World Elder Abuse Awareness Day: India’s elderly suffer in silence

Elder abuse rising in India, says survey

Society

June 15, 2021

/ By / Gurugram

World Elder Abuse Awareness Day: India’s elderly suffer in silence

Senior citizens engage in recreational activities at Mann Ka Tilak, an NGO old-age home (Photo: Wishes and Blessings)

To mark World Elder Abuse Awareness Day, experts weigh in on the causes of India’s increasing reports of elder abuse, and the steps to be taken to overcome the stigma of speaking out against ill treatment.

The Longitudinal Ageing Study in India (LASI), a national survey conducted by an autonomous organisation of the Ministry of Health and Family Welfare (MoHFW), found that 1 in 20 people aged 60 or above had experienced ill-treatment in the last year, most often from their own caretakers.

The World Health Organisation (WHO) defines elder abuse as “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.”

LASI says that the most prevalent form of abuse in India was verbal or emotional as reported by 77.3 pc of respondents, while  26.5 pc complained of economic exploitation and 23.7 pc also reported physical abuse.

Wishes and Blessings, an NGO in South Delhi, started Mann Ka Tilak in 2018 to help elders who had been abused, neglected and abandoned by their loved ones. They provide essentials such as lodging, medication, entertainment and yoga, free-of-cost to senior citizens from all walks of life. Dr Geetanjali Chopra, president of Mann Ka Tilak, explains that MKT takes in a limited number of people to ensure a higher quality of care.

“Our model for running this home is a little different, because usually these homes seem to be more like a dump yard where elder people are just put together, whereas we work on their quality of life rather than quantity and try to give them give them a life and atmosphere where anyone, even you and I, can feel at home,” Dr Chopra tells Media India Group.

After being abandoned by loved ones, residents at Mann Ka Tilak find solace and a new lease of life in a community space that looks after their needs (Photo: Wishes and Blessings)

She says abuse is something most of the elderly persons she had spoken to had suffered in one way or another, often through neglect and disregard of their needs.

“The value systems and cultural traditions of the country are getting eroded. Every individual has had their own sets of trials and tribulations before coming here. Some may have been denied basic necessities like milk or fruits, or in other places they didn’t have access to medicines. One lady had never been to a doctor before even though she was suffering from several ailments,” she says.

Dr Debanjan Banerjee, a practicing geriatric psychiatrist based in Bangalore, frequently encounters stories of elderly abuse, from subtle to major issues.

“The first thing that comes to mind is physical abuse, but actually that is the least common and actually happens mostly in institutional settings or rehab centres. Verbal or emotional abuse through acts of omission, specifically that destroy the relationship of trust between the older person and the perpetrator, are the most common. Ageist tendencies like calling them names, cheating them financially, denying quality or timely food or medication, assistance for walks all have a damaging effect on the senior person’s mental and physical well-being,” Dr Banerjee tells Media India Group.

In its 2016 report, the International Network for Prevention of Elder Abuse (INPEA) listed India as the leading Asian country in elder exploitation and abuse, a finding that may seem ironic and almost unbelievable for a country that seemingly values family honour and values above all. However, experts believe that the changing social structures, such as more women in the workforce, and lifestyles of younger generations have naturally aggravated the situation.

“Earlier there were many members in a joint family to give sufficient attention to the elderly, but now families have become smaller and all the children are working. There is a considerable gap between the younger and older generation, in terms of what is expected from old parents and what can be provided,” Professor T.V. Sekher, principal investigator at LASI, tells Media India Group.

According to the 2019 United Nations report “World Population Ageing” report, the number of Indians aged 65 or above will increase rapidly by 2050.

“The number of older adults financially or physically dependent on the younger population has increased. More importantly, the number of people suffering from dementia is increasing and many caregivers are burnt out or don’t understand how to take care of them,” says Dr Banerjee.

The situation has also been worsened by the sudden social isolation during the Covid-19 pandemic and lockdown, with increasing cases of the elderly reporting emotional distress and abuse as more people get stranded in their rooms and have to spend more time with their families. Sadly, this abuse is often not overt or intended, which makes the issue even more impenetrable.

“Let’s say a 70-year-old person whose only recreation in a day was taking a walk and that was the time he used to meet his friends, but suddenly one day somebody comes to him and says ‘Papa you will not go out anymore because it’s not safe.’ While that is done in his best interest, it does not involve him in the decision-making. That is also a form of abuse in a way because it’s a deprivation of autonomy for the person, which is very important in old age,” Dr Banerjee explains.

Aside from the statistics, one of the most pressing problems, experts believe, is gross under-reporting, especially in rural areas, where most do not have access to the law and are unaware that abuse cases can even be reported.

“What we captured in our surveys is only a portion of the real abuse, because when you go to households to interview the elderly, they are hesitant and reluctant to reveal what is happening inside the house as they fear it may create more problems for them if other family members come to know, and they may be further harassed,” says Professor Sekher.

One of the most important legislations against elder abuse in India was passed in 2007, known as the ‘Maintenance and Welfare of Parents and Senior Citizens Act,’ which was made to ensure that senior citizens can demand maintenance and care from their children if unable to do so themselves.

“It has several important provisions, for example if they find the children are abusing them even after inheriting the family property, there is a provision to reverse the finances to the old parents, but per our survey, only 15 pc of the elderly had even heard about this act,” says Professor Sekher.

Therefore, the most pressing resolution is to improve public awareness of elder abuse in the country, so that more senior citizens have the resources to call for help. Dr Banerjee also believes that educating the public, especially health workers, is essential to catch subtle or hidden instances of abuse. He explains that changes must be made at the individual, community and national level (public policy).

“In private clinics and government or tertiary health centres, there needs to be a screening for elder abuse, because we will only know if we ask. At the grassroots level, primary physicians and multipurpose health workers who do home-based care need to be taught about the common signs and symptoms of elder abuse,” says Dr Banerjee.

Although there are laws in place, doctors believe the implementation still needs work and stringent punishment is required for severe cases.

“Elder abuse in any form is a social evil, and it is not just the responsibility of healthcare workers, the legal system is also important.  Community programmes and enhanced routes of reporting are required, for example if neighbours spot something, or the victims themselves should easily be able to report to the police or call helplines,” he adds.

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