Elderly People: Abuse

Baroness Cumberlege Excerpts

Wednesday 14th May 2014 Lords Chamber

Asked by

[Baroness Cumberlege]

To ask Her Majesty’s Government what assessment they have made of the incidence of elder abuse across the nation.

[Baroness Cumberlege (Con)]

My Lords, I start by declaring my interests which are in the Register of Lords’ Interests.

I am very grateful for the opportunity to have this debate to ask Her Majesty’s Government what assessment they have made of elder abuse across the nation, albeit I appreciate that we are in the sunset of this parliamentary Session.

According to the Office for National Statistics, there are 3 million people aged 80-plus in the United Kingdom. By 2050 this figure will rise to 8 million. The vast majority of these people are well and active and are a great source of strength in supporting their families and communities. Society would, of course, be so much poorer without them. However, the Alzheimer’s Society informs us that there are currently 800,000 people living with dementia. By 2050 the figure will be 1.7 million. They are the most vulnerable and their care is often a challenge for their families and society in general.

It was the wonderful Sir Alec Douglas-Home, a former Member of this House, who said:

“To my deafness I’m accustomed,

To my dentures I’m resigned,

I can manage my bifocals,

But oh how I miss my mind”.

I suspect that few of us here today have not had the responsibility of caring for others at the start of life in bringing up a family and then at the close of life when caring for someone who is increasingly frail. Whereas Patrick and I made a reasonable fist of bringing up our three sons—I do not believe that any of them has helped the police with their inquiries, but I could be wrong—we are now challenged by a close relative with dementia who has lived in residential care for eight and a half years. We acknowledge that we do not have the skills or patience to look after her. Fortunately, she lives in easy walking distance of our house. The staff, who are exemplary, are local, as are many of the residents, and the front door is never locked. We are always welcomed and never cease to admire the quality of the care that is given. Of course, I appreciate that this is not the case throughout the land. Through the media, the CQC and other organisations, we know that there is abuse in nursing and residential homes, hospitals, prisons and, sadly, within families, and this abuse is the most prevalent and the hardest to detect.

The Department of Health estimates that just under half a million elderly people are subject to abuse in the community. Action on Elder Abuse defines abuse 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.

Abuse of elderly people is a huge subject, but I shall this afternoon concentrate on only two areas. Before I do so, I want to pay tribute to successive Governments who have enhanced the lives of retired people through increasing the state pension and introducing other saving schemes. With the Better Care Fund, this Government have strengthened support for carers; and the Care Bill, which might have just been enacted, places safeguarding adults boards and safeguarding adults reviews on a statutory footing for the very first time. Therefore, much is to be commended but still more needs to be done.

There is no statutory code of conduct to hold care workers to account. The majority, with the right support and supervision, do an excellent job in challenging circumstances. However, there are too many reports of staff delivering poor care. There are individuals who, having abused elderly and vulnerable people, are dismissed from one employer and then employed by another. The Cavendish report advocated standardisation of training and supervision for support workers and greater responsibilities for employers. The CQC is strengthening its inspection regime and identifying poor care.

Those initiatives are very welcome but not enough. The Health and Care Professions Council suggests three ways forward: first, a statutory code that articulates the requirements for honesty, integrity and respect; secondly, an adjudication process that can hold individuals to account; and, thirdly, public access to a register of those not fit to work as carers—a barring system. These measures would make a real difference. They would be proportionate and cost effective, and strengthen the current system, but they need to be backed by legislation. The Law Commission spent three years undertaking a huge task in revising the regulation of professional bodies, and that is much needed. It produced a draft Bill incorporating these and many other ideas. I know that it is the wish of the regulatory bodies that the draft Bill be incorporated in the Queen’s Speech. If that is not possible, I ask my noble friend to use his considerable talents to urge his colleagues to set up a cross-party, pre-legislative scrutiny committee of both Houses to at least start the work to examine the proposed Bill so that we can protect elderly people who are in situations of vulnerability.

My second area of concern is financial abuse, which has a devastating effect on older people. Not only can a comfortable lifestyle disappear but older people do not have the time or opportunity to recover financially. Such a profoundly disturbing experience can be a life-threatening event. Cases are complex and often involve family members or others who have “befriended” an older person—first by giving them gifts, then winning their trust, and then demanding a disproportionate amount for services. These cases can be especially difficult where the older person has mental capacity but seems to be under undue influence from the family or friend and cannot resist their requests.

Age UK receives many cries for help on its advice line. For example: Helen is one of three children who all hold powers of attorney for their mother and is becoming increasingly concerned about the actions of her two sisters, who she feels are not acting in the best interests of her mother. One has moved into her mother’s house without paying rent and the other has set up direct debits from her mother’s account to pay personal bills. They have both pressured their mother into selling personal items and taking out loans in her name and giving them the money. Helen is not sure whether her mother is really aware of what is going on but is finding it difficult to talk to her because the sister who lives with her mother is stopping Helen from contacting her. What can she do? That is one example but there are countless others.

A recent study found that financial abuse was the second most common form of mistreatment for those living at home, nearly twice as common as psychological or physical abuse. It is estimated, that 57,000 people aged 66 and over have experienced financial abuse by a friend, relative or care worker. Indications are that 60% to 80% of financial abuse takes place in the person’s own home and 15% to 20% in residential care. The risk is likely to increase as the population ages, with more people living with dementia and increasing financial pressures on people caring for older relatives. As more bank branches close and services move online, a greater number of older people are likely to rely on family and friends to help to mange their finances, including accessing cash.

What should we do about this? I suggest there should be a national task force to tackle financial abuse. It should aim to ensure better co-ordination between banks and other agencies such as trading standards, the Financial Conduct Authority and the Association of Chief Police Officers. The task force should establish clear reporting lines where financial abuse is suspected. It should consider: how to prevent financial abuse, based on the principle that older people are citizens, not just users of care services; how to raise awareness in all sectors, among older people themselves and the public generally; how advice can be provided to older people on issues relating to lasting power of attorney; and how adult protection committees could work better to prevent financial abuse.

This is not a cheerful subject, but it needs to be addressed. One of the objections to the proposed Assisted Dying Bill is the fear of greedy relatives: where there is a will, there is a relation. I thank noble Lords for taking part in the debate and for their contributions. I look forward to what I hope will be my noble friend’s affirmative reply.