Violence against Older Adults per the “Dial 100-Older Adult” Data

  

    
Violence    nature
    
Amount
    
Proportion
  
  

    
Negligence
    
29,792
    
79.54%
  
  

    
Psychological violence
    
20,770
    
55.48%
  
  

    
Financial/property    violence
    
15,620
    
41.70%
  
  

    
Physical violence
    
9,921
    
26.49%
  
  

    
Institutional violence
    
1,638
    
1.71%
  
  

    
Sexual violence
    
171
    
0.46%
  
  

    
Discrimination
    
109
    
0.30%
  

Table 1: Dial 100 reported violations against older adults – 2018.

This table already shows some evidence, the main one being that 79.54% of the complaints report third-party negligence regarding care due to older adults. The main ways this type of violence is manifested appear as a failure to provide support and protection (27,266 complaints, 91.52%); adequate food (16,127, 54.13%); medicines and medical care (14,255, 47.85%); hygiene and personal care (14,150, 47.50%); besides abandonment (7,884, 26.33%); self-neglect (255, 0.86%) and others (2,113, 7.09%). National and international studies show that negligence occurs mainly with people losing their physical, mental, gait, and physiological autonomy. While the Statute for Older Adults says that the family, community, society, and the public power should care for and protect older adults, national and international research on the subject shows that the burden of care falls on the family, and within it, in more than 90% of the cases, a woman, usually already overloaded with the other services [16-18,24-32]. Therefore, under the Statute for Older Adults, the exceptionally high proportion of negligence cannot be attributed only to someone who cares or supposedly should care directly, as highlighted, among other documents, by the European Association Working for Carers [19].

The so-called psychological violence, now known as “ageism”, ranks second among abuse and mistreatment. It can be detailed as follows: hostility or harassment (18,911, 91.01%); humiliation (13,607, 65.49%); threat (6,810, 32.78%); slander, injury, and defamation (1,271, 6.12%); extortion (924, 4.45%); persecution (557, 2.68%); infantilization (150, 0.72%); and others (496, 2.39%). The magnitude of psychological violence means contempt and horror for older adults [21,22]. When reaching their self-esteem and lifestyle, abusers exclude and delegitimize them from social life. Ageism is a prejudice that offends and reduces someone’s potential, disdaining their possibilities to contribute to the family, community, and society [34-36].

A total of 24,662 financial or property abuse reports were recorded on the Dial 100-Older Adult [2] (third on the list of grievances), broken down into the following categories: 12,048 (77.13%) withholding wages and assets; 4,268 (17.44%) asset appropriations and expropriations; 1,514 extortions (9.69%); 906 thefts (5.80%); 846 destruction of goods (5.42%); 415 robberies (2.66%); 290 embezzlements (1.86); 152 other unspecified (0.90); and five concealments of documents (0.03). The magnitude of the greed of family members and fraudsters on retirement money or provisions from other income sources for older adults (77.44%) is highlighted. Financial or property violence against seniors is a crime provided for in art. 102 of the Statute for Older Adults [2]: “appropriating or diverting assets, earnings, pension or any other income from older adults, using them differently from their purpose, with a penalty of imprisonment from one to four years and a fine”. However, this type of violation is widespread. The leading causes are a lack of respect, knowledge of the law and the rights of older adults, and the erroneous idea of family members who consider the property of parents, grandparents, and relatives as theirs. We still have common types of financial violence: forcing older adults to sign a document without explaining its purpose; forcing them to enter into a contract or change their will; donating or signing a power of attorney without their consent or understanding of what they are doing. We should be mindful that older adults aware of their actions, in any social or health condition, prefer their living place, their specific place inside the home, and like to keep their belongings and personal objects because all are part of their history. Depriving them of this history is to kill them in advance, pulling out their roots [25-27,34].

