Those that would pass the latter part of life with honor and integrity must, when young, consider that they shall one day be old; and remember, when old, that they have once been young. Anon

AGEISM and ABUSE IN LATER LIFE Sexual Assault Char Thompson Minnesota Network on Abuse in Later Life

Minnesota Network on Abuse in Later Life The mission of MNALL is to provide community and statewide training and education on intervention, prevention and systems change in sexual/domestic abuse in later life. MNALL is a membership organization made up of organizations and individuals who are committed to our mission

Definition: Elder Abuse Acts or failure to act by persons required to act resulting in harm to an elder or frail or vulnerable adult which may or may not be criminal. National Center on Elder Abuse

Definition: Domestic Abuse in Later Life A pattern of assaultive and coercive behaviors, including physical, sexual, psychological, emotional and financial used against a victim by a spouse, partner, family member or person in a trusting relationship. National Clearinghouse on Abuse in Later Life

Late Life Abuse Includes, but is not limited to: Physical Sexual Emotional Abuse Psychological Abuse Financial Exploitation Isolation Threats Ridicule and…………….

Definition: Sexual Abuse in Later Life Coercing an older person through force, trickery, threats or other means into unwanted sexual activity. It includes sexual contact with elders who are unable to grant consent, and sexual contact between service providers and their elder clients. PCAR 2004

Late Life Sexual Abuse …. Forced viewing of pornography Coerced nudity and sexually explicit photographing Oral-genital contact/digital penetration Vaginal rape/anal rape Rape by objects, attacking the victim’s genitals with blows or weapons Any action believed to be a sexual act by the victim. PCAR 2004

Definition: Consent Consent means positive cooperation in act, or an attitude pursuant to an exercise of free will. The person must act freely and voluntarily and have knowledge of the nature of the act or transaction involved. PCAR 2004

Any form of prejudice or stereotyping based on age. Definition: Ageism Any form of prejudice or stereotyping based on age.

Ageism by the non-elderly is unique in that it is directed toward a group to which, barring early death, the perpetrators will one day belong! Ageism exists precisely because elderly people represent our future in which death is certain, physical deterioration probable, and the loss of current self-worth enhancing characteristics is a distinct possibility. Greenberg, Schimel and Martens 2002 !

Ageism … Ageism is pandemic (in all cultures) At what age – or appearance of age – is it no longer necessary to see persons as the strong, life-experienced, capable, wise and valuable members of our neighborhoods and communities??? I have never been “just right to…” Always too old to, too young to, too big to, to small to, too tall to, too short to……..

Later Life?? Begins at age 50 Three age divisions must be acknowledged: 50 – 65 65 – 80 80 ++

Later Life?? MNALL includes persons over the age of 50. At this age, most have raised their children, may be returning to the workplace with great difficulty, and most services available to abuse victims are geared toward younger women and women with children. Shelters are not accomodating to old women…may have some health issues, no children,and at this time of trauma feel they have little in common with younger women. Funding available for late life victimization is near zero – most federal $s are aimed at educating law enforcement and prosecutors, NOT toward educating communities about the issue of abuse, how to recognize it and how to get help. This remains one of the most hidden and underreported crime in the country today!!

Dynamics Domestic violence/sexual abuse is a pattern of coercive tactics to gain and maintain power and control in a relationship. Schecter 1987 All forms of abuse involve power. All abuse aims to control and manipulate the victim.

Who abuses and Where? Today we are talking about the abuse that takes place in the residence of the victim and perpetrated by a family member – partner, spouse, family member or person in an on-going trusting relationship.

Old people are not sexual! Barrier: Old people are not sexual! Old persons continue to be sexual as they age – sex, romance and intimacy continue to be important in their lives. Old people are a drag on society! Of those over age 65 , 1/3 work for pay, 1/3 volunteer and most contribute to their families and friends, many as caretakers. “Old” and “Disabled” are not synonomous

Barriers and Remedies Persons over the age of 50 often have strong beliefs about privacy and self-reliance Listen to the victim – seldom will you hear the story the first or second time you interview them. It takes time to build a sense of trust. The reluctance to tell is deeply ingrained – “Don’t air the family laundry” Rural communities are small and inter-related – the sense of shame and guilt is often overwhelming the first time a victim talks to an advocate. Seldom is it the victim who comes forward – but a referral by a friend, doctor, social worker, home health aide, pastor, or even a meals-on-wheels deliverer. Expect to take 5 to 7 times longer with an older victim…..

Barriers and Remedies The commitments are traditional and strong to spouse, family, home, church and community. Religious beliefs and practices are especially ingrained in response behavior. Take your time…. Let them know you are truly concerned. Tell them the abuse is not their fault. Never blame - acknowledge the reluctance. Listen! Fear, guilt and shame are often layers deep! Remember that she grew up in times when nothing was talked about, even whispered about abuse—and especially not about sexual abuse.

