Australia’s most comprehensive research study into the sexual assault of older women has recommended the mandatory licensing of care workers and a review of aged care standards to include a focus on prevention.
The three-year study conducted by researchers from La Trobe University is the first and most in-depth account of this issue to date.
Led by Dr Catherine Barrett from La Trobe’s Australian Research Centre in Sex, Health and Society, the research included surveys and interviews with family members, aged care service providers, police and sexual assault agencies.
The researchers said that while it was difficult to estimate the overall prevalence of sexual assaults of older women aged 65 years and over, it occurred in a wide range of domestic contexts, settings and relationships and, like most sexual assaults of adult women, was largely unreported.
In 2012, the former Department of Health and Ageing received 378 notifications of alleged unlawful sexual contacts in residential aged care facilities, although it is not known how many of these were substantiated.
While the authors acknowledged that the majority of sexual assaults occurred outside of institutional care, they said the responses of the aged care sector to this issue was critical.
As a prevention strategy, the authors called for all care workers in aged care to be registered by the Australian Health Practitioners Regulation Agency. They said this would bring the aged care sector into line with other comparable health workers who hold positions of authority and trust.
As AAA reported last year, Australia’s health ministers decided against extending national registration to personal care workers, but committed to introducing a national code of conduct after a lengthy review. The Australian Health Ministers’ Advisory Council report handed to ministers said a national code of conduct was cheaper and would deliver similar benefits as expanding the National Registration and Accreditation Scheme.
Participants in the study also raised the merits of pre-employment screening for aged care employees. To prevent perpetrators targeting older women by moving from facility to facility or from service to service, many participants identified the need for a ‘vulnerable persons check’ similar to that undertaken for those who work with children. Currently in Australia, only the Australian Capital Territory operates a Working with Vulnerable People Background Check.
Mandatory reporting of assaults
On the contentious issue of mandatory reporting of sexual assaults within residential aged care, the authors noted that while a number of individuals and groups support a change to mandatory reporting for all suspected assaults (including those perpetrated by residents with cognitive impairment), there were also genuine concerns about the erosion of older people’s rights to make their own decisions.
The authors said legal and elder abuse advocates have argued that mandatory reporting policies place older people in a different situation to other victims of sexual assault who have the right to choose whether to report to the police or not. The authors said there were tensions between paternalism and autonomy that needed to be carefully balanced.
Other recommendations included strengthening screening protocols for sexual assault through Aged Care Assessment Services and a training program for all aged care staff on the risks of sexual assault and prevention as well as older people’s sexual expression. The study also called for improved research, collaboration and an evaluation of aged care reporting systems and intervention strategies.
Age Discrimination Commissioner Susan Ryan welcomed the report and described it as pioneering work.
“The authors have done all older women a service, first by telling the stories and drawing attention to the dangers of this violence and the circumstances in which it occurs, then by recommending a research approach and designing a framework for action that includes community education, training of carers and new systems for effective vigilance and protection,” she said.
The study called Norma’s Project was named after Norma, an aged care resident who was sexually assaulted by an aged care worker at age 84.
Read the full report ‘Norma’s Project: A research study into the sexual assault of older women in Australia’.