Elder Abuse and Wellbeing of Older Women

1. FerdousAra Begum • Former member, UN CEDAW Committee • International Conference on Elder Dignity and Abuse • March 14-16, 2014 • Centre for GerontologicalStudies • Thiruvananthapuram, Kerala, India. Elder Abuse and Wellbeing of Older Women

2. Introduction • A study by the Head of Policy of HelpAge International reveals that violence against women does not stop in old age. Another study reveals that one in ten older adults have been victims of elder abuseand in most cases, abuse occur in women. This is no exception in the Asia-Pacific Region. Elder abuse is a huge violation of human rights and affects dignity of a person. • Previously older women have never been considered as potential or actual targets of sexual assault and as a result have been under-identified and under-served as victims. The common perception is that elderly women after menopause are not sexually or reproductively active and may not be targeted as a victim of sexual abuse. But in reality older women are most victim of elder abuse. From the above back drop today I would like to present my paper on Elder Abuse and Wellbeing of Older Women.

3. Background • Quoting from UNDESA, Population ageing and development chart, 2011, at present there are 82 men for every 100 women at the age of 60; there are only 55 for every 100 women at the age of 80.Older women continue to outnumber older men. UN projection also states that 80 % men over the age of 60 are married compared with only 48%of older women • As women age and their independence decline they become more venerable to exploitation, violence and sexual abuse • Ageing of population is gradually emerging as an issue not separate from social integration, gender advancement, economic stability or poverty including level of education in the society • This is now more than just a demographic issue – it is a social and economic issue and must be addressed with increased attention and resources allocation

4. Disability and Elder Abuse • Growing old is also strongly associated with greater incidence of disability, which is also responsible for elder abuse. • A major risk factor for elder abuse is cognitive impairment. Approximately 50% of adults older than 85 years are cognitively impaired. Depression and anxiety are highly prevalent among older adults and are risk factors for abuse. • Elder abuse and sexual assault has a serious consequence on women’s physical and mental health and wellbeing in later life • Researchers have identified domestic violence as the most common form of abuse against older women, and many of them who suffered at the hands of their partners or husbands when they were young continue to be abused in their old age.

5. Elder Abuse in Different Countries • In some Asian countries where restricted polygamy is legally allowed, many older wife face violence and death threat from their husbands if they refuse to give consent for a second wife to their husbands • Property grabbing is another reason why older widows face abuse and violence in their later life • Elder abuse victims face unique obstacles in seeking assistance because they often are dependent on the abusers and may not have the option to move or otherwise to end the abusive relationships • Older women in need of long term health care face abuse and discrimination at home from their family members or from the care givers . Many of the health care providers lack training on age related illness and access to palliative care. • Also in some African countries there is a custom called ‘widow inheritance” where widows including older widows are forced to marry with deceased husband’s siblings or any other person against their will to keep the marital property within the family

6. Elder Abuse by Categories • Physical Abuse - inflicting physical pain or injury on an older person, e.g. slapping, bruising, or restraining by physical means • Sexual Abuse - non-consensual sexual contact of any kind • Neglect - the failure by those responsible to provide food, shelter, health care, or protection for a vulnerable elder • Exploitation and financial abuse - misuse or concealment of funds, property, or assets of a senior for someone else's benefit • Emotional Abuse - inflicting mental pain, anguish, or distress on an elder person through verbal or nonverbal acts, e.g. humiliating, intimidating, or threatening • Abandonment - desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person

7. Human sufferings due to Elder Abuse Elder abuse affects dignity and pride of a person and erodes mental strength. The crisis that occurs as a result of a sexual assault or abuse leaves a woman feeling powerless: it damages self-esteem and erodes personal confidence Bruises, pressure marks, broken bones and burns may be an indication of physical abuse, neglect, or mistreatment. Beside these, harm caused to mental health of a victim through stress and indignity cannot be measured.   The cost of the human sufferings due to elder abuse and sexual violence is immense, as it greatly affects women’s body and mind. A major public awareness and further research as well as professional understanding of the issues are important.

8. International Human Rights Norms and Legal Standards for the Protection from Elder Abuse Council of Europe • On 19 February 2014 the Committee of Ministers of the Council of Europe adopted Recommendation Cm/Rec(2014)2 with the purpose to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by older persons without any discrimination. • The Recommendation, which has been widely welcomed by those campaigning for the rights of older persons, requires member states to promote respect for older persons’ inherent dignity (paragraph 1), to guarantee their access to sufficient information about their rights (paragraph 4) • The Recommendation alsosets out detailed guidance in relation to the implementation of measures aimed at protecting older persons from violence and abuse (paragraph 18).

9. General Recommendation No. 27 • The General Recommendation Number 27 under CEDAW Convention is a remarkable protection strategy with state obligation, which addresses all aspects that affects the life of older women • The General Recommendation is equally useful to older women in developed or in developing countries, in rural areas or in urban slums, in the areas of conflicts or in the situation of natural disasters. • It addresses all the key issues like, universal access to all social services, increasing number and amount of social pension, enacting laws and policies that prevent age and gender based discrimination, abuse and violence in all walks of life including discrimination in the work place, access to health needs and education. It also addresses feminization of poverty and ensuring their rights to have dignified, productive and healthy life.

