Motion
Resumed from 6 September on the following motion moved by Hon Nick Goiran —
That —
(1) A select committee into elder abuse in Western Australia is established.
(2) The select committee is to inquire into elder abuse with particular reference to —
(a) determine an appropriate definition of elder abuse;
(b) identify its prevalence;
(c) identify the forms of elder abuse, including but not limited to neglect;
(d) identify the risk factors;
(e) assess and review the legislative and policy frameworks;
(f) assess and review service delivery and agency responses;
(g) determine the capacity of the Western Australia Police to identify and respond to allegations of elder abuse;
(h) identify initiatives to empower older persons to better protect themselves from risks of elder abuse as they age;
(i) consider new proposals or initiatives which may enhance existing strategies for safeguarding older persons who may be vulnerable to abuse; and
(j) consider any other relevant matter.
(3) The select committee is to report by no later than 12 months after the motion is agreed to.
(4) The select committee shall comprise the following members —
(a) Hon Nick Goiran, Chair;
(b) Hon Alison Xamon, Deputy Chair;
(c) Hon Matthew Swinbourn; and
(d) Hon Tjorn Sibma.
[speeches and comments of various members]
HON ALISON XAMON (North Metropolitan) [ 1.39 pm ]: I rise on behalf of the Greens to indicate our very strong support for this motion, and I want to thank Hon Nick Goiran for introducing it, on a topic that I believe is of absolute significance to our community. This is an issue that is often highly detrimental to some of the most vulnerable members of our community, yet it is far too often hidden. The proposal to establish a select committee so that we can go into some of the detail around this issue is well worth supporting. Should the motion be successful in being passed, I very much look forward to the opportunity to work with other members who have been named as potential members of the committee to unpick the insidious effects and impacts of elder abuse. This is particularly important as we look at what is happening with the ageing population of Australia. As we know, our population is ageing, and the risk is that the numbers of people who might potentially be affected by elder abuse can only grow unless we start to take some really important steps towards addressing the root causes of why elder abuse occurs in the first place, as well as looking at the sorts of protections that can be placed around older people to support them legally and with service provision.
It is really timely that we, as members of state Parliament, consider this issue, given that it comes only a few months after the Australian Law Reform Commission released a report documenting the findings of its inquiry into how best to protect the rights of older Australians from abuse. We know that the best chance we have of tackling the really complex array of contributory factors to elder abuse is by implementing change at both the state and federal levels in a coordinated way. I would suggest that one of the opportunities available to the committee would be to draw on the findings of that report to see how best we can complement its proposed strategies. I also note that many of the findings that came out of the federal inquiry into elder abuse mirrored those of previous WA-based reports into elder abuse, so we have a fair bit of data that we can draw on. This is an issue that people have been trying to tackle for quite some time.
One of the reasons the Greens feel so strongly about wanting to support the establishment of this select committee to address the issue of elder abuse is that we have a longstanding approach to older Australians in that we strongly feel that we need to support seniors to be able to maintain optimal health and to ensure that they feel secure. We also strongly feel that our older Australians should be valued, active participants in all aspects of community life. It is certainly my aspiration to one day be an older Australian; that is my intention. Of course, sometimes life can throw things at one that perhaps one did not expect, but it is my hope that I will be joining the ranks of older Australians — the very, very, very older Australians — at some point far into the future, because I am, of course, young and vibrant!
Anyway, we know that we need, as a society, to develop a more positive approach to the ageing of our population. Members will be aware that we in Australia, within the western context, do not revere and respect our older Australians as much as perhaps we should. The participation of seniors within the broader Australian community life should be maximised. Importantly, the contribution of their knowledge and their experiences should be valued, and I am simply not convinced that we do value them enough. Unfortunately, sometimes within our society we lose sight of this, and I think we could all gain so much more if we focused more of our attention on valuing and engaging with our seniors than we currently do. There is an old saying that sums this up: for the unlearned, old age is winter; for the learned, it is the season of the harvest. I like that.
The need for a positive framework is also reinforced within the Law Reform Commission report, and I note that the report observed that vulnerability stems from not only intrinsic factors such as health, but also social or structural factors like isolation and community attitudes such as ageism. All these factors contribute to elder abuse.
