Elder Abuse

International and Cross-Cultural Perspectives

Jordan I Kosberg, Juanita L Garcia

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781317837435
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Here is an informative overview of the causes and consequences of elder abuse in countries around the world. This book delves into the global problem of elder abuse and identifies similarities and differences that occur from country to country. Elder Abuse: International and Cross-Cultural Perspectives increases understanding of the problem of elder abuse, helping you recognize more easily the causes of elder abuse in your own country and find tactics to counter these causes. Strategies from around the world can help in the development of local community resources and social policies to minimize the occurrence of elder abuse and its impact on the elderly, their families, and all members of society. Elder Abuse: International and Cross-Cultural Perspectives discusses elder abuse in countries ranging from Australia to Finland, from South Africa to Hong Kong, from Ireland to Israel. It addresses the consequences of aging, dynamics of elder abuse, family care of the elderly, formal and informal mechanisms for preventing elder abuse, and methods by which to publicize possibilities of abuse. In each chapter, authors explore:

• the definition of elder abuse in their country
• the extent of the problem
• causes of the problem (as related to values and practices)
• societal attitudes regarding the existence of the problem
• private and public efforts to detect and prevent the problem and to intervene where it has occurred Elder Abuse: International and Cross-Cultural Perspectives provides the impetus for community resources, social planning, and public resources. It is of interest to individuals who work in social work, nursing, and psychology settings and to those in social science fields of sociology, anthropology, and gerontology. The book can also serve as an enlightening reader for undergraduate and graduate/professional education.

Chapter 1

Introduction to the Book

Jordan I. Kosberg, PhD
Juanita L. Garcia, EdD

Jordan I. Kosberg is Philip Fisher Professor, School of Social Work, McGill University, Montreal, Quebec H3A 2A7. Juanita L. Garcia is Psychologist, Department of Gerontology, College of Arts and Sciences, University of South Florida.

BACKGROUND

During the late 1960s and early 1970s, the identification of elder abuse was slowly gaining attention. Among the first printed accounts of abuse was an article on “granny bashing” in Great Britain (Burston, 1975). In the United States, causes of the abuse of an estimated 500,000 to 2,500,000 elderly persons each year were being discussed (U.S. Congress, 1980). A variety of theories and explanations for elder abuse were proposed (Kosberg, 1983; Phillips, 1986): sociological, psychological, economic, deviant behavior, intergenerational, social exchange, social ecological, among others. Researchers and practitioners (Kosberg, 1988; Quinn & Tomita, 1986) attempted to identify predictive variables for abusive behavior and high risk factors for the elderly, their caregivers, and family systems. Both antecedents to and consequences from types of abuse were investigated. Throughout the 1980s, increasing numbers of books, monographs, workshops, legislation, education, and research were undertaken on elder abuse. The activities continue today.

It has been generally believed that elder abuse was basically an American phenomenon inherent in its values and history. For example, following a Workshop on Violence sponsored by the U.S. Surgeon General in 1985, Kosberg (1986) testified before a U.S. Senate committee that elder abuse would not disappear until two dominant characteristics of American society disappeared: ageism and violence.

Beyond America, there was a belief that elder abuse was a problem in mainly, if not only, industrialized, westernized, and developed nations (U.S., Canada, Great Britain), for it was from these countries that literature on the topic of elder abuse emanated. One might have concluded that elder abuse was not a problem anywhere else in the world. Indeed, in international travels and conversations with those from other countries, one would have concluded that “there is no such problem here.”

On a lecture and consulting trip to Australia in 1986, a co-editor of this book was asked not to speak on the topic of elder abuse because he was informed that it was not a problem. Yet, a group of social workers in one Australian city told him that elder abuse was very much a problem; a special issue of the Australian Journal of Gerontology (1993) on elder abuse and the chapter in this book have confirmed this declaration made several years earlier. In the same vein, at an international conference on aging, in 1987, a French woman confided to the co-editor, “Well, if elder abuse is a problem in France, we don’t like to talk about it in public.” German and Dutch professors admitted that they would be reluctant to talk about elder abuse in their countries with those from other countries. One said: “You Americans go overboard on too many things–physical fitness, smoking bans, and abusive behavior in the family.”

Growing Awareness of Elder Abuse

In 1986 at a conference in Taiwan, the co-editor was approached by a social worker from Hong Kong who had just finished writing a report based upon his master’s thesis and wished to pass on a copy of his study. His report was on elder abuse in Hong Kong (Chan, 1985). The study conducted under the supervision of two highly respected social gerontologists in Hong Kong, Dr. Alex Kwan and Dr. Nelson Chow, underscored the fact that elder abuse could exist in a country–an area of the world–where filial piety was said to be a sure deterrent to such adversities for older persons.

