Daphne project- 2000-125
MISTREATMENT AND ABUSE OF OLDER WOMEN IN THE EUROPEAN COMMUNITY: ESTIMATED PREVALENCE AND LEGAL AND SERVICE RESPONSES:
A review of the situation in three member states.
Yvonne Barnes-Holmes and Dermot Barnes-Holmes,
Department of Psychology, National University of Ireland, Maynooth, Ireland.
Roberta Morichelli, Francesca Scocchera and Claudio Sdogati,
Coo.S.S. Marche, Ancona, Italy.
Elizabeth Ockleford, Asesha Morjaria and Frederick Furniss,
Centre for Applied Psychology, University of Leicester, Leicester, U.K.
Acknowledgement
This research was undertaken with financial support from the European Commission. Neither the European Commission nor any person acting on its behalf is liable for any use made of the following information. Reference: DAPHNE project 2000/DAP/125/W:
Recognition, prevention and treatment of abuse of older women. This document forms APPENDIX 5 to the final project report.
CONTENTS.
CHAPTER 1. Introduction. 3
CHAPTER 2. Demographic and statistical analysis. 8
CHAPTER 3. Legislative and judicial analysis. 112
CHAPTER 4. Analysis of the public and private care supply 159
To women victims of abuse/violence.
CHAPTER 5. Summary, conclusions and key 205
recommendations.
CHAPTER I: INTRODUCTION.
SUMMARY.
Violence, abuse and neglect directed towards older women receives little attention, with little known even regarding the scale of the problem in Europe. Information on abuse of younger women and of older persons in general, however, would suggest that older women are at particularly high risk of abuse. Older women with cognitive impairments are at especially high risk.. The objectives of DAPHNE project 00/125/W “Recognition, Prevention and Treatment of Abuse of Older Women” were to define the scale and nature of the problem in Europe and to disseminate experience and best practice in responding to the problem.
BACKGROUND.
The problem of violence against women is a social and economic issue which is recognised all over the world, both in the industrialised countries and in the developing nations. UNICEF recently published a report on Domestic Violence Against Women and Girls on the eve of a special session of the United Nations General Assembly from 5th-9th June 2000 on the occasion of the fifth anniversary of the UN Fourth World Conference on Women held in Beijing, China, in 1995, at the end of which 189 countries endorsed the Beijing Platform for Action, enjoining governments, the United Nations system and international non government organisations to take action in the elimination of all the forms of violence against women as one of the twelve strategic objectives of the conference.
A significant proportion of the violence perpetrated against women occurs within the family. A study on domestic violence released by the UNICEF Innocenti Research Centre (IRC) in Florence, Italy, highlighted alarming data on abuse against women inside the family. The study in particular reveals that worldwide “from country to country between twenty and fifty per cent of women have experienced physical violence at the hands of an intimate partner or family member”.
A significant aspect of the studies in this area is the almost total lack of data and information about the situation of elderly women. From a cultural point of view, a woman appears to be regarded as an “interesting” subject when she is in the central groups of age (from 15 to 50 years more or less), when she can be considered an active and productive subject from a sexual and economical perspective. For older women, even basic statistics on the extent of violence and abuse are minimal.
The last meeting about the condition of elderly women in Europe, held in Denmark in 1994, dealt with different aspects of female ageing without underlining the problems of violence and abuse, either physical or psychological. This impression of a gap in research seems to be confirmed also by the observation of the projects funded and realised within the Daphne programme in the previous period, 1997/99. It appears that none has been working with this specific aspect of violence against elderly women.
Eastman (1989, 1994) and others have identified five forms of violence towards and abuse of elders: physical violence and threats of such violence; sexual abuse; neglect; psychological and emotional abuse; and material and financial exploitation. Estimating the prevalence of such abuse is difficult because of problems of definition, because both perpetrators and victims may not disclose abuse, and because professional staff may not recognise and investigate signs of abuse. It has, however, been estimated that between four and ten per cent of all persons over sixty-five are abused or neglected by family members (Browne & Herbert, 1997). It is, however, clear that the majority (70-80%) of abused older people are women (Johnson, 1986; Eastman, 1994), and that persons with physical or mental impairments, such as dementia, are particularly at risk (Pillemer & Finkelhor, 1988; Eastman, 1994).
Crucially, however, the research on which these conclusions is based comes largely from the USA. A recent review of published prevalence studies (Reay, 1999) identified seven from North America and only four from Europe, three from the UK and one from Sweden. There is thus an urgent need to identify the scale of the problem of abuse and neglect of older women throughout the states of the European Union.