On a more tangible level, it is also important to acknowledge that if we focus on helping older Australians maintain their mobility, wellbeing and participation — we should be finding as many opportunities to do this as we can — we will also be engaging in one of the prime protective factors; we will be reducing the risk of people potentially being subject to elder abuse.
We know that many older people are already making enormous contributions to our society. Again, I am one of those people who intends never really to retire; I do not think it is in my DNA. I would like to continue working in some capacity until such time as I fall off the perch, which, again, I am hoping will be a very long, long way away. I think that is the case for many of our older Australians, who have a great level of knowledge and wisdom that should be valued. I do wonder what would happen if we were to place greater emphasis on valuing the wisdom and knowledge of our older Australians, and provide further avenues for their contributions to be expressed.
Before I talk specifically about elder abuse, it is important to start by setting the context and focusing on some of the issues that are affecting older Australians more generally. The question has to be asked: how are older people faring? One of the key issues I would like to speak about is the issue of older Australians and mental health, which should come as no surprise to anyone in this place.
We know that although depression is common throughout the population, older people are more likely to experience contributing factors such as physical or economic dependency; mental and physical health problems; living with grief; loneliness; and carer stress — the stress of looking after a sick or elderly spouse, in particular. It is estimated that between 10 and 15 per cent of older people experience depression, and about 10 per cent experience anxiety. Rates of depression amongst people living in residential aged care are believed to be even higher; in fact, it is estimated to be around 35 per cent. I think it is really heartbreaking to think that one-third of residents living in aged-care facilities are living with a diagnosed mental illness like depression. This is aggravated by the fact that older people can be more hesitant to share experiences of anxiety and depression with others. This is a characteristic of this particular generation. Many people aged over 65 years feel quite acutely the stigma attached to mental health problems. We are talking about a generation of Australians who were raised when mental health issues were viewed as character flaws, rather than being recognised as genuine health conditions, which they are. Unfortunately, this self-stigmatising behaviour can contribute significantly to preventing older Australians from feeling comfortable to reach out for help.
I also want to talk about the often hidden issue of older Australians and suicide. The 2015 Australian Bureau of Statistics data shows that the death rate for intentional self-harm is the highest in men aged 85 years and over, with a rate of 39.3 deaths per 100 000. We do not talk about this very often. We talk about suicide in young people and in at-risk populations, but our male older Australians are one of the groups at highest risk of suicide. Furthermore, suicide is likely to be under-reported in the elderly, with general practitioners and other doctors being more likely to record deaths in our frail elderly as somehow due to natural causes, because they wish to avoid the pain and the stigma for families. A concern raised in the research is that in some circumstances, it is possibly done to cover up assisted suicides.
I am particularly concerned to look at the intersection between elder abuse and rates of older adult suicide. The figures coming out on the issue of older adult suicide show that it relates to factors such as loneliness, isolation, a sense of despair and the potential impacts of elder abuse. As Hon Sue Ellery referred to, it can also relate to the sorts of pressures that are brought to bear around money. People may feel as though, in the worst-case scenario in my mind, they are effectively being pressured into needing to take their own lives. It is very important to unpick this issue.
Also, it is important to talk about how this impacts on particular populations of older people. As with all ages, suicide risk is even greater for lesbian, gay, bisexual, transgender and intersex elderly people, who do exist. Elderly LGBTI people are at increased risk of social isolation and lack of support networks compared with non-LGBTI people. We are talking about people who, for the most part, have spent almost a lifetime having to hide their sexual orientation and living in the closet, if you like. They are also less likely to approach support services until they reach a point of absolute desperation. That is often due to a fear of homophobic retribution and abuse. There are also particular concerns about LGBTI people being discriminated against in aged-care facilities. I want to acknowledge the important work of organisations such as GLBTI Rights in Ageing, which is doing much to highlight the needs of this cohort of older Australians and to highlight their needs as they age.
