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A Global Response to Elder Abuse and Neglect: Building Primary Health Care Capacity to Deal with the Problem Worldwide

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United Nations estimates indicate that by 2025 the number of older people will double from the current 600 million to 1.2 billion. Of the one million people who reach their sixtieth birthday each month, 80% are in the developing world. Although the proportion of older people out of the total population is higher in developed countries, the percentage increase of the elderly population is much greater in the developing world (UN Population Division, 2004). Furthermore, rapid ageing in developing countries is taking place in the context of fast social change, such as urbanization, increased participation of women in the workplace, industrialization and prevailing poverty.

Although elder abuse is not a new phenomenon, the speed of population ageing worldwide, in the context of such profound societal changes, inevitably will lead to an increase in its incidence and prevalence. Until very recently, elder abuse, the mistreatment of older people, was a social problem hidden from public view and mostly regarded as a private matter. However, elder abuse is a manifestation of the timeless phenomenon of interpersonal violence. Child and partner (mainly female) abuse were the first to emerge and were both seen as mostly family (domestic) violence issues. Public awareness towards child abuse and violence against women gained prominence only once studies in the last quarter of the twentieth century provided evidence of their magnitude. As a consequence, interpersonal violence was then framed only within agespecific compartments. Apart from other parameters that try to explain victimization in different population groups, ageing may trigger an additional risk of abuse due to the increased dependence on others, social isolation and frailty that accompany it. Moreover, older men and women come from generations that avoided discussing private issues. As a result, elder abuse continues to be a taboo, mostly underestimated and ignored by societies across the world. Evidence is accumulating, however, to indicate that elder abuse, which includes the pervasive issue of neglect, is an important public health and societal problem that manifests itself in both developing and developed countries. As such, it demands a global orchestrated response. From a health and social perspective, unless the primary health care (PHC) and social services sectors are well equipped to identify and deal with the problem, elder abuse will continue to be underdiagnosed and overlooked.

WHO/ALC and CIG-UNIGE, with partners from all continents, conducted this study in order to develop a strategy to prevent elder abuse within the PHC context. The study consisted of a qualitative research project in eight participating countries focused on testing questions originally devised by researchers in Montreal. These questions were aimed at raising awareness among PHC professionals of the issue of elder abuse.

Read WHO’s report here.