Giving a voice to those who suffer in silence

Most of the country's health boards have yet to appoint case officers to deal with the 20,000 elderly people believed to be victims of abuse, writes Pat Brosnan.

JOHN McINERNEY thought he had a reason for ritually killing his uncle.

He believed 82 year-old Seán Daly to have been possessed by the devil.

Late last year he was found guilty but insane by the Central Criminal Court.

Seán Daly is not the first person to have been abused by a relative, nor will he be the last, although this unfortunate case, dramatic, bizarre and tragic though it was, was conceived by a mentally disturbed mind.

Other elderly people - mothers and fathers, aunts and uncles - are abused and sometimes killed in this country for the more base and age-old motive of greed.

Abuse can take the shape of elderly people being put under pressure to sign over their homes to their children, who see them sitting on a huge asset.

It can include physical abuse, taking charge of their pensions, depriving them of food, threatening them, neglecting their medical needs and locking them in their rooms.

Because there are no official records, it has been estimated that more than 20,000 elderly people may be suffering from abuse, neglect and/or maltreatment.

Yet, the vast majority of the country's health boards have not appointed case officers to deal with elderly abuse, although they have received Government funding to do so.

The Southern Health Board, for instance, has just one.

As far as Mary Nally, of the Senior Helpline, is concerned it is not enough.

"This is a growing problem and there's an urgent need for trained professionals and trained volunteers. One professional in an area such as the size the SHB covers is totally inadequate," she said.

"We receive several thousand calls every year, and for many it's the first time they have broken silence."

The Senior Helpline is a national service with nine centres around the country, including Ballincollig, Co Cork. It has 300 extensively trained volunteers, which will be increased to 400 shortly.

"All the lines are manned by older people, so when somebody rings us, it's peer-to-peer. As well as that, they will get all the time in the world from a sympathetic person to discuss the problem."

About two years ago a Government-appointed working group on abuse of elderly people made a range of recommendations, including the establishment of a steering group in all health board areas, and the appointment of a health board officer with responsibility for abuse and support staff.

It also said that clear policies on abuse of elderly people should be introduced at all levels within the health, social and protection services, as well as the provision of a e4.5 million budget for the provision of staff and services, as well as a national centre on research and training.

At this stage, apart from making additional funding available to health boards and the setting up of an implementation group, those recommendations are still only recommendations.

Despite the huge area covered by the Southern Health Board (SHB), it confirmed that within the board there was one senior social worker employed in Kerry Community Services dealing with protection services for older people.

This post deals very specifically with cases of elder abuse within Kerry Community Services, which has a population of 18,208 people over the age of 65.

The lone social worker is fully funded through an allocation from the Department of Health and Children, which is currently rolling out a national programme to deal with elderly abuse.

THE position arose from a pilot project which was carried out in Kerry during 2001/2002. The service has not been extended to other areas of the SHB as yet.

In 2003 there were a total of 91 referrals to the service, 80% of whom were female, with an average age of 75.

Referrals predominately came from within the health service. The reasons for referral included neglect, emotional abuse, financial abuse, self neglect, physical abuse and psychological abuse.

The Irish Nurses' Organisation (INO) has called for new legislation to tackle the hidden problem of abuse of elderly people, which, it warns, is a growing problem in both their homes and in care facilities.

It also wants the establishment of an ombudsman for elderly people, full implementation of the 2001 Health Strategy and the funding of a public awareness campaign.

According to the INO, which has drawn up guidelines to aid nurses understand and deal with the problem, the international trend would suggest that as many as 21,500 elderly people in Ireland could be subjected to some form of abuse at any one time.

The guidelines advise nurses to be aware of signs which vary from burns, disrupted sleep, sudden alterations to wills, malnutrition to human bite marks.

Paul Murray, a spokesman for Age Action Ireland, said that abuse of elderly people was international but was only coming to the fore now in Ireland because people had only been thinking of child abuse.

"It's difficult to be precise about the number of elderly people being abused. Some figures would indicate 35%, while a House of Commons report suggested up to 10%," he said.

Paul Murray said that every bank branch should have an employee designated to elderly customers to monitor movements in their accounts for their own sake.

"People give their adult children signatory rights, which is generally a good idea, but it can be abused. Such a person in a bank could see if there's any abnormal change in the account, such as large sums of money being moved out of it," said Mr Murray.

The Senior Helpline can be contacted for the price of a local call on 1850 440 444 and is open from 10am to 1pm, and 7pm to 10pm daily.