Elder abuse is recognised as a continually increasing and serious problem. Despite legislations, this evil is rampant in our society. There are an estimated 100 million older people in India and as per the estimates of Helpage India report, 30 million are being abused. Thalaikoothal (oil bath in Tamil Nadu), and other traditional practices of involuntary euthanasia on the elders, is illegal in India. But, the practice has long received covert social acceptance. It is estimated that hundreds of cases of senicide occur each year. Dr. Archana examines the deep-rooted problem and suggests the way out in this in-depth report. Here’s a special feature on the World Elder Abuse Awareness Day by Different Truths.
Following is the excerpt of a letter written by a father from old age home to his son who didn’t come to see him for the past two years. Undoubtedly, it is a form of elder-abuse.
Dear Son,
Hope you and bahu (daughter-in- law) are doing fine. Yesterday was my 76 th birthday and I waited the whole day for your phone call or a message to wish me. I checked my cell phone several times fearing its battery may not be down and my heart was longing to hear your voice. Sitting lonely in my room here, with tears in my eyes, I was in reminiscence how you used to plan surprise parties and gifts for my birthdays along with your mom. In never imagined that one day I would be utter lonely on my birthday and will not receive even a wish from you.
After the demise of your mom, I have become very lonesome. I miss her with my each breath. There is no point in dragging on with life. Each morning I open my eyes with utter hopelessness – nowhere to go, none to talk to, nothing to do…but death will come at its own time…
I desperately wish that this be my last letter to you. I pray that you achieve all the worldly success and fame in your life. May your each moment be filled with happiness and contentment…and, lastly, your child does not leave you in some old age home to die million times each day while waiting to hear from loved ones for whom we spend our entire life….
My regards to Bahu,
Yours Papa.
Today, June 15, is observed as the World Elder Abuse Awareness Day. In a traditional society like India, where old age is a cherished and revered stage of life, signifying wisdom, maturity and knowledge, elder abuse comes as a shock.
The socio-cultural contours of Indian society have invariably reflected utmost respect and status to the elderly. They would Head the household, control family property and make all the major decisions in the family. In the community too, elderly would play significant role in resolving conflicts between people, as panch members. Their words would often be a law.
However, forces of social change such as industrialisation, urbanisation, commercialisation, and now globalisation have altered the scenario putting the elderly amidst several vulnerabilities, marginalsation and social exclusion. Elder abuse is one such manifestation of marginalisation of the aged.
Quite ironically, the elderly, who have once occupied the utmost position, reverence and unquestioned authority in the society in ancient and medieval times, are finding themselves marginalized and socially excluded. Once an epitome of knowledge, power and authority, they are now perceived as vulnerable, dependent and spent-force. They are increasingly losing their traditional ascribed status, respect and authority in the family and society.
Despite our claims of respect for the elderly as an integral cultural norm, the reality is that the incidences of elder abuse are on the rise in India as in many other countries. They are ever more becoming the victims of crime, abuse and exploitation.
Elder abuse is 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. There are diverse forms of elder-abuse. Hitting, beating, pushing, shoving, kicking, burning or biting, inflicting bodily injury, pain, or impairment comes under physical abuse. One would frown upon the existence of such a form of abuse on the aged. Unfortunately, it is not uncommon for sons to slap, beat or thrash their aged mothers in India (see: Khan, Yusuf and Kaushik, 2013). It may come as a shock for many of us that the Indian culture and tradition of which we are very proud, approves senicide or killing of the elderly.
Recently found in some parts of southern districts of Tamil Nadu, family members employ certain traditional practices of involuntary euthanasia to their elderly relatives who become ‘useless’ or ‘burden’ to them. Thalikoothal (oil bath) is one such practice when the elderly person is given an extensive oil-bath early in the morning and subsequently made to drink glasses of tender coconut water which results in renal failure, high fever, fits, and death within a couple of days. Alongside, head massage with cold water may lower body temperature sufficiently to cause heart failure. Another method entails forced feeding of cow’s milk to the elderly while plugging the nose, causing breathing difficulties. Recent methods used are injecting poisons by quacks and nurses, who charge from Rs. 2000 to 7,000 per case depending upon the agility of the victim elderly.
Although thalaikoothal is illegal in India, the practice has long received covert social acceptance and it is estimated that hundreds of cases of senicide occur each year.
Emotional or psychological abuse that involves neglecting, ignoring, yelling, insulting, isolating, name calling, avoiding, threatening, is the most common and widespread form of elder abuse.
Though subtler, implications of this type of abuse are indeed severe. Being abused by their offspring, for whom the aged have lived and worked hard throughout their prime-time, emotionally wrecks the victim-elderly.
Mental agony as a consequence of being ignored, neglected, verbally abused by loved ones affects the health status of elderly, who because of ageing changes are already susceptible to many ailments. Silent suicide is not uncommon, though hardly any research attention has been paid to it in India. In the West, studies have found that the rate of silent suicide among the aged is very high. All types of abuse involve emotional abuse.
