Monday 24 October 2016

It's no country for old people when society makes them feel like a burden

Ending the systematic mistreatment of old people should be as much a priority as stamping out child abuse

Eilis O'Hanlon

Published 26/07/2015 | 02:30

‘What if it was children who were being left without food or water, or drugged to keep them docile?’
‘What if it was children who were being left without food or water, or drugged to keep them docile?’

How would we have responded last week had a report revealed that a group of vulnerable children were still not being cared for as ordered, months after the problem was first identified and those responsible directed to put the matter right?

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Probably with much more shock and urgency than we did to the results of an unannounced inspection by HIQA of New Ross Community Hospital in Wexford, which found that recommendations made in February to improve the quality of life of elderly patients had still not been acted upon. That report was preceded by another describing how elderly patients at a care facility in Leitrim had been forced to go unwashed for weeks at a time. People were appalled by what they heard, certainly, but there was almost a sense of weary acceptance in the headlines: "Another state-funded home fails to protect elderly residents."

Such horror stories have become a regular feature of national media, ever since RTE ran an expose at the end of last year, using hidden cameras to show residents at the Aras Attracta home in Swinford, Co Mayo being force fed, pinched, hit with keys, kicked, dragged along the floor. Some residents were left in the same chair unattended for up to 11 hours at a time. Staff ignored them when they cried or pleaded for attention.

Figures released last month showed that there was a record 2,592 referrals received by the HSE's elder abuse service in 2014. Eight new cases are being reported every day, mostly involving neglect, financial abuse (where the elderly are inveigled into handing over money or possessions), and psychological abuse, but also 300 cases of physical abuse as well. The number of unreported cases is believed to be substantially higher.

Nor are nursing homes solely to blame. Children of the victim were implicated in nearly half of all cases (49pc); husbands and wives in one-in-five cases; and a majority of victims were living in their own homes at the time, with only 11pc in nursing homes.

The situation in Ireland is not as bad as in other parts of Europe, but this is still no country for old men - and it's even worse for old women, who make up two-thirds of victims. It's one of the downsides of greater female longevity that it exposes them to a higher chance at some point of elder abuse.

There's a sense that all this is not seen as such a pressing problem because the victims are coming to the end of their lives anyway; which is monstrous in a way, because that ought to make us more sensitive to their needs, not less.

There's also that underlying question: what if it was children who were being subjected to this litany of emotional bullying, harassment, and intimidation? Who were left without food or water, or drugged to keep them docile?

There are many parallels between the way children were systematically mistreated in the past, and how old people are mistreated now. One woman at Aras Attracta was warned that she'd be put out in the cold and dark if she didn't stop crying. There's the same pattern of using the withdrawal of food or attention as a punishment.

Then there's the fact that old people, like children, often don't tell anyone what's happening because they're afraid of the consequences if they do, or don't think they'll be believed, or because they rely on the person who is mistreating them to provide them with care in the first place. Children and the elderly are at opposite ends of their lives, but equally vulnerable and powerless in the face of an overwhelming authority.

The same excuses are also made for those who do the mistreating as we once used to make about those who hurt children. They were stressed. They couldn't cope. They get low wages, and work long hours with little training. We don't make those excuses any more for those who place children in harm's way, so why tolerate them when it's the elderly on the receiving end?

It's not that governments don't care about the issue. It's simply that old people are always pushed to the back of the queue.

Paschal Moynihan, HSE specialist in services for older persons, argues that elder abuse stems from a lack of respect, a belief that older people don't have as many rights as others; and the really awful part of it is that many old people often seem to agree with that sentiment and are reluctant to make a fuss.

This is exacerbated by a growing culture of euthanasia, which is rooted in a compassionate desire to ensure that those who are suffering should have the right to end their lives painlessly and with dignity if they choose, but which has the potential to be exploited to make elderly people feel as if they are unwanted, a burden, that they cost too much, waste too much of everyone's valuable time, and would be better off shuffling off this mortal coil as quickly as possible.

It's a feeling which can only be further cemented when so much of the public debate centres on the costs and logistical problems of an ageing population - the "demographic time bomb", as it's known.

It's always about how much the old cost the young, rather than acknowledging that the old have already paid their fair share for the world which the young inhabit in the first place; and how much more they're going to cost in the future, with people living longer. And it's always "they" who are the problem, as if the old are a separate tribe, when "they" are simply all of us in a few decades' time.

It was striking that a recent review commissioned by the Department of Health concentrated on how many nursing home residents might be under-declaring their assets in order to qualify for financial help rather than on the quality of care which they receive in return for the ongoing contribution they've made over the course of their entire lives. Now a "clampdown" is being urged to recoup some of the annual €1.5 billion cost of nursing homes.

It's natural to want to tighten up the rules if they're being bent by a small wealthy minority, but the majority of elderly people have very modest assets, and the only property they own is the family home which they worked hard to pay off and now understandably want to leave to their children.

Money seems a minor consideration when set against the far more important question of whether old people are being well looked after; whether they're healthy, happy, warm, properly fed, safe.

It's hard not to wonder whether future generations will look back on how we treat the elderly the way we look back on previous generations and tut tut smugly over how they treated children. Each generation is better at seeing its predecessors' sins than its own.

A growing realisation of the nightmare of child abuse was, rightly, the dominant social and political discourse in Ireland for the past two decades. It helped shaped a revolution in the way we think about Irish society, and our relationship with the church, and about sexuality in general. It was all ultimately to the greater good.

Making the end of elder abuse the commanding theme of the coming decades could wind up making an equally huge contribution to working out what sort of society we really want to live in.

Sunday Independent

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