Assaults on the Elderly

“Horrendous and unfathomable” is how the police described alleged attacks on 5 elderly residents with dementia by a care giver in a NSW aged care centre on the south coast. Many thanks to the staff members who had the courage to report the abuse because that has forced the facility to take appropriate action. It is unfortunate that the aged care industry keeps appearing in the news for the wrong reasons but, is it really that bad in aged care? I don’t think it is. Still, one incident is one too many because old people are human beings who feel pain and their family members also feel pain and guilt for being unable to provide the necessary care. In spite of the story, I truly believe that elderly people are safer in an aged care facility than at home because assault and abuse happen at home too. The nation needs to come up with solutions for this problem.

I believe that elderly people are safer in an aged care facility because they always have someone to look after them there whereas at home they are alone most of the time. Although I am an advocate for aging in place, I know that family members are not always available to look after the elderly and they do not have the necessary skills. Family and community members must step up in many ways to make homes safe for old people as what was asked of them under the NDIS.

I can never endorse abuse of elderly people like what has been reported recently. However, everyone must ask these questions:

Is assault per capita higher or lower in aged care than in the general population?

Do assaults tend to be more violent in the aged care sector than in the general public?

Is abuse and assault on the aged reported more in residential facilities than at home including those who are aging at home without aged care services?

The nation needs answers so that we can get better at identifying the problem and intervening early to stop the assault on the elderly. In fact, we should focus on the broader problem “abuse.” Assault is simply "Direct (and immediate/confrontational) infliction of force, injury or violence upon a person or persons or the direct (and immediate/confrontational) threat of force, injury or violence where there is an apprehension that the threat could be enacted.” (ANZSOC, 2011). In the case The Queen v Phillips (1971) 45 ALJR 467, it was held that an act that causes fear or apprehension of unlawful injury – without physical contact – can constitute assault. In NSW, the maximum sentence for assault without causing injury is two years in prison [Crimes Act 1900 (NSW) s 61]. Abuse has a wider meaning since it includes physical assault, sexual assault, verbal abuse, emotional abuse, withholding of assistance, neglect and financial abuse. It is time for the current narrow definition of abuse of elderly people to be expanded.

The recent assault took place in an aged care facility and such facilities have received a bad name in the past few years and hopefully something is going to be done about that. What is not as well-known is abuse at home. The elderly living at home are just as much at risk, if not more at risk, of abuse by family, friends and general public. At least aged care facilities are accountable and they will take action to stop the abuse if it is reported. But at home, the abuse is not easy to see and the affected person may not have the means to report it especially if the phone is hidden to prevent communication! Assault at home can be include inappropriate handling or providing care in a cruel or rough manner or sexual assault. Then there are various forms of physical abuse such as withholding needed care in exchange for sexual favours, removing resources such as wheelchairs, plus financial abuse, emotional abuse and neglect.

I am sure all Australians are wondering why the assaults in the story continued for two months without being reported even though guidelines for reporting do exist. In my opinion, the aged care service provider should have 96 hours, now that the charges are laid, to give the 'Watchdog' a without-prejudice snapshot of what worked and what did not work to allow this to happen over such a long period of time. Then the “Watchdog” should design an alert bulletin to all service providers so that they can check out what is happening in their facilities and make sure that no such abuse or assault is taking place in their facilities. Since the ‘Watchdog’ is required to improve quality and safety essentially through compliance, the alert bulletin becomes a tool that they can refer to when reminding service providers about compliance.

We should not second-guess the concerned aged care service provider here per se since they took swift action against the staff member once they became aware of the assault. We can accept that no matter how much we all try to care for people, there will always be a bad apple somewhere in the system. What we should all do is to check all our facilities and all our systems to make sure we have a safety net in place in case a good apple starts to become rotten.

We also need the ‘Watchdog’ to be tough and to keep an eye on the industry and ensure that all service providers conform to the set standards of care. It is hoped that the Royal Commission on Aged Care Quality and Safety comes up with recommendations for those standards of care and that government will implement those standards in the form of policies. Then the ‘Watchdog’ can enforce those standards and have stiff penalties for any service provider who does not comply. They can work closely with communities so that they can report any assault or abuse of the elderly in their areas. Yes. we all know the new standards are coming 1 July but will they really resolve the matters at hand.

Abuse of elderly people either at home or in a facility is not acceptable at all. Australia must plan and implement a long awareness campaign to conscientise Australians about the plight of old people. The campaign should include public dialogue about respect for life and human rights of the elderly. If we can learn to love and accept people even when they are frail and need help, then we can never get to the stage of abusing them.