ELDER ABUSE AND NEGLECT IN SINGAPORE

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ELDER ABUSE AND NEGLECT IN SINGAPORE

• BROUGHT TO YOU
• BY
• JAYANTHI D/O NAGALINGAM

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OUTLINE

• Introduction
• Literature on elder abuse and neglect
• Research Question and Claim
• The Conceptual Framework
• The Theoretical Framework
• Methodology data collection, preliminary
  fieldwork, potential challenges
• Significance of Project.

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INTRODUCTIONThe future of an ageing society
will be shaped by all of us because in the end
the old are simply our future selves (Moody, H.,
2001420)

• Rapid economic and social developments,
  effective family planning programmes have caused
  rapid ageing in many countries.
• In developed countries, approx 1 in every 6 is
  at least 60 years old and this proportion will be
  close to 1 in every 4 by 2025 (ESCAP, 19961).
• According to the UN (1994206), the worlds
  elderly population aged 65 and above will
  quadruple to 1.445 billion.

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.contd

• Singapore proportion of elderly population aged
  65 and above will increase from 7 in 1999 to 19
  by the year 2030 (IMC Report, 19995)
• 1 in every 5 persons will be an older person,
  thus making Singapore one of the fastest ageing
  countries in Asia.
• With an increasing elderly population, elder
  care that was previously not seen as a major
  long-term task for families as few persons lived
  to be old, is now seen as a substantial challenge
  for many families.

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WHAT IS ELDER ABUSE AND NEGLECT?

• Increase in elderly population
  increasing need for elder care rise in
  social problems such as elder abuse and neglect

• 1st hurdle deciding on a definition
• 2nd hurdle multi-dimensional nature that lacks
  clarity and precision.
• Various ways of conceptulisation and to date, no
  universally accepted definition of the term.

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.contd

• Definition elder abuse can be defined as any
  action or inaction, perpetrated by a person in a
  position of trust, which jeopardises the health
  or well-being of an elderly person. It includes
  the infliction of physical, emotional and sexual
  harm on the older person. Elder abuse, therefore,
  takes the form of physical, financial/material,
  sexual and psychological/emotional abuse (MCDS
  definition).

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TYPES OF ELDER ABUSE
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ELDER NEGLECT

• 2 types
• - Passive neglect an act of omission of not
  doing something, or withholding goods and
  services, perhaps because of ignorance or stress
  on the part of the caregiver
• - Active neglect when the neglect is deliberate
  and malicious and the perpetrator knows fully
  that he/she is neglectful
• (Quinn and Tomita, 199747)

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LITERATURE ON ELDER ABUSE AND NEGLECT

• To date, studies mainly exploratory and
  descriptive. The typical objectives has been to
  define, examine the extent and nature of elder
  abuse and neglect among adults aged 60 and above.
• Reformers in the19th century were urged by new
  beliefs about the ideal family.
• - Sarah Orne Jewett (1880s), in her novel on The
  Country of the Pointed Firs, wrote of pervasive
  physical abuse of the elderly people in
  working-class families.

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contd

• Pioneer research by Dr Suzanne Steinmatz in the
  US in 1978 -Battered Parents.
• OMalley et.al (1979) provided preliminary
  data on the nature of elder abuse.
• - physical trauma was the most reported injury
  (over 41).
• - victims over 75 years of age and female(80)
• Douglass, Hickey and Noel(1980)explored if
  elder neglect and abuse was of sufficient
  magnitude to justify investment of resources.
• - passive neglect most prevalent and physical
  abuse the least.

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contd

• - no predominant explanation for mistreatment as
  most attributed cases to multiple causes.
• Gray Panthers of Austin (1983) studied the
  extent, location kinds, frequency and underlying
  factors of elder abuse.
• - self- neglect (82), exploitation (75),
  verbal/emotional abuse (72), physical abuse
  (62).
• - most frequent causelong-term environmental
  conditions, such as extreme poverty, crowded
  living quarters and marital conflict.

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.contd

• Change in terminology Granny battering/bashing
  (1980s) to Elder Abuse (1990s)
• Increasing research on elder abuse and neglect
  in America (NARCEA) and Britain.
• Landmark study National Elder Abuse Incidence
  Study(NEAIS)
• - new baseline estimate of the incidence of
  abuse 450,000 older persons in domestic settings
  were abused or neglected women abused at higher
  rate than men the oldest-old(80 and above)as the
  most vulnerable group and perpetrators likely to
  be adult

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.contd

• children and spouses.
• Local Literature
• ST article (13/9/98), Elder abuse and neglect
  under-reported here- 86 PPOs filed and
  12/120(10) of elderly patients is an abused
  person.
• Cham and Seow (2000), The pattern of elder
  abuse presenting to an Emergency department-
  17/62,826 cases of elder abuse found (frequency
  0.03).
• ST article (28/10/02), Action urged to protect
  the elderly - 6/200 cases annually involved the
  abuse of

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.contd

• the elderly. Initiation of workgroup to define
  and analyse the extent of the problem here.
• Limitations existing studies document the
  existence, forms of mistreatment but do not
  provide clear, or consistent information on the
  antecedents, causes or consequences of
  mistreatment or on the characteristics of the
  abused or abuser.