Family support is also a significant protective factor in preventing suicide. That is precisely why the effects of elder abuse, which is often perpetuated by family members, has such deeply entrenched ramifications. I think it is important for members to be aware and not to assume that older people are taking matters into their own hands simply because euthanasia is not legal. We know that the suicide rates are higher in countries where euthanasia is legal, such as the Netherlands, Belgium and Switzerland, than those in Australia. Access to euthanasia does not affect the high rates of suicide in old men, which is unsurprising because it is important to note that they are two very different issues. I would like to point out that confusing the idea of an older person’s right to die with suicide is serving only to hamper suicide prevention work. As a suicide prevention advocate, I get really frustrated when the issue of older Australians taking their lives is trivialised by people who try to say, “If only we had access to euthanasia; it would mean that we would not have the rates of suicide because that is what people are trying to do by default.” The figures do not bear that out. We need to look at the issue of why older Australians are choosing the path of suicide.
I also want to look at the intersection with disability, which, as we know, is more common among older people. More than 80 per cent of people aged 85 years or over have some disability. Almost one-third of people aged 74 years or over have limitations . The prevalence of cognitive impairment also increases with age. From age 65, the prevalence of dementia doubles every five years.
There is also an ongoing concern for older Australians about access to housing. Housing is a key determinant of health and mental health wellbeing, yet we are seeing more and more older people facing housing insecurity. Given that the majority of seniors have fixed incomes, this makes them particularly vulnerable to changes in housing affordability. Housing insecurity impacts on older people’s ability to access support networks and to maintain social connections, both of which are important protective factors. Limited housing options for seniors is a particular concern in the regions, particularly when older Australians who may have a strong connection to a community find themselves unable to live within that community any longer.
I want to talk about defining “elder abuse”, which I know is one of the first tasks of the committee. Determining an appropriate definition will be the first thing that needs to be done. It is one of the stumbling blocks when trying to establish the prevalence of elder abuse, because it is nearly impossible to find a consistent definition of elder abuse. By way of example, the authors of the Australian Law Reform Commission report have used the World Health Organization definition, which defines “elder abuse” as —
“a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which cause s harm or distress to an older person”
The definition from the Older Peoples Rights Service at the Northern Suburbs Community Legal Centre — I will talk a bit more about that service in a moment — is somewhat narrower. It states —
… clients abused or are at risk of abuse by family members, friends or carers.
Agreeing on a definition is tricky. If the definition is too broad, it will become meaningless; if it is too narrow, it can make it difficult to be a useful tool in picking up the full range of forms that abuse can take.
There are also inconsistencies around age limits and where elder abuse intersects with other issues, such as domestic and family violence. We know that all definitions recognise that elder abuse can take many forms, including financial, physical, emotional, psychological and sexual and neglect. Agreeing on a common definition is a necessary first step to ensure that we are all speaking about the same thing.
Another issue is unpicking the prevalence of elder abuse, which has already been referred to. Notwithstanding the difficulties that I have already outlined with establishing a clear definition of elder abuse, we can begin to draw some inferences about the scale of the issue. Of note is the fact that the Australian government has already committed to an Australia-wide prevalence study undertaken by the Australian Institute of Family Studies, and work has begun. As I alluded to earlier, it makes sense that, at the very least, we take into account the work that has been done on this matter at the federal level. As at 2015, 473 703 people — 18 per cent — living in WA were aged 60 or older. By 2050, the number of people aged 65 to 84 years will double and the number aged over 84 years will quadruple. I am planning on being in that latter cohort. A 2011 study into the extent of elder abuse in WA, undertaken by the Crime Research Centre at UWA in partnership with Advocare, found that an average and heavily qualified prevalence rate for WA was calculated to be 4.6 per cent. Using the most recent numbers in WA, this currently equates to almost 16 000 Western Australia ns over the age of 65, with the number continuing to rise.
There is a genuine issue around the fear of reporting elder abuse. These figures are thought to under-represent the scale of the problem because we know that many cases go unreported due to a legitimate fear about the alternative to family care or maybe a nursing home not being available, if that is what needs to be provided. There are fears of not being believed and fears of retribution. Tragically, there is a sense of shame that this has come about, if it has come from the family, and also a lack of confidence in the justice system. By any measure, elder abuse is clearly a significant issue for our community. Increasingly, in our fast-changing world, more and more seniors are finding themselves supporting adult children and grandchildren. At the same time, some of them are still caring for their own parents. We know that most often the perpetrators of elder abuse are sons and daughters, with the abuse happening behind closed doors. Typically, it is happening in the older person’s home. We also know that perpetrators are equally male and female and that far too often issues of substance abuse, drug addiction and underlying mental health issues can be common in perpetrators, but not always.
