BATTERED GRANNIES
Elder abuse may be a sign of the changing times, says geriatrics-psychology expert
By GRACE ROXAS, CONTRIBUTING WRITER
Western experts call it "another hidden, unspoken issue in society," similar to wife beating, incest, and child abuse. It is said to be something habitually misdiagnosed, underreported, even ignored by health professionals, and the perpetrators of abuse are usually family members.
However, despite gaining attention in the West as far back as 20 years ago, "granny battering" or abuse of the elderly has never hooked the local news media or elicited activism among cause-oriented groups in the same way as other criminally deviant behaviors in the family setting.
Based on some preliminary findings, local geriatric-psychology expert Joe Eleazar says Pinoys may have to live with the disturbing truth that granny abuse is not unknown in our modern culture, despite our strong tradition of filial piety. "Does elderly abuse occur in the Philippines? Some people would say never. But elder abuse in the country may be a sign of the changing times," Eleazar said.
He cited the results of a pilot census he had undertaken with some colleagues in 1999 among elderly residents of a nursing home called Lualhati ng Maynila. Using a questionnaire based on the parameters set by a European elderly-abuse watchdog, the census was an index, albeit an extremely limited one, of the possible extent of this hidden social rot.
Among the 38 residents interviewed, 86.8 percent fell prey to active negligence characterized as indifference, forsaking of the frail, and breach of duty, presumably by family and nonfamily caregivers.
The next most common offense recorded was psychological abuse (81.6 percent) through isolation (38.8 percent), verbal assault, psychological maltreatment, and instilling fear of violence. There were also cases of financial exploitation, material abuse, theft, withholding of income (e.g. pension), misrepresentation, and even the adversarial use of the power of attorney.
A further 26.3 percent were denied their basic rights to food, clothing, shelter, and health services and their liberty to decide. Physical abuse, through physical cruelty and restriction of movement, was also reported by a few respondents.
Noted to be at highest risk for abuse were single or widowed females between 60 and 69 years, of poor economic status, low education, and nonprofessional working background, those with medical and/or psychiatric problems, and are highly dependent on their families.
In general, Eleazar said that the risk factors for elderly abuse are older age, lack of access to resources and poverty, social isolation, minority status, functional debility, and cognitive impairment such as dementia, psychological and character pathology, and substance abuse.
The caregiver's history of violence and sheer burnout may also expose an elderly individual to ill treatment. In terms of caregiver burnout, Eleazar pointed out that the notion that cumulative stress in the relationship of the caregiver and the elderly can be a powerful powder keg for abuse.
A caregiver experiencing social isolation, employment problems, and financial hardship-not to mention physical hard work, ignorance, and poor coping skills-is likely to develop an attitude leading to abusive behavior.
Eleazar cited feelings of loss, loneliness, humiliation, hopelessness, and stigmatization on the part of the caregiver, all of which perpetuate a vicious cycle when they are confronted with an elderly patient's dependent and demanding behavior, difficulty in communicating, agitation, aggression, and paranoia toward the caregiver.
Interventions needed
Being old in the Philippines is a double-edged reality, Eleazar said. "Usually, the elderly Filipino is independent, well-loved by their family and community, and treated with utmost respect. However, they also have very poor life expectancy, a lot of health problems yet without much access to health-care benefits. In the Philippines, elderly people have become a victim."
Since undertaking the minicensus seven years ago, Eleazar and his colleagues have called for positive action to address elderly abuse. "We have Bantay Bata here or kids' watch, but there's no such thing as a Bantay Matanda, no hotline whatsoever for the elderly," he said.
He noted that laws regarding abuse of older person are nonexistent in the country. In connection with recommendations for putting in place legislation against elderly abuse, he and his colleagues are planning to undertake a collaborative baseline study with custodial care institutions to serve as basis for policy making. M
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