Finally, data on physical violence on the Dial 100-Older Adult [2] totaled 15,900 complaints. They break down into 7,731 (77.93%) mistreatment cases, such as hitting, pushing, pinching; causing bodily harm (7,139, 71.96%); incarceration in private prison (867, 8.74%). The list is completed with 161 attempted homicides (1.62%), 19 robberies (0.19%), and ten completed homicides (0.10%). Some data are unspecified. The numbers and proportions cannot obviously be seen only by the quantities they represent. On the one hand, daily violence mainly affects dependent people who have difficulties reacting. On the other is severe violence that kills or attempts to kill. For example, the denunciation of 867 older adults (8.74%) in a private prison in 2018 is appalling. The competent bodies were expected to have taken appropriate measures, followed by the complaint by 19 female older adults who were raped during a robbery or killed by homicide. These facts deserve society’s reflection on how this vulnerable population is being cared for, particularly its economically poorest segment [25,33-39].

Sexual and institutional violence data were not qualified by the technicians and lawyers who manage the Dial 100-Older Adult. However, the denunciation of 171 sexual cases (0.46% of the total) is not negligible. It has been highlighted in the literature as mainly caused by the actions of strangers or people working in long-stay institutions [37,38].

As for institutional violence, not classified on the Dial 100-Older Adult, studies show that the main complaints of older adults point first to the deficient health services, which do not prioritize them, schedule extremely late tests and follow-up appointments, or belittle them: Some seniors even say, “I might be dead by then”. If the sentence may be a rhetorical exaggeration, most cases in question are people with chronic illnesses such as diabetes and hypertension who need continuous monitoring. Next are complaints about public services in general, such as insufficient or non-respectful transport; traffic lights that open very quickly, bumpy streets that facilitate falls, and lack of ramps for wheelchairs, and others [25,38].

The Dial 100-Older Adult [2] carried out a survey of complaints referring to what it classified as “older adults with disabilities” and that the health literature calls “dependent older adults”; that is, those with physical, mental, neurological, and other difficulties requiring permanent help from third parties to support them in functional or daily living activities [25,26,39]. A study on 2018 data shows that around 70% of the complaints referred to older adults who preserved their autonomy. However, 13.35% had a physical disability; 13.57% had intellectual and mental problems; 3.71% and 1.42% had visual and hearing impairments, respectively. In all national and international studies that analyze the situation from the health viewpoint, dependent older adults suffer from negligence, psychological abuse, and physical and institutional violence the most [16-18,25-29].

Women appear as the primary victims (26,689, 62.61%) in data from the Dial 100-Older Adult [2], which is consistent with the literature. Men correspond to 13,745 (32.25%). There is much underreporting about age: there was no information about the age group in 3,757 cases (8.31% of the total). Approximately 65.47% of the victims identified by age were 70 or older, and the most vulnerable group is the one with those aged 76-80 or older (18.32%). Several authors [5,23,25,26,40,40] draw attention to the fragility of older adults who should deserve special attention from families and society. Under the ethnicity/skin color category, unlike the case of young people, 41.36% of the reported victims were identified by the denouncers as white and 36.64% as brown and black.

Crucial data presented by the Dial 100-Older Adult is the profile of perpetrators whom the report calls “suspect”: 26,819 (41.52%) were women 18-50 years old, and 15,627 (39.68%) were men, with an underreporting of 18.79%. We should discuss why there are more female perpetrators than males. In general, they are the ones closest to the older adults, assisting them at home or when they become dependent. Although their presence is the most frequent, the literature shows that, in general, those who suffer from extreme stress, who isolate themselves from social life, those with mental problems, and who were mistreated by the older adults they care for become perpetrators [33]. On a scale of abusers, daughters and sons (52.96%), grandchildren (7.8%), sons-in-law and daughters-in- law (4.69%), and brothers (3.09) rank first. In a broad list made by kinship and proximity categories, we summarize that 63% of the reported abuse was caused by family members; 8.28% by unknown persons, and the rest people not identified in the complaint. The home is the victim’s refuge and was also detected as the place with the highest violations in 85.6% of the cases [36-40].

