e burden of child care on older people is
overwhelming. In almost all households, older people take care of the needs of their grandchildren.
Financial insecurity is the most important source of elder abuse; where it exists, it is sufficient to prompt suspicion of elder abuse. e older people have no reliable or known source of income to meet their basic needs. In spite of the financial insecurity older people face, financial dependence on them is very high. e average household has four children or grandchildren fully dependent on elderly people for financial support for food, clothing, fees and medical care.
Most abuse is emotional, which has a far- reaching impact on the older people. Sexual abuse was not identified as an experienced form of elder abuse. e issue of sex is too sensitive in an African context, since it is not a matter to be discussed in public, espe- cially with “strangers”.
Close family members are the main abus- ers of older people. Although older women identify their sons as frequent perpetrators, older men claim their wives and children to be their abusers. At the household level, older people reported the following mis- conduct and situations that characterize their living situation to warrant suspicion of elder abuse: alcohol-dependent sons, lack of respect for parents, sons projecting their failure on parents, abandoned chil- dren, refusal to help in domestic chores and demand for food.
A GLOBAL RESPONSE TO ELDER ABUSE AND NEGLECT
Focus groups with PHC professionals
e three focus groups with physicians
chose Questions 4, 5, 1, 8 and 12 to be the most relevant from the bank of 12 ques- tions.
Question 1: Loneliness is considered important in detecting elder abuse because loneliness is a real issue among older mem- bers of society today. e question tackles only one issue and therefore is appropriate. It is also a short and easily understandable question without any redundancy.
Question 4: is question is important in detecting elder abuse. e examples provid- ed make the question comprehensible. e question guides the respondent in terms of what is required, and there is no redun- dancy. e wording is clear and gives the respondent the opportunity to explore.
Question 5: is question is important in detecting elder abuse. e question is too wordy and long-winded, however, to the extent that an older patient may forget the beginning of the question by the time the questioner has finished enquiring. A sug- gestion for rephrasing is as follows:
“Are there times when a person close to you unfairly treated you? How did you feel? If yes, has it happened once or several times?”
Question 8: is question can be used to detect elder abuse because it is a common phenomenon in modern society. e word- ing is appropriate and self-explanatory.
ere is no element of redundancy, and the
question can create an environment for discussion with the respondent.