ISSUE Ageways 59
Practical issues in ageing and development APRIL 2002
Violence and abuse
Elder abuse - a hidden reality Challenging harmful beliefs Learning about rights Action to promote respect plus Gender in project planning NOTICEBOARD
Comment Letters
Action against abuse New format one aspect of ageing, and that Welcome to Ageways 59, in which Thank you to everyone who has education never ends. we focus on an issue that is written about Ageways’ new format. She came to the group feeling beginning to emerge as a serious Here are a few responses.We will isolated. Now she says it has changed and widespread problem – violence include a survey form in issue 60 her life. She began to see herself as and abuse of older people. to obtain more feedback. an ageing person, with inevitable A key problem is lack of recognition Thank you very much for your excellent loss, but also with new things to of elder abuse, and a taboo in publication.The contents are useful for discover: living alone without feeling talking about it. The causes of elder us, and the new look is better. lonely, developing her independence, abuse are often complex, linked widening her social and emotional Sarangadhar Smal, Director, Nysasdri, India. links, and planning projects she to wider problems in society and Email: [email protected] age-discriminatory attitudes could achieve. and systems. We like the new style Ageways and Prof. Psic. Graciela Petriz, have always found Ageways a very Programme of Continuing Education This issue of Ageways suggests useful resource for our training and for Older People (PEPAM), Faculty of practical ways of identifying, community work. Humanities and Educational Science, preventing and dealing with elder calle 47 N° 879, 1900 La Plata, Argentina. Maria Kanger, Executive Director, COMBRA, abuse. It emphasises the need for Fax: 54 221 423 6672 Uganda. Email: [email protected] a broad approach that tackles not Email: [email protected] only the effects of abuse but also Congratulations on the new look of its underlying causes, requiring Ageways, which will definitely Support for disabled children action at all levels of society. contribute to make it a more I have informally rendered services effective and attractive tool for to older people since 1985. I am Celia Till and Fiona Clark information exchange. increasingly convinced that Editors Birgitte Ebbesen, UNHCR, rue Van Eyck, 11B, community-based rehabilitation 1050 Brussels, Belgium. projects for older people and for those with mental handicap are Contents We are glad about the contents and mutually supportive. Elder abuse – a hidden reality 4 new presentation of Ageways.It gives us useful guidance on extending We find from home visits to identify Challenging beliefs services to older people. mentally handicapped children, that about witchcraft 6 they always live with older people, R M Premadasa Bodhinayake, President, A place to learn about rights 7 Uva Farmers Development Foundation, either grandparents or other relatives. Dealing with abuse 8 Jangulla, Hali Ela, Sri Lanka. Indeed, we often rely on the oral Finding out about abuse 10 traditions of older people to identify One woman’s experience those with mental handicap. Information sources 12 I would like to tell you the story of one Last Christmas 2001 we held a party Taking gender into account 13 woman’s experience from the many in the village for disabled people. Members and programmes 15 workshops we hold with older people The turn-out was amazing. From Action to promote respect 16 as part of the Programme for the youngest to the oldest, Continuing Education of Older People. everyone enjoyed themselves. Themes of future issues Issue 60 (June 2002) HIV/AIDS In the group, people can discuss their In our outreach stations we have Issue 61 (October 2002) Livelihoods fears – of ageing, illness and death. found 30 previously unknown older Issue 62 (March 2003) End of life By sharing these fears, they are disabled people.We now have plans Issue 63 (June 2003) Disability gradually understood. Participants get to build a day care centre specifically to know each other and establish a We welcome articles for for older people. network among themselves. consideration.They should be Please could you consider issuing received three months before A student in the 80-plus group has guidelines on how to approach this the month of publication. learnt that chronological age is just combination of older people and
2 Ageways 59 NOTICEBOARD
