Analysis

Older domestic abuse victims need targeted support

Domestic abuse charity SafeLives is calling for a focus on older victims of domestic abuse who they describe as a ‘hidden’ group.

Domestic abuse charity SafeLives is calling for a focus on older victims of domestic abuse who they describe as a hidden group

In a report called Safe Later Lives, the charity reveals that approximately 120,000 over-65s will have suffered abuse in the past year and older victims experience abuse for twice as long as those who are younger before seeking help.

Nearly half of older victims are likely to have a disability and are more likely to experience abuse from an adult family member or current intimate partner. One quarter of older adults who are known to services have been victims of abuse for more than 20 years.

Priorities

The charity also wants national policymakers to prioritise domestic abuse as a health issue, incentivising hospitals

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Domestic abuse charity SafeLives is calling for a focus on older victims of domestic abuse who they describe as a ‘hidden’ group

In a report called Safe Later Lives, the charity reveals that approximately 120,000 over-65s will have suffered abuse in the past year and older victims experience abuse for twice as long as those who are younger before seeking help.

Domestic abuse
Older domestic abuse victims should be given the opportunity and space to talk Picture: iStock

Nearly half of older victims are likely to have a disability and are more likely to experience abuse from an adult family member or current intimate partner. One quarter of older adults who are known to services have been victims of abuse for more than 20 years.

Priorities

The charity also wants national policymakers to prioritise domestic abuse as a health issue, incentivising hospitals to provide a seven-day a week independent domestic violence adviser (IDVA) service.

SafeLives chief executive Diana Barran says: ‘All victims and especially older victims, have more engagement and contact with the health sector than others. In health settings we need to support people earlier. Domestic abuse is not an issue that can, or should, be dealt with by the police alone.’

RCN professional lead for public health Helen Donovan says: ‘From a nursing perspective it’s about being aware of the risks and the fact domestic abuse exists. It is important nurses know which questions to ask.

120,000

Number of over-65s who have suffered abuse in the past year

Source: Safe Later Lives

‘Often the difference with older people is that they may live with domestic abuse for many years and think it is just part of life. Older people can also become victims of domestic abuse as they age, it might not always be a partner – it could be a son or daughter or a carer – someone who is in a trusted relationship and even someone who is visiting on a regular basis.

‘If as a nurse you have suspicions it is important to find the right time to ask. It is vital the person feels safe and that the alleged or potential perpetrator is not in the room.

‘Nurses should be mindful of trigger points and that certain times in people’s lives can be more risky, like changes in a relationship because of care needs.

‘One indicator on its own does not mean someone is being domestically abused, but nurses are often able to see the wider picture.’

She adds that in addition to a section about domestic abuse on the college’s website, the RCN is developing a risk assessment tool poster and a pocket guide that nurses can use as an aide-mémoire when working with people they think are at risk of domestic abuse.

Get talking

‘In nursing we need to talk about domestic abuse in the same way as we talk about safeguarding children,’ Ms Donovan adds.

Bridget Penhale, a reader in mental health at the University of East Anglia, is an award-winning academic in the field of elder abuse. She says that in addition to more information and training for health professionals, there is a need to raise awareness among older people about recognising abuse and the help that might be available to them.

‘Tailoring support services to the needs of the older person, developing outreach programmes and peer-support networks are important elements of the specialist support which individuals are likely to need,’ Ms Penhale says.

25%

Percentage of older adults who have been victims of abuse for more than 20 years

Source: Safe Later Lives

Julie McGarry, a nurse and associate professor at the University of Nottingham, is chair of the university’s domestic violence and abuse integrated research group.

She has developed an educational resource with older women who are survivors of domestic violence detailing their stories.

‘For nurses and healthcare practitioners this report further highlights the historical invisibility of older women as experiencing domestic violence and abuse – this includes sexual violence, intimate partner violence and family abuse,’ Dr McGarry says.

Duty of care

Amanda Burston spearheaded a domestic violence service in an emergency department and was named RCN nurse of the year at Nursing Standard’s Nurse Awards 2015.

3%

Percentage of domestic abuse victims aged 60 or over who are accessing independent domestic violence adviser services

Source: Safe Later Lives

Her direct experience of working with older people who have experienced domestic abuse includes a patient in her nineties. She says: ‘When safe to do so, ask if patients are safe at home, or wish to discuss any concerns. Observe behaviours of “loved ones”.

‘If you fear for the safety of your patient, you have a duty of care under safeguarding and all staff should follow local policy.

‘Staff should attend training on domestic abuse in order to improve their own awareness and knowledge of local care and support providers.’

Legislation

The Care Act 2014 in England states that adult safeguarding means ‘protecting an adult’s right to live in safety, free from abuse and neglect’.

Safeguarding duties apply to an adult who:

  • Has needs for care and support.
  • Experiences, or is at risk of, abuse or neglect.
  • As a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of, abuse or neglect.

The Care Act specifies that freedom from abuse and neglect is a key aspect of a person’s well-being. The guidance outlines that abuse takes many forms. It describes the following types of abuse, which include exploitation as a common theme:

  • Physical abuse.
  • Domestic violence.
  • Sexual abuse.
  • Psychological abuse.
  • Financial or material abuse.
  • Modern slavery.
  • Discriminatory abuse.
  • Organisational abuse.
  • Neglect and acts of omission.
  • Self-neglect.

In Wales the outcome of a closed consultation on guidance on domestic abuse and sexual violence for older people is awaited. The Scottish Government has passed the Abusive Behaviour and Sexual Harm (Scotland) Bill.

Source: Safe Later Lives

 

Recommendations

The Safe Later Lives report has six categories of policy and practice recommendations, including:

  1. Systematic invisibility, for example, provide training for health professionals so that they understand the dynamics of an abusive relationship involving an older victim, and how to provide a safe place for disclosure.
  2. Long-term abuse and dependency issues, for example, a cultural understanding in professional services that older victims may need prolonged interventions due to their abuse being sustained over a longer period.
  3. Generational attitudes about abuse may make it hard to identify, for example, services must be aware that older people are less likely to disclose and must ensure they ask appropriate questions and give victims the space and opportunity to talk.
  4. Increased risk of adult family abuse, for example, training for independent domestic abuse advisers specifically on inter-family violence and the adult safeguarding concerns related to this.
  5. Services are not effectively targeted at older victims, and do not always meet their needs, for example, consider older women in service redesign such as housing and refuge options.
  6. Need for greater coordination between services, for example, implement a multiagency domestic abuse training programme.

Source: Safe Later Lives

 


Reference

SafeLives (2016) Safe Later Lives: Older People and Domestic Abuse.

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