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RESEARCH QUESTION

• Bearing in mind the complexities and social
  dynamics as unique in each society, what are the
  determinants of elder abuse and neglect in
  Singapore?
• The avenues that will be examined
• - individual- level characteristics such as
  investigating ethnic and gender differences,SES
  status like family income, educational level
• - type of circumstances in family settings such
  as cultural values about elderly, attitudes/

MICRO
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RESEARCH QUESTION

• perceptions of aging.
• - Inter-generational relationships such as the
  quality of family ties, transfers over the
  life-course, child-rearing practices to
  understand the notion of reciprocity/reciprocal
  relationship patterns between the elderly and
  their children.
• - Societal perceptions of aging such as the
  changing role of the elderly and their economic
  value( resource or liability).
• Aim to offer a descriptive and an explanatory
  study of elder mistreatment specific to the
  Spore society.

MACRO
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CLAIMS

• 1.Individual-levelcharacteristics, family
  circumstances intergenerational relationships and
  societal perceptions of older persons will
  influence the levels of elder abuse and neglect
  in Singapore.
• 2.Older persons with lesser resources and in
  vulnerable positions, e.g the frail, the women,
  those with no/low income, no/low education would
  be more likely to be abused than those with more
  resources.

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CONCEPTUAL FRAMEWORK
Cultural/religious beliefs
Empowerment
Powerlessness
Role identities
Attitudes/ perceptions
Determinants of Elder Abuse and Neglect
Economic value
Intergenerational transfers
Policy
Family ties
Child-rearing practices
Individual- level characteristics
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THEORETICAL FRAMEWORKS

• Pathology model analysing the individual
  characteristics of the abuser.
• Situational stress model analyses how dependency
  of the elder causes stress for the abuser.
• Symbolic interactionist theory perception of
  individuals of old age quality of power
  relationship.
• Social learning theory analyses how violent
  behaviour is learnt within the family.

MICRO THEORIES
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THEORISING ELDER ABUSE AND NEGLECT

• Life-Course Perspective to understand changes
  in transitions families experience
• the meanings elderly give to such transitions
  the developmental changes that pertains to issues
  of identity, family ties work.
• Social Construction of Old Age focuses on the
  impact of society, for e.g the attitudes
  perceptions, on the lives of old people.
• Political Economy of Aging looks at the impact
  of policies practices on gendered patterns of
  care disability.

MACRO THEORIES
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METHODOLOGY

• Qualitative approach
• Primary Data
• - Participant Observation in contexts where
  conversing with abused or neglected elderly is
  not viable,either because they are unwilling to
  share their experiences or unable to.
• - Interviews and In-depth interviews with
  relevant frontline service providers like social
  workers, doctors, police and with victims.
• Egs of sample questions
• what are your family or communitys expectations
  of you as you grow older?

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METHODOLOGY

• Are you able to meet up with their expectations?
• What do you think of how your family, in general
  view older persons? What about the society?
• Shed some light on the roles, identities,
  intergenerational relationships and societal
  perceptions of older persons which in turn shape
  the way older persons are being treated.
• Secondary Data
• - Newspapers, official reports.

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METHODOLOGY

• Sampling
• Sampling method Snowball sampling
• - in order to gain access to my potential sample
  of
• of abused or neglected elderly, theres a need to
  identify the relevant ministries and interviewing
  those authorities dealing with elder abuse and
  neglect in Singapore.
• Preliminary fieldwork Hua Mei Mobile Clinic,
  MCDS, SAGE.

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METHODOLOGY

• Sample selection
• - thro referrals from the social service
  agencies, hospitals voluntary welfare
  organisations (VWOs).
• - elderly aged 60 above from both gender
  across all ethnic groups, with varying mobility
  and socioeconomic statuses.
• Potential Challenges
• - unwillingness to be interviewed
• - language barrier

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SIGNIFICANCE We dont have much groundwork
evidence on what the situation was beforeand
whats going on at present. We just have a
feel. Its not an easy study youve embarked
on, but is a very needed study (One of the
Deputy Directors in MCDS)

• With a lack of adequate work on elder
  mistreatment in the local context, the thesis
  will be one of the very first study to contribute
  essential information on elder care.
• One of the very few studies that has aspired to
  look at the determinants of elder abuse and
  neglect from both the micro and macro
  perspectives.
• Provide information for policy makers concerned
  in combating elder abuse and neglect in
  Singapore.

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Making Choices to live out ones life is basic
to the individuals sense of self-esteem
dignity(National Advisory Council on Aging,
199234)THANK YOU.