Special Articles / B. Devi Prasad / Old Age in an Indifferent Society
Many of those who work with older people know that cases of elder abuse and neglect not only exist but abound. Elder abuse is the most pervasive yet an under recognized human rights violation in the world. It is also a profound health problem that saps energies of the elderly, compromises their physical and mental health, and erodes their personal dignity and self-esteem. Despite the high costs of abuse against the elderly, till two decades back, public institutions in almost every society seemed to lack an awareness in assessing the enormity of the problem.
What is elder abuse? It was defined as ‘a single or repeated act or lack of appropriate action occurring in any relationship where there is an expectation of trust, which causes harm or distress to an older person’ (Action on Elder Abuse, 1995). The abuse can take on different forms - physical abuse, emotional abuse, financial exploitation and neglect or even self neglect if the elder person is forced by depression to that state. While these forms may occur simultaneously in the life span of an older person, they may manifest in extreme expression of one form at a particular stage in their life. Often, the abuse is so subtle that it may get hidden under the normal interpersonal stress.
In the context of changing demographic scene and social values, the situation of the elderly world over and particularly in India, has become critical in the recent years and the maltreatment of the elderly in the family context is emerging as a significant problem. Elder abuse does constitute a separate category of abuse requiring special attention for three important reasons. Firstly, The elderly, especially those over 75 years, become more and more vulnerable to abuse and neglect. This is more so because of their devalued social status and dependency on family, which increases as they advance in age. Secondly, it is learnt from many preliminary studies both in the West and in India, that elder abuse exists. It is estimated that in USA alone, an estimated 4 million elderly are subjected to physical, psychological and other forms of violence and neglect annually (American Psychological Association (APA), 2012). Quite a few Indian studies also gave strong indications as to the existence of maltreatment of elderly in the family context (see Sebastian and Sekher, 2011 and Devi Prasad, 2000 for a comprehensive review). It was revealed that nearly 50 per cent of the elderly faced some form of abuse in their lives and that the incidence of physical abuse varied between 10 to 12 per cent for the previous year. In one of the community studies (Devi Prasad and Vijayalakshmi, 2008), nearly 48 of 100 older adults reported overall abuse while it was 9 per cent for physical abuse i.e .nearly one out of every ten elderly in rural A.P. was physically abused during the past year by one of their intimate family members. Further, an attempt was made in this study to project the incidence rate of physical abuse to the rural populations (as per Census 2001) of the state of A.P and the country. Accordingly, the projections showed that in absolute numbers, it is nearly 4,11,107 rural elderly who are physically assaulted, every year, by their family members. One caveat is that in view of the sensitive nature of the problem, elder abuse is largely hidden and underreported. Disclosure of abuse is difficult because the victim may be frightened, unable or embarrassed to tell anyone, or it may happen ‘behind closed doors’. Therefore, estimates based on the studies need to be considered with caution. And lastly, the maltreatment of the elderly significantly undermines the quality of their life, leads to lower self-esteem, greater occurrence of depression and loneliness among them and may have a profound effect on the moral fiber of the society.
Studies have indicated that more than 95 per cent of the abuse of elderly takes place at home. A majority of the elderly live with their spouses, children and grand children, and other relatives. That is why son, daughter-in-law, spouse and the daughter are frequently reported to be the abusers. While the typical profile of an elderly victim of abuse, whatever be the form of abuse, is found to be a ‘woman, widowed, of advanced age, poor and assetless’; a typical abuser is - middle aged, a principal caregiver, and usually the offspring of the older person. With slight variations, this is the scenario we get through a review of the studies in the field.
If we look more closely at the question of why women have a higher risk for victimization, one of the reasons that comes out clearly is their gender which makes them vulnerable for greater social and emotional harm as compared to men (Prakash, 2000). Generally, more women are illiterate, poor and assetless, unemployed, not receiving any family support and are mostly staying alone. These factors, in addition to the cultural factors, put women in India at clear disadvantage and higher vulnerability for abuse and neglect than men. Further, studies have consistently showed, age and dependency of the victim, gender, widowhood, and economic status as the potential risk factors for the abuse of the elderly (APA, 2012; Devi Prasad, 2000).
Let us see how these factors are played out in the lives of the abused elderly as narrated in the following tales.
The Tales Of Woe And Abuse
These narratives are part of the field data of research studies on older people. An attempt is made here to capture their narratives under each theme relating to abuse to see how the story unfolds highlighting the relationship between the particular theme and type of abuse of the older person. These cases are selected from two different settings - rural and urban - and two states i.e Andhra Pradesh (A.P) and Gujarat (Devi Prasad and Vijayalakshmi, 2008; Smita, 2012) to show that irrespective of geographical location, the phenomenon of abuse and neglect continues to be the same. In the narratives, the names of the elderly are changed to ensure confidentiality.
