and it is often intersectional’.[12] UnitingCare Australia, for example, suggested that ageism ‘lies at the heart of elder abuse’ and that ‘effective elder abuse prevention can only be achieved with the support of education and awareness programs that deal with the negative perceptions and assumptions about ageing and older people’.[13]

2.16       Research undertaken by the Age Discrimination Commissioner in 2013 drew attention to the damaging effects of negative stereotypes or misconceptions about older people; and that ageist attitudes were deeply ingrained and evident in all aspects of Australian society.[14] ‘We are invisible’, said Adam Johnston, referring to the experience of older people with disability.[15]

2.17       Addressing stereotypes and enhancing understanding could involve education and training for people working with older people; and broader community education and awareness campaigns to improve knowledge and understanding of the rights of older persons and pathways for support. It would also include strategies for improving understanding of those who provide support for older persons: in particular, what is the extent and limit of their roles.

2.18       The Townsville Legal Community Service noted the prevention programs introduced in states and territories ‘aimed at raising awareness, educating those at risk of abuse or offending and offering remedial and support services’, but ‘wider rollout’, ‘greater visibility’ and improved resourcing were needed.[16]

2.19       Promoting respectful relationships would also require strategies that are directed towards understanding the dynamics and experiences of particular groups, including: older persons from Aboriginal and Torres Strait Islander and culturally and linguistically diverse (CALD) communities; from lesbian, gay, bisexual, transgender and intersex (LGBTI) communities; and people living in regional and remote communities. The Australian Securities and Investments Commission observed that ‘Senior Australians are a diverse cohort’:

A large proportion (around 31%) of seniors aged 65+ come from CALD backgrounds. A third (34%) are entering their older years without a spouse, and the proportion living alone is almost double that of the pre-war generation (11% versus 6%).[17]

2.20       The Ethnic Communities’ Council of Victoria stressed the importance of culturally informed awareness campaigns:

ECCV highlights the effectiveness of elder abuse prevention and legal rights awareness campaigns designed for culturally and linguistically diverse people. It is suggested that such campaigns are developed through a co-design process and by working in partnership with culturally and linguistically diverse community members, their organisations and service providers. It may include communicating key messages through ethnic and multicultural media outlets, and would be mindful of culturally appropriate use of language and the need for information to be provided in preferred language of different groups.[18]

2.21       The Townsville Legal Community Service urged that a life-course approach, advocated by the World Health Organization, should be ‘a cornerstone of any structural reform agenda’.

Law reform must be driven by the need to combat ageism in all manifestations: Stereotyping (incompetence, illness, and irrelevance); Prejudice (benevolent or hostile); Discrimination, harassment and vilification; and Abuse, exploitation, neglect and violence.

Benevolent prejudice is among the most entrenched forms of ageism. It is the tendency to pity, seeing older people as friendly but incompetent. It is superficially positive but ultimately reinforces inferiority. It positions older persons as frail, easily duped and needing protection rather than vital, active and independent. It keeps older persons in an inferior position. It is embedded in public policy.

The impact of ageism is amplified where it also involves another ‘ism’. Much of the research on elder abuse validates that gender and race can exacerbate ageism as is common with intersectional discrimination.[19]

2.22       The Northern Territory Anti-Discrimination Commission identified as crucial, a campaign ‘addressing societal attitudes to older people’:

elevating the value we place on older people rather than seeing them as a burden, plus education to raise awareness of the signs of elder abuse and to suggest ways to prevent it including inclusion and support of older people in the day to day life of the community.[20]

Making systems work together effectively

2.23       Consistency was identified as a key element in addressing elder abuse: a consistent national approach, with consistent laws and coordinated responses.

2.24       A need for consistent laws was a dominant theme among stakeholders.[21] As National Seniors observed:

It makes little sense that the legal frameworks to protect older Australians from abuse differ across the various states and territories. National laws or at the least nationally consistent laws are required to reduce confusion and improve protections for older people.[22]

2.25       The Townsville Community Legal Service suggested that a ‘consistent national approach’ should combine a number of measures, including:

  • a suite of federal laws for matters within the constitutional responsibility of the Commonwealth parliament;

  • a guiding national policy framework;

  • model and uniform state and territory laws for matters outside Commonwealth constitutional responsibility;

  • a national public awareness and education campaign; and

  • training to key areas of industry, professions and the community.[23]