Fran Ottolini, the senior lawyer for the Older Peoples Rights Service, has described four key drivers for older people seeking assistance through that service. The first is inheritance issues, from people who perhaps feel as though mum or dad need to hurry up and die because they are sitting on their money and they would like to have it, thank you very much, to parents lending money to their children without contracts and then again, perhaps those children feel that it is simply an early inheritance and they are entitled to it so why on earth should they have to give it back? There is a problem with granny flats, particularly if they are built on land that the older person does not own. If the land is subsequently sold, that older person has no rights over the granny flat. Very often we hear cases of older Australians who have paid for the granny flat to be built, perhaps on their child’s property, yet they do not end up seeing anything for it. Of course there are ongoing problems with enduring powers of attorney. They are very easy to put in place but it can be very hard to recover funds if they are misused. This mirrors the experience of Advocare, one of the main organisations that assists with issues of elder abuse, as well as what is happening in other states. Financial abuse is the most common reason for older people seeking assistance.
Elder abuse can often result in older people who have worked hard their whole lives finding themselves living in poverty and not having access to even basic human rights such as secure housing. We also know that some of the likely risk factors for people subject to elder abuse include how dependent they are on others, poor physical and mental health, low incomes, living with a cognitive impairment and being socially isolated. Again, as I have said already, older people are not a homogenous group; their experiences can be shaped from being part of one or more particular communities. Being part of a particular group can also affect how likely it is that a person will be abused or it can affect their ability to access services. As I have said, disability is more common among older people, and there is an intersection between elder abuse and the abuse of people with disabilities. I note that my Greens colleague in the federal Parliament Senator Rachel Siewert has been calling for a royal commission into violence against and the abuse and neglect of people with a disability because alarming evidence is emerging of the level of abuse of people with disability in institutional and residential care. There are some intersections there also with older Australians.
It is imperative that we acknowledge the particular challenges for older people who are living in regional WA. I note that t he “Ageing in the Bush Report”, which was produced by the Regional Development Council, stated —
Projected growth rates for the older population in regional WA are greater than for metropolitan areas. There is a pressing need to address current issues and prepare for future demands. It is imperative for the economic and social viability of regional WA that the number of older people who have to leave their homes to access the care they need, is reduced.
As I articulated earlier, LGBTI older people may be at risk of elder abuse because they can often be subject to discriminatory practices. Often they are also members of what we term “families of choice” rather than biological families. Unfortunately, these families may not be recognised by service providers as family members.
There has also been little research about elder abuse in Aboriginal communities. However, in 2005, the WA Office of the Public Advocate undertook an investigation into this issue, although the project was conducted only over a three-month period so it could not be considered definitive. This research identified significant issues linked to elder abuse in communities, including a loss of respect for old people and culture and the need to teach young people respect; alcohol and substance abuse in the community; the number of grandparents raising their grandchildren; and poor housing conditions. The final conclusion from this research was that, given the social complexities of Aboriginal communities and the factors contributing to elder abuse within their own communities, a whole-of-government approach, in partnership with Aboriginal communities, is required. Cultural expectations and norms can inform the way abuse is understood within different communities. For some people from culturally and linguistically diverse backgrounds, limited English skills can contribute to a sense of social isolation. I think it is really useful to look at the prevalence of elder abuse within various multicultural communities. Some multicultural communities have maintained strong respect structures for older people. It will be interesting to see how that plays out as a protective factor. Clearly, any strategies to curb the effects of elder abuse must recognise the diversity of older people, as well as their commonalities.