10. CEDAW Convention The CEDAW Committee has increasingly addressed the violation of the rights of older women and sexual exploitation in various countries in its concluding observations, during constructive dialogue and in its list of issues and questions, as well as through follow up mechanism with time bound recommendations and policy measures.

11. Madrid International Plan of Action on Ageing • The Second World assembly on Ageing, which took place in Madrid, in 2002, adopted the Madrid International Plan of Action on Ageing, with an aim of promoting and protecting human rights and fundamental freedom of all older persons including rights to development • It has developed a new social protection mechanism, such as old age allowances, free medical services with limited coverage. • Many of the signatory States parties not have developed any policy approach integrating ageing into the development agenda and allocation of budget for empowerment of older persons also it lacks strong monitoring mechanism with binding obligation.

12. Protection from Abuse and State Obligation • Despite a growing interest in the problem of elder abuse, most countries have not introduced specific legislation on elder abuse. • Only Canada, USA and few other countries have legislation for the mandatory reporting of abuse of the elderly. France has a separate ministry for older persons • Although elder abuse has been proven to exist in several low income or middle-income countries in Asia and Africa, very few specific programmes have been established in this respect. • The China National Committee on ageing has taken several positive measures to address these challenges. They are offering tax breaks to investors working in the ageing industries

13. Bangladesh Scenario Government initiatives to address the issues of ageing population 1. The Government of Bangladesh has adopted a National Policy for ageing population on 11th February , 2014, based on the of Madrid International Plan of Action on Ageing. This policy has recognized older person’s contribution in the society and their rights for security in life and property, financial security and their security for health and nutrition and education as well 2. Government also enacted a new Law, making it legally binding upon children to provide care and support to their elderly parents 3. Other existing programmes are Pensions, as retirement benefit for Government Employees, family pension for widows Govt. Servants in the public sector 4. Old Age Allowances, this is the largest single programme for the benefit of poor older persons in the country. Number of beneficiaries is 2.5 million who get 300 taka per month. Besides there are widows allowances, allowances for distressed and destitute

14. Innovative Protection Strategies to Prevent Elder Abuse, Violence and Sexual Assault 1. Governments and NGOs should encourage media to address negative stereotyping of older women as dependent, fragile and useless through projecting and promoting good images of older women as care givers in the family for migrant children and for ageing adults or sick persons in the family as unpaid workers also their past contribution in the society to change the mind set of people 2. Governments should initiate nationwide advocacy programmes about the exiting legislative measures to prevent elder abuse including the rights of older women so that they may have access to essential public services. This will also educate people about their rights.

15. Innovative Protection Strategies to Prevent Elder Abuse, Violence and Sexual Assault 3.Governments and NGOs should take initiatives to address poverty and marginalization of older women in rural areas through providing support system and collateral free microcredit including affordable transportation to enable older women to participate in economic and social life and community activities. States Parties also should provide affordable water, electricity, housing and other utilities to older women so that they may have a better life. Expert on extreme poverty also raised concern on the same issue and said that non contributory pensions are the most efficient way of ensuring protection for older women and compensating them for their years of unpaid and inadequately paid works.

16. Innovative Protection Strategies to Prevent Elder Abuse, Violence and Sexual Assault 4. Governments should adopt a comprehensive health policy for the protection of mental and physical health needs of older women. This should ensure affordable and accessible health care and include interventions promoting behavioral and lifestyle changes to delay onset of health problems. Post- menopausal difficulties and diseases, neglect in disability and absence of geriatric medicine require special attention. Older women face a higher risk of chronic illness and disability as well as risk from degenerative diseases such as osteoporosis, cervical cancer. Protection strategy should take care of women from different age groups beyond 70 years, who have different kinds of health needs, which may vary depending on their health conditions and economic and social situation. Training for health care providers and creating networking also an effective strategy for their safety.

17. Save for Yourselves When You Are Young • One of the main reasons for elder abuse is economic and financial insolvency and absolute dependency on the family, which due to poverty cannot bear anymore burden. • There are many countries including Bangladesh have enacted laws, that made it legally binding upon their children to take care of their elderly parents. But it will not work if there is no Government subsidy for elder maintenance. • Elderly care, both supply of medicine and nutrition along with long-term treatment is very costly. So my suggestion is save for your own, when you are young. You never know how long you are going to live and how much money you will need for a decent life. • So save for your old age and make your old age as a gold age.

18. Conclusion • To improve the prevention and support mechanism for older women who are at risk, effective protection strategies including appropriate legislation and policy measures, increasing knowledge base and public awareness about the issue, capacity building, treatment and empowerment of the victims and vulnerable groups are essential. • Professional training for care providers along with effective implementation of the CEDAW Convention and its General Recommendation No 27 are very important to protect the human rights of older women, so that they have a decent and dignified life.

19. Thank You