Aged Care Insite Issue 106 | Apr-May 2018 | Page 15

industry & policy Older carers at risk too National plan on elder abuse should also focus on carers. By Ara Cresswell C arers Australia joins with others working in the sector and representing the interests of the aged in applauding the announcement of a national plan to address elder abuse. We acknowledge that family and friend carers are frequently identified as the perpetrators of elder abuse. Sometimes the focus is on carer negligence, which may occur because the carer is disinclined to provide the level of care needed or because the carer simply doesn’t have the information to understand the standard of care they need to provide. In other cases, we hear of financial abuse if the person being cared for is bullied or cajoled into giving the carer access to their finances or because they cannot manage their finances themselves. In other cases, physical abuse, including sexual abuse, is perpetrated by family members. However, it is important to remember that when we’re talking about elder abuse, many carers are themselves aged – bearing in mind that 36 per cent of all carers and 26 per cent of primary carers are over the age of 65. Most are caring for a partner. Even if they’re not caring for a partner but one of their children or another relative, they are still at risk of abuse. What is commonly overlooked is that carers themselves are often the victims of abuse by the person they are caring for. Twenty-five per cent of respondents to a 2015 Carers Queensland survey of 571 carers admitted to being abused – physically, financially or emotionally – by the person they are caring for. Not all these carers will be caring for someone over the age of 65, but many will. Many carers also admitted to experiencing more than one type of abuse. There are many reasons and they will vary by the type of abuse. For example, practising emotional and psychological abuse may simply be the outcome of becoming dependent upon a carer, leading to frustration, embarrassment and denial about their care needs. It can arise from the experience of chronic pain, psychosocial disorders and dementia. In cases where an older carer is caring for a younger person, the triggers are likely to be similar. What the literature on abuse in caring relationships does suggest – whether we are talking about abuse of a carer or of the person being cared for – is that physical or mental abuse is much more likely to take place if it is embedded in the relationship prior to the caring situation. Older carers who are abused continue to care for their abuser for a number of reasons, some of which are shared by other people who are locked into abusive situations: ∞ There is no alternative care or accommodation available other than perhaps the person they care for moving to an aged care home – which that person may not be prepared to contemplate and which the carer might not be willing to contemplate either. ∞ The carer may be fully or partly financially dependent on the perpetrator and cannot see a clear way to break this dependence. ∞ The carer may not be able to contemplate the stress associated with intervention services – especially in the case of physical abuse. ∞ Loyalty and commitment to the person they care for may prevent carers from reporting or addressing the abuse, especially if it is linked to deteriorating capacity or behaviours related to disability and not seen as intentional. Just as is the case with people experiencing abuse in other age groups and other situations, it is important for carers to have services available to them that address their specific circumstances. Such services are available both through carer support programs and through other services in the community and the justice system. However, carers may not be aware that this is the case. We would hope and expect that the national plan to address elder abuse focuses on carers as well as those being cared for – both from the perspective of addressing the circumstances in which a carer may commit abuse and the circumstances of the carer being the victim of abuse. ■ Ara Cresswell is the chief executive of Carers Australia. agedcareinsite.com.au 13