I will now speak to the current state of play in the elder abuse space, at both a state and federal level. I will begin by outlining some of the key recommendations from the Australian Law Reform Commission report on legal responses to elder abuse. Although the ALRC report is framed as a legal response to elder abuse — because it is always really helpful to look at the laws and unpick what is happening legally, and it is great that we will have so many lawyers on this committee — it ostensibly focuses on legal frameworks across commonwealth, state and territory laws to try to bring about some national consistency. It makes what it calls a capstone recommendation for the establishment of a national plan to combat elder abuse. The commission made this recommendation in recognition of the need to develop strategies beyond legal reforms. A national plan would present the opportunity to develop national awareness and community education campaigns, provide training, establish elder abuse helplines, and direct future research. This recommendation is strongly supported by the Greens. A number of other wideranging recommendations in the report reflect the broad scope of actions that can be taken to reduce the incidence of elder abuse. These include aspects such as enhancing employment screening for people who work in aged care; regulating the use of restrictive practices; introducing greater safeguards for enduring powers of attorney and guardianship; enabling tribunals to have jurisdiction over disputes relating to family agreements; reviewing provisions around superannuation and wills; and amending the Code of Banking Practice to require banks to take reasonable steps to identify and prevent the financial abuse of vulnerable customers. The report makes a number of recommendations for the introduction of adult safeguarding laws in each state and territory.
Of particular relevance at the state level and to the select committee are the recommendations to improve the criminal justice response to elder abuse, including how police respond to issues and help witnesses who need support to participate in the criminal justice system. In 2002, I found myself in an unexpected position when I suddenly became the carer for my grandfather and my grandmother. They were the parents of my father, who had taken his life, so the caring responsibilities skipped a generation. Even though I had a young child and was pregnant with my second, I found myself needing to look after my grandmother, who had been debilitated by 20 years’ worth of strokes. The first one occurred after my father chose to die. My grandfather, who we found out had been living with Alzheimer’s, had been trying to cover it up for the previous two years. My grandpa had just enough cognitive ability to be able to choose to appoint me as the enduring power of attorney for both him and my grandmother. It is a role that I took on with great pride until last year, 14 years later, when my grandmother finally passed away. When I started going through what was happening with my grandfather’s finances to pull them together so I could do the job properly, I became aware of a particular guy and his girlfriend, who were drug addicts. They did not know my grandfather very well; they had come across him via church. They were going around to see my grandfather every week and taking him — marching him — up to the bank and helping themselves to his money at anything from $1 to $500 at a time. He was terrified of these people. He did not know how to respond. My grandmother, who was completely bed ridden, was unable to do anything about it and begged me to try to do something. I went to the police, who were marvellous and wanted to try to do the best they could, but they said that, unfortunately, I was not able to do anything about it because I was not my grandfather’s guardian. I had only the enduring power of attorney. I was desperate to try to take a restraining order out against these people to make sure that they kept the hell away from my grandparents. I wanted to stop them from being able to do this. Trying to protect him became a long, drawn-out and very painful saga. The only legal advice I was given was that I had to try to apply for guardianship over my grandparents. That, in itself, would have been a drawn-out process and would not have provided the level of protection that my grandparents needed to make sure these people stopped stealing from them and terrorising them. My grandfather was a very well known elder at the local church. Eventually, thanks to the good work of the local reverend, who came with me, and through no legal recourse, I was able to successfully manage to get these people to keep away from my grandfather. That was not before they had stolen $24 000 of my grandparents’ money. My grandparents lived in Gosnells. They were not wealthy people; they had just worked hard their whole lives. I raised this because I want to point out how vulnerable older people can be to people who choose to prey on them. It is not always family members. Sometimes family members are desperate to do something about it. This goes to the inadequacy of our laws in ensuring that there is a swift way to step in to stop people from being able to prey on vulnerable, frightened older people. We never saw that money again. I managed to successfully sue the couple in court but they did not have any money, so I never saw it. But I did manage to keep them away.
