A few years ago Police Inspector Sylvana Briffa reported some 400 cases of abuse of elderly people for the year ending in 2014.
In reality, that figure is likely to be much much higher. A recent report from Europe indicated that one in 20 older adults experience some significant abuse each month. Using these rates, in Malta, with over 66,000 older adults, there will be around 3,300 elder abuse events each month – suggesting that reporting of abuse in Malta is exposing less than one in 10 cases.
We might have different definitions of what abuse is in Malta, but abusive behaviour itself remains very common, whether or not we define it as such. In Malta, these abuses included bodily harm, domestic violence and theft. The saddest aspect of elder abuse is that in most cases, abuse is a family affair.
By understanding what brings about elder abuse, it is possible to address it before it happens. We need to be honest to be able to truly understand the circumstances of abuse. Victims of abuse are more likely to be frail and dependent and living with their caregiver. In most cases victims are more likely to have varying stages of dementia and are socially isolated.
In contrast, the abuser is more likely to be a caregiver – usually a spouse, daughter, son or an acquaintance – who relies on the older adult either for money or support and is likely to have alcohol/drug abuse issues. These are of course generalities; there are exceptions.
Sadly, we are more likely to see a cycle of abuse in families. Emerging studies are showing that most people who commit physical or sexual elder abuse have themselves been abused as children. Especially with physical harm, studies are showing that children who have been physically punished growing up have learned to address inappropriate behaviour by becoming physically abusive themselves.
In Malta, with over 66,000 older adults, there will be around 3,300 elder abuse events each month
Unlike children, older adults who are abused and neglected are three times more likely to die earlier than those who are not abused. In response, family caregivers are the most likely type of perpetrator we prosecute. But this is not the only type of offender that abuses older adults.
In 2010, in one of the few European cross-national studies, it was reported that financial abuse forms one in 20 cases of elderly abuse. Financial abuse is becoming a much larger type of abuse throughout the world. In some cases, serious financial elder abuse remains invisible because of the perpetrators. These untouchable topics include abuse by casinos, banks, doctors and lawyers and those committed by churches/synagogues/mosques.
Legally, it is difficult to prosecute a case when your chief witness, the victim, is mentally impaired. As the Speaker of the House, Anġlu Farrugia highlighted, the problem of identifying incapacity remains a problem that Inspector Briffa calls “credibility of the person”. Can we believe the victim when they are demented or when they are old with all our prejudices?
When casinos supply older customers with alcohol, giving them access to medication that impair judgement and then allowing them to access loans so that the incapacitated customer can still play (and lose a lot of money), this is abuse. When older adults bequeath their estate to churches/synagogues/mosques/private companies, before being allowed to move into one of their nursing homes, this is abuse. When a physician takes advantage of their patient and leads them to expensive and ineffective treatment, this is abuse. When a lawyer changes the last testament and will of an older demented client so that they become the primary or sole beneficiary of their estate, this is abuse.
Although there is increasing investment in education and outreach – getting people to understand what abuse is so that they can report it – so far there has been very little change in the increase of abuse. This is hardly surprising since most efforts are not aimed at prevention.
Since one of the ways criminals manage to abuse older adults is by first isolating their victims, making them rely solely on them, by staying in daily contact with vulnerable older adults you can ensure that they have an opportunity to disclose what they are being asked to do. This is known as the ‘buddy programme’ and has been found to be effective in reducing repeat offending.
But in most cases, befriending older adults is not enough to stop or prevent scams and financial abuse. In some cases, we need more than a community; we need law enforcement to prosecute. So when Justyne Caruana, Parliamentary Secretary for Rights of Persons with Disability and Active Ageing, reported harsher penalties for crimes perpetrated against older adults, this is a positive move, but we have to look at whether this also extends to professional criminals.
We know it is happening all around us.
Mario Garrett was born in Malta and is currently a professor of gerontology at San Diego State University in California, US.