Little consideration of rural and remote communities in elder abuse policies

Blundell B & Warren A. Reviewing the extent of rural and remote considerations in elder abuse policy: A scoping review The Australian Journal of Rural Health. 2019; 27(4): 351-357.

Review question

•      To what extent are elder abuse policies tailored to the unique characteristics of those living in rural and remote communities?

Background

•      This scoping review defined elderly abuse as “a single or repeated act, or lack of appropriate action, occurring within any relationship where there is a violation of trust, which causes harm or distress of an older person.”

•      Recent research found that elder abuse may affect up to 15.7% of community-dwelling people aged 60 years or over in middle- and high-income countries.

•      This rate is estimated to be even higher for older adults in “at-risk” categories, including those with physical or mental disabilities and those living in institutional care settings.

•      The geographical and social isolation associated with rural and remote communities, as well as barriers to accessing legal and support services, is thought to heighten the risk of elder abuse outside of urban settings.

•      The aim of this scoping review is to identify research focused on policy responses to elder abuse in rural and remote communities.

How the review was done

•      Review authors conducted a detailed search of eight research databases for eligible studies.

•      Database searches used a combination of keywords related to elder abuse, family and domestic violence, ad rural and remote communities (with a focus on Australia).

•      In addition to the database searches, authors looked to relevant policy documents on government websites, and consulted with other researchers.

•      Overall, a total of 47 articles relevant to elder abuse were included in this review.

•      This research has been supported by funding from the Older Person's Advocacy Network in Australia.

What the researchers found

•      A review of relevant Australian state and territory elder abuse policy documents found that only four of 13 documents explicitly considered issues related to rural and remote communities.

•      Of the documents which considered rural contexts, little information was provided aside from a brief mention that living in these communities may increase vulnerability to elder abuse, as has been highlighted in research studies.

•      Only one document suggested a preventative approach—early succession planning, in relation to farming families.

•      Though the literature has highlighted the unique challenges in addressing elder abuse in rural and remote communities and the importance of developing specific policy responses that consider existing local services, this was not reflected in Australian elder abuse policy.

•      Overall, there was a clear sense of urban‐centrism in the reviewed policies, with many jurisdictions either not considering rural and remote areas at all or assuming that elder abuse policies or protocols can be implemented state‐wide.

Conclusion

•      Overall, the review highlighted a lack of meaningful consideration of the effect of rurality and remoteness on elder abuse experiences and responses. It also underscores the need for more explicit consideration of these issues in Australian elder abuse policy.

•      Review authors recommended that future policy development includes recognition of the distinctive features of elder abuse in rural and remote communities, as well as ways these may impact on prevention and responses.

•      These features include isolation, lack of access to services and transportation, confidentiality issues, and the need for culturally sensitive approaches for Indigenous people, which consider the impact of colonialism and historical disenfranchisement.