Financial or material exploitation of the senior citizens is another category of elder abuse that is becoming prevalent. Newspapers frequently report murders of elderly for property, while cases of forgery and forced property transfers by one’s own children are hardly reported. It is often assumed that only rich and well-off elderly encounter financial or material exploitation.
Contrarily, poor and impoverished elderly are also not spared. Numerous instances are reported where sons and daughters-in- law have snatched away the meager amount of old age pension or few kilograms of food grains under Annapurna scheme received by the victim-elderly. In fact, in old age poverty and destitution go hand in hand. Poor elderly are quickly abandoned by their children claiming that they cannot feed another mouth (of the elderly relative, of course) with the minimal income they have.
Though magnitude of elder abuse is very difficult to assess, the World Health Organization estimates that, worldwide, between four and six per cent of older persons have suffered some form of elder abuse. Helpage India (2012) brings out that nearly one in every three elderly in India is facing abuse. Gerontologists estimate that for every case of elder abuse as many as 23 cases go undetected (American Psychological Association, 2005). Certainly, elder abuse is an unacceptable attack on human dignity and human rights. Making matters even worse, cases often remain unreported and unaddressed. Fear of losing family reputation and one’s own positive image in the society refrain elderly from reporting the abuse. In addition, many aged fear that if their children are punished by the law for abusing them, then the chances of reconciliation are over. Dependence on children forces many elderly to silently suffer abuse.
Elder abuse is recognised as a continually increasing and serious problem in our society. Unfortunately, due to under-reporting, variations in the definition of elder abuse, and the absence of a nationwide uniform reporting system, it is difficult to determine the scope of this issue. There are an estimated 100 million older people in India and as per the estimates of Helpage India report, 30 million of them are being abused, which indeed is frightening.
Alarmed at this widening problem, Ban Ki-moon, the Secretary General, United Nations, on June 15, 2012, World Elder Abuse Awareness Day, has said, “….As we commemorate the Day for the first time, let us all join in reaffirming that the human rights of older persons are as absolute as those of all human beings. I call upon governments and all concerned actors to design and carry out more effective prevention strategies and stronger laws and policies to address all aspects of elder abuse. Let us work together to optimize living conditions for older persons and enable them to make the greatest possible contribution to our world”.
The United Nations International Plan of Action adopted by all countries in Madrid, April 2002, clearly recognises the challenge of Elder Abuse and puts it in the framework of the Universal Human Rights. It makes prevention of elder abuse in an ageing world is everybody’s business.
Viewing the high prevalence of elder abuse across the globe, the World Health Organisation in 2002, came up with ‘The Toronto Declaration on the Global Prevention of Elder Abuse’.
The Declaration is a Call for Action aimed at the Prevention of Elder Abuse, with major points as – developing proper legal instruments to deal with cases of elder abuse; its prevention by involving multiple sectors of society; primary healthcare workers playing key role in dealing with elder abuse; education and dissemination of information; and research work in this area for greater understanding. It recognises cultural and gender perspectives as the cross-cutting variables for better understanding of complex phenomenon of elder abuse. It urges that all countries should develop structures that will allow the provision of services (health, social, legal protection, police-referral, etc) to appropriately respond and eventually prevent the problem.
In the Indian Constitution, the Article 41 of Directive Principles of State Policy asserts that, “the State shall, within the limits of its economic capacity and development, make effective provisions for securing the right to …..public assistance in the case of …old age…”. It implies the State’s role in curbing and preventing elder mistreatment. The Code of Criminal Procedure, 1973, Section 125(1) (2) makes it incumbent for a person having sufficient means to maintain his/her father or mother who, is unable to maintain himself/herself. This legal provision is applicable to all, regardless of religious faith and includes adoptive parents.
Likewise, Hindu Adoption and Maintenance Act, 1956 lays down that every Hindu son or daughter is under obligation to maintain aged and infirm parent, if unable to maintain himself/herself, quantum of maintenance allowance to be determined by the court. On similar lines, governments of Himachal Pradesh and Maharashtra have passed the bills related to maintenance of aged parents.
In 2007, the Maintenance and Welfare of Parents and Senior Citizens Act came into force. As per the Act, a maintenance application can be filed by parents and senior citizens above 60 years who are unable to maintain themselves, against children or relatives in case they are mistreated or not looked after. Under the Act, States shall form tribunals for deciding upon the order for maintenance. If, children or relatives ordered by the Tribunal to pay Maintenance to the elderly fail to comply, they are liable to a fine or imprisonment. Abandonment of the elderly is now a cognizable offence. In case those responsible for looking after or protecting the senior citizen leave him/her in any place with the intention of wholly abandoning, they can be punished and fined.
