1. Rosanna Thurlow Policy Development Officer Action on Elder Abuse

2. Who are Action on Elder Abuse?
Formed in 1993, Action on Elder Abuse (AEA) works to protect, and prevent the abuse of vulnerable older adults.  We were the first charity to address these problems and are the only charity in the UK and in Ireland working exclusively on the issue today

3. What do AEA do? The Helpline:
Established in Provides advice and guidance to older people and others
Lobby government
Speak at conferences
Provide training
Raise awareness wherever possible

4. Abuse and Definitions
A violation of an individuals human or civil rights by any other person or persons - No Secrets
A single or repeated act or lack of appropriate action, occurring in any relationship where there is an expectation of trust that causes harm or distress to an older person - AEA
‘any incident of threatening behaviour, violence or abuse (psychological, physical, sexual, financial or emotional) between adults, aged 18 and over, who are or have been intimate partners or family members, regardless of gender and sexuality.’ (Family members are defined as mother, father, son, daughter, brother, sister and grandparents, whether directly related, in-laws or step-family.) (ACPO definition)

5. The Categories
Physical Abuse – Hitting, Kicking, Slapping, Punching, Spitting, Restraint – chemical and physical?
Psychological Abuse – Using against a person what they love or value. – JSP!
Financial Abuse – Remains too easy to gain control of an older persons finances. Many abusers never deny spending or having access to money
Sexual Abuse – Forcing a person to participate in sexual acts and conversations against their will. Must ignore prejudices and assumptions about people with dementia, mental health issues and/or a learning disability
Neglect – Failure to provide people with what they need to live. Neglect is not a separate thing to abuse and crime!

6. The Prevalence Study UK Study of Abuse and Neglect of Older
People – 2007
In 2004 the House of Commons Health Select Committee concluded an Inquiry into elder abuse. Following representations by AEA, a major recommendation was that there should be comprehensive research into the prevalence of elder abuse in the UK
The Prevalence Study was undertaken by the Institute of Gerontology at Kings College London, and the National Centre for Social Research.

7. Leicester population: 330,574
UK Study of Abuse and Neglect of Older People
The overall prevalence of abuse, defined by ‘expectation of trust’ in the year preceding the survey was 4%
This equates to 342,000 people aged 66 and over, or 1 in every 25 of the population aged 66 and over
KEY MESSAGES:
Prevalence figure is 4%, or 342,000 older people – more than the population of some of our cities.
2.6% of older people face abuse by those who society would consider to occupy a position of trust i.e. family or paid staff
Leicester population: 330,574
Excluded Care homes, NHS institutions and people with dementia!
(2.6% of older people were abused by someone in a ‘position of trust’)

8. Percentage of all respondents who experienced abuse
UK Study of Abuse and Neglect of Older People
Abuse by Gender
Percentage of all respondents who experienced abuse 6
5.4
Women 5 4
Percentages
KEY MESSAGES:
In keeping with what we know from our Helpline, in general more women than men experience abuse
But there is some variation across the Nations 3
2.1
Men 2 1

9. UK Study of Abuse and Neglect of Older People - 2007
Percentage of all respondents who had experienced abuse in the last year
The Abusers 40 35
Partner 33
Other family 33
Neighbours and
Acquaintances 35 30 25
Percentage 20
KEY MESSAGES:
Victims could experience abuse from more than one person at a time.
But primarily we are looking at partners, other family members, and neighbours/acquaintances: mention the potential for grooming.
9% of all abusers are home helps. 15 9
Home Help 10 3
Friend 5

10. UK Study of Abuse and Neglect of Older People - 2007
Abuse and Health 14
Percentage of respondents who had self-reported their health, and had experienced abuse
12.5
Women 12
9.2
All abuse
Bad Health 10
Percentage 8
5.1
Neglect
KEY MESSAGES:
And there is an obvious link between stated bad health and abuse.
You are ten times more likely to suffer abuse if you are a man in bad health than good; and seven times more likely if you are a woman.
Good Health
1.2 6
4.8
Men 4
1.9 2
0.4
0.5

11. UK Study of Abuse and Neglect of Older People - 2007
Percentage of abuse that had occurred in the last year
Types of Abuse
1.4
0.7
Psychological
Neglect
1.2
Ten instances in order to be counted once in the Survey
0.7
Physical
0.5
Sexual
Financial 1
One instance in order to be counted once in the Survey
1.2 1
0.8
Percentage
KEY MESSAGES:
Neglect and psychological abuse has been under-reported in the survey and is in reality much higher – use of a twenty year old American model that does not reflect society’s increased intolerance of abuse
Important to note that neglect can be wilful or unintentional, but the impact on the victim is the same.
Example: one instance of psychological abuse can lead to the loss of a house or to sexual abuse.
0.6
0.4
0.2

12. Types of abuse Source: Hidden Voices 2004 5 10 15 20 25 30 35 40 5 105 10 15 20 25 30 35 40 5 10 15 20 25 30 35 40 34
Psychological 3
Sexual 12
Neglect 20
Financial 19
Physical
Percentage of calls excluding ‘Other’

