Rodje Malcolm | Ageing with dignity?
This week, an elderly man begged me to help him escape his nursing home. He can't leave the facility because he is on "punishment", but wants to escape the daily abuse he suffers from the facility staff. He can't have visitors. His requests to be discharged have been ignored. He is sick, disabled and fears that they will eventually kill him. He is a prisoner. His crime? Being too old and being too poor.
He is not alone. Last month, a distressed man who lives overseas contacted our office asking for help to rescue his father from a nursing home. His father complains of abuse and theft of his belongings by staff. His son's complaints have been ignored because someone else pays for the father's care. When we made contact with the father, his greatest fear was that the staff would forcibly administer injections given to other residents that sedate and render them helpless.
Then, there is the woman who reported her caregiver to the police and was subsequently prohibited from leaving the home, deprived of her belongings, and physically abused. She is afraid of dying in the home but cannot leave.
These stories are common. Many elderly persons who are dependent on others for care suffer daily violations of their human rights. Their dependence makes them vulnerable to abuse and less able to directly improve their situation - much like children and the disabled. These vulnerabilities are why governments across the world implement special measures to protect elderly persons, such as passing elder care and abuse laws. These laws often define elder abuse, provide a framework to respond, and regulate residential-care facilities like nursing homes and golden-age homes.
In Jamaica, we have no strong legal framework for elder care.
The World Health Organization (WHO)'s research shows that around one in six persons 60 years and older (15.7 per cent) experience abuse in a given year. They note that these figures are low estimates, because incidents are under-reported globally.
Elder abuse can be physical, sexual, psychological, and financial (such as exploiting an elder's funds, property or other assets). Abuse can also result from intentional or unintentional neglect. It can occur in households and in residential institutions like golden-age homes. However, research shows that rates of abuse are higher for people living in institutions than for those in households.
Commonly reported forms of abuse inside institutions include staff physically restraining ageing persons, leaving them in soiled clothes, over- and under-medicating them, and withholding healthcare as a form of punishment. When we speak to people seeking help, their dependence on their abusers and inability to improve their situation on their own devastate them profoundly.
Modernize Elder Care
Globally, the number of elderly persons needing care is increasing. As people live longer, the number of people over 60 years old will double by 2050, according to the UN. In Jamaica, the number has increased over the past four years, growing by eight per cent since 2013. As the population ages, our need for humane and dignified elder care will intensify.
In 2011, a Gleaner expose brought the inhumane conditions in one golden-age home to light. At that home, residents were subjected to forced, communal bathing by a garden hose in a corridor every morning. Disabled residents were seen creeping around on their hands, naked and swarmed by flies between foul dormitories where others were tied to beds with strings.
Many of the reports that we receive would constitute unlawful acts in other jurisdictions. For example, one man reported that as part of his punishment, his nursing home prohibited doctor visits. In jurisdictions like Australia and the USA, that would be grounds for criminal or administrative sanction under their elder-care laws. Those laws set strong standards for facilities providing care to the elderly. Jamaica can do the same - much like we have defined child abuse and regulated childcare facilities under the Child Care and Protection Act.
In Australia, the 1997 Aged Care Act introduced mandatory reporting of elder abuse in care facilities to identify and stop harmful practices. And just two months ago, the USA passed the Elder Abuse Prevention and Prosecution Act that augments their existing laws governing the assessments of facilities providing elder care. Moreover, various states have adopted criminal and civil definitions of elder abuse - an essential measure.
Strong laws matter. Multijurisdictional research has already found a statistically significant relationship between the reporting and investigation of elder abuse and the strength of elder abuse laws, particularly where those laws included mandatory reporting (with penalties) and mandatory public education. Based on the available research, if we want to reduce abuse, we should adopt strong laws.
Ageing with dignity is a human right. Let's get serious about safeguarding it.
- Rodje Malcolm is a human-rights campaigner. Email feedback to firstname.lastname@example.org.