About this same period of time, a paper on elder abuse in Norway (Johns, Hydle, & Aschjem, 1987), co-authored by a Norwegian anthropologist, a geriatrician, and a psychiatric nurse, was presented at a conference in the U.S.; a book (written by a Japanese physician) was published on elder abuse in Japan (Kaneko, 1987); and a paper was written on a study of elder abuse in Denmark and Sweden (Tomstam, 1987). Thus, it is evident that elder abuse is a worldwide phenomenon, not limited to any one country or any particular stage of development.

The Aging World and Social Changes

The world is aging and so are the countries in the world, a result of decreasing birth rates and death rates, improved medical advances, and the out-migration of younger members of the less developed nations. Coupled with these demographic changes are the changes in the family, the traditional mechanism for the care of the elderly (Kosberg & Garcia, 1991; Kosberg, 1992). There are more divorces and remarriages; mixed marriages; and decisions not to marry and/or to remain childless. Greater mobility (both internal and external migration) also has resulted in the increased possibility that the family may not be available to undertake its traditional caregiving responsibility for the older members of the family.

So, too, there has been significant economic changes that have adversely affected countries and families. The family unit can be under significant economic stress (perhaps with unemployment or underemployment) that requires all able-bodied adults to be employed outside the home. A related and most significant social factor in the world is the emancipation of women from the home as they pursue education and careers. Thus, the female member of the family, the traditional caregiver of the elderly, is less available to provide such care.

In addition, populations have become more mobile than ever before. Large scale urbanization has moved the generally younger members of traditionally rural countries to urban areas to escape poverty and seek employment opportunities. Groups have immigrated elsewhere in the world to seek educational and employment opportunities. Often, it is the older members of the nation who are left behind in such an exodus.

Modernization in the World

Modern health technologies, scientific procedures in economic production and distribution, urbanization, and the extension of literacy and mass education have severely challenged the traditional way of life and values of the less developed countries of the world. Cowgill and Holmes (1972) suggest that, as countries become more modernized, the importance of the elderly in society is reduced. According to this view, the less developed countries treat the elderly with more respect, have more roles for them, and accord them higher status. In more developed nations, they are treated with less respect, have fewer roles to play, and hold a lower status in society.

Recent changes in one country in the Far East, an example of modernization and its impact (Kosberg & Kwan, 1989), included increases in working women, divorce and separation, in remarriages and mixed marriages (by race and religion), in gender equality (in education and employment), in the desire for children to live apart from their aging parents, in the freedom for mate selection, and in decisions regarding the size of one’s own family. The consequences of such changes affect the composition and responsibilities of contemporary families in society.

Despite widespread support for the Modernization Theory, it has more recently been modified (in the face of challenges). Palmore and Manton (1974) suggested that while the status of the elderly does decline in the early stages of modernization, after a period of modernization has occurred, there is a tendency for the status of the elderly to stabilize and then rise. This improvement is the result of actions such as the growth of new programs to replace the farm and the family in maintaining the status of the elderly (retirement benefits, more adult education and job retraining, policies against age discrimination in employment, etc.). Cowgill (1974), too, revised his earlier theory.

The impact of such changes on family caregiving to the elderly are many and affect the existence, quality and quantity, availability, suitability, and desirability of family caregiving. This is to suggest that the social, demographic, and cultural changes in countries adversely affect the continuation of the family as a panacea in the care of the elderly. Overstressed, unmotivated, and ill-prepared family members may prove to be ineffective caregivers. It is also believed that such caregivers might engage in elder abuse.

SOCIAL AND CULTURAL CHANGES RELATED TO ELDER ABUSE

While the number of articles on elder abuse has increased over the past few years, much more has been written about the pressures on traditional family care of the elderly. Although not referring to elder abuse, per se, the situations discussed in such articles can well be signs of the problem and indicative of the growing existence of elder abuse. For example, reports on Nepal (Goldstein & Beale, 1982; Goldstein et al., 1983) alluded to “a cautionary tale from South Asia” resulting from the social and economic forces affecting intergenerational relationships in extended families in this Third-World country. Another article (Cheung, 1988) entitled “Implications of the One-Child Family Policy in … the People’s Republic of China” suggested possible adverse consequences in the future for the traditional family care responsibilities. An article on Japanese attitudes toward the elderly (Koyano, 1989) stated that there was a discrepancy between “tatamae”–culturally-defined normative “shall” attitudes and “honne”–actual feelings toward caregiving responsibility. The “American idealization of aging” led to a courtesy custom without substance in Japan.

In a book on Family Care of the Elderly: Social and Cultural Changes (Kosberg, 1992) that includes chapters written by authors from 16 countries in the world, reference was made to elder abuse in only a few chapters. However, all the authors alluded to conditions that could very well be related to elder abuse. The following is a summary of the dynamics affecting family care of the elderly (and the possibilities for elder abuse) found in the 16 countries represented in the book.

• In the three “young” countries (Ghana, Mexico, and Thailand) with less than 4% of the population elderly, poverty, migration, and adverse economic conditions are affecting the traditional family structure and responsibilities.

• In the three “youthful” countries (China, Costa Rica, and Egypt) with between 5% and 7% of the population elderly, there is decreasing family size, poverty and unemployment, and mobility resulting in large proportions of impoverished elderly in rural areas.

• In the three “adult” countries (Argentina, Hong Kong, and Israel) with between 8% and 10% of the population elderly, independence of the elderly is being challenged by economic problems and a clash between traditional and contemporary values.

• In the four “mature” countries (Australia, Greece, Japan, and the United States) with between 11% and 14% of the population elderly, family care of the elderly is less likely because of the increasing size of the elderly population, emigration, changes in the value for filial piety, and the emancipation of women from the home.

• In the three “aged” countries (Austria, Great Britain, and Sweden) with 15% and more of the population elderly, the independence of the elderly is challenged by economic conditions that are adversely affecting their old age pensions, excessive reliance of female caregivers is causing problems in family caregiving, and formal welfare assistance is being strained by the growth of the elderly in hard economic times.

TRADITIONAL CONTROL MECHANISMS FOR FAMILY CAREGIVING

Family caregiving of the elderly has been sustained over time by a variety of mechanisms, from informal norms and mores to more formalized laws and policies. The latter group of enforcement mechanisms mandate and require families to care for their elderly relatives. Such formal policies have seldom been seen in contemporary societies. In the U.S., legislation for family caregiving requirements has been determined to be unconstitutional in states that possessed such statutes (Garrett, 1980). Even in those countries that have legislated family responsibility, there has been great difficulty in enforcing the law (Gibson, 1984).

Informal mechanisms to sustain family caregiving of the elderly are probably more effective than are the formal mechanisms. The influence of religious teachings and sanctions by friends and relatives are considered to be more powerful. Yet, several of the chapters within the book on family caregiving in the world (Kosberg, 1992) noted the changes that are adversely affecting the informal system for family caregiving of the elderly. For example, in a Buddhist country (Thailand) that has embraced ancestor worship, divorce, geographic mobility, and smaller family size are challenging traditional social relationships. Although the Koran influences the daily life of Moslem Egyptians, the family is undergoing changes (resulting from poverty and emigration) that are affecting its ability to care for the elderly. The Confucius teaching in China is undergoing revisions. Despite the fact that the Judeo-Christian admonition to honor one’s father and mother is still valued in places such as Israel, the United States, and Mexico, authors from these countries described a growing lack of desire and/or inability to implement such a commandment.

Even village life, which had been glamorized as a location in which reciprocity and mutual concern provided supportive environments for the elderly, has undergone considerable change. The migration of younger members of a society have generally taken them from rural to urban areas, thus, leaving behind increasingly elderly populations (with fewer younger members for their informal support systems); and in urban areas, the elderly have been adversely affected by victimization and by new urban social norms that have influenced their younger relatives (and lessened the desire to take on caregiving responsibilities). Finally, Ken Tout (1989), in his book Aging in Developing Countries, concluded his analysis of aging in many countries of the world by suggesting that even religion could not be relied upon to “stay the process of disintegration” (p. 15) of marriage and the family in many (if not all) countries he studied in the East, Africa, and South America.

ELDER ABUSE IN THE WORLD

With more and more being written about elder abuse in the world, the question arises whether the problem is a relatively new one that is being discovered for the first time, whether it has always existed and is now increasing and can no longer be ignored, or whether it has always existed but is now the subject of study and practice. Although the consensus is that the problem of elder abuse has always existed, the demographic, social, and economic factors probably have led to a significant increase in the problem. In addition, of course, there has been an increase in the awareness of the problem influenced by research from the United States, Canada, and Great Britain.

As an example of the increased attention to elder abuse worldwide, the Journal of Elder Abuse & Neglect, over the past three years, has had articles from Japan (Kaneko & Yamada, 1990), Norway and ...

Table of contents

• Cover
• Title Page
• Copyright Page
• Dedication
• ABOUT THE EDITORS
• Table of Contents
• Chapter 1: Introduction to the Book
• Chapter 2: ‘Elder Abuse’ as an Innovation to Australia: A Critical Overview
• Chapter 3: Elder Abuse in Finland
• Chapter 4: Mistreatment of the Elderly in Greece
• Chapter 5: Elder Abuse in Hong Kong: A New Family Problem for the Old East?
• Chapter 6: Elder Abuse in a Forming Society: Israel
• Chapter 7: Elder Abuse in India
• Chapter 8: Elder Abuse in the Republic of Ireland
• Chapter 9: Norway: Weakness in Welfare
• Chapter 10: Elder Abuse and Neglect in Poland
• Chapter 11: Elder Abuse in South Africa
• Chapter 12: Common and Unique Themes on Elder Abuse from a World-Wide Perspective
• Index