Applying an Equity Framework to Elder Abuse Awareness, Prevention and Response

Editor’s Note: This column is spon­sored by the AARP Thought Leadership and International team. Thought Leadership and International seeks to position AARP as a global thought leader by identifying emerging trends around the world, cultivating and elevating new ideas and sparking new solutions that empower people around the world to make the most of a longer and healthier life.

The preamble of the United Nations’ Universal Declaration of Human Rights testifies to an abiding “faith in fundamental human rights” and “the dignity and worth of the human person.” Unfortunately, for many older persons around the world, these rights are threatened by various forms of maltreatment, commonly known as elder abuse.

The World Health Organization defines elder abuse as action or lack of action that occurs “within any relationship where there is an expectation of trust, which causes harm or distress to an older person.” Elder abuse takes many forms, including emotional, sexual, psychological, physical and financial, as well as abandonment and neglect. Too often, polyvictimization occurs, when individuals endure more than one form of abuse.

Older persons who have suffered abuse may have higher rates of depression, hospital admission, nursing home placement, mortality and even suicide. A 2017 analysis from 28 countries found that one in six older persons were subjected to abuse. Sadly, this often-silent global public health threat reportedly has only increased during the COVID-19 pandemic.

A Response Centered in Equity 

COVID-19 has killed thousands of older people around the world and disproportionately impacted the most vulnerable among us. The virus has exposed and exacerbated the toxic intersectionality between compounded inequity and ageism. The United Nations Policy Brief on COVID-19 and Human Rights speaks of the “high levels of inequalities”—that—“fuel its spread,” as well as the ageism in public discourse that the pandemic has unleashed. This tragedy is felt acutely by the forgotten victims of elder abuse and gender-based violence.

Often missing from the conversation on elder abuse and gender-based violence against older persons is intersectionality and equity. The weight of compounded inequity is acutely felt by those who are marginalized due to their age, race, gender, sexual orientation, economic status, religion and/or other social identities. Marginalized older persons are more isolated and may experience violence at higher rates. However, they do not often have the knowledge or means to access traditional legal and social service protections.

Older Women Are Often Forgotten

As the United Nations Policy Brief on the Impact of COVID-19 on Older Persons states, “Since the outbreak of COVID-19, there have been widespread reports of increased rates of violence against women, and particularly intimate partner violence, exacerbated by lockdown conditions.”

‘Current societal systems are not responsive to the intersecting needs of marginalized older women.’

This violence against women also exists in group settings like camps for displaced persons where—without large-scale protections—women are acutely at risk for gender-based violence. Older women are often overlooked within systems that seek to identify and safely respond to abuse, neglect and exploitation of women. Such invisibility leaves older survivors of trauma in a cycle of violence that remains unchecked. The National Center on Elder Abuse (NCEA) highlights that previous experiences of trauma may increase risk of emotional, sexual and financial abuse.

According to the UN Policy Brief cited above, policy reforms addressing these inequities must “incorporate the needs and rights of older persons, especially older women.” Unfortunately, current societal systems are not responsive to the intersecting needs of marginalized older women.

Codifying Human Rights and Dignity

Fortunately, frameworks concerning older people’s human rights have been developed in the international arena.

Adopted at the Second World Assembly on Ageing in 2002, the Madrid International Plan of Action on Ageing set an objective to eliminate all forms of neglect, violence and abuse.

The African Union, meanwhile, adopted a Protocol to the African Charter on Human and People’s Rights on the Rights of Older Persons in Africa. The protocol calls for an end to “harmful traditional practices targeted at older persons.” Such practices can include widowhood rites that strip older women of their assets and property.

Finally, the Organization of American States adopted the Inter-American Convention on Protecting the Human Rights of Older Persons, which declares older people have a “right to safety and a life free of violence of any kind.”

These important frameworks are a step in the right direction. However, older persons remain the only at-risk group lacking a legally binding international instrument.

Words Become Action

Fighting elder abuse requires everyone to work together; the Madrid Plan encourages cooperation between government and civil society to address it. In that light, it is widely recognized that effective interventions are multidisciplinary. The NCEA highlights various types of multidisciplinary teams tackling the issue. Effective multidisciplinary team models include stakeholders from the fields of law enforcement, social services, healthcare, legal and others.

The U.S. Departments of Justice and Health and Human Services, meanwhile, worked with stakeholders to launch the Elder Justice Roadmap, which provides a strategic framework focused on direct services, research, policy and education. The Roadmap identifies major priorities for reducing the prevalence of elder abuse, including increasing public awareness; conducting research and enhancing the focus on brain health; providing better support for caregivers; quantifying the economic impact of abuse; and investing in resources to reduce abuse.

The United Nations has declared 2021–2030 to be the Decade of Healthy Ageing. A focus of the Decade is to create age-friendly environments where older persons can “age safely, continue to develop personally, and contribute to their communities.” The maltreatment of older persons, in all its insidious forms, is a mortal threat to healthy longevity and the building of such a community. Equity and the inclusion of older people must be at the center each country’s social and economic response to “build back better.”

Dr. Elizabeth Podnieks, founder of World Elder Abuse Awareness Day, once said, “There is a need for extraordinary leadership, clarity of vision and complete commitment in knowing that in a civil society, each person can and must resolve to do better, be stronger, to reach further, to find solutions.”

These words must translate to actions to preserve the dignity and worth of every older individual.

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Ben F. Belton is director, Global Partner Engagement, at AARP International in Washington, DC. Tovah Kasdin is director, ElderSAFE Center at Charles E. Smith Communities in Rockville, MD.