Economic Dependency And Advanced Age
When economic necessity more than affection forces the elderly to co-reside with children, they are likely to be subjected to abuse. Thus, co-residence may not always mean that the needs of the elderly are adequately met. If property is owned by the elderly and is at their disposal, then care may be provided primarily in the hope of inheritance (Bali, 1999). Therefore, given the poverty and enormity of deprivation faced by most of the people in rural India, it is not surprising if issues of abuse and neglect of the elderly revolve around matters of money or inheritance (Mander, 2008).
Satyavathi’s life story showcases the situation of widowed dependent elderly women in many of the rural households. She is a frail 72-year-old widow from Potnuru, a village in A.P. Two months prior to this interview, her husband suddenly fell ill and died. She has two daughters and one son, and all got married. She is completely dependent upon her son. Satyavathi owns a house in which she is currently staying with her son who is an alcoholic and wants the house to be transferred on his name so that he can sell it. She tried to explain to him that if the house was sold she would be without shelter. It became a major issue of conflict between the mother and the son and he started regularly abusing her verbally and even resorted to physical abuse. He threatened to kill her and beat her up 6-7 times during the last two months. Once, the neighbors came to her rescue and took her to the doctor for treating the bruises. The daughter-in-law, though being her niece (brother’s daughter) says to her, “You did not give us any property hence we don’t have any obligation to take care of you”. She did not have respite even from her daughters’ side. Her son-in-law demands money or a share in the house. She has no source of income and cannot go for work due to her frail health and advanced age. Drinking tea is her only luxury which she buys from the amount she secures by selling a portion of rice she gets through Annapurna Scheme - a government programme for the poor elderly. She often laments, ‘there is no happiness in my life since marriage. Even my husband used to come home drunk and beat me’. She recollects that the only happy moments of her life were during her childhood and says “I was happy only during my childhood when I was with my parents”.
Gender And Widowhood
Saritaben’s story shows how elderly women after loss of their spouse and having some property in their name which they refuse to part with would be vulnerable to abuse and exploitation. She is a 67 year old Hindu widow who migrated with her husband to Vadodara 35 years ago and started living in a slum settlement. She had been working as a domestic help in a household. She had two sons who were both married and were living in the same house.
Saritaben’s husband built a small 3 roomed house on an encroached land in the slum. After her husband’s death, for some time, she lived amicably with her married sons. However, within two years they started demanding that the house be registered in their name. One day, her elder son hit her, threw all her belongings on the street and told her to leave the house. She filed a police complaint in order to protect herself and the son was arrested. However, she took back the complaint as she did not want her son to be in trouble. When he was released from custody, he had a fight with her and dumped all her belongings on the small verandah in the front portion of the house, while her younger son looked on in silence. They told her that from then on that verandah would be her place to stay.
“I am their mother. Yet, they do not want me in the house that belongs to me; they bully me every day; they wish to abandon me and don’t seem to care that I have nowhere to go. My family is against me for the small property. No one is trying to stop this injustice and who would support me? I feel helpless”.
After her son dumped her belongings in the verandah and warned her not to enter the house, she put up a small stove, arranged the belongings she possessed -a few utensils, a small bed, a tattered mattress and some clothes - and started cooking on her own. From then on she considered herself as living alone. In her own words,
”Yes, I live here alone. They treat me as if I am invisible, they avoid me. They do not seem to realize, even now, that their actions are wrong”.
She often worries that her belongings would be tampered with or thrown away by her sons or daughters-in -law when she was away at work. She had put a small barricade of cardboards against her bed and belongings. This chronic stress has affected her physically and emotionally.
Multiple Manifestations Of Abuse
Often the patterns of abuse do not come in neatly cut forms. Instead, they mesh with one another, subtly or explicitly, and get reflected in how the older people are engaged, valued, sheltered, entertained or neglected.
Narasinga Rao, 67 has been facing constant abuse from his sons and even his minimum needs were neglected. He has three sons and two daughters. He lives separately with his wife and his eldest daughter who is deserted by her husband. Narasinga Rao hails from B.Tallavalasa in A.P., owns a piece of land (half an acre), works as a casual labourer in others’ fields, and runs a bullock cart on which he earns Rs.50 per day. His sons want him to transfer the land and house on their name. They beat him several times when he tried to convince them that the land was the only source of his livelihood and hence he cannot part with it. But they did not budge and even labeled him as mad.
