The 'A' word: saying NO to disability and elder abuse

by Paul Russell:

We talk about 'human nature' as code for our base instincts and actions of the lowest kind and, paradoxically, also as an appeal to the highest of human ideals as a remedy. But it is an inescapable reality that not every person acts or will act at all times with the best intentions towards others.

No-one can deny that abuses do happen. We live in a less-than-perfect world that requires vigilance as well as the creation and application of laws that frown upon abuse while, at the same time, creating penalties for those who do abuse.

Laws are no guarantee against abuse. Laws create a pause for thought, a penalty for those who transgress and an opportunity for education; they are absolutely necessary - but they cannot replace sound social norms and good behaviour.

It is in that context that the Victorian and New South Wales Parliaments recently reported on their inquiries into disability abuse and elder abuse, respectively. The Victorian report looks into abuse of people living with disabilities in and by those working in disability services and their clientele.

The Greens Party are also calling for a Royal Commission into 'abuse, violence and neglect' of people living with disabilties. In November 2015, the Senate Standing Committee on Community Affairs tabled its report into disability abuse, also recommending a Royal Commission.

'The committee is convinced that violence, abuse and neglect against people with disability is widespread and is occurring across all Australian communities. At the heart of this mistreatment are questions as to how our society views people with disability.' (Senate Report finding 3.65)

And this observation from one submission: 'People with disability are painted as being 'less than' in Australian culture, and our lives are consequently regarded as less, and 'other'.' A clear marker that their needs to be both a legal and social response.

The Report to the Victorian Parliament echoed their Senate counterparts in calling for a Royal Commission. In a section covering personal stories and testimony before the committee, the Executive Summary observes: "These devastating accounts provide the substantive evidence of the widespread nature of sexual and physical assault, verbal abuse, financial abuse, and neglect that have occurred across the disability sector, and continue to occur. The Committee also heard about the link between neglect and unexplained deaths."

The committee also addressed 'the experiences that people with disability, their families and carers have had when disclosing or reporting abuse. The Committee found that a number of factors contribute to an increased risk of abuse for people with disability, including gender, age, type of disability, type of accommodation, and cultural background.'

They also identified the key reasons that frustrate and perhaps reduce the reported incidences of abuse:

'The Committee heard that people with disability and their families face barriers when seeking to report abuse. Barriers to reporting include: a fear of reprisals from service providers; a belief that allegations of abuse will not be taken seriously; and a lack of accessible knowledge about how to make a report.'

Families told the Committee about their frustration with the process of reporting and the emotional toll of pursuing complaints across a number of different agencies with little prospect of resolution. The Committee heard that disability support staff also face barriers to reporting abuse, and require increased protection from reprisals.

This is all so desperately sad both for people living with disabilities but also for their families in the struggle to protect their loved ones in environments where, as stated above, the culture acitively works against them.

This is where the connection between disability abuse, both generally and in disability services, can be seen in respect to elder abuse.

While financial elder abuse remains the most common form of abuse (what the committee called: 'inheritance impatience') the NSW Parliamentary Committee also heard of other forms of abuse; often in tandem with financial abuse. For example: the report is critical of some elements of the legal profession:

"The committee takes very seriously the allegations that some lawyers unwittingly - and in some cases deliberately - facilitate financial abuse. There is a need for action to improve legal practitioners' assessments of people's mental capacity, and some lawyers also need to devote more time to ensuring that the parties to wills, enduring powers of attorney, contracts of sale and other financial transactions understand the implications of the documents they are about to sign. The evidence before us has highlighted the weighty responsibilities that the law confers on lawyers here, the complex issues of which they should be aware, and the substantial risks of not exercising their duty as carefully as they should."

The report quotes a Ministerial Advisory committee commenting on 'ageism'; defined as, 'negative community attitudes towards older people and allows elder abuse to go unreported and unrecognised'. There are clear parallels here with what the disability community call 'ableism'; disability here also being further noted:

"Ageism, when combined with other domains of disadvantage, such as poverty, disability, and cultural and linguistic diversity, may put some older people at greater risk of becoming victims of abuse. As ageist attitudes become entrenched in our culture, older people may internalise feelings of low self worth, become more passive and feel more dependent. Such perceptions can lead to an older person believing that they deserve to be treated more poorly than others and avoid speaking up when experiencing abuse from family members or a caregiver. Many older people may not be willing to report elder abuse because of the isolation that comes from a lack of self esteem and a feeling of invisibility. Ageism can also affect our understanding of the prevalence and severity of elder abuse and cause many instances of abuse to go unnoticed."

Ms Meredith Lea, Project Assistant in Violence Prevention with People with Disability Australia, 'emphasised (to the committee) the overlap between ageing and disability, suggesting that 'ableism' and disability discrimination are also drivers of elder abuse':

'Firstly, it is essential to understand that violence against older people is heavily shaped by ableism and discrimination against people with disability. Elder violence is frequently enabled by the deprivation of autonomy, agency and rights that becomes possible as people acquire disability, including being forced into residential facilities rather than ageing in place and substitute decision makers being appointed. People with disability have been fighting to have their rights, agency and autonomy recognised for many decades, often in the face of ongoing human rights violations.'

The Report includes some case studies and further references to personal stories made in submissions. Comments include evidence of professionals such as lawyers, doctors, bank staff etc. who failed to question the capacity of the elderly person to understand and to agree to what happening to them; allowing transactions, wills etc. to be executed in favour of abusers.

In both disability abuse in care and in elder abuse, as both reports note well, the response must include legal penalty and remedy. As we observed earlier, however, community awareness and working to build social cohesion is also essential as also outlined in the reports' recommendations.

Council on the Ageing (COTA) NSW called for a community education campaign aimed at helping people to understand the dimensions of elder abuse:

'Can government legislate against elder abuse? No, because it will happen behind closed doors whether it is there or not. What the Government can do is provide funding for campaigns. There is an education campaign which is necessary. We have very small numbers that are calling the helpline in reality when there is an issue there. There needs to be a far greater understanding of what elder abuse is, what causes it, what happens and what the abuser is doing. That is for the abuser as well; they need to understand.'

No, we can't legislate good behaviour. There's a very real need for not only a human rights based recognition of the rights of the aging and the rights of people living with disability, but also education and social structures that connect or reconnect communities. This cannot be simply a longing for a long-past 'better time'; it must embrace new and dynamic engagements in a world that seems increasingly atomised and time poor. The recent media release from the Victorian Government on elder abuse offers us a salient 'last word':

"Council home carers, community organisations and health centres, men's sheds and health workers will be among the participants of a program to mobilise the power of locals to help older victims, deter perpetrators and identify the signs of abuse."

"We want to take prevention to where older Victorians meet and to the people who interact with them the most. We want them to know they will be supported and understood, and that help is at hand."

The Reports:

PARLIAMENT OF VICTORIA Family and Community Development Committee Inquiry into abuse in disability services.
PARLIAMENT OF NEW SOUTH WALES Legislative Council General Purpose Standing Committee No. 2 Elder abuse in New South Wales
FEDERAL PARLIAMENT Senate Standing Committee on Community Affairs Violence, abuse and neglect against people with disability in institutional and residential settings