News people with mental disabability. Second World Assembly on Ageing More information: Andrew Humphreys, We need to work towards integrating HelpAge International has arranged Campaign Coordinator, Action on Ageing, the two vulnerable age groups within for more than 50 older people from HelpAge International, PO Box 32832, London N1 9ZN, UK. one action programme. Africa, Asia, Latin America, Caribbean Email: [email protected] Josephine Bakhita, Director, Amani Centre and eastern Europe to take part in the Website: http://www.helpage.org for Children with Mental Disabilities, Second World Assembly on Ageing, The draft Plan of Action is available PO Box 579, Morogoro,Tanzania. Madrid in April 2002. A new on the United Nations Programme Fax: +255 23 2600829 International Plan of Action on Ageing on Ageing website at: Email: [email protected] will be adopted at the assembly. http://www.un.org/esa.socdev/ageing Radio programme is run by us The move forms part of HelpAge International Day parade I would like to correct some errors in International’s Action on Ageing the article in Ageways 56 about my campaign, which seeks to ensure that radio programme, Older People’s Words. the demands of older people living in poverty are included in the new plan, Firstly, the programme is run entirely and that resources will be available to by the production team – currently implement it. myself and Maximiliano Mores. It does not belong to FAIAF. At the assembly, HelpAge International will launch a new report, State of the The programme was my own idea. As a world's older people 2002. The report social communications graduate, I was draws on consultations with older interested in using communications to people around the world, and provide a social service. A colleague Mbané Jean Robert/EPV identifies three pillars for policy and and I researched older people’s action on ageing: equal rights for older Older people in the village of Fomopea, communications needs, and we Cameroon, celebrated the International citizens; a fair share of national and developed the programme as a result. Day for Older People on 1 October with international resources; and inclusion a march and speeches organised by local FAIAF – an Argentinian NGO in decision-making and in civil society. NGO Ensemble Protégéons les Vieux (EPV). supporting older people – took part in one of the programmes. Later, we received money to cover some of our expenses from an NGO coordinating New publications body which FAIAF is a member of.We have never received any professional How to build a good small NGO is More information: HelpAge International Asia/Pacific Regional Development Centre fees or government support. available on the web. It contains guidelines and exercises, with links to (address on page 15). If anyone needs further information, other resources. It includes a section please can they contact me. on best practice for projects with older Addressing the nutritional needs María Cecilia Lorenzo, people in Africa, written by Amleset of older people in emergency Older People’s Words, Av.Tronador 2395, Tewodros, HelpAge International’s situations in Africa: ideas for action Bo Parque Capital, Córdoba CP 5016, highlights key issues affecting the Argentina. Tel: +54 351 4692079 Africa regional training coordinator. nutrition of older people in Email: [email protected] Available at: emergencies and suggests ways in http://www.networklearning.org which the rights and needs of older We welcome letters from readers. people can be more effectively Please write to: The Editor, Working with video provides practical addressed. Ageways, HelpAge International, guidelines on using video to empower older people, developed at a PO Box 32832, London N1 9ZN, UK More information: Dolline Busolo, or email: [email protected] workshop organised by HelpAge Regional Nutritionist, HelpAge International Letters may be edited. International’s Asia/Pacific Regional Africa Regional Development Centre Development Centre in October 2000. (address on page 15).
Ageways 59 3 VIOLENCE AND ABUSE Elder abuse a hidden reality
The extent and nature of violence and abuse of older people Experiences is just beginning to emerge. Fiona Clark discusses why it of abuse happens and what can be done to prevent it. Based on evidence in the HelpAge International network, older people have most frequently identified physical violence as their primary concern, as well as financial abuse, such as robbery, theft and being persuaded to hand over money or property.
In Africa, older people are increasingly at risk of physical violence related to cultural beliefs and accusations of witchcraft, especially against older women.
