Elder Abuse: hearings

Meeting report

WELFARE AND POPULATION DEVELOPMENT PORTFOLIO COMMITTEE
7 June 2000
ELDER ABUSE: HEARINGS

Relevant Submissions:
Associated Psychiatric Hospitals
Help Elder Abuse Hotline (HEAL)
ANC Gauteng Veteran's Commission
Centre for the Study of Violence and Reconciliation
Ikamva Labantu
Aryan Benevolent Home
South African Council for the Aged

SUMMARY
Public hearings continued for the second day on elder abuse. The hearings are in response to an episode of "Carte Blanche" which illustrated the extent of the problem in South Africa.

Organisations present pressured the Committee to take swift action to address the plight of the elderly. Recommendations made to the Committee included:
· establish a national 24-hour abuse line so the elderly can report abuse;
· create support systems to aid in family intervention where abuse had occurred;
· create community action programmes against abuse;
· improve the conditions of pay-point stations by making them safe and more accessible to the elderly in rural areas. Recommendations were put forward that pensions be granted at financial institutions rather than in open areas where the elderly were susceptible to attack.
· develop mechanisms and strategies to develop and promote sensitive and informed community participation. It was advised that interventions should be intersectoral, including participation of Government, NGOs, and the private sector.

The Committee is expected to table a report outlining recommendations on the plight of the elderly in Parliament after the hearings have concluded. The report will then go to the Department of Welfare.

MINUTES
The Committee continued public hearings addressing the issue of elder-abuse. The hearings were in response to an episode of "Carte Blanche" illustrating the extent of the problem in South Africa. Mr Saloojee (Chairperson) stated the hearings were an essential part of the process in attempting to find proper solutions to the problem. The Committee is expected to table a report in Parliament based on the findings of the hearings.

Associated Psychiatric Hospitals
The Committee was briefed by Ms Lynn Smit, social worker for Associated Psychiatric Hospitals.

Discussion
(Q) Mr Masutha (ANC) asked what was the preferred policy choice between home-based care and institutionalised care?

(A) Ms Smit responded that there could not be a preference between the two, since not all individuals had the option of affording or having access to institutionalised care. Institutional care was seen as an essential service for those individuals with no family to care for them, or for those that needed 24-hour supervision. Home-based care was the viable option where proper care was given in the home. It was recommended that home-based care be supported through education and monitoring programmes within communities.

Concern was raised regarding measures needed to avoid financial exploitation of grants. Ms Smit stated that financial exploitation usually resulted from actions taken by immediate family members. It was suggested that a system be developed that took financial control away from families if required.

(Q) Ms Gandhi (ANC) asked whether a medical certificate was required before power of attorney was given?

(A) Ms Smit answered that generally power of attorney was available without a medical certificate being granted.

(Q) Ms Chalmers (ANC) asked why doctors were not ensuring that patients received the correct doses of medication?

(A) Ms Smit replied the over-medication of the elderly resulted from two factors. First, that most doctors had not been sufficiently trained in writing prescriptions, resulting in many patients receiving higher doses than necessary. This led to patients being in a semi-comatose state. The second factor was that many elderly would visit numerous doctors, resulting in mixing medications without their own doctor's knowledge. Ms Smit recommended that to correct the situation, increased trained psychiatric staff was needed, as well as a shift from the chemical control of patients to a more behavioural control approach.

Clarification was asked for on the difference between dementia and Alzheimer's? Ms Smit stated that dementia was the term used to refer to the global category of dementia, while Alzheimer's was a specific type of dementia. Alzheimer's accounts for approximately 50% of all cases of dementia.

Help Elder Abuse Line (HEAL)
The Committee heard from Ms P. Lindgren of the Help Elder Abuse Hotline.

Discussion
(Q) A Committee member asked for clarity on how calls for abuse were handled?

(A) Ms Lindgren stated that once a call had been received it was referred to the Council for the Aged Association in that specific province, or alternatively, to a local NGO that could best deal with the matter. These organisations were contacted within 30 minutes of the call having been received. Once the organisation made contact with the elderly person, a verbal report was submitted to the Council for the Aged on the immediate situation. The line is currently in operation from Monday through to Friday between the hours of 09:30 - 13:00. Ms Lidgren stated that their intention was to establish a 24-hour hotline, once additional funding could be secured.

(Q) Ms Chalmers asked what measures had been taken to publicise the Hotline, and what training is given to the volunteers?

(A) Ms Lindgren responded that they relied on posters and pamphlet distribution, and radio broadcasts. Radio broadcasts are the sole method by which people in the rural areas are reached. A toll-free line has been established so that people can call the centre at no cost. Ms Lindgren admitted that they often faced difficulty in locating the abused elderly in rural areas, but every effort was made to find them. With respect to the training of volunteers, HEAL relies on volunteer centres in each of the provinces to aid in volunteer training. In addition, four people were recently sent to UNISA for victim empowerment training. These individuals are now training other volunteers within the centre.

(Q) Ms Ghandi (ANC) asked how the organisation resourced sending people in to rural areas to assist the elderly?

(A) Ms Lindgren responded that they rely heavily on the Council for the Aged to put them in contact with NGOs that work in rural areas, which are capable of assisting the elderly. It is HEAL's intention to develop a more national network, but insufficient funding has restricted that from occurring.

ANC Gauteng Veterans Commission
Mr Lungelo Mayekiso, provincial secretariat for the ANC Gauteng Veterans Commission briefed committee members on behalf of the Gauteng Senior Citizens Association.