OBJECTIVES OF THE PRESENT RESEARCH
The aims of the research project described in this report were as follows:
i)To investigate the nature and the scale of the problem of abuse and neglect of older women in the European Union on the basis of detailed analyses of the situations in the three partner countries.
ii)To promote social awareness of these problems, in the general population, in associations concerned with the needs of older persons, and in associations and services supporting female victims of violence.
iii)To stimulate the exchange of information and good practice between the European countries involved in the project.
PROJECT METHODOLOGY
The project involved a comprehensive evaluation of the scale of the problem in each partner country. Given the recognised difficulties in assessing the prevalence of elder abuse, and the additional difficulties presented in recognising abuse of women with mental impairments, the analysis reviewed the situation from three distinct perspectives, integrated this information, and also included a specific focus on the situation of women affected by dementia. The project had a duration of twelve months and comprised five work-packages, described below.
WP 1: DEMOGRAPHIC AND STATISTICAL ANALYSIS
This work-package was articulated in two different tasks:
-task 1.1: Review of general demographic statistics about the female population, including age structure trends, financial and social trends, and prevalence of risk factors identified in previous research, in order to estimate the size of the ‘at risk’ population
-task 1.2: Review of available statistics about different kinds of violence against women in general and against elderly women in particular, identifying the centres appointed for the collection of this information and their level of knowledge of the problem (e.g., EUROSTAT, ISTAT (National Central Institute for Statistics) in Italy), together with review of relevant published prevalence and epidemiological studies, to provide estimates of incidence and prevalence across EU member states. Given the paucity of European studies, we also carried out a field analysis (direct interviews using structured questionnaires) to a sample of people (elderly women, carers, relatives, etc.) to have indications from a qualitative perspective of the nature of the problem in the European context.
WP 2: LEGISLATIVE AND JUDICIAL ANALYSIS
This work-package was articulated in three different tasks.
-task 2.1: Documentary review of the legislative material, either in force or in the planning stage, directed to the protection of women at European, at national and regional level
-task 2.2: Description and analysis of the main types of violence and abuse towards women, especially elderly women (juridical, physical, physiological, sexual, economical, etc.) with reference to the places in which it can be perpetrated (private homes, work-places, residential care services, public spaces, etc.)
-task 2.3: Review of the criminal and judicial statistics of the offences against women which have been reported to the major protection services (including institutions such as police stations, prefectures, law courts, hospitals and health agencies, social services inside the Municipalities, etc., specific services for women victims of abuse, like centres against violence, women houses, help lines, etc., and other general services for victims of crime (counselling services, victim support agencies, etc).
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WP3:ANALYSIS OF THE PUBLIC AND PRIVATE CARE SUPPLY TO WOMEN VICTIMS OF ABUSE/VIOLENCE
This Workpackage comprised a single task:
-task 3.1: Individuation and analysis of the main public and private supply services provided to women who have experienced abuse or violence at a local and national level, with particular regard to their number, to the characteristics of their management, to the typology of the involved personnel and to the characteristics of users. We focussed particular attention to three related issues, i.e., the level of awareness of abuse of older women in these services, the extent to which services are oriented to and accessible to older women, and the numbers of older women actually using these services.
WP4: THE SITUATION OF WOMEN AFFECTED BY DEMENTIA
The aim of this work-package was to investigate in detail the nature and extent of abuse of women with dementia, whether living in their own homes or in residential care, proceeding in parallel with work-packages 1-3. There were therefore three tasks:
-task 4.1: Review of epidemiological and demographic data on the numbers and situations of women affected by dementia
-task 4.2: Review of legal frameworks regarding the rights of persons with mental impairments in different EU states
-task 4.3: Review of data on types and prevalence of abuse, and protection measures provided, in different EU states.
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WP5: DISSEMINATION AND DIFFUSION ACTIVITIES
This work-package involved two key tasks:
-task 5.1: Production and distribution of an information leaflet about the project and development of a website (early in the project).
-task 5.2: Development of a network of relationships between partners and national and European organisations interested in the phenomenon of violence, abuse and neglect of older women.
The remainder of this report presents the key findings from the first four Workpackages. Work in Workpackage 5 will be described in thev final report on the project to the European Commission.