In a single month, HelpAge Hein du Plessis International partners in Pension queue in South Africa – attacks at pension pay points relate to wider issues Mozambique identified 142 acts of poverty and unemployment, and ageism in society. of abuse committed against older people in the communities in which neglect and abandonment – lder abuse is a serious they work. Of these, two-thirds were insufficient care or attention to problem across the globe, committed against older women, meet the person’s nutritional, health, but it is still under- and the largest number related hygiene or emotional needs acknowledged and largely to witchcraft accusations. E sexual – any sexual act against the under-reported. Cases that do come to light are often dismissed as a person’s will, from suggestive words In a study in townships of the domestic issue – in a way that or actions to forced sex Cape Flats, South Africa, however, domestic violence and child abuse economic or financial – robbery, older people identified sexual abuse once were – rather than being related theft, illegally taking assets and as the most common form of to wider issues of discrimination property violence, including adult sons requiring action cultural – being forbidden to speak forcing their mothers to have sex at all levels. the person’s own language or wear with them. traditional dress Abuse can take different forms, and structural or institutional – lack of Older people in Eastern Europe there are many reasons why it takes social security systems and fair and Russia have identified increased place. Studies have identified the pensions to allow a reasonable street crime and robbery as a form following forms of elder abuse, quality of life, difficulty accessing of abuse. Research by HelpAge drawing on older people’s own government services because of International in Kenya highlights definitions: mistreatment and harassment by institutional abuse faced by older government officers, age people in health centres. physical violence – beating, discriminatory policies and practices. pushing, pinching or any act that Another form of abuse is the causes physical injury Key problems are a lack of recognition insecurity and violence that older psychological or emotional – of elder abuse (acts of abuse may be people are subjected to in conflict insults, jokes, threats or indifference, regarded as normal behaviour), situations and emergencies, and affecting a person’s mental people’s reluctance to talk about it, and lack of provision for older people wellbeing the consistent denial that it takes place. in relief programmes.
4 Ageways 59 VIOLENCE AND ABUSE
of poverty and unemployment, Who are the Who is most at risk? combined with ageism in society. While it is difficult to generalise, abusers? Ultimately, however, violence is an certain factors can increase the risk of The reasons for elder abuse are outcome of unequal power relations abusive situations arising. Guidelines often complex, relating both to the and abuse of power.Violence against from the Department of Health in individual and to the economic, social, older people is an extreme example South Africa state that elder abuse is cultural and political situation. of their powerlessness. more likely to occur if the person is Many studies point to carers of older physically dependent, mentally people – whether family members, impaired, or has insufficient income Action at all levels to be self-reliant. volunteer carers or professionals – Action to combat elder abuse as the main abusers.While this is a A study of violence against older needs to be taken at all levels. serious problem, the circumstances women in Chile found that gender, need to be taken into account. More information is needed on the co-residence with an adult carer, causes and consequences of elder Abusive behaviour by public services, mental or physical disability, abuse, drawing on data provided by such as at pension pay points, diminished family role, and fear older people themselves. government offices or other service added to their vulnerability. Broad-based interventions need to providers, is a reflection of society’s be developed, which involve older Older people with strong social negative attitudes to poor and people in tackling abuse and its contacts, and those with economic vulnerable people. underlying causes. and material assets, are likely to be A change in attitude is required, to better able to resist the threat of Older people themselves can be break taboos about elder abuse, abuse, or to seek support if it does abusive.They may abuse themselves and treat the issue as seriously as occur. However, assets and property through self-neglect, or they may gender-related abuse, child abuse, can also put older people at greater abuse members of their families or and generalised crime. risk of abuse, from younger family communities. A report from South Governments need to develop members wishing to inherit property. Africa states that older people's comprehensive strategies to stop abusive behaviour is often the result In many African countries, for example, abuse of older people, including a of alcohol abuse, unemployment and a widow’s property is passed to her supportive legal framework, and post-retirement depression. eldest son or back to the husband’s public education and training for public sector staff to equip them to It is important to see older people in family, which can put pressure on the detect and act on abuse. the context of their family, community widow to move out. In countries such A change of attitude is required and political environment, and to as Argentina and Brazil, the recent among families, communities and recognise and deal with the causes economic downturn has resulted in older people’s organisations to of abuse as well as its effects. adult children moving back to their parents’ houses with their children. acknowledge the extent of the Sometimes, the older person is problem and deal with it on a The law enforcers do relegated to the smallest room, practical, day-to-day level. or forced to move out. Older people need to be informed of not take us seriously. their rights and responsibilities and When I reported physical HelpAge International has also supported in exercising them, with received repeated reports of older reference to the Universal Declaration assault by my son, I was people in South Africa being attacked of Human Rights, the United Nations told:‘Old man, go and and robbed at pension pay points, Principles for Older Persons, the and of older people in Russia being International Plan of Action on sort it out with your robbed in their apartments.These Ageing, and national laws and polices. family.’ types of violence relate not only to References are available on request. older people’s difficulty protecting Fiona Clark is policy officer, Older man in Kenya themselves, but also to wider issues HelpAge International London.