2.26       ‘Without a consistent national approach’, remarked the Office of Public Guardian (Qld),

the governing legal framework will remain a combination of inconsistent and disconnected Commonwealth and state or territory law, amounting to a piecemeal approach to the protection of the interests and rights of persons who are vulnerable to abuse, and will likely result in gaps in safeguards.[24]

2.27       Stakeholders drew attention to a range of issues concerning responses to elder abuse affected by a lack of consistency. People with Disability (Australia), for example, advocated that there be a ‘clear and nationally consistent definition and response’ and ‘no wrong door’.[25] The Commissioner for Senior Victorians urged that there should be ‘clear reporting pathways and responses to ensure abuse, when identified and reported, is addressed’.[26] The Office of the Public Advocate (Qld) stressed that ‘complaints mechanisms are integral to a comprehensive system of safeguards for older people’.[27]

2.28       The Older Women’s Network (NSW) said that what was necessary was ‘a national framework and protocols enabling interagency and collaborative work between older people, community based agencies and service providers’: this would assist ‘in ensuring consistent and constructive responses to older people experiencing violence and abuse across Australia’.[28]

Improving the response

2.29       Essential elements in improving the response to elder abuse, in addition to national consistency, are: training of all those who deal with older people to recognise and respond to elder abuse; improved accessibility of services and forums; and better response to perpetrators.

2.30       The advocacy group, TASC, observed, ‘[d]elivering best practice means ensuring accessibility to our and other legal services and facilitating opportunities for support’.[29] The Legal Services Commission of South Australia said that ‘often there was confusion or misunderstanding about where an individual can seek recourse’.[30]The Housing for the Aged Action Group said that older people ‘want services that are easy to access and engage with’ and that ‘[f]ew organisations are able to take the time that older people need to work through a legal issue’.[31] For CALD groups, accessing services is difficult because of the ‘limited culturally proficient mainstream services and ethno-specific services with limited capacity that are accessible to provide assistance to seniors who experience elder abuse’:

Many mainstream services are not adequately funded or resourced to provide culturally appropriate or language specific services to culturally and linguistically diverse seniors.[32]

2.31       Particular challenges are presented in improving the response to abuse of older persons in remote Aboriginal and Torres Strait Islander communities. The National Aboriginal and Torres Strait Islander Legal Services stressed the importance of ‘culturally safe and joined up services’.[33] Michelle Alexander, for example, observed that

The biggest difficulty for governments looking at yet more policy and legislative reform related to remote indigenous communities is understanding what it means to incorporate traditional normative systems into western paradigms of community and service administration. Governments and researchers understand at a broad level that local engagement and consultation is imperative but do not understand beyond this how to drive such engagement through traditional decision making structures nor how to envelop these decision making processes to maximize the effectiveness of services in remote communities. In coming to terms with this, governments will need to come to terms with the intrinsic value that lies in indigenous law and culture.[34]

2.32       Improving responses to elder abuse may also include expanding the range of forums and remedies;[35] ensuring accountability of those who abuse older persons; and identifying areas for further improvement.

Improving the evidence base

Proposal 2–2              A national prevalence study of elder abuse should be commissioned.

2.33       Policy change to address elder abuse requires a sound evidence base. Kaspiew, Carson and Rhoades observed that, as responses ‘are spread across different legal, policy and practice frameworks, the evidence available from these sources offers a piecemeal empirical understanding of elder abuse’.[36] Hence there is ‘very limited evidence in Australia that would support an understanding of the prevalence of elder abuse, and there is emerging recognition of the need for systematic research in this area’.[37] National Seniors also emphasised the lack of a clear picture particularly as it relates to specific populations.[38] Older persons ‘are not a homogenous group’, observed the Townsville Legal Community Service Inc.[39] The Northern Territory Anti-Discrimination Commission, for example, said that

any prevalence studies must include a focus on Aboriginal and Torres Islander people in all settings, urban, rural and remote, as the anecdotal evidence we are aware of is that elder abuse is occurring but takes different forms and has different solutions in specific communities.