They identified the main cause of abuse as "molestation" by children who are intoxicated or under the influence of narcotics. In response to this, they identified the need for the following measures to be taken:
· the Committee consider appointing a special investigative unit in the Department of Justice to deal specifically with crimes of abuse against the elderly;
· the Committee explore ways by which the elderly can be alleviated of service charge arrears;
· allow pensioners' associations to be included in making arrangements for services to pensioners at pay points;
· not allowing banks to charge the elderly for opening new accounts;
· retired nurses and midwives be employed by the Department of Welfare to exercise the type of care that certified social workers are unable to perform.
· for medical clinics to implement policies that fast track the elderly so they do not wait for treatment.
· establish day care centres for the elderly.

Discussion
It was asked if Mr Mayekiso was aware of which authorities had the power to deduct monies from pension grants. Although no answer could be given, the Chair stated the names of the authorities would be identified, and included in the Committee's report. Mr Masutha stated that depending on income, pensioners could either receive a full or part pension. He asked that the Committee research whether the process by which pensions were being granted was applied correctly.

Centre for the Study of Violence and Reconciliation
Ms F Spencer briefed the Committee on the elderly in relation to immediate families and institutionalised care.

Ms Spencer stated that while the family structure was supposed to play a supportive and protective role for it's elderly, it was clear through much evidence and research that family members were the primary source of violations against the rights of the elderly.

Although, institutionalised care was introduced to alleviate abuse within the home, much abuse occurs within the homes. These include:
· violent and criminal attacks which traumatise elderly residents.
· neglect by family members.
· poor administration of pensions by the Government.

Ms Spencer urged the Committee to develop preventative and supportive policies and programmes to promote and enhance the position of the elderly in our community.

Discussion
Ms Spencer stated that one of the problems in eradicating abuse of the elderly was that the Government had been inactive in proposing a clear mandate. In order to break the cycle of violence, she argued that criminal action needed to be taken against those who were abusive.

(Q) Mr Masutha asked what could be very focused measures that the Government could start with?

(A) Ms Spencer responded that the elderly are too often marginalised, and so it becomes necessary that they be made aware of services that are available to them.

The Chair stated that the Committee had heard very concrete suggestions from the presentations given, and that policies would be developed on the basis of those recommendations. He added that the Minister of Welfare had already created a special committee to deal with the issues long-term.

Ikamva Labantu
Mr Sipho Puwani, Managing Director of Ikamva Labantu, briefed the Committee on types and causes of abuse based on a research survey conducted in conjunction with the Centre for Gerontology at the University of Cape Town.

Forms of abuse revealed through the survey included emotional and verbal abuse, financial abuse, sexual abuse, general neglect, and systematic abuse.

Although the causes of these forms of abuse varied, the survey illustrated that drug and alcohol abuse, unemployment, poverty, and the government's marginalisation of the elderly were contributory factors. These problems were found to be exacerbated in rural areas and townships as a result of social disorganisation.

Participants of the survey recommended that the following measures would drastically assist in the reduction of elder abuse:
· protection through additional transport and residential options;
· support systems to aid in family intervention where abuse has occurred;
· establishment of a 24-hour help line;
· create community action programmes against abuse;
· greater public awareness

Mr Puwani stated that recommendations based on western literature were not a feasible solution to the problem. He addressed the present political economic climate of dwindling resources and large-scale termination of formal services in black townships as being a key reason.

Mr Puwani recommended that among the appropriate measures needed to be taken were the following:
· change must occur in regard to the wide reluctance of older persons in communities to disclose or report instances of abuse for fear of retaliation.
· increase the older women's personal and political power, and capacity for self protection. This is especially relevant for black women in townships who represent a high-risk category for abuse.
· greater co-operation between Government and NGOs to make up for the inadequate services for the elderly under the post-apartheid government.

Discussion
(Q) Ms Chalmers asked if the elder abuse line was well publicised, and whether it was often used?

(A) Mr Puwani replied there were two major stumbling blocks to people in rural areas using the hotline. First, that few elderly had access to a telephone, and secondly, that many are illiterate and have trouble articulating the problems even in their own language. If they think they will have to explain their problem in another language, then many elderly will not call. There was also a problem of confidence about speaking of abuse over the telephone. The results of the study indicated that it took a lot of prodding for people to speak about abuse. As a result, more direct interaction is necessary so that people will feel more comfortable.

Mr Masutha disagreed that legislation should contain a special clause for elder abuse. Mr Puwani agreed that any action identified as amounting to an offense should be applicable to all humans, however, since elder-abuse had been so hidden, it was thought necessary to establish special mention of and relation to it in policy and legislation.

(Q) Ms Ghandi (ANC) asked if their research showed issues of loneliness, lack of geriatric services, such as physiotherapy, or lack of medications?

(A) Mr Puwani replied that most elderly thought support services referred to social workers at clinics. Most were unaware of any other social services that were available to them. Physiotherapy was not an option for most seniors as it was expensive and time-consuming.

The Chair acknowledged that there needed to be such services made available to the elderly.

(Q) It was asked what Government could do to assist Ikamva Labantu with their functions?

(A) Mr Puwani responded that Ikamva Labantu was a multi-purpose organisation, that has projects that deals with various groups in society. The organisation is decentralised in nature and consists of clubs that work within the communities. He called for the Government to work in partnership with the NGOs to come up with solutions. He stated the Government had to allocate more resources to assist the NGOs in their efforts.

Presentations were also heard by the Aryan Benevolent Home and the South African Council for the Aged.

The Chair stated that the hearings had provided insight into how the government could work in partnership with organisations to develop a process for change. He felt assured that the hearings would correlate into strong policies and legislation.

The meeting was adjourned.