13. UK Study of Abuse and Neglect of Older People - 2007
Abusers and Type
Percentage of those who had been identified as abusers in the last year 70 62
Partner
Neglect
Domestic Violence 60 51
Other family 50 45
Percentage 9
Financial 40 35 31
Other 35 30
KEY MESSAGES:
Domestic Violence is a reality for some older people
Financial abuse / Other abuse (Psycho/physical/sexual) is mostly perpetrated by partners or other family members and should be better described as domestic violence. (but prev study didn’t refer to it as such)
Need to start calling it what it is to ensure older people receive appropriate interventions within domestic violence situations 20 20 20 13
Home Help 11
Neighbour or
Acquaintance 10 4 3
Friend 1

14. Older People and Domestic Violence
Older People = Victims
Older People = Perpetrators
Key messages: need to stop patronising older people etc.
Are and can be both vicims and pepetrators.
65th birthday etc

15. Abuse and Crime Hitting, slapping, pushing, kicking
Common assault s.39 Criminal Justice Act 1988; actual bodily harm s.47 Offences Against the Person Act 1861; grievous bodily harm/with intent s.20 and 18, OAPA 1861
Misuse of medication to manage behaviour
Assault; false imprisonment; applies stupefying/overpowering drugs/matter or thing with intent to commit indictable offence s.22 OAPA; poisoning with intent to injure, aggrieve or annoy, s23/24 OAPA; unlawfully administering medication s.58 Medicines Act 1968; injuriously affecting the composition of medicinal products, s63 Medicines Act 1968; failure to comply with conditions/contravention of regulations s.24, 25 Care Standards Act 2000

16. Percentage of all respondents who experienced abuse
UK Study of Abuse and Neglect of Older People
Abuse by Age
Percentage of all respondents who experienced abuse 6
5.5
85+ 5
4.2
75 -84 4
3.5
Percentages 3
KEY MESSAGES:
Again, in keeping with what we know from the helpline, the potential for abuse increases with age. 2 1

17. The Demographic ‘Time bomb’
16% of UK population are aged 65 or over
Dementia affects 5% of people over 65 yrs old and 20% over 80
The implications of this?
More vulnerable older people =
More potential for abuse
The older but no safer campaign
Women disclosing when receiving palliative care
Risk assessments: stabbed to death victim
Coping mechanisms not working anymore – not acceptable to just offer domiciliary care packages – need to establish comprehensive risk assessments
Provisions for older victims of domestic violence unacceptable: from basics such as refuges not having stair lifts to cater for people with mobility problems etc
Police reluctance to put an older perpetrator of domestic violence in cell over night – this has to change

18. Safeguarding from abuse - the wider agenda
Empowerment
Preventing isolation
Valuing
Re-humanising

19. Safeguarding Vulnerable Adults
Social Services are coordinating agency
Multi agency partnership
Prevent abuse and protect people from abuse

20. But…
Less than one in ten older people who experience neglect, psychological, physical or sexual abuse is having their case referred to local authority adult protection services

21. What to do if you are alerted?
Who is suspected of causing the harm?
What level of seriousness is it?
Who do you report to?
In what order?
Do you seek to supplement the information you have?
What support do you provide to victim?
What support do you provide for alleged abuser – if any?

22. The Carer Stress Debate
Assumption that an older person receiving care is ‘difficult’
Therefore carer’s stress results in abusive behaviour which is understandable
We would not accept carer stress as an explanation in child abuse – why do we for older people?
Note-Victoria Climbie v Margaret Panting – would carer stress have been acceptable to explain what happened to that child?

23. Adult Protection Legislation
Legislative situation currently confusing and piecemeal 
Definition of a vulnerable adult varies, depending upon the legislation. 
Processes and systems to protect older people are based on guidance and lack the resources and drive to ensure comprehensive protection. 
Adult Protection Teams under-funded, under-resourced, and under-staffed. 
Increased referrals to some teams would result in crisis. 
Abusers escape through the huge gaps that exist
Need parity with child protection
Need for intervention orders
Need to send out message to general public that vulnerable adults need protection worthy of legislation
Would ensure that statutory agencies would have to participate in joint partnership working and wouldn’t prioritise other work that has performance indicators attached
We have produced a document based on a survey of 150 practitioners. It outlines what we would like to see in such legislation, based on out work and the views of the practitioners who responded. We are asking for feedback from anyone with a stake in AP work on this.
There are debates to be had – is it acceptable to over rule wishes of adult with capacity if we feel they are being abuse? Conversely, is it right to rely on the alleged perpetrators co operation so much?
Shouldn’t we apply a positive action approach similarly to domestic violence?
Are existing measures / guidelines / legislation acceptable?

24. Elder Abuse Response Line
9.00am – 5.00pm
Monday - Friday
Action on Elder Abuse: (0)