In Australia today there are more people aged over 65 than at any time in the nation’s history – in 2017, there were 3.8 million Australians aged 65 and over, 15 per cent of the population, an increase from 1.3 million 30 years ago. According to the government it’s a trend that will continue, with a projected 8.8 million older people in Australia by 2057.
The University of South Australia recognises the new challenges all this poses for society – and for older people themselves – and has responded by incorporating in its research profile a dedicated theme of inquiry called An Age Friendly World.
An unfortunate by-product of this ageing trend is elder abuse, which has become a significant human rights, community wellbeing and public health problem.
A recent World Health Organization study estimated that in the previous year, 15.7 per cent of people aged 60 and older had been subjected to some form of abuse.
Locally, a South Australia Parliamentary Inquiry noted an “unprecedented state and national concern about, and discussion of, elder abuse.”
Meanwhile, the Royal Commission into Aged Care Quality and Safety is examining the current situation of aged care in Australia, including in nursing homes, and has heard evidence that there were 3,773 reportable assaults, excluding incidents when residents attack each other, in nursing homes in 2017-18.
However, thanks to the work of a dedicated team of UniSA researchers led by Dean and Head of the School of Law, Professor Wendy Lacey, changes to legislation and policy are underway to better protect the rights of older people and to prevent abuse.
Lacey has been recognised as the “pre-eminent Australian expert on the prevention of elder abuse”, ensuring that individuals’ rights are preserved, and not seen to diminish, with age.
“Just because you turn 65, or just because you might go into residential aged care, that doesn’t mean that you no longer have the right to make decisions for yourself, to be treated with dignity and respect, and to make decisions for yourself if you have full mental capacity,” says Lacey, who helped to shape the key SA Government Strategy to Safeguard the Rights of Older South Australians, and the landmark South Australian Charter of Rights and Freedoms of Older Persons.
“It’s absolutely essential to ensure that we treat older people with respect and dignity and with full recognition of their rights for as long as possible, and to enable them to exercise their rights as fully as possible,” adds Lacey, who heads a team that has developed strong partnerships with the aged care sector, peak advocacy groups and government agencies.
Recognised expert in human rights
Professor Lacey, who has previously held academic positions at the University of Adelaide and the University of Tasmania, is a founding member and co-convenor of the Australian Research Network on Law and Aging (ARNLA), and also sits on the SA Minister for Health’s Steering Committee tasked with monitoring the implementing the State’s Strategy for Safeguarding the Rights of Older Persons.
She has been the Chair of the Steering Committee’s Legislative Response Working Group and was co-convenor of the Human Rights and Security Research and Innovation Cluster at UniSA. Lacey was also invited to be a member of the Expert Advisory Committee assisting the Australian Law Reform Commission during its Inquiry into Elder Abuse (ALRC Report 131 Elder Abuse – A National Legal Response, 2017). Further, she drafted the terms of reference for the NSW and SA Parliamentary Inquiries into Elder Abuse in 2016 and 2017 respectively.
“Older people are the only group of humans that don’t have a United Nations convention on their human rights. I think that leaves a really significant normative gap in the international legal framework,” says Lacey, whose legal background spans constitutional law, administrative law, international law, government decision making and processes, and also human rights.
Lacey says the notion of human rights brings with it “a different mindset and a different language”, however – “it’s important to get people to start speaking that language because so often people may easily fall into ageist or paternalistic patterns when considering what may be seen to be in the older person’s ‘best interests’, without trying to work out what the older person really wants”.
“I’ve been a really strong proponent for ensuring that everything we do around ageing has to be informed by the recognition of and respect for the rights of all people.”
A constitutional division of powers
The legal framework around the rights of the elderly is complex, with Lacey pointing out that there is a constitutional division of powers between the states and the Commonwealth.
The Aged Care Act, for example is Federal legislation, but State and Territory governments also have a powers for dealing with elder abuse – giving as an example the new Adult Safeguarding legislation introduced in South Australia last year.
“Prior to that, there was no one agency in South Australia that had the statutory authority to really coordinate and conduct an investigation into a report of elder abuse,” Lacey says.
“If you want to be able to support vulnerable people, then you need to be able to call someone other than just a police agency, because many people are reluctant to report it if they’re going to have a uniformed police officer coming to their front door with the prospect of criminal sanctions being imposed on their family members.”
It is important that “we think of innovative ways to utilise the legislative powers of our state and territory parliaments as well as the federal parliament, and to essentially have different mechanisms so that we provide a safety net to our most vulnerable older people”.
Lacey points out that elder abuse is often “a largely hidden issue” – mainly because the perpetrators tend to be the children of the older victim, a close relative, or a carer.
UniSA research reveals elder abuse is not limited to any one demographic – it’s a problem that spans across society.
But there are some key indicators around who is likely to face abuse.
“Certainly the older you get, the more frail you are, then the more likely you are to be a victim of abuse,” she says, adding that 79 years of age “is often a peak time when elder abuse, or some form of exploitation or neglect, might actually be affecting you”.
People in residential care or other care settings, and who are dependent on others for their day-to-day needs “tend to be more vulnerable”.
“But it’s not age alone which makes you vulnerable to abuse,” says Lacey.
“It’s the combination of advanced age, dependence on others, ill-health or disability … that tends to mean that, as a consequence of the combination of those factors, you tend to become more vulnerable or more prone to abuse.”
‘Very keen to inherit assets and finances’
Although not widespread across the community, there are some children and grandchildren of elderly people “who are very keen to inherit assets and finances from their parents or grandparents”, she says.
Sometimes there are “assets for care” arrangements in which a child or other relative agrees to take care of the older person for the rest of their life, provided that they get the financial assets from the sale of the previous family home.
Often such arrangements can be well intentioned at the outset, “but then you might have other siblings who were not pleased with the arrangement, or the elderly person is not getting the care that they need or their care needs increase over time, and that places strain on the people looking after them”.
“And then you can end up with those arrangements falling apart, and the older person then being without a place to live or being pressured to move into residential care.”
Arrangements involving powers of attorney – which can be an important protective measure for ageing people – are widely known to be “a very common instrument of abuse”.
“Children or family members having the power of attorney so that they can then deal with the assets and make financial decisions on behalf of the parent, can be a situation that’s easily exploited.”
A strategic initiative based around research themes
“We’ve seen significant funding internally for age related projects that enhance the wellbeing and the lived experience for older people. But we don’t just focus on older people, we focus across the human lifespan as well,” she says.
“It’s not just about funding and providing an environment that’s conducive to stimulating multidisciplinary scholarship, it also helps to build connections across the institution and to our industry stakeholders outside.”
“We’ve got outstanding scholars across the institution in all sorts of disciplines working in the ageing space, and I think that’s given a momentum to the research that we’re undertaking. We don’t do it alone, and we don’t assume that any one discipline is going to provide all the answers.”
“We assume that we’re going to get much better and more nuanced answers if we work collaboratively across disciplines, but also if we’re working with industry and government departments as well.”
Lacey argues that the whole point of engaging in research is to ensure that it has a beneficial impact.
“It’s all well and good to get lovely articles in refereed journals,” she says.
“But at the end of the day, you want policy makers, you want industry providers, you want the people at the coalface doing the hard work, to actually take notice of the research that you do.”
“And I think this is a classic case of how the University has invested in its people and its research in a way that we can actually see a clearly defined link between the original research that we’ve done and changing the environment in which we live. And I think that is remarkable.”