Monday, 13 May 2013

Elder Abuse: Anti-oppressive Perspective (Anish Alex MSW, RSW)

Elder Abuse: An Anti-oppressive Perspective  

Abuse of elderly is a social problem resulting from socially and structurally constructed negative identity. Studies illustrates that, one among five elderly adults experienced some kind of abuse in the forms of insulting, threats, violence or holding important information’s from them (MacKay-Barr & Csiernik, 2012).   Elder abuses and oppression are viewed as different levels of abuse spectrum from spousal abuse to a friend or formal paid giver abuse. I argue that elderly abuse is the end result of socially constructed old age identity, prejudice about ageing process and various interlocking oppressive factors including behaviors that exclude elderly adults (Calasanti, 2005; Overall, 2006). 
     Conceptualization of certain identities are not natural rather a socially construct one.  This kind of socially created identities are constructed, reinforced and established with intentionally through normative ideologies, relations and practices.  The biological deprivation related to age is universally considered as ‘old age’ of the person, so that elderly characteristics as being recognized as partial or incomplete participation of normative social demands. Which means that the material foundation of the identity of elderly person is socially acquired in terms of years lived in the society and how the person is responding to the societal norms. The assumptions related to aging are a “culturally-imbued” process (Overall, 2006 p.128).  I think these assumptions are misleading; in terms of the stages of life attainments and years lived in the society are socially constructed and misinterpreted. 
     A study conducted by MacKay-Barr & Csiernik (2012) explains that elders with low socio economic status and vulnerable physical and mental conditions are facing greater amount of risk abuse compared to healthy, affluent and educated group of their counterpart.   WHO defined elder abuse as “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” (as cited in Donovan & Regehr, 2010 p.175). Even though many of them are aware where to find assistance, a fraction of the cases are reported and a self disclosure is happening to friends than family members or public assistance. Elder population, those who are experiencing various kinds of abuse and neglect encounters significant barriers to disclosure.  These obstacles can include “diminished capacity to comprehend, ignorance of the law, cultural differences and lack of knowledge about abuse” (Donovan & Regehr, 2010 p.175).
     Those who are vulnerable condition in relation to health and other factors are facing social isolation and a greater amount of abuses. In a study, the participants responded that they fear about the abusers that if they report the abuse, there may be increase of abuse, institutionalization or abandonment (Walsh, Olson, Ploeg, Lohfeld & MacMillan, 2011). MacKay-Barr & Csiernik (2012) explains that abuse among elderly is perhaps the most complicated type of violence inside the family and society. 
    Various elderly abuses can be in the forms of physical, sexual, psychological, emotional, financial, abandonment, neglect or self neglect and/or combination of various abusive forms (WHO 2002c as cited in Donovan & Regehr, 2010). According to Wahl and Purdy (2002), due to various forms of elderly abuses “depression, fear, anxiety, unexplained physical injury, dehydration, lack of food, poor hygiene, pressure sores and missing money or personal items” are common (as cited in Donovan & Regehr, 2010 p.175).
     Vulnerability to abuse is a result of oppression experienced as the greatest consequences of “ableism”, “racism”, “ageism”, “disability”, “heterosexism”, “sexism”, “classism” and various intersectionality of oppressive factors (Walsh et al., 2011).    The voices of marginalized elderly population are rarely solicited.  Studies shows that the relationship between maltreatment of elders and various oppressive factors are contributing each other and that are not properly investigated.  According to Van Wormer (2005) oppression among elderly people described as “a system of dominance and subordination where elder population divided from the general population and categorize, dehumanized, discriminated and made visible in terms of their age and vulnerability” (as cited in Walsh et al., 2011). Analyzing and addressing various oppressive factors are not only limited as ageism rather it is associated with various intersecting consequences of oppression.
     Power imbalance creates greater level of oppression among marginalized elderly people.  Power creates high level of risk abuse.  It also can increase the vulnerability of elder abuse as the society perceived this population as “weaker, dependent or different”.  Researches related to elder abuse has not profoundly incorporated the analysis of power imbalance which control and contribute to older adult abuse.  Power plays different levels of controlling factors in elderly life.  It can be within the ongoing relationship who using “a pattern of coercive tactics” to maintain the control over the relationship or economically exploit. Oppression is a “salient issue” often resulting from the feeling of “powerlessness, risk of abuse, victims of help seeking behaviors and influences action taken by professionals” (Walsh et al., 2011 p. 18-19). 
