Elder abuse is a single or repeated act, or lack of appropriate action, occurring within a relationship where there is an implication of trust, which results in harm or distress to an older person. It can include acts of physical, financial, psychological, social and sexual abuse, as well as neglect. Elder abuse is often from an adult child towards their parent (National Ageing Research Institute 2015).

Some older women also experience long-standing and continuing intimate partner violence or violence within a new relationship.

Little evidence is available about the prevalence of elder abuse in Australia but it is estimated to be between 2 and 10% of older Australians. It is likely that the actual figure is higher due to under-reporting (Kaspiew et al. 2016).

This is because many older people do not recognise their experience as elder abuse or they can be reluctant to report for fear of losing family relationships. Further, a lack of understanding by service providers of the factors and nature of elder abuse can create missed opportunities to provide support (State of Victoria, Royal Commission into Family Violence 2014–16).

Elder abuse has been shown to lead to an increased risk of depression and can increase the risk of ill-health and early death. It can also mean an increase in hospital visits or early admittance to residential care (Seniors Rights Victoria 2018).

About the project

The Victorian Royal Commission into Family Violence found that older people who experience elder abuse are largely invisible to the family violence service system, and do not have their abuse recognised or addressed within broader health sectors. Consequently, elder abuse is under-reported, unrecognised and not adequately responded to.

In particular, the Royal Commission noted that health professionals are in a unique position to identify family violence by detecting common warning signs or sensitively asking questions that will help uncover it. Once identified, it is crucial that the violence is acknowledged and effective steps are taken to minimise risks to the victim. For older people, responses need to be sensitive to choices about family relationships (State of Victoria, Royal Commission into Family Violence 2014–16).

In response to these findings, the Department of Health and Human Services has implemented the Integrated Model of Care for responding to elder abuse which is being trialled for 12 months at five health sites in Victoria:

• Latrobe Community Health Gippsland
• Melbourne Health
• Monash Health
• Peninsula Health
• Western Health

Project aims

The key aims of the project are to:

• implement a patient-centred and carer/family-inclusive practice model;
• build the capacity of the workforce to identify and respond to suspected elder abuse presentations across the healthcare continuum;
• improve response options and pathways for older Victorians at risk of/or experiencing elder abuse;
• identify opportunities to strengthen existing relationships with key organisations providing family violence services in order to enhance responses and referral pathways for older people; and
• raise community awareness about the underlying causes, behaviours and attitudes in order to prevent elder abuse from occurring.

Project delivery

There are four key components of the project:

• An elder abuse prevention and response liaison officer based at each of the trial sites. A key component of the liaison officer position is to provide specialist clinical advice and consultancy regarding complex discharge decisions for older people at risk of/or experiencing elder abuse. The liaison officer can also provide secondary consultation to community organisations requiring advice and referral on elder abuse cases across their catchment area.
• Free professional training on recognising and responding to elder abuse, open to all health service staff, community partners and organisations
• A counselling and mediation service, including financial counselling, based on site at each health service, offering a therapeutic option for older people and their carers and/or families. Provides support to the older person to make choices to help reduce or protect against abuse while also working to maintain or restore family relationships.
• A prevention network based on a membership of organisations, community groups and businesses that work with or provide services to older people in the trial site catchment area. The network will focus on primary prevention and awareness raising activities.

For further information

Latrobe Community Health, Liaison officer – Deirdre Howard
PH: 0427 031 541

Melbourne Health , Liaison officer – Helen Rushford
PH: 0400 544 530

Monash Health, Liaison officer – Selina Nivelle
PH: 9265 7835

Peninsula Health, Liaison officer – Mandy Strange
PH: 9784 7073

Western Health  Liaison officer – Warren Fuge
PH: 0423 842 103

References

Kaspiew, R., Carson, R., & Rhoades, H. 2016. Elder abuse: Understanding issues, frameworks and responses. Australian Institute of Family Studies.

National Ageing Research Institute in partnership with Seniors Rights Victoria, 2015 Profile of elder abuse in Victoria

Seniors Rights Victoria, 2018 Elder Abuse as Family Violence discussion paper

State of Victoria, Royal Commission into Family Violence: Summary and recommendations, Parl Paper No 132, 2014–16.

State of Victoria, Royal Commission into Family Violence, 2014–16 op. cit.

Helen Rushford is an Elder abuse prevention and response liaison officer at the Royal Park Campus, Parkville, Victoria

Warren Fuge is an Elder abuse prevention and response liaison officer at Western Health at Footscray Hospital, Victoria