A GLOBAL RESPONSE TO ELDER ABUSE AND NEGLECT
of terms that are too difficult to apply, such as “adequate living space” (Australia, Brazil, Chile, Singapore), “free movement” (Brazil), “unwanted approaches” (Brazil), “health aids” (Chile), “basic daily needs” (Australia, Brazil, Singapore, Spain) “and taking advantage” (Singapore). Other expressions are not specific enough, such as “needed things” (Australia).
Some of the questions should be separat- ed as they contain different concepts that are not related to one another. For instance, Question 4 inquires about both basic and secondary needs. Question 5 asks about different emotions (“sad, shamed, fearful, anxious or unhappy”) in one sentence. In Question 8, two different issues are ad- dressed: misuse of money and being forced to sign documents. Other questions could be combined, such as Questions 2 and 3, and Questions 11 and 12.
Some words are difficult to translate into other languages, e.g. an equivalent for “dependent” (Question 3) does not exist in Mandarin. Generally, it was challeng- ing to translate some of the expressions into Brazilian Portuguese and to translate whole questions into Bahasa Melayu and Mandarin and its dialects.23
General remarks looking at the questions as a whole recommended that the second part of each question (where applicable) could be omitted (i.e. “Was this an isolated event or has it occurred more than once?”) (Australia, Brazil, Singapore, Spain). It is important, however, to get some idea of whether this is an isolated incident or part of an existing and/or long-standing pat- tern, even in detecting suspicions of abuse. Furthermore, the time frame of the ques- tions is not clear: should the main focus be on recent situations or on events that happened several or many years ago or even within a lifetime? Another suggestion was to add a part asking about the relationship with the perpetrator (Costa Rica, Spain).
Similar to the discussions with older people, it was mentioned that many older people feel uncomfortable when request- ing help, either because they want to stay independent or because they are afraid of being rejected. is factor renders it more difficult to identify abuse, as some people may not answer the questions fully be- cause they fear repercussions by the per- petrator. A trusting relationship between the physician and the patient, where the medical practitioner has prior knowledge of the social or home situation and family relationships of the older patient, is cru- cial. Moreover, some of the questions (e.g. Question 12) would require several visits to the doctor before they can be asked (Australia, Singapore).
For the groups in Singapore, the questions were translated into Mandarin, as the majority of Singaporeans are Chinese and speak not English but Mandarin and its dialects.