     Oppression itself is considered as abusive.  There are various forms of oppression influences elder abuse.  Age places a vital role in various abusive scenarios.  Generally, elder population is stigmatized and excluded from the society on the basis of age.  Harbison (1999) explains that older adults have admiration of youth and devaluation of their peer groups (as cited in Walsh et al., 2011).  Maltreatment is a result of aging, rejection of elderly people from the society and the societal beliefs about older population as a burden.  Crichton (1999) noted that ageism took the power from elder adults and makes them more vulnerable to abuse (as cited in Walsh et al., 2011). 
    Ageism is the least reported factor while considering elderly studies.  Ageism as structurally oppressed factor influencing health and social service programs and social security initiatives compared to the provision of children and youth program (Walsh et al., 2011). Ageism is generally considered as a systematic stereotyping categorization and prejudice because they are old age (Calasanti, 2005).
          In practice, providing service for the seniors especially in the case of abuse in the larger community is a difficult one.  A major barrier of service is that the personal histories are a collective result of individual and structural oppressions surrounding aging. A protective social work approach almost the same model of child abuse reporting and response system model of domestic violence can control elder abuse to a great extent (MacKay-Barr & Csiernik, 2012). However there are controversies about the individual rights and self determination of the elderly in this context.  The capacity to resist abuse and understand the situation is again creating controversies while equalizing elderly to children in need of protection (Donovan & Regehr, 2010).
     There are certain limitations while working with elderly abuse.  The challenging factors can be presented as the misinterpretation of the abusive situation of the elder person when the abuser is very much cooperative and supportive. Another challenging factor in the field of elderly abuse includes various kinds of barriers like language, time and cognitive limitations. It is very important to understand the cognitive ability, physical health status and mental health about the client particularly to understand the capacity of the client to make a decision and report vulnerability or abuse. Abused and neglected elders are the marginalized population of the society requiring professional social assistance. Advocacy efforts can protect this disenfranchised group from the existing continued abuse. Professional assistance can ensure the abused and neglected elders right to self determination (Donovan & Regehr, 2010).
     Advocacy about abuses on behalf of elderly population in collaboration with other disciplines and community service organizations is an important role of social workers.  A promotion of community-wide intervention to prevent the maltreatment of elder people is also important. Social workers are expected to take the responsibility to get the clients on various legal matters in terms of human rights, decisional authority of well being, health and their financial matters (Schwiebert et al., 2000 as cited in Donovan & Regehr, 2010).
     As a social worker I think our research, theory and practice should focus more on successful ageing. There are various factors associated with biological ageing. Compared to other forms of oppression ageism defers in terms of its source of disadvantaged position is an unavoidable part of life (Calasanti, 2005). In addition our culture itself is ageist; as a result the society oppressed themselves and try to avoid ageing process (Overall, 2006).  Old age is a stage of human life, but materially reconstructed by the individual and the society. Due to the internalized oppression of ageism, the elder population feels shame about their life stage. 
     In this article I was trying to review ageism as a materially reconstructed identity by the society. Besides, I also tried to make an understanding about elderly abuse and its connection with various oppressive factors. A critical social work perspective is that the elderly abuses are potentially more powerful in conceptualizing the phenomena of risk of abuse.

“If old age is a social product, not a biological given, then aging is a potential site not only for oppression but also for liberation. Social and political reforms in the areas of employment, education, housing, health care, family structures, social welfare and architecture could redefine the societal context of aging, eliminate or at least reduce ageism, and support increasing rights, opportunities, and freedoms for people who have lived many years” (Overall, 2006 p. 134).

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