CHAPTER 2: DEMOGRAPHIC AND STATISTICAL ANALYSIS
SUMMARY
The aim of the current work was to investigate the situation of older women in the European Union and the nature and scale of mistreatment to which they are exposed. This investigation was conducted on two levels. First, we conducted detailed analyses of existing statistics and research on the female population and the types and prevalence of mistreatment they experience. Second, we carried out a field study investigating this phenomenon within three European Member States. The collation of information from these two sources was then used to facilitate one of the first estimates of the size of the elderly female population “at risk” of mistreatment in the European Union
RESEARCH_REPORT_Daphne-project_2000-125 _1
The remainder of the current chapter is presented in four parts. In part 1, we focus on the demographics of the elderly female population in the European community. In part 2, we review the existing literature on the prevalence and types of mistreatment to which elderly European women are exposed. In part 3, we examine the prevalence and impact of dementia among elderly women in the EU and any correlations that have been identified between dementia and susceptibility to mistreatment. In part 4, we present the findings from the field study conducted in the three partner EU nations, and we therein discuss the extent to which these support the existing literature on elder mistreatment and identified risk factors for older women in the European community.
PART 1: DEMOGRAPHICS OF THE ELDERLY FEMALE POPULATION IN THE EUROPEAN COMMUNITY.
In this section of the report we will describe four significant trends that characterise the lives of women, and older women in particular, in the European Union. These trends include population structure, social, health and financial status. Each of these categories will be dealt with individually and a number of sub-categories within each will be discussed. All of these measures greatly influence the quality of life experienced by European elderly women and impact, perhaps in important ways, on the types of mistreatment to which they are exposed.
POPULATION STRUCTURE.
In examining the population structure of women, especially elderly women, in the European Union, we will focus on the age structure, gender profile and life expectancies of this population.
Age Structure
At the beginning of 2001, the estimated population of the EU-15 was 377,026,300. This figure represented an increase of 1,052,700 or 0.28% since the beginning of the year 2000 and a continuation of the modest growth rate characteristic of the last 20-30 years. The populations in the countries of the EU-15 and the estimated population changes between 2000 and 2001 are presented in the table below.
Table 2.1.1 Population and Population Change (1000’s) in the EU-15, 2000-2001
Country / Population 1/1/2000 / Population 1/1/2001Belgium / 10,239.1 / 10,262.3
Denmark / 5,330 / 5,349.2
Germany / 82, 163.5 / 82, 192.6
Greece / 10,542.8 / 10, 564.7
Spain / 39,441.7 / 39,489.6
France / 58,744.1 / 59,039.7
Ireland / 3,776.6 / 3,819.7
Italy / 57,679.9 / 57,844
Luxembourg / 435.7 / 441.3
Netherlands / 15,864 / 15,983.1
Austria / 8,102.6 / 8,121.3
Portugal / 9,997.6 / 10,022.8
Finland / 5,171.3 / 5,181.1
Sweden / 8,861.4 / 8,882.8
U.K. / 59,623.4 / 59,832.1
EU-15 Total / 375,973.6 / 377,026.3
Although the population of the EU as a whole is experiencing only modest growth, a very different growth pattern emerges when the population is categorised by age group. Eurostat estimates in 1999 suggested that the number of persons age 60+ in the EU will double in the next 30 years. The share of the elderly in the total population of the EU is expected to rise from 21% to approximately 34% by 2050. The number of persons aged 80+ (i.e. the ‘old-old’) is expected to “soar drastically” in the next 50 years. The proportion of this age group in the total population is predicted to rise from 4 to 10%, such that by the year 2050 there will be an estimated 37 million EU citizens aged 80+. The percentages of the populations aged 45-64 and 65+ in the countries of the EU-15 in 1996 are presented in the table below.
Table 2.1.2 EU-15 Population and % Distribution by Age (1996)
Country / Total Population (000’s) / % AgedTA / 65+ Years
Austria / 8,054.8 / 22.8 / 15.2
Belgium / 10,143 / 23.1 / 16
Denmark / 5,251 / 24.5 / 15.1
Finland / 5,116.8 / 24.7 / 14.3
France / 58,255.9 / 22.1 / 15.2
Germany / 81,817.5 / 25.1 / 15.6
Greece / 10,465.1 / 24.1 / 15.8
Ireland / 3,615.6 / 19.4 / 11.5
Italy / 57,333 / 24.8 / 16.8
Luxembourg / 412.8 / 23 / 14.1
Netherlands / 15,493.9 / 23 / 13.3
Portugal / 9,920.8 / 22.8 / 14.7
Spain / 39,241.9 / 22 / 15.4
Sweden / 8,837.5 / 23.9 / 17.5
U.K. / 58,694 / 22.6 / 15.7
E.U. Total / 372,653.6 / 23.5 / 15.6
(Eurostat, Demographic Statistics, 1997)
The table above indicates that 15.6% of the total EU-15 population in 1996 was aged over 65. Given the 2001 estimates of the size of the total EU-15 population noted above, 15.6% of this figure conservatively suggests that there were approximately 5,881,610 persons over 65 in the EU-15 in 2001. The world population of persons aged 65+ is expected to show a similar ageing trend to that of the EU, and is expected to grow from 660 million to 1 billion in the next 20 years.
