Elderly Abuse Issue in India

Elder abuse – An emerging scourge in India

Shashikantha SK, Harashish Jindal*, Bhumika Bhatt

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In the 21st century, health is determined by broad social trends. Economies are globalizing, more and more people live and work in cities, family patterns are changing and technology is evolving rapidly. Today, the population of the world is going through a demographic transition with increase in life expectancy. Soon, the world will have more elder people than children and increasing the dependent population than ever before.

The global share of older people (aged 60 years or over) increased from 9.2 per cent in 1990 to 11.7 per cent in 2013, is estimated to double, reaching approx. 21.1 per cent by 2050. Maximum number of older persons about two-thirds live in the low and middle income countries. By 2050, nearly 8 in 10 of the world’s older population will live in the less developed regions. ^1,2

The timeless phenomenon of inter-personal violence has, in the latter part of the 20^th century, been framed within age-specific compartments. Societally hidden, but manifest in literature, child and wife abuse were the first to emerge. Both types of abuse were framed as family violence issues and were originally referred to as baby battering and wife beating respectively. Eventually, the problem of elder abuse (which was initially called “granny battering”) evolved. Elder Abuse is 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”. It can be of various forms: physical, psychological/ emotional, sexual, financial or simply reflection of intentional or unintentional neglect ³

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The growing world-wide focus on the abuse of older people since then has sought to parallel the focus upon human rights, gender equality and especially population ageing.

There is scarcity of information regarding the extent of abuse in elder populations. Very few population-based studies have been conducted, but suggest that about 4% to 6% of elder people have experienced some form of abuse at home. There is also pretty much risk of abuse in institutions such as hospitals, nursing homes and other long-term care facilities. A survey conducted in the United States, showed that, about 36 % of nursing-home staff reported having witnessed at least one incident of physical abuse of an elderly patient, 10% of them have committed at least one act of physic0al abuse themselves, and 40% had psychologically abused patients.⁴

India is growing old! The stark reality of the ageing scenario in India is that 8.3% of the total population in India is aged 60 years and above.⁵ Continued progress in life expectancy contributes to the increase in the proportion of older people, as more individuals survive to ever older ages. In India the life expectancy at birth is 67.3 and 69.6 years for males and females respectively in the year 2011.⁶ However, this transition has put considerable pressure on all aspects of care for the older persons – be it financial, health or shelter.

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There is growing realization among older persons that they are more often than not, being perceived by their children as a burden. As Indian culture supports value based, joint family system so old Age has never been a problem here .Indian culture teaches of being respectful and supportive towards elderly. Due to this, elder abuse has never been considered as a big problem in India and has always been thought of as a western problem. However, the coping capacities of the younger and older family members are now being challenged and more often than not there is unwanted behavior by the younger family members, which is experienced as abnormal by the older family member but cannot however be labeled. ⁷

Elderly who are co-residing have felt due to the changes in lifestyles and generation gap issues of marginalization, isolation and insecurity have risen among the older persons. Increase in life expectancy results in chronic functional disabilities creating a need for assistance required to manage chores as simple as the activities of daily living. Earlier, the lady of the house have looked after the older family members at home but now with women participating in activities outside home and following their career ambitions, have also led care of the elderly to take a backseat.

In India, it has been documented, more than one fifth of the elderly(23%) have experienced elder abuse and every 7 out of every 20 elderly are reported to have been victim of the same on a daily basis. The daughter-in-law and son being the primary perpetrator of abuse. The most common form of abuse experienced by elderly are disrespect (79%) followed by verbal abuse (76%) and neglect( 69%), and (39%) beating/slapping. The major reasons cited by the elderly, for prevalence of elder abuse are lack of adjustment, economic dependency and increasing longevity. ⁸ Many studies have concluded that there has been an increased prevalence of psychological illness particularly depression and dementia among these victims.^9-12 This is not only lowers quality of life among the elderly but also makes it hard to live an independent life.

Conclusion

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With the non-deserved abuse by the young, there has been a constant increase in old age home all across the globe but the quality of life is not what they yearned for. They deserve the respect and honor which is now seen to be lost some where in the glamor of the world. In India, though elderly have been respected in the past but with cultural transition elder abuse has emerging to be a big problem. There is an urgent need to address the issue and requires a multisectoral and multidisciplinary approach with strict laws against the perpetrators. However, inculpation of love and respect towards elderly, right from the childhood is the prime need, to reduce the generation gap and thus to reduce the elder abuse.

References:

1. World Health Organization. Good Health Adds Life to Years-Global brief for World Health Day 2012. Geneva: World Health Organization; 2012. Available from: http://whqlibdoc.who.int/hq/2012/WHO_DCO_WHD_2012.2_eng.pdf.
2. United Nations. World Population Ageing 2013. New York: Department of Economic and Social Affairs, Population Division, United Nations; 2013.
3. HelpAge India. Report on Elder Abuse in India 2012.HelpAge India;2012 Available from: http://www.helpageindia.org/about-us/reports-a-surveys.html
4. Factsheet: Elder maltreatment.World Health Organization;2011 Available from: http://www.who.int/mediacentre/factsheets/fs357/en/
5. Officer of the Registrar General & Census Commissioner, Director of Census Operations India. Census of India 2011. New Delhi: Ministry of Home Affairs, Government of India; 2011. Available from http://www.censusindia.gov.in/vital_statistics/srs/Chap_2_-_2010.pdf.
6. Ministry of Health and Family Welfare, Press Information Bureau. Press note: Life expectancy increases by 5 years in the past decade Government increases health sector allocation by 335% to Rs 3 lakh crore in 12th Plan, 27Jan2014. New Delhi: Press Information Bureau, Ministry of Health and Family Welfare, Government of India; 2014. Available from: http://pib.nic.in/newsite/PrintRelease.aspx?relid=102772.
7. Soneja S. Elder Abuse in India. Report for the World Health Organization. 2001
8. HelpAge India.Elder abuse in India 2013. New Delhi.Helpage India;2013
9. Dyer CB, Pavlik VN, Murphy KP, Hyman DJ(2000). The high prevalence of depression and dementia in elder abuse or neglect. J Am Geriatr Soc.;48(2):205-8.
10. Dong X, Simon MA, Odwazny R, Gorbien M2008.Depression and elder abuse and neglect among a community-dwelling Chinese elderly population. . J Elder Abuse Negl.;20(1):25-41.
11. Kraaij V, Arensman E, Spinhoven P2002. Negative life events and depression in elderlypersons: a meta-analysis. J Gerontol B Psychol Sci Soc Sci.57(1):P87-94.
12. World Health organization. The Toronto declaration on the global distribution of the elder group. Geneva:WHO;2002.