At one time, he sold away the bullocks and cart as the bullocks grew old and the cart needed repairs, and kept the money in the house with plans to buy a new cart and a pair of healthy bullocks. As his sons took away this money forcibly, he could neither buy a cart nor could exert himself in manual work thus finding it difficult to make both ends meet. The sons kept on threatening him to hand over the documents of the land so that they can sell the land. During last year, he was beaten up more than 10 times and once he was also thrown out of the house. His wife joined the sons and abuses him verbally which made him all the more an easy prey to the violence of his sons. Though he sought help of the village elders and the sarpanch of the gram panchayat, nothing was done to contain the adamant behaviour of his sons.
Though generally his daughter gives him food twice a day, she taunts him often with the remark : “Why should I look after you old man! Go to your sons and get beatings from them”. Many a times, he was given a meager meal and there were times when he went without food. He smokes and loves to have tea twice a day. As he didn’t have money, he could not fulfill these trivial pleasures even one time a day.
Denying Place Attachment - A Form Of Neglect?
The meaning of place and attachment to place assumes greater relevance in old age. As people grow older, they form affective, cognitive and behavioral ties to their immediate surroundings – home, close neighborhood, and support networks where most of their daily activities take place. Therefore, forced relocations during old age involves deconstruction and reconstruction of social networks, engagements, and identities in the new place. Also, the common aspects of place attachment such as ‘safety, rootedness, privacy, joy, togetherness, recognition and control’ would get disturbed (Bond et al, 2008). So, if older people are not allowed to age in place because of circumstances beyond their control, does it come under neglect or disguised abandonment?
Krishnakant is a 79 year old Hindu married man belonging to the Patel caste. His wife is about the same age. They have two sons and three daughters who were married and settled abroad. Their source of income is the remittances received from children. For the past 19 years only he and his wife have been staying together at their own house in Vadodara, Guajarat. His house is well-kept and comprised of three spacious bedrooms, a well furnished hall and a kitchen.
He narrated how his home brings him a lot of memories and attachments. He said that his grandmother used to stay with him till her death in the year 1976. Later his father and stepmother moved in and stayed with him and eventually, in the year 1980 his father passed away, followed by his stepmother in the year 1992. During the period between 1978 and 1990, all his five children one by one, moved abroad for studies. Krishnakant was 58-year old when his youngest child moved abroad, and he felt it was a great achievement for him and his family that all his children settled abroad.
Between the years 1990 and 1999, he and his wife regularly visited their children abroad for varying periods. While abroad, they were confined to the home and had to abide by a lot of restrictions so that they did not fall ill. Over a period of time, their excitement for going abroad had faded away and the frequency of their visits reduced.
In the year 2011, his children asked him and his wife to shift permanently to the U.S to live with them, as they will not be able to come down to India if either or both the parents passed away. Though Krishnakant partly agreed to this, his wife who is attached to their house felt that she would lose her autonomy and would feel out of place abroad. So, she was opposed to this decision. She felt that if the children were not able to come here, they might arrange for their funeral through some relative who lived here. However, after a great deal of persuasion by her husband she had agreed, though half-heartedly, to go abroad. But Krishnakant was still apprehensive of the kind of life that awaited them there.
The stories reveal different angles of the abuse of the elderly. One angle is that the patterns of elder abuse and neglect reflect and reinforce the prevailing negative stereotypes toward the elderly and their roles in society. The other angle is how we are constructing and explaining the phenomenon of maltreatment of the elderly in the larger context of socio economic realities.
Butler (1975) defined ageism as “a process of systematic stereotyping of and discrimination against people because they are old, just as racism and sexism accomplish this for skin colour and gender”. He argues that 'underlying ageism is the awesome dread and fear of growing older and, therefore, the desire to distance ourselves from older persons who are a proxy portrait of our future selves. We see the young dreading ageing and the old envying youth. Ageism not only reduces the status of older people but of all people'. As in the case of West, in contemporary Indian society, when youth is romanticized and marketed with great fervor in media and family spaces, old age will be perceived as a non-productive and dependent existence in the context of increasing poverty and competition for resources. These negative attitudes tend to dehumanise old people and make it easier for an abuser to victimize them without feeling remorse.
Another perspective we need to acknowledge is about the selective way in which the whole discourse on elder abuse had come to be framed and how the analyses often ends up as a ‘conflict between ‘innocent’ elders and ‘bad’ families. Phillipson (1997) observed:
‘On the one side, we have a stereotyped view of the old as relatively powerless, undemanding and invariably blameless… On the other side, there are families, for whom various ‘risk factors’ can be identified, ranging from psychopathology on the part of the abuser to various forms of stress (p.9)’
Thus, in the process, we fail to “acknowledge the extent to which abusive situations themselves are socially constructed (italics mine) through low-incomes, inadequate community care, and ageism” in our society. Consequently, if we disproportionately highlight the role of individual families ignoring the wider socio-economic context, the broader issues will be ignored in the debates on elder abuse.
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