A private matter? Elderly peoples’ perception of violence and abuse and reporting such abuse.

SUMMARY

Background
Violence and abuse against the elderly are among the most hidden and least
accessible kinds of violence. Only a minor fragment of this violence is
recorded by the police, and in national public victimisation surveys elderly
victims are almost non-existent. Surveys targeted more directly at the elderly
and clinical experience from work with old people suggest, however,
that this group is considerably more exposed to abuse than shown by public
figures. It is therefore important to gain more knowledge about possible
reasons for this underreporting.

 

Objectives

In this study we have looked at some conditions that may influence elderly
people’s willingness to report and seek assistance when they are abused:

• Do they deem what they have experienced to be violence, or do they
look upon it as behaviour they have to accept?
• Do they feel that their right to self-determination has to be renounced
for more practical considerations if in conflict?
• Are they unaware of elder-abuse, or do they have unrealistic notions
about how much and how grave it is?
• Do they feel that elder-abuse has to be tolerated, either because of
considerations for the abuser or because they think the abused deserves
the abuse?
• Do they feel the abuse to be a private matter and do not want others to
interfere?

Method

The study is based on similar studies which have been carried out with
different ethnic groups in USA and in several other countries in Asia and
Europe, and the answers from the Norwegian respondents are compared
with some of the other groups. The Norwegian study was constructed as
a postal survey with a sample of 1000 old age pensioners’ drawn from the
membership list of the Norwegian association of old age pensioners, while
all the other studies were carried out through personal interviews and with
smaller samples of 50 to 100 respondents. In addition to the survey, direct
face to face interviews were conducted with 7 respondents in Oslo who also
gave supplementary comments. Less than 50% of the Norwegian sample
answered the questionnaire, but the moderate response rate does not seem
to have disturbed the representativeness of the sample.

The respondents should give their opinion on 20 different statements and say
if they completely agreed, disagreed, partly agreed or that they did not know.

Results

Despite differences in research design and cultural and social differences
between the respondents, the different national and ethnic groups did not
differ much in their opinions on most of the statements.

Phsyical abuse

Almost all of the respondents, no matter what cultural or national background
they represented, thought that physical violence, like when a spouse
hit his partner, was unacceptable. When the abuse consisted of tying
mentally or physically impaired old people to the bed or calm them with
medication, the attitudes were more mixed. The Norwegian sample was somewhat
more tolerant towards these measures of control than most of the
other groups, but even among the Norwegians a majority felt that these
measures were not acceptable.

Economical abuse

Next to physical abuse, what raised the strongest opposition was economical
abuse, as when children did not repay loans or used their parents’
money as if it were their own.

Psychological abuse

The different groups also showed fairly similar attitudes towards psychological
abuse, and in all of the studies a significant majority found it
unacceptable for grown children to yell at their old parents.

Neglect

The feelings about lack of care were somewhat more conditional. On the
one hand a significant majority agreed that when elderly persons could no
longer take care of themselves their children ought to do something about it.
On the other hand more than three fourths of the respondents agreed at least
partly with a statement saying that it was acceptable for children who were
caring for their old parents to leave them for a couple of hours now and then.
The comments given by the directly interviewed suggest that many respondents
find this to be a borderline case and do not look upon it as abuse.

It looks as if most of the respondents have a relatively unanimous opinion
about most of the actions described in the different statements as being
not acceptable. The one exemption was the question whether or not it was
OK for children to temporarily leave old parents in need of nursing. Here
the value of taking care of the parents was opposed to the children’s need
of carrying out other important tasks. This was seen as an ethical dilemma
where many found it hard to take a clear stand.

Much of the same goes for the question of whether or not it is permissible
for children to force parents to eat if they do not want to. More than half of
the Norwegian respondents either meant it depended on the circumstances,
or they did not know what to think. The arguments given in the direct interviews
suggest that this is seen as a conflict between on the one hand the
elderly person’s right to self-determination and on the other hand the plight
of the children to take care of their parents. It seems that the Norwegian respondents are more inclined than the other groups to take a conditional
standpoint on this, or to conclude that the practical considerations should
weigh more heavily than the parents’ right to self-determination.