Reflections on the Information and Conclusions

It never hurts to remember that the Dial 100-Older Adult [2] is a Brazilian society asset, a reporting body, and an instrument of action by the competent bodies regarding human rights violations. However, only what is known or visible to the naked eye is generally denounced. Also, the data do not evidence an organized counter-referral process; we need to be made aware of whether the complaints sent to local authorities were forwarded correctly and the cases were adequately resolved. It is essential to have this assessment because most of the violence is suffered in the silence of homes, long-stay institutions, hospitals, or the streets. In the qualitative surveys that listen to older adults, many seniors mention that they do not denounce their relatives or do not complain about the harm they suffer because they need their relatives. Home is where they return after making complaints. Thus, silence is often a survival strategy in the hardships at the end of life.

Despite its limitations, the Dial 100-Older Adult [2] contributes a lot when we have eyes open to understand what its data represents. For example, the fact that the primary violation is negligence sheds light on an increasingly clear reality in the country: many Brazilian men and women reach old age invisible and dying before dying: they lack social conditions, adequate food, and medication; above all, care and support to live their final years healthily, dignifiedly, and peacefully. When talking about negligence, the first temptation is to blame the families. One is correct to a certain extent, as it is the haven where every older adult hopes to rest and receive protection. However, governments already know that the family alone cannot cope with the task in the contemporary world. The State should implement a specific protection policy for seniors and other dependent groups, as pointed out by several international organizations such as the OECD [41], OAS [42], and PAHO [43], which have been consolidating specific proposals in all developed countries.

As provided for in the Statute for Older Adults [3], caring for seniors has also become a duty of society and the State: family groups are getting smaller, men, women, and children have to work to survive, and one cannot sacrifice just one individual to be a caregiver. Therefore, the first point of the Dial 100-Older Adult that addresses negligence raises a crucial problem for Brazil, which already has more than 35 million people over 60, a group within which the subgroup that grows the most is the 80 years old and more. What does society think about these people, and how does it propose to include them in the country’s development and the care they need?

The second point addressing psychological violence complements what has already been said. The new term of the hour is “ageism”, which in its genesis shows that there is no place at home and outside of it for those who can no longer work, who are marked by wrinkles and slow gait speed, who quickly forget names and things, who do not understand electronic codes or cannot maintain themselves simply because they are poor. Stimulation studies show that older adults can and should be productive: it is necessary to have creative proposals built together with them. When they become dependent and need care and support, they should remain citizens and be worthy of respect.

There is a thread in the violations. From negligence to psychological abuses, we reach financial and property crimes that, by removing people from their places and social positions, deprive them of the goods they amassed in life and kill them before they die. This problem occurs even in the face of the apparent fact that today older adults are responsible for or contribute strongly to sustain their families. For example, Camarano [44] states that this contribution to the household budget is more than 50% even in a condition of dependency, reaching 73.8% in the Northeast, because the country has one of the highest social security coverages in the world (85%). The paradox between the contempt for older adults and the need to rely on them and their assets is one of the sources of financial and property violence in low-income households and middle-class and affluent homes. Some relatives even invent dementia cases for their elderly relatives to take over their resources.

Finally, it must be said that even when care for older adults transcends the home and must be addressed as a problem of society and the State, knowing that most perpetrators are sons and daughters and, by extension, the entire family core induces a reflection on life, more than on its end. Without blaming them, what children without empathy and compassion have been raised, to the point where they do not hesitate to kill those who gave them life socially? Indeed, the lesson is that it is necessary to prepare human beings for old age from an exceedingly early age so that it is a celebration of life until the hour of death! Just as it is necessary to prepare society for the social interaction and well-being of all ages, as the UN pointed out at the Second World Assembly on Aging in Madrid in 2002 [45].

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