Ageways 59 5 VIOLENCE AND ABUSE
Challenging beliefs about witchcraft
In northern Tanzania, communities are participating in a wide-ranging programme to improve the security of older women, including challenging beliefs about witchcraft.
n some parts of the world, cooking methods. Red eyes, for notably Africa, older women example, are seen as a sign of being are accused of being witches. a witch. An actual cause is a lifetime They are driven from their cooking over an open fire. New I designs of fuel-efficient stoves are communities and even killed. The problem is particularly being tried out, to reduce the risk acute in Sukumaland in to women’s eyes. northern Tanzania. The programme also challenges The Sukumaland Older Women’s negative attitudes to older people, Programme was started two years which allow accusations of witchcraft ago by HelpAge International and to thrive. It includes awareness-raising International Susan Majiba/HelpAge local NGO, the Magu Poverty about ageing and gender issues, Making baskets to sell is part of a broad Focus on Older People Rehabilitation and training older people in their programme to improve older women’s security. Centre (MAPERECE). It aims to legal and human rights. reduce witchcraft allegations and Cultural groups who perform improve the security of older representatives were not serious traditional dances and songs are people, especially older women. about implementing forestry by-laws. helping to promote positive messages The forestry officer promised to look about older people, by developing into the issue. new songs that encourage respect Building support for elders.They also perform role-plays In one village, the older people’s The programme uses a wide range depicting how older people are committee has identified vulnerable of practical interventions and accused of witchcraft and the violence older people and mobilised the advocacy to tackle the underlying that may result, sometimes to crowds community to provide them with causes of elder abuse, and strengthen of more than a thousand people. basic care in the form of food, local capacity to support older people. soap and firewood. In several Participants range from older people’s villages, the community has agreed groups and local communities to Change in attitude to build houses for vulnerable government officials, schools and older people. There are signs that attitudes are the media. beginning to shift in favour of older Older people themselves are The programme began with a gradual people. Initially, the government noticing a change in attitude. process of building support. Meetings denied the existence of witchcraft As one older woman said: involving both men and women were beliefs. However, in 1999, the ‘Before, I had to step off the path held in 70 villages to identify villagers’ International Year of Older Persons, to get past a group of young people, needs and elect village committees, it officially condemned the practice, but now the young people step through which the programme and government representatives aside to let me pass by.’ is implemented. are starting to show support. The programme is funded by Comic For example, at a village meeting The programme includes interventions Relief and the UK Department for between the older people’s aimed at improving older people’s International Development. health and wellbeing, focusing on committee, village leaders and the new approaches to vital areas such district forestry officer, older people More information: HelpAge International as nutrition, housing, agriculture and remarked that village government Programme (address on page 15).
