School of Population Health

Logistical and Cultural Barriers Are Inhibiting Older Adults from Accessing Elder-Mediation Support Services, Study Finds

Image Elderly

Elder abuse is defined by the World Health Organisation as “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.”

It can take the form of physical, sexual, psychological, emotional, or financial abuse. It can also include neglect, or the failure to meet a person’s basic needs, such as food, housing and essential medical care.

Elder abuse is a complex problem that often goes unrecognised or unreported due to a number of barriers, including a general lack of information and understanding, feelings of shame, and fear of loss of relationships with key family members. For this reason, the road to help is often slow and complicated for people experiencing abuse.

In combating the problem of elder abuse, a method known as ‘elder-mediation’ has shown promise, and is appropriate in some settings. It is also appropriate in situations where no abuse or mistreatment is occurring, but there is some dispute – for example regarding a financial matter or care arrangements. Elder-mediation is a conflict resolution process that works by identifying the interests underpinning different opinions in a dispute and working creatively to align these interests. It is typically a goal-oriented, structured process, involving a systematic set of negotiated agreements and steps, with a focus on transparency and education. The end goal is to permanently increase the safety of older people and ensure that their rights are being respected.

A new study led by Dr Craig Sinclair from the ARC Centre of Excellence in Population Ageing Research in partnership with an interdisciplinary team of UNSW researchers, including the SPH’s Dr Adrienne Withall, however, has identified a number of logistical and cultural barriers impacting the accessibility of elder-mediation for those who might benefit from it. The research was funded by the UNSW Ageing Futures Institute and canvassed responses from a range of groups involved in elder mediation.

The study revealed that Aboriginal and Torres Strait Islander people and culturally and linguistically diverse Australians may be less likely to identify and name elder abuse. In Aboriginal and Torres Strait Islander communities, the title of ‘Elder’ is imbued with status and respect, meaning that the notion of ‘elder abuse’ often seems incongruous and may thus go unrecognised.

Culturally and linguistically diverse Australians, who are at higher risk of experiencing elder abuse, disproportionally experience feelings of shame that impede them from seeking help, with the notion of ‘failing as a parent’ being particularly pervasive.

Older people who are LGBTQI+ are vulnerable to unique forms of elder abuse, which can further complicate access to elder-mediation.

The affordability, location, and usability of elder-mediation services were also cited as barriers. For those who live in rural and regional areas, distance from elder-mediation services is a deterrent. Additionally, many older people experience difficulty with using systems that provided services and information regarding elder abuse and treatment due to complexity. Online systems were reported to be particularly difficult for older people to navigate.

In addition to barriers inhibiting access to elder-mediation, there exist a number of barriers within the actual mediation process to its effectiveness.

For one, the prevalence of cognitive and other impairments was cited as a difficulty in the success of elder-mediation. While cognitive impairment does not necessarily eliminate the possibility of elder-mediation’s success, the perception that it might is sometimes enough to deter families from ever considering it as an option.

Elder-mediation is also not universally suitable for cases of elder abuse. Dr Sinclair explained that “in cases where a dispute was long-lasting, complicated, dangerous, or involved significant power imbalances, practitioners felt that other interventions might be more useful. For these more complex cases, family therapy, counselling, the courts, or domestic violence services may be more suitable”. Disputes in which there was alcohol or drug abuse, current or past domestic violence, or clear evidence of criminal activity were also identified by practitioners as being inappropriate for resolution by elder mediation.

While acknowledging these exceptions, the study judges elder mediation to be a promising and effective approach for resolving disputes involving older people. Dr Withall said “it is clear that there is more work to do in building awareness of the potential benefits of elder mediation as well as working with communities to ensure that the method and specialists working in this area are meeting the needs of the older people they seek to help. It is obvious more work is needed in partnership with Aboriginal and Torres Strait Islander communities in particular.”

The researchers call for greater efforts to raise awareness both of elder abuse as an issue and of elder-mediation as a potential restorative pathway. More needs to be done in the way of training elder-mediators and the establishment of mediation services, with special regard to the development of services equipped to aid diverse and/or higher-risk groups and enable access for regional and remote communities.

Based on the project findings the research team has produced practical resources to assist general practitioners and others working with older adults in making appropriate referrals to elder mediation services. This resource is available on the UNSW Ageing Futures Institute website. Dr Sinclair stated “This study has provided some indications of the barriers for older adults in accessing mediation. In the future we aim to work closely with older adults to identify possible solutions for these problems.”

Photo by Matthias Zomer from Pexels

 

Contact: School of Population Health, UNSW Medicine