Motions

Elder Abuse Awareness Day

The Hon. G.G. BROCK (Frome) (12:31): I move:

That this house—

(a) recognises that Elder Abuse Awareness Day is held on 15 June 2021;

(b) acknowledges the impact of the health and wellbeing of those involved;

(c) acknowledges the importance of being aware of the symptoms of potential elder abuse;

(d) urges the state government, together with non-government agencies, to aggressively promote the awareness of elder abuse;

(e) urges the state government, together with the commonwealth government, to ensure adequate protection for these elderly people; and

(f) urges the state government to ensure the most severe penalties are in place for offenders.

World Elder Abuse Awareness Day will be held on 15 June 2021. It is an annual event. With the growing global population of elderly people, and as longevity increases, abuse of the elderly is an increasingly serious problem that affects health and human rights that can cause death, so it is vital to raise awareness of it and thus prevent it whenever and wherever possible.

Elder abuse is a global issue and comes in many forms, including physical, emotional, sexual and financial, as well as neglect, silence and negativity. Elderly people are human and deserve the same dignity and respect as people in all other age groups. Elderly people are particularly vulnerable to abuse, to being unable to defend themselves and to get help, as fear and infirmity can be major barriers to seeking and getting help, and sometimes spotting and challenging abuse in the elderly is not very easy.

Some are isolated, having outlived family and friends, and some are abused in institutions where abuse is not spotted or is covered up. In some cases, the elderly are not given priority by authorities in abuse matters. I will speak further about that later in my speech.

Virtually all countries are expected to see substantial growth in the number of elderly persons between now and 2030, and that growth will be faster in developing regions. Because the numbers of elderly people are growing, the amount of elder abuse can be expected to grow with it. While the taboo topic of elder abuse has started to gain visibility across the world, it remains one of the least investigated types of violence in national surveys and one of the least addressed in national action plans.

The recent COVID-19 epidemic has highlighted the issues that these elderly people have to endure. Not being able to see their families due to isolation rules is in actual fact a form of abuse—maybe not so as in previous times, but it is still an abuse. However, this needs to be put in place to ensure that people's wellbeing during this very trying period is sustained. I have had many people come to my office for assistance to see their elderly parents in their respective aged-care facilities. These people miss their parents, and can you imagine how the elderly miss their own children and, in particular, their grandchildren.

Each year, it is reported that one in six elderly people experience some form of elder abuse. Rates of elder abuse in institutions such as nursing homes and long-term care institutions are likely to be higher than in the community, with two in three caregivers reporting abuse in institutions in the past year. While there are many institutions that work hard and provide excellent service and quality care to residents, there is evidence that suggests that an inadequate number of caseworkers or careworkers, difficult working conditions (both physically demanding and emotionally testing), low pay and inadequate training on the human rights of elderly people can contribute to rates of elder abuse in institutions.

Elder abuse can be defined as 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. Elder abuse can take various forms, such as physical, psychological or emotional, as I said earlier, and can include sexual and financial abuse. It can also be the result of intentional or unintentional neglect from both parties.

In many parts of the world, elder abuse occurs with little recognition or response. Until recently, this serious social problem was hidden from the public view and was considered mostly as a private matter. Even today, elder abuse continues to be a taboo discussion point—and again I will elaborate further on that a bit later—that is mostly underestimated and ignored by societies across the world. However, evidence is accumulating that indicates elder abuse is an important public health and social problem.

Abusive acts in institutions can include physically restraining patients; depriving them of dignity, by leaving them in soiled clothes, for instance; intentionally providing insufficient care, such as allowing them to develop pressure sores; over and undermedicating residents; emotional neglect; and abuse. Elder abuse can lead to physical injuries ranging from minor scratches and bruises to broken bones and disabling injuries, sometimes with serious, long-lasting psychological consequences, including depression and anxiety. Again, there will be more on that a bit later in my speech.

The consequences of abuse can be especially serious for elderly adults, placing them at a higher risk of nursing home placement and hospitalisation. Risk factors in communities can include: gender (women are often at a higher risk of abuse); poor social support; silent treatment from family and partners; isolation of financial support or knowledge of financial matters; sociocultural factors, such as erosion of the bonds between generations of the family; conflicts over inheritance; and the financial inability to pay for care. In institutions, there is a higher risk of abuse where staffing levels are insufficient, where staff may be poorly trained or poorly supported, and where there are inadequate care standards and no quality control.

