Reducing the stigma of elder abuse to improve older people’s health

Elder abuse causes declining physical and mental health in older people. But older people are often too ashamed to report it. Professor Bianca Brijnath is trialling a new model of care to help older people report abuse and improve their health.

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Elder abuse is usually done by family members

‘One in six older Australians experience elder abuse,’ says Professor Bianca Brijnath, Director of Social Gerontology at the National Ageing Research Institute.

Elder abuse is where an older person experiences some form of abuse. It can be physical, financial, social, sexual, or psychological.

‘Sadly, elder abuse often occurs in a relationship of trust,’ Bianca tells us. ‘The main perpetrators of abuse of older people are their family members, often their adult children.’

Elder abuse can happen on a small or large scale

‘An adult child might visit their parent and say, “I'll do the shopping for you.” Mum gives her child her credit card and they use it to buy groceries for their family as well. Or Mum gives them $100. They spend $80 on groceries and keep the change.

‘On a larger scale, families might tell older parents, “Sell your house and move in with us. You can live in a granny flat out the back. We'll look after you as you're getting a bit older and need more care at home.”

‘Families also use psychological manipulation. They might say, “If you don't transfer your assets into my name, I won’t let you see the grandchildren.”

‘What can happen is the older person transfers their assets and then the family reneges on their commitment. Older people can end up in very difficult circumstances. They could be in their 80s and have no money or home.’

Older people can be ashamed and desperate

Older people who find themselves in this situation often don’t seek help. This is because it is their own family perpetrating the abuse.

‘Older people experience a great deal of shame and sadness when family members abuse them,’ Bianca explains. ‘It's a source of embarrassment. They think it's a reflection on their own parenting.

‘Even if they are desperate, older people don't want to report their children to the police. They don't want to seek legal intervention.’

Health care providers can help

Health care providers are a trusted source of information and help for older people. For this reason, older people are more likely to disclose abuse to their health care provider.

‘But often health care providers don't know how to look for signs of abuse,’ Bianca says. ‘They don't know what to do when the disclosure happens. That is a missed opportunity.’

Bianca’s research will address this problem by upskilling health care providers to recognise the signs of elder abuse and make a timely referral to specialist care and social workers.

Specialist professionals can give the older person the help they need. They can offer wrap-around services including family mediation to stop the abuse, and financial and housing assistance.

A model of care for change

Bianca codesigned a support model of care for hospital health care providers. The model includes:

  • training for health care providers on elder abuse and how to screen for it
  • a screening tool
  • a site champion for more help and support.

Bianca worked with family carers, older people, hospital health care providers and elder abuse experts on the design of the model. 

‘Stakeholders at the co-design workshops gave us great advice on the skills that heath care providers will need,’ Bianca says.

‘They talked about empathy, respect and putting older people at the centre. They said the provider must have absolute loyalty to the older person.’

Creating greater awareness of elder abuse

Bianca hopes her new support model will achieve:

  • greater awareness of elder abuse across the health system
  • more confidence and knowledge in health care providers about engaging in this issue
  • willingness of health and social care providers to use the screening tool.

If the trial creates these results, stakeholders want to roll out the program in the community.  ‘We'd love to see this used in residential aged care and community-based aged care,’ Bianca agrees.

The MRFF funded Bianca’s No More Shame project with $1.5 million.

Get help now: Call the elder abuse phone line

Watch videos about elder abuse by the National Ageing Research Institute.

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