In addition, the Protection of Women from Domestic Violence Act, 2005, although indirectly, has relevance to elderly women facing physical and emotional abuse or abandonment by family members.
The National Policy on Older Persons, 1999, assures older persons that their problems are national concerns and that they would not live unprotected, ignored or marginalised. Among others, it sets out measures for curbing and preventing elder abuse and exploitation involving inter-sectoral cooperation and collaboration, within the government as well as with other stakeholders. To operationalize the National Policy on Older Persons, a ‘Plan of Action’ (2000-2005) was initiated with due involvement of concerned ministries. On the other hand, National Council for Older Persons, under the chairmanship of Minister of State for Social Justice and Empowerment, is designed to receive suggestions, complaints and grievances from individual older persons, and to initiate appropriate remedial measures.
These laws, for several reasons like lack of awareness, especially in rural and tribal areas, inordinate delays in judicial administration, heavy investment in pursuing cases in terms of energy and money by victims, have not been able to address widely prevalent problem of elderly abuse as effectively as is expected. Also, law, having coercive mechanisms, often does not result in amicable solutions. Nevertheless, it provides a sense of confidence to the elderly that the State would not let them remain unprotected and deserted (see: Khan and Kaushik, 2008).
Suggestions
Elder abuse, like other forms of violence, is never an acceptable response to any problem or situation, however stressful. Effective interventions can prevent or stop elder abuse, some of which may be suggested as below:
Counselling services play a critical role in preventive and curbing elder abuse. To caregivers, it aims at resolving or mediating conflicts and address tension/stress and burnouts that give rise to abuse. Counselling for victims or vulnerable adults can help them assess their options, plan for their safety, resolve conflicts, and overcome trauma.
Support services such as support group or network of caregivers, service network, etc., aid in reducing the care-giving burden by lessening older person’s dependence and isolation. It provides relief to caregivers. These support services can be for the aged persons or for caregivers.
Respite care is one such support service, especially important for caregivers of patients suffering from chronic ailments. It provides caregivers much needed time to be free from the worry and responsibility of looking after their elderly relative and rejuvenate and relax.
Isolation of elders increases the probability of abuse, and it may even be a sign that abuse is occurring so systems should be created for increased social contact by means of attending day care centres/recreational centres, having elder’s clubs, hobby clubs, etc.
Health and medical professionals play a key role in the identification and treatment of abuse. They need to be trained as mentioned in The Toronto Declaration on the Global Prevention of Elder Abuse. Law enforcement personnel too need to be trained.
More research work should be carried out in this field that is critical in designing effective interventions and services.
Concerned citizens can play a vital role in preventing abuse by reporting cases, helping to raise awareness about the problem, volunteering at agencies, and advocating for needed services and policy Free legal aid should be provided to elders. The laws like Maintenance and Welfare of Parents and Senior Citizens Act, 2007 work like a deterrent and also an enabling law for those in need of such help.
There should be nationwide programmes in schools for sensitizing the children towards ageing and aged.
Elder Abuse has its roots in the culture of any society. Certain long term steps should also be taken to develop atmosphere that is free of ageism. For this, print and electronic media should be sensitized to highlight urgent concerns of older persons on a regular basis.
A sound social security system to ensure income security to older persons is required. There should be opportunities for income earning and income generation so that dependence is reduced.
The National Policy on Older Persons maintains that programmes will be developed to promote family values, sensitise the young on intergenerational bonding and security and safety of older persons. The Policy expresses, “tackling the issue of Elder Abuse within the parameters of family would be a socially rewarding exercise as it would be culturally appropriate and the most enduring solution. It would be better than the legal and punitive measure that should be reserved only as a last resort”.
References:
American Psychological Association. 2005. What is Elder Abuse? Retrieved on December, 28, 2012 from http://www.apa.org/pi/aging/resources/guides/elder-abuse.aspx
Government of India. 1999. National Policy on Older Persons, Ministry of Social Justice and Empowerment, Shastri Bhawan, New Delhi.
Helpage India. 2012. Elderly abuse in India. New Delhi: Helpage India.
Khan, M.Z. & Kaushik, Archana. 2008. Ageing: Policies and Programmes in India. BOLD, Quarterly Journal of the International Institute on Ageing (United Nations – Malta), August, 18(4).
Khan, M.Z., Yusuf, Mohd. & Kaushik, Archana. 2013. Elderly Women: Vulnerability and support structures. New Delhi: Gyan Publishing House.
World Health Organization. 2002. The Toronto Declaration on Global Prevention of Elder Abuse. Canada: World Health Organization, University of Toronto and Ryerson University, and International Network for the prevention of elder abuse. Retrieved on 25 th December 2012 from http://www.who.int/ageing/projects/elder_abuse/alc_toronto_declaration_en.pdf
©Dr. Archana Kaushik
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