Barriers and Remedies Usually the victim/survivor has little or no knowledge of what constitutes abuse. Isolation has kept her from many contacts – relatives, friends, neighbors, community activities…… Listen but also educate! Ask if they have ever been hit, kicked, slapped, sexually violated or mistreated by someone important to them. Is someone close to you hurting, blaming, threatening or shaming you?

Barriers and Remedies The survivor/victim you are talking with seldom knows there is help and support for her in her own community. Offer options and resources, including exploring ways she could take advantage of those services. An advocate provides options and helps the survivor to achieve the option chosen. Be very creative! She needs to know she will not be putting herself in a position to be abused again and even more severely.

Barriers and Remedies The older the victim the more likely they adhere to rigid gender roles Listen carefully as they reveal parts of their story – gently explain that many gender role differences have disappeared. They are free to make choices on their own When the abuse has a long history, it will take patience and development of trust for the victim/survivor to believe that their voice will be heard – and without prejudice!

Barriers and Remedies Victim/survivor seldom believes there can be relief, but has a glimmer of hope! Believe her, ask her what she wants, assure her that you will help her towards her goal. An advocate does all she can to help a survivor move toward her own goal, even when the advocate knows that goal is not possible. Not meeting her initial goal is not failure, but an opportunity to try another way – and you are there to support her. It is possible that the survivor was sexually abused as a child or adolescent but never revealed - - or if she told, was not believed by the adult(s) in her life.

Barriers and Remedies Health and disability issues can be overwhelming. A perpetrator will take advantage of any perceived weakness in the victim. At times there are age specific declines that cause vulnerability. Help the survivor/victim to see their own inner strength and guide them to safe resources for both health and safety.

Barriers ---- Economic – A complete dependence on the perpetrator for life’s needs. In the rural area, many women never worked anyplace but on the farm and nothing was paid into Social Security for them. Also, all assets are in “his” name alone, and she has no knowledge of state law protecting her interests.

…and Remedies The problems surrounding money or lack of same are unending, especially for an abuse victim. This overlaps with lack of transportation, communication availability, housing and daily needs. Many agencies and their advocates and counselors may eventually be involved to bring safety and relief to one victim. The more creative you are, the greater the possibility of early relief and a longer term solution. Understand that a long marriage often results in the survivor/victim returning after a respite – he/his partner needs them and they have never lived away from them. In many cases, if the survivor/victim is a widow and she has an adult son living with her, they have developed a skewed interdependence. She will not report the son’s violence against her because that would be admitting she was not a good mom – and she is fearful of his violence.

Barriers and Remedies… Communities of color and Native communities, underserved and marginalized communities…..immigrant status and culture…. All of the barriers that apply to communities in general are multiplied for older survivor/victims. We urge you to develop working relationships with all service providers so no survivor/victim will ever go without support and safety in your community.

…Remedies … Know that each survivor/victim has a life story that brought them to this point in time, and the strengths she has need to be discovered and acknowledged.

Working with the Survivor/Victim: Develop a safety plan – now! Maintain confidentiality regarding all victim information Do not tell the survivor what to do, inform of choices of action, and assure you will assist. Remember, it usually has been a long time since anyone listened to her, or believed her.

Working with the survivor/victim Respect a victim’s desire to work with someone close to their age, gender, race, religion, class, culture, sexual orientation…and check your own ageism!

Red Flags: A Perpetrator May… Insist on being present at every interaction Be verbally abusive or charming and friendly to service providers Blame the victim for being difficult, stubborn, stupid or clumsy Forbid the victim to see family and friends, leave the house unaccompanied and eventuallly create total isolation

Red Flags……. Ridicule victim’s spiritual beliefs and practices Minimize victim’s injuries and physical ailments Control all jointly held assets Have a history of alcohol and/or drug abuse Create fear and guilt in the victim in all communications -

Work in Partnership Refer to appropriate agencies with permission, and…if mandated, explain what you are doing and why Maintain a working relationship with all senior providers in your area, know who to refer to…

Partners…Collaborators SA and DV Advocates Adult Protective Services Health Care Providers Law Enforcement Prosecutors and Judges Social Services Faith Communities Senior Centers……………and others…… Each community is unique in the potential partners that may help keep seniors safe and meet specific needs.

Minnesota Mandated Reporters Professionals or professional’s delegates while engaged in the care of vulnerable adults Law enforcement Educators Health care related professionals Nursing home administrators Nursing personnel Social workers Psychologists

Resources Call 911 if the danger is immediate MN Senior Linkage Line 800-333-2433 MN Day One Hotline: 866-223-1111

Resources Minnesota Network on Abuse In Later Life www.mnall.org National Clearinghouse on Abuse in Later Life www.ncall.org National Center on Elder Abuse www.ncea.org

The manner in which our ageist attitudes invade our decision making process and observations will have a direct influence on our actions and reactions as we provide services.

WORLD ELDER ABUSE AWARENESS DAY JUNE 15, 2011 SAVE THIS DATE!!! WORLD ELDER ABUSE AWARENESS DAY JUNE 15, 2011 My World, Your World, Our World, Free of Abuse in Later Life!