The progress of a society can be measured by how it cares for its elderly citizens. Expressing esteem for the elderly and mirroring that respect in the way they are treated are among the hallmarks of a well-grounded society. They are also clear indicators of the value that a society places on experience and the weight it gives to the plight of the vulnerable.

Earlier this year, the World Health Organisation (WHO) issued a document about the abuse of older people. It says that around one in six people aged 60 and older experienced some form of abuse in community settings during the previous year.

The WHO data are in line with figures published recently by the Foundation for Social Welfare Services that, in 2021, had to deal with 134 cases of victims of domestic violence aged over 60 in their own homes.

Data on the extent of the problem in institutions such as hospitals, nursing homes and other long-term care facilities are scarce. However, the WHO report says that a review of recent studies on abuse of older people in institutional settings “indicates 64 per cent of staff reported perpetrating some form of abuse in 2021”.

What constitutes an abuse of older people is well defined. It is a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person. It embraces all forms of abuse – physical, sexual, psychological, financial and material – as well as abandonment, neglect and any other behaviour that degrades dignity and disrespects the person.

The incidence of abuse of the elderly in Malta may go beyond the published statistics. Nora Macelli, who works with vulnerable elderly people as part of her work with St Jeanne Antide Foundation, states: “I confirm that the situation is indeed getting worse. COVID has exacerbated the issue, especially since the sense of helplessness experienced by some during the pandemic lingered on.”

A positive change in attitude towards the elderly should lead to positive change in behaviour

The risk factors that could lead to abuse may be readily identified. Individual-level characteristics which increase the risk of abuse include functional dependence or disability, poor physical health, cognitive impairment, poor mental health and low income. To these, one needs to add community and societal-level factors that may include ageism and certain cultural norms such as the normalisation of violence.

There will always be those who take cruel advantage of the vulnerable. In the case of the elderly, the perpetrators are often their relatives, carers or neighbours. However, a culture change would go some way towards solving this sad and growing problem. Society has for too long dismissed the capabilities and worth of the elderly and overlooked their contribution. This has given rise to an unvoiced sentiment: that reaching a certain age automatically renders one a second-class citizen. The elderly are sometimes victims of mockery or they are just omitted from the conversation.

A positive change in attitude towards the elderly should lead to positive change in behaviour. For example, private and public care services for the aged need to be viewed as a tool to help families care for their loved ones rather than as a service that completely takes over the family’s duty of care.

One place to start a culture change is among children. While the closeness of families in Malta means the young generally have plenty of contact with their grandparents, their upbringing and education should include real-life examples of how those in their twilight years ought to be treated: with full deference and dignity.