A critical evaluation of ageism within policy and practice is needed in order for the sector to effectively tackle elder abuse, an advocacy group has said.
Aged Rights Advocacy Service residential projects manager Brenton Pope told Australian Ageing Agenda that often there was little consideration or acknowledgement as to how ageism or beliefs and opinions about older people impacted the recognition and response to elder abuse in residential aged care.
Mr Pope, speaking ahead of his presentation at the National Elder Abuse Conference in February, said while there was mandatory reporting of sexual and physical abuse within residential aged care, in some cases staff did not report as they did not recognise signs of abuse.
Looking at the example of physical abuse, he said staff could often assume a resident may have bruises from falling over and would not investigate how the bruises occurred. In cases of sexual abuse, staff may discount the reality of abuse occurring due to assumptions about older women’s attractiveness or a mistaken belief that sexual assault only happens to younger women.
Mr Pope said often beliefs such as these were subconscious, and people could only become aware of them and start to change their behaviour when they were specifically addressed and talked about openly.
“If we really want to address this effectively, I believe we need to have some process of critically examining those beliefs,” said Mr Pope.
Mr Pope said this needed to take place at organisational level, with an investigation of how certain beliefs may impact existing policies and procedures around elder abuse. There also needed be assessment of staff in order to develop targeted education and training, he said.
However, Mr Pope also made a distinction between ‘overt’ and ‘covert’ forms of elder abuse, and noted that while the sector generally recognised overt abuse was problematic and needed to be addressed, covert abuse was normalised and often deemed to be acceptable and appropriate.
Overt forms of abuse referred to situations that were commonly associated with elder abuse, such as physical, psychological, social, financial abuse and neglect.
Covert abuse, on the other hand, referred to policies and procedures that restricted residents’ human rights and ability to make decisions for themselves. This may refer to things such as not being able to leave the facility unaccompanied, a lack of ability to make choices around what they ate or activities they did, or the choice to have certain appliances or objects in their room. Mr Pope said often these restrictions had no rationale except that people were ‘old’.
Mr Pope acknowledged that in some cases, such as where a resident had dementia, a facility may need to take certain measures for safety. However, he said often restrictions were applied across all residents, such as in blanket bans on certain items, rather than based on individual assessment or merit.
“In the vast majority of cases we are dealing with, there’s no question of the facility being able to fulfil its duty of care while still respecting that person’s self-determination and their right to make autonomous decisions,” he said.
He argued in some facilities there was a disconnect between ideal of person-centred or consumer-directed care and practice. Mr Pope said restrictive policies and procedures were often dehumanising and had significant impact on residents’ quality of life.
In addition, Mr Pope noted that when staff, residents or family members questioned the legitimacy of these practices they were often labelled as ‘troublemakers’, or worse, bullied or intimidated. He argued management needed to consider policies and procedures from the perspective of people they served.
“It is time to pause and reflect, and completely look at a paradigm shift as to how these things are considered,” he said.
Mr Pope suggested that when putting a policy or procedure in place, facilities could apply a variety of questions in order to examine that policy from the perspective of potential ageism. Examples of such questions included:
• If this policy was applied to me personally, would I be comfortable with it?
• If I encountered these restrictions in my own home, would I be comfortable with complying to them?
• Would I be comfortable if the same policy was applied to younger people?
• If I were to apply this policy to a particular racial group or gender, only on the basis of their race or a gender, would it be considered to be socially appropriate and acceptable?
The 4th National Elder Abuse Conference will be held on 23 – 25 February in Melbourne.
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