The Norwegian respondents also had less clear viewpoints than the other
groups on the prevalence and graveness of the abuse. This is probably not
a result of lack of knowledge; on the contrary research has shown Norwegian
elders to be better informed about elder-abuse than elders in many
other countries. More probably the different results are, at least partly, a
consequence of different research designs. Originally the statements about
graveness and prevalence were made to indicate how the respondents subjectively
felt about the importance of elder abuse, but they could also be
understood as statements about factual numbers and impact on the victims.
In a survey like the Norwegian study, where the respondents are filling in
an anonymous questionnaire all by them-selves, there is, in contrast with
personal interviews with an interviewer present, no possibility to influence
the way the questions are interpreted.

Why abuse takes place

The respondents were asked to give their opinions on several statements
concerning why abuse takes place. Two of the statements suggested the
abuse was motivated by characteristics of the abuser, either because he was
mentally ill or a close family member. A considerable proportion of the Norwegian
sample perceived this as statements concerning the factual importance
of mental illness and close family ties as reasons for abusive behaviour,
and said they did not know. In this respect the Norwegian respondents
differ from several of the other groups who to a greater extent expressed a
definite viewpoint, and agreed with both statements.

In two other statements the reasons for the abuse were seen as results of
the victim’s own behaviour, either because they had done something that
made them deserve to be treated badly, or because they themselves had
abused their children when young. None of these points of view won much
approval from the respondents. Almost no one agreed among the Norwegians
or in any of the other groups.

Involvement from outsiders

The respondents’ attitudes towards involvement from outsiders when an
elderly person was abused were tested through four different assertions. The
first one concerned whether or not an outsider should take action if he knew
an elderly person to be abused. The viewpoints on this were rather comparatively
evenly divided, half the sample felt he should not interfere, while the
other half thought he ought to do something, at least on some occasions.

The next two assertions stated that if a neighbour either suspected or
knew that an elderly person was being abused, he should report it to such authorities as social service agencies or the police. The Norwegian sample
differed markedly from all the other groups on these themes. A significant
majority of the Norwegian respondents, 70 percent, agreed that the neighbour
should not report it if he knew an elderly was abused. The Norwegian
sample also differed in that a larger majority was opposed to the neighbour
reporting when he knew the elderly was abused than if he just suspected it. In
all the other groups only a few meant he should not report if he knew while
the opinions where somewhat more divided if he just suspected.

The final statement in the study stated that to report the abuse would
ruin the life of the abuser. Only a few, less than a fifth of the sample, agreed
on this, almost half disagreed, while the rest felt it depended on the circumstances,
or they had no opinion. The Norwegian respondents are pretty
much in line with the other groups on this.

There seems to be a rather pronounced unwillingness among Norwegian
elders to have any involvement from outsiders or public authorities
in instances of abuse. There is a considerable consistency in the answers on
this, in the sense that almost everyone that was against that people outside
the family should interfere was also opposed to the neighbour reporting his
suspicions to the authorities, and most of those who where against the neighbour
reporting if he suspected abuse also were against him doing so if he
knew it for sure. Of all the themes encompassed in the study this is the one
giving the most probable explanation of why elderly people are so reluctant
about contacting the protective services.

It is hard to see any good reasons why the Norwegian elders are more
reluctant than the other groups to involve outsiders and public services. The
observed differences may at least partly be dependent on linguistic differences
so that reporting (melde fra) in Norwegian has a stronger connotation
towards slandering or denouncing than in English. It may also be that the
Norwegian concept of “sosialomsorgen” is felt as more stigmatising than the
English “Social Service Agencies”. The different designs of the studies, with
the Norwegian study carried out as a survey, where the respondents answered
anonymously, while all the others were conducted as personal interviews,
may also have influenced the results. This assumption is supported by the fact
that almost all the Norwegian respondents who were interviewed face to face
thought it was all right for outsiders to interfere or report the incidents.

The observed differences between the groups could of course also reflect
actual differences, and indicate a more privatising attitude towards abuse
among Norwegian elders. This may be connected both to cultural qualities
of the Norwegian society and because specialised services and agencies dealing with elder abuse is not very much developed in Norway. As we do not
know where in Norway the respondents live we cannot tell if those living
in areas with elder protective services are more positive than others to have
people outside the family involving themselves or reporting the incidents.
However, all the face to face interviewed were living in Oslo where elder
protective services has been established for some time and are well known
among the elder population.