Also NT CALD communities which are smaller and more dispersed need to be reflected in research. As do the experience of current older LGBTI community members who are a generation who experienced a world where homosexuality was a criminal offence etc and have very particular place in history and may be particularly vulnerable to be re-traumatised in an aged care setting or when needing to invite providers into their homes.[40]

2.34       Without an appropriate evidence base to guide best-practice models, there is the potential ‘that strategies which lack evidence could cause more harm’.[41] As the National Ageing Research Institute (NARI) and the Australian Association of Gerontology explained, most current data about elder abuse comes from phone lines, longitudinal studies (physical abuse of women) and individual research projects, ‘which makes it impossible to extrapolate to the wider population’.[42] Additionally, a number of stakeholders suggested that elder abuse is underreported.[43] While data from the helpline provides a constructive starting point,[44] a carefully constructed national prevalence study, designed to provide the appropriate evidence base to inform coordinated responses across the Commonwealth, states and territories, is needed.[45]

2.35       While there is a sense that elder abuse is widespread, just how widespread is unclear. Western Australia Police noted the problem of determining the prevalence of elder abuse due to underreporting. They suggested that some of the reasons include:

that the victim is dependent on the perpetrator for their daily care and is fearful that reporting may see them placed in a residential care facility, the shame associated with being a victim of elder abuse, fearful of jeopardising relationships with family, and fear of retaliation. There may also be the inability of the older person to access police services to be able to report crime, and the inability to be able to communicate what has been happening to a police officer due to the abuser being the primary carer, the presence of cognitive impairment, or language and cultural barriers. Due to the lack of awareness, individuals may not be aware that elder abuse is a crime. The presence of these factors will impact on the distortion of prevalence of elder abuse and the ability of policing organisations to adequately respond and implement strategic responses.[46]

2.36       Another stakeholder observed that ‘the underreporting of elder abuse is the norm’.[47] Macarthur Legal Centre suggested that significant gaps in reporting occur because of ‘the familial nature of much of this abuse’, and that ‘[m]any people may simply not be aware of the support services available’.[48]

2.37       While state-wide studies are valuable, as the Office of the Public Advocate (Qld) observed,

they are not a substitute for a national prevalence study, particularly if such a study collects data about the characteristics of perpetrators, victim, the specific abusive behaviours and the circumstances in which elder abuse has occurred.[49]

2.38       NARI and the Australian Association of Gerontology pointed to a number of things to be considered in establishing a prevalence study:

  • Data collection needs to distinguish between suspected, reported and confirmed abuse and consideration of who is reporting the incident. …

  • Elder abuse occurs in a variety of settings (home, community, aged care, hospitals, etc) and each have unique challenges for data collection.

  • Lack of awareness around what constitutes elder abuse—some older people may not recognise their situation as abusive, while some professionals may not be able to identify abuse being experienced by their clients.

  • Staff from agencies identifying potential abuse can be reluctant to label a situation abusive without further investigation or evidence, which could lead to under reporting.

  • How to identify occurrence of neglect and self-neglect.

  • How a person’s cognition and capacity can affect their ability to identify and act on abuse.

  • Diversity of older people and communities (including people in rural and regional areas; people with diverse gender and sexual identities; people from culturally and linguistically diverse backgrounds; Aboriginal and Torres Strait Islander people; people with disabilities)—What is considered abusive behaviour may differ depending on cultural norms of different communities, which can affect knowledge of extent. …

  • The consequences of reporting abuse—the inherent power imbalance between individuals and institutions may discourage people from reporting abuse, making it difficult to accurately measure.

  • Types of abuse—prevalence is likely to vary between different types of abuse.

  • Any attempt to establish prevalence of various types of elder abuse should also try to gather as much information about perpetrators or potential perpetrators as possible.[50]

2.39       Mapping existing sources of data relating to abuse of older people, ensuring that these are consistently collected and collated is also an important part of improving the evidence base.[51]

2.40       Data collection is assisted by a common definition of elder abuse. The WHO description of ‘elder abuse’ is a common reference point:

Elder abuse can be defined 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’. Elder abuse can take various forms such as physical, psychological or emotional, sexual and financial abuse. It can also be the result of intentional or unintentional neglect.[52]

2.41       As noted in Chapter 1, this description is used across a range of government and non-government bodies and was used in the Australian Institute of Family Studies (AIFS) study. As one stakeholder observed, any definition of elder abuse ‘should be comprehensive enough to capture the full range of abuse practices’, but it also needed to be ‘simple enough for workers and potential reporters to understand’.[53] The Financial Services Institute of Australasia noted that

A clear, agreed definition of elder abuse is also important in researching the prevalence of elder abuse and from this developing tools and guidance so that service providers build awareness and develop strategies to identify and report suspected cases.[54]