Too little attention is given to preventing elder abuse, especially in institutions. Raising awareness, screening staff properly and adequate training are clearly essential. In addition, implementing care guidelines, mandatory reporting of abuse to authorities, and offering psychological support for both abusers and the abused will assist.

With the extra precautions needed due to the COVID-19 pandemic, all aged-care facilities need to have the extra staff necessary to maintain the highest standards and cleanliness, and the real issue emerging is that there are not enough suitable people to carry out these tasks. This could be both in terms of training and also being able to emotionally handle and carry out these tasks.

Approaches to define, detect and address elder abuse need to be placed within a cultural context and considered alongside culturally specific risk factors. For example, in some traditional societies older widows are subject to forced marriages, while in others isolated older women are accused of witchcraft. From a health and social perspective, unless both primary health care and social service sectors are well equipped to identify and deal with the problem, elder abuse will continue to be underdiagnosed and overlooked.

Recent research findings draw specific attention to financial exploitation and material abuse of older patients as a common and serious problem. Based on available evidence, 5 to 10 per cent of older people globally may experience some form of financial exploitation; however, such abuse often goes unreported, partly due to shame and embarrassment on the part of the victims or their inability to report it because of cognitive and other impairments, and most prevalence studies are based on self-reported surveys.

I have a personal involvement with someone with whom I have had a close family relationship over many years. From my observations, she had a happy marriage for nearly 50 years. We have since found out that this particular wife wanted to leave her husband after 14 years of marriage, as the children had then grown from young children to basically adults. The husband threatened to kill himself if she left him, and made it quite clear that she would lose contact with her children and would be seen as the culprit, so she stayed with him in this very stressful situation.

After a few years, with the assistance of her sister-in-law, she finally left. For the first time in nearly 45 years, she experienced living by herself and felt relieved by not being constantly berated and belittled. She invited her sister-in-law around to the new rental, but the sister-in-law was not aware that the husband was also there. When she arrived, the husband verbally abused his wife for letting her sister-in-law come around to this particular location. When the sister-in-law thought it was best that she leave, she asked the husband to move his car. He threatened both women and told the sister-in-law that he would deal with her next.

This sort of behaviour apparently was reported, but each time the relevant government department interviewed the wife the husband was always in the next room and, as such, the real truth never came out until just recently. Since then, unfortunately, the family have rejoined and moved to Adelaide. Even then, when the sisters-in-law asked where the new home would be, the husband would not divulge the new address to them. As far as I know, not even the wife knows the actual address of the new home, which may be due to her mental condition due to the continued belittling and berating she has received over the years.

To make issues worse, her husband has convinced authorities to give him power of attorney over his wife, and she is not fully aware of the consequences, mainly due to her mental capacity after many years of verbal intimidation. From investigations undertaken since this was brought to our attention, the issues were then reported by the sisters to the elder abuse hotline in 2020. However, as they did not receive a response, they contacted the elder abuse hotline again in 2021 only to be told that the file had been closed as they had spoken to the husband and everything was fine.

At this point, it was discovered that the husband applied for guardianship early in 2021 and was granted guardianship over his wife. Again, the sisters-in-law made further moves, contacting the Adult Safeguarding Unit and giving them the full story. The real concern here is that no-one from any government agency spoke to the wife to fully understand the actual activities and the behaviours.

Each time the discussions were held, either the husband was there with her or in the next room, so his wife was not prepared or did not have the strength or the fortitude to be able to tell the truth as she had been intimidated and told she was no good. She had no money and had not been given any idea about finances and things like that.

Once we were aware of these issues, a communication was sent to the Attorney-General. Even if not much can be done for this woman, we need to ensure that the situation does not happen to anyone else in the future in this regard. I am disappointed that this was not brought to my attention by these people earlier on.

As I say, we are a small community, we are a very close-knit community and most of us know the issues. To our knowledge and to everyone else's knowledge, this family had a very loving relationship and marriage. What goes on behind closed doors is not always evident to those outside, but once it was reported we communicated with the Attorney, and I have full faith that the Attorney will be able to look at opportunities to make certain that this does not happen again.

Now that the husband has the guardianship it will be a bit hard, but I reassure everybody that we are making every attempt to ensure that the sister-in-law and the sisters themselves and the agencies are fully aware of this, and a close watch will be kept on those families. We have been able to communicate with the children since then to ensure that they at least know the story and give their mother the opportunity and support she needs both financially and emotionally.