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A place to learn about rights
An older people’s centre in Bolivia is proving a popular Pedro Chambi is a member of the Mama Margarita older people’s group. venue for research, training and advocacy to promote ‘In the meetings we talk about issues older people’s rights. to do with older people,’ he says. ‘Lately we have been talking about Older people in Bolivia are the poorest Together, the Archbishop of La Paz, the the law.The young women at the sector of society, but policy makers fail older people’s network, DEFAN, and centre help us a lot.’ to take them into account.Their social the government agreed to introduce a invisibility and the view that they are provisional documentation system, in seen as unproductive and dependent which older people who had no birth Guidelines on leads to violation of their rights. Many certificate could produce witnesses to abuse older people from indigenous groups testify to their approximate age.This are illiterate and do not speak Spanish, highlighted older people’s The centre has reviewed the effectiveness of the legal system which makes it harder for them to vulnerability, and showed what and health service, from the point defend themselves against abuse could be done by joining forces. of view of older people.This has or claim their rights under the law. highlighted a lack of provision for The government has made some Recognising rights dealing with elder abuse, and the important commitments to older The following year, DEFAN established centre has developed a methodology people, but without a concerted the Social-Legal Centre in La Paz. and drafted guidelines. effort by government and civil At the heart of the project is a The centre is developing a training society, these achievements will not recognition of older people’s right programme for older people on rights be implemented. In 1997, it to benefit from social services, and and leadership, and coordinating with introduced the bolivida, a universal the need for older people to be different organisations such as local pension.This provides only a small involved in development processes government, ministries, schools and payment once a year, but it makes and policies that affect them. colleges, and the police, to raise a difference to the poorest older awareness of older people’s rights people. However, the majority of The centre is housed in a room on loan and promote their involvement at older people could not claim it, from the bishop’s office. It is staffed by a higher level of decision-making. because they had no documentation. a multi-disciplinary team of social workers and students on placements, Contacts are now being made in four a part-time legal advisor, psychologist, more regions of Bolivia with a view and members of DEFAN. Its activities to replicating the centre. In future, it include individual socio-legal advice, is hoped that the role of the centre strengthening older people’s groups will change, as older people take on and networks, campaigning for more leadership roles, and public programmes for older people, carrying services assume their responsibilities out research, and raising awareness to this sector of the population. of older people’s rights. In a short time the centre has gained The centre is funded by the UK Department the support of a range of institutions, for International Development and the including local government and the European Commission through HelpAge police. In the past year, it has been International’s Active Ageing programme. used by 3,500 older people, mainly With thanks to Sonia Cuentis, from rural areas around La Paz, Social-Legal Centre including older people’s groups (email: [email protected])
Beatriz Lucero Amurrio/HelpAge International Amurrio/HelpAge Beatriz Lucero who have come for training in and Sarah Allen, HelpAge International Pedro Chambi values the chance to group organisation and income- Latin America Regional Development socialise and learn about the law. generating projects. Centre (address on page 15).
Ageways 59 7 VIOLENCE AND ABUSE
Dealing with abuse Everyone working with older people needs to be aware of the Taking action possibility of abuse.They need to be able to recognise and deal Those who abuse older people may with abuse, and know how to reduce the risk of abuse. do so for a variety of reasons. It is important to find out about and deal with the underlying causes of abuse. various reasons – illness (such as For example, relatives may be stressed Signs of abuse dementia or depression), side effects because they lack information or Abusers are often those close to an of medication, disability (such as training, or are too busy with other older person. Abuse may be taking blindness or mobility problems), or, responsibilities.The same can apply place in the older person’s home, particularly with older men, because to health workers or professional residential home, day centre or they do not know how to carry out carers. A carer may have been abused hospital. Abuse can take many forms domestic tasks. Neglect may also be as a child, and not know how else and show up in different ways. a result of poverty – because the to behave, or wish to ‘get their person cannot afford food or fuel. Physical abuse, which includes own back’. hitting and pushing, can result in Financial or material abuse includes If you suspect that an older person visible signs, such as cuts and bruises, stealing or using the person’s money may be at risk of abuse: perhaps broken spectacles, or a or belongings without their consent, change in the person’s behaviour. including moving into their home or Be vigilant Keep in touch with the Giving inappropriate medication selling their possessions. older person.Try to visit them or using physical restraint to keep regularly so that you can notice if a ‘difficult’ older person quiet is a Cultural abuse includes forbidding there are any changes in their form of physical abuse. people to speak their own language