Gender Profile.
In all EU Member States there are more women than men. Estimates for 12 States in 1993 indicated that there were more than 177 million women living in the EU, 51.2% of the total population. The number of women and the percentage in the total population of the EU-12 for 1993 are presented in the table below.
Table 2.1.3 Women in the Total Population of the EU-12 (1993)
Country / Total Population (000’s) / Women / % WomenBelgium / 10,068.3 / 5,144.8 / 51.1
Denmark / 5,180.6 / 2,626 / 50.7
Germany / 80,974.6 / 41,674.6 / 51.5
Greece / 10,346.4 / 5,243.9 / 50.7
Spain / 39,114.2 / 19,912 / 50.9
France / 57,529.6 / 29,509.9 / 51.3
Ireland / 3,560 / 1,1790 / 50.3
Italy / 56,960.3 / 29,255.4 / 51.4
Luxembourg / 395.2 / 201.1 / 50.9
Netherlands / 15,239.2 / 7,703.9 / 50.6
Portugal / 9,859.6 / 5,107.5 / 51.8
U.K. / 58,088 / 29,671 / 51.1
E.U.-12 Total / 347,316 / 177,840.2 / 51.2
The feminization ratio is defined as the number of women to men in a given population. The feminization ratio for particular age groups clearly indicates that the female population in the EU is markedly older than the male population. For example, at community level in 1992, there were 95 girls for every 100 boys at birth, 143 women to every 100 men at age 60+ and 224 women for every 100 men at age 80+ (although there were notable differences across Member States). In the EU-12, 22.2% of women were aged 60+ in 1987 and this figure rose to 23% in 1993. Using the 1993 population figures, one could calculate that there were over 40 million women in the EU-12 aged 60+.
Life Expectancy.
Life expectancy is defined as the number of additional years a person of a given age can expect to live. Because there are many more females than males in the elderly population, one can assume that the life expectancy for females is longer than that for males. The life expectancies for females at birth and at age 65 in the EU-15 (average 1993) are provided in the table below.
Table 2.1.4 Life Expectancy for Females at Selected Ages in the EU-15 (1993)
Country / Life Expectancy in Years at Age0 / 65
Austria / 80.1 / 18.7
Belgium / 80.2 / 19.1
Denmark / 77.8 / 17.5
Finland / 80.2 / 18.6
France / 81.8 / 20.6
Germany / 79.7 / 18.5
Greece / 80.3 / 18.4
Ireland / 78.6 / 17.4
Italy / 80.7 / 19.3
Luxembourg / 80.2 / 19.2
Netherlands / 80.4 / 19.1
Portugal / 78.6 / 17.7
Spain / 81.4 / 19.8
Sweden / 81.4 / 19.7
U.K. / 79.2 / 18.1
E.U. Average / 80 / 18.8
(Eurostat, Demographic Statistics,1997)
Everywhere in the EU females can expect to outlive males. The table above indicates that the average overall life expectancy of a woman in the EU-15 is 80 years and women aged 65+ might expect to live on average for a further 18.8 years. On the whole, women live longer than their male counterparts. The life expectancy lead of females over males in 1999 was estimated to range from 5.2 years in the UK to 7.9 years in France.
SOCIAL STATUS
In examining the social status of older persons in Europe, we will focus on a number of key areas of their social lives including; marital status/living arrangements, accommodation, levels of social contact and assessment of morale.
Marital Status/Living Arrangements.
People increasingly live alone, especially the elderly. At community level, one-person households represent a growing percentage of all households. Eurostat estimates for 1999 indicated that 11% of EU citizens lived alone, compared to 8% in 1981. Although this figure has increased, it remains significantly below the OECD average solitary living rate of 40%. Fifty-five percent of households in the EU consist of a couple with children, 19% are childless couples and 7% are lone parents.