My new word is “dementia-ism”. It often goes hand in hand with ageism (already rife in our society) and when combined, they can have disastrous consequences for an older person.
As an elder abuse advocate, I have seen first hand the all too tragic results of this combination. Sometimes, it’s the patronising way a worker communicates with an older person, sometimes its blatant discrimination by agencies and institutions, and sometimes its much, much worse……
Let me tell you about Arthur (or “dad” as we shall also call him)…….
In 2011 Arthur, who is 77, began to exhibit early signs of dementia. He forgot things, got a little muddled sometimes and needed a little prompting about birthdays and paying accounts. Other than this, Arthur was living an independent and relatively fulfilling life. He was well connected socially, had a dog that he loved (and loved him), was playing golf regularly and was keeping himself and his small home in reasonably good order, although he admitted it wasn’t as good as when his wife was alive. When he had any uncertainties about all of this, he tended to ring his eldest daughter (most often for recipes or how to clean a doona).
Trouble was, his oldest daughter could see “the writing on the wall” – or at least that’s how she described it to her brother. She was convinced that dad would be better off in an aged care facility where he could have all the services he needed. Besides, dad was probably lonely now that mum was gone so this was the best place for him. Her brother certainly didn’t want the burden of caring for their dad, so the decision was made – he would be moved into an aged care facility.
A capacity assessment was organised so that a suitable placement could be arranged. Unsurprisingly, Arthur resisted, but this was viewed as “normal” by the professionals involved so a good deal of persuasion was aimed at Arthur and as the tension within the family had began to mount, causing his anxiety and stress levels to increase (exacerbating his muddle-headedness) Arthur reluctantly acquiesced to the assessment.
Naturally, with the elevated stress, things didn’t go well for Arthur and he was assessed as having only “limited capacity” which allowed his daughter to apply to VCAT for guardianship. She was able to show that her father was a danger to himself, citing an occasion when he had left the stove gas jets on). His age was duly considered and Guardianship was awarded. Arthur’s son was made Administrator. As a result, his home was placed on the market to pay for the aged care facility bond, and he was admitted to the facility in mid 2012.
When asked, he believed his age and his forgetfulness were his “enemies” and that these had been used against him by family and professionals alike. He resented the loss of power and the fact that his own wishes had been ignored. Sadly for Arthur, his dementia has since plateaued (and not worsened as anticipated) and it is likely that he faces upwards of 10-15 years in institutional care (with almost no independence), rather than in his family home.
Arthur isn’t alone. I have seen many more instances where a person’s age and “forgetfulness” have been used to remove a person’s independence, primarily through Enduring Powers of Attorney and Guardianship orders. It is common to hear older people say that they have noticed distinct changes in the way that their family, friends and service providers treat them as they age or once early dementia begins to be evident. “They treat me like a child” is perhaps the saddest comment.
At the present, there is a draft Bill on Powers of Attorney before the Victorian State Government for which the Department of Justice is calling for comments. This is a timely Bill, given the fact that by the year 2050 the number of people aged 65 and over will have doubled and the number of people with dementia will have tripled. We know that a person’s vulnerability to elder abuse dramatically increases when both these factors are at play.
The Bill is also timely, given the extent to which Enduring Powers of Attorney and Guardianship are misunderstood, not only by the donors and recipients, but also by a wide range of professionals who are frequently presented with these documents, including police, aged care workers, bank tellers and GP’s, with, as I have said and as we saw with Arthur, disastrous consequences.
Removal of an adult’s right to make their own decisions, good or bad, is a serious matter. Doing so without proper and thorough investigation is a form of elder abuse. We all need to remember (and this is an important point) that being “a pest” or “a burden” is not a crime. There are many strategies to resolve these issues that do not involve removal of an individual’s rights and independence.
It is up to all of us to be fully aware of how ageism and dementia-ism can colour our perceptions of older people and the way in which we communicate and/or assist them. When we see it occurring, we should challenge it and raise awareness of the implications wherever and whenever possible.
After all, one day, Arthur’s story could be yours…..
Written by Kaz Mackay
Elder Abuse Prevention Co-ordinator, Eastern Community Legal Centre
For World Elder Abuse Awarness Day, 2014