behaviour or appearance. or wear traditional clothes, or giving Sexual abuse means sexual contact of them food that they are not meant Speak out It can be difficult to any kind without the person’s consent. to eat for religious reasons. speak out against abuse.The person An older person may be too frail to you are accusing of abuse may be Structural or institutional abuse is resist, or feel too ashamed to report able to harm you.The older person a failure by the state and society to what has happened. Signs include experiencing abuse may be unwilling protect older people’s human rights. bruising in the genital area, discharge to talk about it, because they are If an older person is too poor to be or infection, and change in behaviour. too ashamed, or cannot accept that able to meet their basic needs for their son or daughter is neglecting Psychological abuse can take the form shelter, food and health care, they them or stealing from them, or they of isolating the older person, are suffering from structural abuse, are scared of making things worse. humiliating them, making fun of them, because everyone has a right to Make sure you know where to go or treating them like a child, including these. Structural abuse includes for support. ‘punishing’ them. Signs include crying, being denied the right to education, insomnia, confusion, being either very employment, legal protection, Work with others to oppose abuse passive or agitated, trembling, not participation in civil society and so Abuse of any vulnerable person, making eye contact, and looking on, because of age discrimination. young or old, is a violation of their scared or anxious. human rights. Learn about human For all forms of abuse, there are two rights and help others to do so (see Neglect may show up as malnutrition signs to watch out for and respond to: page 10). Find out what laws or or dehydration.The person may have if an older person tells you that they organisations you can use to promote chronic health problems, or look are being mistreated older people’s rights.Work with people uncared for (poor hygiene, uncombed if a carer – in the family or an in your community to set up groups hair, dirty or torn clothes). Older institution – refuses to allow visitors and networks to support older people people may neglect themselves for to see an older person alone. and raise awareness of their rights.
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Government Assist older people's groups to advocate for policies supporting their need for a dignified life, such as a universal social security system, and to press for laws protecting older people to be implemented.
Legal rights There are many legal instruments supporting the rights of older people. These include:
David Woodroffe/HelpAge International Source:Woodroffe/HelpAge David there is no artist Where Universal Declaration of Encourage older people to learn about their rights. Human Rights United Nations Principles for Older Persons Often the best counsellors are older Encourage the group to carry out Regional declarations – for example, people themselves. In Mozambique, awareness-raising campaigns directed the American Declaration of Human Tanzania and Peru, for example, older at families and the local community. Rights mentions the right to social people are trained as counsellors Families Share discussions that have security, and the duty of children to to support other older people taken place in the older people’s support and protect their parents (see page 16). group with families, so that they when they need it become aware of the messages and National constitutions – for example, treat older people with respect. the Peru constitution mentions the Avoiding abuse duty of the community and state to There are ways in which you can Local community Organise protect older people work with older people’s groups and discussion groups and campaigns. National and international laws. others to help reduce the risk of Stick up posters with slogans Adapted with thanks from Del elder abuse. promoting a culture of respect for older people. Organise activities with Maltrato al Trato Digno (From Abuse to Respect), a handbook in Spanish Individually Encourage older people younger age groups, such as school for counsellors produced by Centro to feel positive about themselves. students, to raise awareness of older Proceso Social, Peru. Centro Proceso People who love and respect people’s rights and contributions. Social trains older people as themselves are better able to stand Spread the news about older counsellors, supports the up for themselves and others. people's rights. development of older people’s Focus on the older person’s positive Institutions Develop a 'watchdog' groups, and encourages institutions qualities, involve them in the group, to promote older people’s rights. and give them responsibilities so group to ensure that older people are that they feel useful. treated well. Get the support of local More information: Luz Barreto Carreño, public and private institutions to set Programmes Director, Centro Proceso Groups of older people Get the up a local network to protect older Social, Av. Gerardo Unger 663 – San Martin de Porres, Lima, Peru. group to think about the poor people, and offer them help to do so. Email: [email protected] treatment that older people receive. Get them to commit themselves long- Additional information from American Promote the idea that everyone term, and to establish mechanisms Association of Retired Persons website: deserves to be well treated. Support and resources to protect older http://www.aarp.org/confacts/health/ those who have been abused. people’s rights. avoidabuse.html
Ageways 59 9 VIOLENCE AND ABUSE
Finding out about abuse
The following exercises can be used to raise awareness Pass round copies of the Universal of older people’s rights, and to find out if older people Declaration of Human Rights (see page 12). Use the following questions are being denied their rights. to prompt discussion: