Elder Abuse as a Challenge in Social Services – Supporting older women Sirkka Perttu MSc, Health Care; RN Tartu 29 August 2017 WLF

Sirkka Perttu, Daphne project 2016-2018 29/08/2017 Sirkka Perttu, Daphne project 2016-2018

Why older women do not leave – Cohort effects A certain generation of women: women born in 1930-1940 who raised their children during the 1960s and 1970s various kinds of attachments to their abusers: psychological/emotional, social or financial nature; eg. loss of a place that has been home for decades, fear of going into a nursing home as an alternative T. Zink et.al 2003. different values: First, olderwomen have been socialized with more traditional attitudes and values, particularly relating to gender roles, marriage, and family, divorce was a taboo, greater commitment to traditional religious values socialized with a keen sense of privacy about family matters and a strong commitment to family loyalty and solidarity Silvia M. Straka & Lyse Montminy 2006. Responding to the Needs of Older Women Experiencing Domestic Violence. Violence Against Women, Volume 12 Number 3, March 2006, p. 251-267. 29/08/2017 Sirkka Perttu, Daphne project 2016-2018

Why older women do not leave – Cohort effects Financial barriers may be even greater for older women than younger women many did not work outside home when they were younger – low pension in retirement age Education and independence were not encouraged for women Lack the skills to seek and find employment 29/08/2017 Sirkka Perttu, Daphne project 2016-2018

Why older women do not leave – Period effects Changes in laws, policies and services over time women’s rights, child abuse, elder abuse, and domestic violence were not discussed or even recognized may be unable to realize that there are choices Have no experience dealing with financial or legal matters 29/08/2017 Sirkka Perttu, Daphne project 2016-2018

Why older women do not leave – Age effects Older women are more likely than younger women to have health or functional problems that make them dependent on someone for care this makes it more difficult for them to seek help or to leave Some older women are receiving care from their abusive partners, others may be providing care because of their strong care ethic, it can be extremely difficult for an older woman to leave a dependent, abusive husband 29/08/2017 Sirkka Perttu, Daphne project 2016-2018

Why older women do not leave – Age effects Social networks have been severely reduced by the death of their peers the abusive spouse/adult child may be the only person left in such an older woman’s life loneliness and the fear of loneliness - fear to lose the only relationship If the abuser is own adult child – guilty that could not protect him/her in the childhood from abuse/the result of my upbringing Resources may not exist for the oldest of older women 29/08/2017 Sirkka Perttu, Daphne project 2016-2018

Supporting older abused women If abuse is suspected Create a safe environment for discussion Speak to the client and the caregiver/relative separately Establish a trusting relationship mutual respect Using soft and non judgmental words helps the person ease up Recommended is to use “I” statements instead of straight forward questions (e.g. ”have you been..) – ”According my experience many women are suffereing..”) You can use your own perceptions why you ask Best situation if asking is a routine working model, is not pointing way to ask 29/08/2017 Sirkka Perttu, Daphne project 2016-2018

Supporting older abused women Older women may be asked How are things going at home/in residential care? How are you spending your days? How are you feeling about the amount of help you are getting at home/in residential care? How do you feel your (husband/daughter/other caregiver) is managing? Do you have everything you need to take care of yourself? 29/08/2017 Sirkka Perttu, Daphne project 2016-2018

Supporting older abused women Important with older women: Do not mistake trauma reactions together with disabilities (e.g. hearing/vision impairment, aphasia) for senility Be aware that older women may process information more slowly than younger adults and take longer to put their thoughts into words provide sufficient time to respond that is a normal age-related change and should not be viewed as evidence of lack of mental capacity Some older victims may be reluctant to tell about the abuse or seek help because they fear losing their independence 29/08/2017 Sirkka Perttu, Daphne project 2016-2018

Supporting older abused women Older women needs: Information on abuse and its consequences Practical help and emotional support from workers in a wide range of agencies housing, legal or financial support (e.g. benefits) Support on a longer term basis Effective co-ordination of different services (NGO:s, volunteers, social and health care services) is often seriously lacking Leaving abuser may not be an option Taking care of safety issues/ risk minimization Advice for emergency situations Possibility to contact when needed 29/08/2017 Sirkka Perttu, Daphne project 2016-2018

Sirkka Perttu, Daphne project 2016-2018 Empowerment approach Based on the belief that victims of domestic violence should have access to information, education, and other necessary social and economic support to make informed decisions that best reflect their interests and needs placing power over decision-making in older people’s own hands - respect their decisions a set of services that victims control services that support victims coping with emotional, psychological, and physical trauma, restoring self-esteem, and building independence 29/08/2017 Sirkka Perttu, Daphne project 2016-2018

Sirkka Perttu, Daphne project 2016-2018 Empowerment approach goal of case management is generally to maintain the highest level of independence and autonomy possible The principles underlying responses to elder abuse e.g. in Ireland are: empowerment; rights of the individual; self-determination can involve risk; ‘least restrictive alternative’; protection of the law; access to judicial process. 29/08/2017 Sirkka Perttu, Daphne project 2016-2018

Sirkka Perttu, Daphne project 2016-2018 29/08/2017 Sirkka Perttu, Daphne project 2016-2018