Isolation and elder abuse during COVID-19

The COVID-19 pandemic and the physical distancing measures that have been implemented across much of Australia have left many older people socially isolated.

It arises not only from the loss of face-to-face contact with family and friends, but also from the closure of community centres, libraries, and all the community-based groups and clubs that provide opportunities to mix with others.

Older people with care needs or sensory deficits have been further disadvantaged by services being stopped or restricted due to physical distancing requirements.

Healthcare appointments and assessment for aged care services may now be conducted by phone or online instead of face to face. Planned activity groups can’t run. And with aged care facilities becoming high-risk environments, respite options for older people and their carers are minimal.

Even when in-home services–including assessment for aged care services–are still offered, fear of COVID-19 has led many older people or their carers to cancel them.

The results for the older person are deeper isolation and worse health and wellbeing. If there is a family carer, their care burden and stress levels also increase.

Elder invisibility

The cumulative effect of the loss of socialisation opportunities, face-to-face appointments and in-home services is invisibility.

Elder abuse services rely on a network of formal and informal channels to identify abusive situations: it could be a council carer who first notices something is not right, or the local pharmacist, or friends at a community venue.

When this network isn’t functioning, and the services mandated to respond to elder abuse are not visiting older people in their homes, the risk of elder abuse going undetected and unreported becomes extreme.

The pandemic effects

Definitive data on the impact of COVID-19 on older people and on the prevalence of elder abuse are not yet available. However, preliminary research conducted by the National Ageing Research Institute suggests that neglect abuse increased substantially in the Melbourne metropolitan area during 2020, based on emergency department admissions.

There were also reports of generally worse mental and physical health in older people presenting for aged care assessments in 2021.

And elder abuse advisory services are concerned that there will be a spike in financial abuse cases in a couple of years’ time, when the abuse is detected by a third party or the abuse victim finally decides to report the perpetrator they have been protecting–most often, their son or daughter.

In addition, a new type of elder abuse emerged in 2020: one based on amplifying the fear generated by COVID-19 safety messages and the high number of deaths in Victorian residential aged care facilities. Abuse perpetrators are able to use and exaggerate this information to control the older person’s contact with the outer world, and their finances.

There was also novel institutional abuse when two Victorian retirement villages locked down their residents, denying them free movement outside the villages and visits from paid and family carers. This was, of course, illegal, and was resolved by an elder rights advocate with help from Victoria Police.

There are some lessons to be learned from all of this.

Finding solutions

Everyone from primary school children upwards moved online in response to COVID-19 restrictions and were supported to do this by their educational providers or employers. Most people are now able to maintain virtual contact with family, friends and health providers via online platforms such as Zoom and Telehealth, and can access up-to-the-minute COVID-19 information (and disinformation, unfortunately).

Yet relatively few older people are set up with the equipment and skills to do this, especially those most vulnerable to elder abuse, and there is no broad-based strategy to remedy this. There should be.

There will always be situations where only a face-to-face appointment or in-home visit can meet the needs of an older person, especially when there are sensory deficits, a high risk of abuse, or complex casework involved. Blanket restrictions on provision of face-to-face services work against the interests of the most vulnerable; service providers need the ability to operate a flexible service response based on the situation of the client.

More broadly, our local environments need to be set up so that there are people and places for isolated or vulnerable older people to go to, even in lockdown conditions.

Every locality has at least one centrally located library, sports centre or other community venue that is closed for its normal functions, but could be re-purposed as a safe zone where older people can find information, support and physically (but not socially) distanced company.

By Peter Feldman, Research Fellow, National Ageing Research Institute