Elder abuse and neglect.

Elderly mistreatment is a hidden, and often ignored problem in society. In the general population many will have heard the phrase 'Granny Battering' but will know little more than that, other than perhaps some awareness of problems publicised in television programmes on Care Homes. The term 'Granny Battering' dates back to 1975 [1], so this is not a new phenomenon; but in the UK we have been slow to respond to the challenge, with persisting resistance to the idea that such a problem could exist. By the late 1980s every state in the USA had legislation related to elder abuse. In the UK, however, a major catalyst was a multidisciplinary British Geriatrics Society Conference 'Abuse of Elderly People: an Unnecessary and Preventable Problem' [2]. This led to various projects and research; the first British Medical Journal paper about elder abuse, concerning the abuse of older people by their carers, was published in 1990 [3]. Subsequently the charity Action on Elder Abuse was formed in 1993. In 2004 a major House of Commons Health Committee report [4] highlighted a series of problems and made several proposals including improved Care Home inspection, mandatory training in elder abuse recognition for professionals working with older people, mandatory local availability of multi-agency guidelines and better regulation of care staff. Action on Elder Abuse developed a definition which was later adopted by the World Health Organisation : 'elder abuse is a single or repeated act or lack of appropriate action occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person'. There has been debate about prevalence figures since the syndrome was first recognised. Cooper et al. in their systematic review [5] of international elder abuse prevalence looked at studies where abuse was reported by older people themselves or by family or professional caregivers, and was investigated using objective measures. In their extensive literature search they found only seven studies which fulfilled these criteria: one of these was the first major study in the United Kingdom, by Ogg and Bennett in 1992 [6]. The systematic review of studies found that more than 6% of the general population, a quarter of vulnerable adults and a third of family caregivers reported being involved in significant abuse: this suggests a much larger number of episodes than are known to statutory services. Since Cooper et al. completed their work, Comic Relief …