KUALA LUMPUR, Sept 21 — Malaysia’s ageing population is on the rise and based on recent projections, the number of people over 65 is expected to triple from two million today to over six million by 2040.
The sharp increase in the number of elderly population means a rise in people living with non-communicable diseases (NCDs) and likely higher incidents of elderly abuse incidents.
A recent study published in the BMJ Medical Journal by local researchers found that about over 8 per cent or about one in 11 elderly adults polled experienced physical (3.4 per cent) or financial (4.8 per cent) abuse.
The findings of the study titled, 'Mortality of elder financial and psychological abuse victims in rural Malaysia: A prospective cohort study', weren't far from the statistics in the Health Ministry’s National Health and Morbidity Survey 2018.
Similarly, the 2018 survey found that one in 11 elderly were at risk of abuse at the hands of someone they trust.
It was also found that the elderly with the poorest social support experience the most abuse.
Elaborating on the findings, researcher Dr Raudah Mohd Yunus said there are many known risk factors for abuse of the elderly.
"Some of them include family disharmony or poor relationships between elderly and caregiver, mental health issues or substance abuse among caregivers, older adults’ dependency on others due to chronic illness or physical dysfunction as well as poor education or low socio-economic condition.”
The study — which surveyed 1,927 elderly — highlighted that about 70 per cent of the abuse victims had at least one NCD.
According to Dr Raudah, NCDs may not be the determining factor for the prevalence in abuse of the elderly.
She, however, noted that having NCDs generally makes it more difficult to care for an older adult, which may eventually lead to neglect or the inability of the caregiver to cope with the situation.
"NCDs can also lead to more physical dysfunction needing aid for most of their daily activities or even poor mental health.
"This situation makes them more prone to abuse and neglect.”
Dr Raudah said the study also found that the elderly living alone is at higher risk of abuse.
"In my opinion, it also depends on the type of abuse.
"For instance, those living alone may be more prone to neglect or other types of abuse mainly because they are isolated and the abuser has easier access to the victim.”
On the other hand, she said if the victim lives only with the abuser, this will also make abuse easier to happen.
"Our paper found that having companions other than the caregiver or abuser in the house can be protective against abuse.
"This is rather obvious because if other family members are there, it won't be so easy for the perpetrator to victimise the elder.”
Dr Raudah noted that the financial situation of the abuser or the victim can also be a contributing factor to elderly abuse incidents.
"In general, our data shows that those from the lower income groups are more prone to financial abuse.
"For example, the elder may get regular pension money which the abuser can take advantage of, or maybe the elder has properties that the abuser may claim ownership, or deceive the old parent into unknowingly signing a document.”
Speaking about the prevalence of elderly abuse, Dr Raudah said she believes many abuse incidents are not reported for various reasons including shame, stigma and lack of proper reporting channels.
"Some ways to prevent such incidents include promoting healthier family dynamics and relationships, caregiver training and having greater awareness on this issue among the public and family members.
"It is also important to train social workers and healthcare providers on how to detect and manage elder abuse cases, having laws that protect our elders from abuse and strengthening the welfare support system.”
Tackling the core of the issue
Looking at the bigger picture, the Health Ministry’s deputy director for non-communicable diseases Dr Feisul Idzwan Mustapha said the issue of elderly abuse goes back to a lack of awareness and caretakers’ knowledge in handling emotional stress and coping skills.
"Additionally, lack of support for victims in the family is among the contributing factors towards family violence.
"Basically, this relates to the level of health literacy.”
Moving forward, Dr Feisul said efforts towards abuse prevention should focus on increasing awareness towards a strong family structure and cohesiveness, increasing mental health literacy, coping skills and self-care among family members.
"Mental health life skills such as anger management, communication and conflict resolution are vital in tackling the elderly abuse issue.”
Dr Feisul also noted that measures to prevent abuse should be targeted to address the predisposing factors towards abuse.
According to him, there are some measures that are already in place or should be strengthened in Malaysia.
"One of the ways is to support primary caregivers in terms of training and mental strength in handling patients.
"The caregivers also need support to find community resources in terms of obtaining financial and emotional support, self-care and stress management.”
Dr Feisul said there is a need to increase accessibility to provide comprehensive support for family violence victims in primary care settings, including psychosocial support, counselling and strengthening capacity building of health care workers to handle family violence cases.
"Empower the older adults on keeping active, engaging activities in the community and practising a healthy lifestyle.”