Elder abuse is something we have to be able to understand. Sometimes we talk about it, sometimes we do not know about it and emotionally and physically get personally involved with it. But, once you become part of that journey with those people, it is the most traumatic thing when you get involved with it and see it personally. We need to keep pushing, talk about it and take it away from being a taboo subject and make certain that we talk about it openly without any fear of being ridiculed or intimidated by anyone. I hope this motion goes through.

Ms LUETHEN (King) (12:46): I rise to speak on the motion moved by the member for Frome. I move to amend the motion moved by the member for Frome so that it reads as follows:

That this house—

(a) recognises that Elder Abuse Awareness Day is held on 15 June 2021;

(b) acknowledges the impact of the health and wellbeing of those involved;

(c) acknowledges the importance of being aware of the signs of elder abuse;

(d) urges the state government, together with non-government agencies, to actively promote awareness of elder abuse;

(e) urges the state government, together with the commonwealth government, to ensure adequate protection of the rights of older people; and

(f) urges the state government to ensure appropriate consequences are in place when abuse is perpetrated.

Amid an ageing population and the federal budget's renewed aged-care focus, I lend my support to recognising Elder Abuse Awareness Day on behalf of many elderly constituents and their families in my community. Oftentimes elder abuse flies under the radar, so acknowledging its warning signs and effect on those involved is very important.

Elder Abuse Awareness Day is held on 15 June every year. Older South Australians have the right to feel safe, to be treated with dignity and respect. Decisions about their lives, finances, where they live, health care, lifestyle and relationships are important, and older people have the right to make these decisions as they wish. With the annual Stop Elder Abuse community awareness campaign underway, concluding on 20 June, we are reminded that older people do have rights, and these rights need to be respected and safeguarded. If we suspect abuse or are concerned about someone we know, it is important to speak up and call the South Australian Abuse Prevention phone line on 1800 372 310.

SA Health also continues to promote the Stop Elder Abuse website at www.sahealth.sa.gov.au/stopelderabuse, so that people can easily find more information about elder abuse and what to do about it. Feeling safe from abuse and harm is a basic human right, and the Marshall Liberal government is committed to upholding it. Eighty per cent of elder abuse is committed by a trusted family member, and it often occurs silently and in secret. Elder abuse can frequently go unnoticed, and that is why as a community, just as we did during the 2020 COVID pandemic, we need to look out for our neighbours.

Notable effects of elder abuse documented by the Australian Institute of Family Studies include physical injury, early death and loss of personal autonomy. From a more local perspective, elder abuse's most alarming effects were revealed in the SA Health's harrowing Oakden report. I make particular mention of page 34, which stated, 'female consumers in mixed gender units [were] vulnerable to threats, harassment and abuse'. Also, 74 per cent of residents experiencing fear and distress were women.'

The Oakden story was one of the former Labor government's indifference, ineptitude and incompetence, with South Australians rightfully expunging the former government a month after the Independent Commissioner Against Corruption reported on this scandal. Nevertheless, the Oakden humiliation shone a light on how elder abuse can fall on deaf ears.

Briony Dow and others, writing in the Journal of Family Violence, identify numerous obstacles experienced by elder abuse victims to sharing their stories. These barriers, as described by the authors, generally stem from the fact that the perpetrator is the victim's adult child, causing the victim to fear adverse consequences for the child. The authors also describe evidence of victims experiencing shame and embarrassment at the response they received after disclosing their abuse.

While Oakden was a dark chapter in our state's history, it has provided a timely impetus to protect our most vulnerable. In contrast, in February, the Marshall Liberal government's Repat Neuro-Behavioural Unit, an Australian first, opened to patients living with extreme dementia symptoms. This is a key initiative in implementing the Oakden report's recommendations. With the Neuro-Behavioural Unit opening to patients, the government is ensuring the community can access specialised dementia services closer to home and when they need them.

The new facility was designed in partnership with people with lived dementia experience, including families of former Oakden residents as well as carers of people living with dementia. The Neuro-Behavioural Unit is a safe, open space where South Australians experience everyday things they enjoyed at home as well as quieter areas where families can gather, interact and share meals. Four years on, South Australians can be proud that we now care for people with severe dementia in an advanced facility with high-quality staff. We have only achieved this through sensitivity to the holistic needs of vulnerable elderly people needing regular and sophisticated care.