As we know, a number of well-established initiatives, networks and services are already doing great work to support victims of elder abuse in WA, but a lot more still needs to be done and lots of protections need to be considered. Elder abuse networks are in place, including the high-level interagency policy group Alliance for the Prevention of Elder Abuse. This network is currently working on updating the “Elder Abuse Protocol: Guidelines for Action”. These protocols are designed to assist organisations that work with older people to respond to elder abuse. The WA Network for Prevention of Elder Abuse is another mechanism designed to coordinate service provision around this issue. However, as is the case at the federal level, there is a need for a more cohesive approach to elder abuse across government and non-government organisations, beginning with an agreed definition. There is a lag in public awareness of elder abuse compared with child abuse and domestic violence in terms of public recognition and social responses. The 2011 report, “Examination of the Extent of Elder Abuse in Western Australia ”, jointly undertaken by the University of Western Australia and Advocare, recommended further exploration of the commonalities and differences between elder abuse policy and practice and that of child protection and domestic violence. Other recommendations from the report include elevating community awareness and introducing greater protections against financial abuse, and provision of training. Although the government’s “Seniors Strategic Planning Framework 2012 – 2017” echoes many of these recommendations, it is not at all clear what has been achieved in this space. Much work still needs to be done with greater emphasis on prevention and early intervention, education and training, and providing greater safeguards.
I also want to make some comments about the Older People’s Rights Service. As I referred to earlier, a lot of great work is already being undertaken in WA and I want to mention an example of this. We are fortunate here in WA to have the Older People’s Rights Service, which is run out of the Northern Suburbs Community Legal Centre.
The service has two full-time staff working to provide legal aid and wraparound support for the victims of elder abuse. In delivering this service, those working at the legal centre have come to realise that in nine out of 10 cases their clients do not proceed with legal proceedings related to the abuse. This can be because the system is set up so that few legal remedies are available to them, or because of the emotional complexities around taking legal action against a family member or carer. It has becoming increasingly clear to this service that there is a pressing need for more work to be done in the early intervention and prevention space, in raising community awareness about elder abuse and in educating older people about how to best protect against it.
In response, the Northern Suburbs Community Legal Centre, in partnership with Southern Communities Advocacy Legal and Education Service, has developed a peer education package called the older people’s peer education scheme. It has secured funding under the Criminal Property Confiscation Grants Program and Lotterywest for a two-year pilot study, and the project is proving to be very successful. The centre has employed two coordinators, one for the south and one for the north, to support volunteer peer educators. As a peer-based service, the volunteers are able to connect better with the people with whom they are trying to engage, and it also provides a mechanism for older people to participate, which is one thing that we need to do. This scheme has seen the generation of all sorts of ideas for projects to raise awareness of elder abuse and the supports out there, including what is known as the Purple Road project, which is designed to connect, inform, support and empower older people. The campaign centres on the construction of a three-metre long road made up of hundreds of handmade purple flowers contributed by arts and crafts groups and senior members of community. Every flower represents someone’s story or a conversation related to elder abuse. Another idea that has come from participants of this scheme includes the making of bookmarks that raise the awareness of elder abuse and are to be distributed by libraries. The coordinator at the Northern Suburbs Community Legal Centre said that one of the biggest issues is to find a way to fund all these great initiatives, and what worthwhile initiatives they would be to fund. This peer-based scheme is a prime example of how important it is to ensure that we create mechanisms through which older people can contribute their vast skills and knowledge. We know that, ultimately, older people need to be at the heart of co-designing an approach to reduce elder abuse in our community.
We know that elder abuse is a significant issue for the community. With an ageing population and changes to our societal structures, it will become increasingly prevalent and this will elevate its importance, so we need to take action now. Raising awareness of how to recognise and respond to elder abuse should be everybody’s business and a critical part of reducing abuse. It is a sensitive and really complex issue because the perpetrators are often family members and those closest to the person who is being abused. Responses to reducing elder abuse must recognise this context and work on so many levels within an overarching and positive framework of inclusive, age-friendly communities that ensures access to housing, public transport, health and wellbeing services. It needs to focus on early intervention and prevention, including peer-based education, preventive legal work and information on how to put in place legal protections. There must also be supports for those affected by elder abuse and avenues to pursue legal remedies if all else fails. We need to build on the positive work that has already been undertaken at a state level, and the momentum generated at the national level, and tap into the expertise already out there. There needs to be a political will to address this growing issue.
Once again, I commend Hon Nick Goiran for putting this motion forward, which the Greens wholeheartedly support.
[speeches and comments of various members]
Question put and passed.