Families, untrained caregivers cause severe elder abuses – Stakeholders

Stakeholders and advocates for the rights of elderly persons in Nigeria have expressed concerns over rising cases of abuse in the country.

They mentioned that much of the elderly abuse is perpetrated by family members and caregivers who lack adequate training and skills.

Speaking to PUNCH Healthwise in separate interviews on World Elder Abuse Awareness Day, the stakeholders emphasised the pressing need for state governments to domesticate the National Senior Citizens Centre Act and the National Policy on Ageing, 2021.

The World Elder Abuse Awareness Day, celebrated every June 15, was initiated by the International Network for the Prevention of Elder Abuse in 2006 and was adopted as a United Nations Day in 2011.

According to the World Health Organisation, Elder abuse is “a single, 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.”

The WHO notes that elder abuse could be physical, psychological, emotional, sexual or financial, adding that it could be a result of intentional or unintentional neglect.

June 15 is set aside to address and acknowledge the significance of elder abuse as a public health and human rights violation.

The theme for this year is ‘Spotlight on Older Persons in Emergencies’.

In Nigeria, an elderly person is an individual 60 years and above.

The National Bureau of Statistics Nigeria Living Standards Survey, 2019, reports that 14.8 million older persons live in Nigeria, making it the country with the largest population of older persons in Africa.

It added that 50.2 per cent of older persons are male and 49.8 per cent female, with 5.3 million living in the urban centres and 9.5 million in the rural areas.

Also, data from the National Social Safety Net Coordinating Office, 2022, reveals that about 2.5 million older persons are captured on the national data system for the poor and vulnerable.

The population of the elderly in Nigeria is projected to have a growth rate of 2.8 per cent by 2050, indicating that there will be about 30 million of them in Nigeria.

The National Policy on Ageing, approved in 2021, is a policy that recognises the inclusion of senior citizens in nation-building and guarantees their security, independence, participation, comprehensive care, self-fulfilment and dignity.

It also recognises the diverse population of older persons, addresses various challenges and recommends interventions for different socioeconomic statuses and health conditions, such as cognitive impairment and dementia.

The National Senior Citizen Centre was inaugurated in 2021 to identify and cater for the needs of senior citizens and integrate them into the national policy.

Speaking with the PUNCH Healthwise, the Director General of the National Senior Citizens Centre, Abuja, Emem Omokaro, said the lack of trained and certified caregivers and the dependence on family members to care for older persons was responsible for such abuse in the country.

To curb the abuse, she noted that the agency established training and certification programmes for caregivers and family members in state and tertiary teaching hospitals with geriatric centres.

“When older people are no longer vulnerable and needy, it will reduce abuse. Family members will feel relief knowing that they can access skilled caregivers. We are working with the National Health Insurance Authority and state governments to ensure that domiciliary care systems can provide coverage, reducing the burden on families and decreasing abuse,” she said.

Omokaro added that through the partnership with the National Agency for the Prohibition of Trafficking in Persons, and constant awareness through jingles and other materials, the centre has been able to reduce the rate of abuse and false accusations against older persons.

“We have developed a programme that we call elder justice and this creates a network of support for older persons to ensure that they have access to justice, redress, mitigation of abuse and so on. Most of this abuse we talk about happens in families and through caregivers who are not skilled, trained and certified.

“So many factors give rise to abuse of different kinds, and before now, non-governmental organisations were doing the best they could because there was no government regulation, system, institution and no umbrella body to have national policy guideline and a standard operating procedure to train and certify. But all these things I’m talking to you are now in place,” Omokaro stated.

The NSCC DG noted that 40 ageing desks have been established in 40 Ministries, Departments & Agencies and 78 ageing desk officers trained in ageing policy, planning, implementation, monitoring and evaluation to enhance understanding of ageing.

She added that the agency has partnered with the National Human Rights Commission, National Legal Aid Council of Nigeria, National Emergency Management Agency and the Red Cross to address the specific needs of older persons during emergencies and in IDP planning.

Also, Omokaro revealed that the agency is working with the Primary Health Care Development Agency, WHO, and executive secretaries of state PHCs to develop and create age-friendly facilities.

She emphasised that ageing is a natural progression and it is important for everyone to support older people in their communities, treat them with respect and empathy and make the environment age-friendly.

Speaking on the theme of this year’s World Elder Abuse Awareness Day, she stated that older persons were first humans and their rights must be respected.

“Human rights do not diminish with age and for you to respect a person, it means you must first identify and acknowledge the values, qualities and achievements of that particular person and admire it. Our older persons deserve to be acknowledged as persons that have values and they continue to contribute.

“In emergencies, they should not be left behind. When it comes to communal living in IDP camps, their peculiarities should be taken into consideration.

“Ageing is progression and is the future for anybody praying to grow old. We should in our little corners become the support network for older people.

“We should treat them with respect and empathise. That is, you put yourself in their shoes and do everything to make the environment age-friendly,” the NSCC DG stressed.

Also speaking on the issue, the Founder and Chairperson of Alzheimer’s Disease Foundation, Josephine Anenih, affirmed that most elder abuse happens within the family setting.

She said such abuse is often hidden and silenced, allowing the perpetrators to continue their actions unchecked.

“The culture of silence around this issue emboldens the perpetrators to continue but when we start talking about it and everybody knows about it and it is out in the open if somebody is abusing their parents or the person they are caring for and people around speak about it, I think it will serve as a deterrent to some extent,” she said.

Anenih noted that engaging communities in recognising the signs and features of elder abuse would be instrumental in addressing and preventing such from happening in the country.

The ADF president added that once awareness campaigns of actions categorised as elder abuse are made, structures will be established for reporting such cases and measures taken to mitigate or prevent the abuse of the elderly.

The advocate decried the abuse, neglect and deprivation of the human rights of the elderly, strongly asserting that old age did not diminish the respect of older persons.

She said, “That somebody is old or is cognitively impaired, has inertia or whatever, does not take away their rights as human beings and their fundamental human rights to dignity, respect, to not being abused, to say what they want and should be respected.

“We are also looking at what happens to the elderly during periods of emergency. Because most of them are frail and vulnerable, when there is an emergency, how does the community look after them and cater for their needs? So, we are shining the light on that issue because the impact of COVID-19 on the elderly was grievous. We also have floods and other disasters, so what is the response as far as the elderly people are concerned?”

Anenih further called for serious and intentional social welfare programmes targeted at the elderly to ensure they are not left behind in any government policy.

She advocated insurance packages to provide senior citizens, especially the poor, with access to free healthcare.

Speaking on the WEAWD, Anenih said, “I urge Nigerians, especially the wealthy, to embrace philanthropy for the sake of giving, not for politicking. We need philanthropists to fund support for older people and their caregivers. Many family caregivers are unpaid, and the few who are paid receive inadequate compensation for their work. Proper pay and care for these caregivers are essential.

“There is a need for spaces or homes where elderly people can socialise and where those who are frail and living alone can spend their final days with care, love, and dignity. We need more private investment in this area because we can’t rely solely on the government.

“The few old people’s homes we had before now were managed by missions or in some cases, the government. But it is not enough and we find that they are not well cared for, so people despise or look down on old people’s homes. As a result, these homes often lack proper care, leading to societal disdain for them.

“We should have well-maintained old people’s homes, like those in other parts of the world, where individuals can choose to spend their old age with dignity.”

She noted that the argument against establishing old people’s homes is weakening due to the realities of modern life, stressing that it is wickedness to leave aged parents in the village uncared for under the guise that it is not culturally acceptable.