In September last year, the government rolled out an expansive awareness campaign urging South Australians experiencing or at risk of abuse or neglect and anyone concerned about another's welfare to reach out to an expanded hotline. The Adult Safeguarding Unit, which initially focused on elder abuse, now provides broader protection against abuse and neglect of vulnerable South Australians. This has been achieved by informing the community about the unit's expanded role and how to report to it.

Under the previous Labor government, South Australia had no single government agency with a clear statutory responsibility for safeguarding vulnerable adults experiencing abuse or neglect. The Adult Safeguarding Unit ensures people experiencing abuse or neglect are not left to navigate complex systems alone. Key functions of the Adult Safeguarding Unit include responding to reports of suspected or actual abuse of adults who might be vulnerable; providing support to safeguard the rights of adults experiencing abuse, tailored to their needs, wishes and circumstances; and raising community awareness of strategies to safeguard the rights of adults who may be at risk of abuse.

The Adult Safeguarding Unit works positively with and for an adult at risk of abuse to work towards solutions while preserving relationships that are important to them. Whilst reporting abuse to the Adult Safeguarding Unit is voluntary, the ASU has a legal mandate to respond to all reports received. Responses have included increasing support to the person at risk, assisting the person to make new legal documents or walking alongside the person to seek police involvement.

This coming World Elder Abuse Awareness Day, our community must do much more than simply acknowledge the existence of elder abuse. More valuable is the action of encouraging elder abuse victims to speak out and reporting elderly at risk in our local community so the government can help and protect them. Every South Australian has a responsibility in safeguarding the rights of older citizens and adults in vulnerable circumstances.

If someone witnesses or suspects abuse, they can take action by calling the South Australian Elder Abuse Prevention Phone Line on 1800 372 310 during Monday to Friday, nine to five, for information or support; by making a report to the Adult Safeguarding Unit; or by emailing adultsafeguardingunit@sa.gov.au. The trained and experienced staff of the Adult Safeguarding Unit are there to provide free confidential advice and support and to take reports of actual or suspected abuse. I commend this amended motion and thank the member for Frome for his motion.

The SPEAKER: The Minister for Innovation and Skills.

The Hon. D.G. PISONI (Unley—Minister for Innovation and Skills) (12:55): Thank you very much, sir.

Mr PICTON: Point of order.

The SPEAKER: The minister will resume his seat. The member for Kaurna on a point of order.

Mr PICTON: The minister and I were both on our feet. Was there not a standing order or a tradition in this house that the call passes between both sides of the house, as opposed to continuing to call on the government side of the house, as you have just done?

The SPEAKER: Order! There is no point of order. It is simply a standing order 106 point. The Minister for Innovation and Skills was, in my observation, on his feet, having risen first. Those are the terms of the order. It has simply been applied in those terms. The minister has the call.

The Hon. D.G. PISONI: I am certainly very pleased to support the amended motion, as amended by the member for King. I will take this opportunity to agree with the member for Frome about the need for a skilled workforce in the aged-care sector. It is unfortunate that it is a challenge that was obviously ignored by the member for Frome when he was a cabinet minister under the previous government.

It was not until there was a change of government that there was a focus on skilling the aged-care workforce here in South Australia, and I do not mean the only way in to the aged-care sector being institutional learning and then being forced to work for free for an employer in what they call a placement, which is really working as an employee without being paid for up to eight weeks for the on-the-job experience.

When I came to office, I identified that this was a significant problem for getting the number of people who are required with skills that are needed in the aged-care sector. We know what the aged-care royal commission said about the quality of care; they said that there needed to be increased skills in that sector. I am very pleased that we had already started the rollout, even before the aged-care royal commission started—paid traineeships in the aged-care sector, Cert III in Individual Support. We started rolling those out because we spoke to employers and those who were delivering that care in the disability sector and the aged-care sector, which are very similar skill sets.

We know that there is a high turnover of staff—up to 60 per cent per annum—who work in the aged-care and disability care sector. By having paid traineeships in that sector, we know that it is the beginning of a career pathway; it is not just a job anymore. In South Australia, we are leading the nation when it comes to the rollout of new paid career pathways in vocational education.

Of course, we are thankful for the Morrison government recognising the importance of ensuring that Australians are skilled and seeing what we have been achieving here in South Australia and backing the paid apprenticeship and traineeship model with their boosting apprenticeships program, which we are using here in South Australia—not as a sugar hit, as we are seeing in some of the other states, but to change the culture of vocational education here in South Australia. I seek leave to continue my remarks.

Leave granted; debate adjourned.

Sitting suspended from 12:59 to 14:00.