Covid-19 intensifies elder abuse globally as hospitals prioritise young

When Souzi Bondeko’s grandfather started showing symptoms of Covid-19 and was struggling to breathe, she took him to a hospital in the Democratic Republic of the Congo’s capital, Kinshasa, where he was put on a ventilator.

She dashed home to get some food and returned to be told by a member of staff that he had been taken off the machine as it it was needed elsewhere.

“There were only three ventilators in the hospital and they were in great demand,” she said. “Five minutes later, my grandfather died. Staff told me they had to give the ventilator to a younger man as it is their policy to prioritise younger patients.”

The 33-year-old market trader reported her grandfather’s treatment to Anatole Bandu, the country representative for the charity HelpAge International. He said: “Unfortunately this is not the first instance of older people dying as a result of ventilators being given to younger people. Sadly, older people are seen as dispensable in DRC.”

Discrimination against older people has been on the rise since the pandemic, according to the organisation. It has heard reports from many countries of older people left to die from Covid-19 as younger patients are prioritised – or simply refused treatment amid fears they would infect others.

At the Cox’s Bazar refugee camps in Bangladesh, for example, health workers were afraid to treat older people with seasonal flu in case they had Covid-19. In Cameroon, Paa Mathieu, an older disabled man from Koa village in Centre region, was turned away from hospital despite suffering from pneumonia. He said: “They did not take care of me, saying there is no bed for people like me.”

While accessing healthcare has been a challenge faced by older populations during the crisis, the pandemic has also amplified violence and abuse of older people around the world.

Chris Roles, the managing director of Age International, said: “Regrettably, the pandemic has highlighted and exacerbated the abuse and neglect older people were already facing.

“Too often, elder abuse is kept hidden and not reported; older people may fear retribution or stigma, may not recognise what is happening to them as abuse or national bodies may not even record abuse over a certain age.”

He added: “Based on experience, we are concerned that older people will be sidelined as coronavirus continues to shape the world in 2020, despite clear evidence they are among those most at risk from this disease.”

Before Covid-19, it was estimated that one in six older people were subject to abuse but emerging evidence suggests this has sharply increased since the crisis, the charity has reported.

Such abuse includes physical, financial, psychological, verbal and sexual assault. Women and those with disabilities are worst affected.

In Nepal, calls to the police about the abuse of older people more than doubled between March and May compared with the previous three months.

Domestic abuse is reported to have worsened as families have been forced to spend more time together due to quarantine measures.

A crisis centre in Kyrgyzstan that received 29 calls from older people reporting domestic abuse said many of those seeking help had complained that family members were taking their pensions, especially those with relatives who were dependent on alcohol.

In Jordan, the Solidarity is Global Institute reported 812 requests for urgent help during the first two months of lockdown – more than it usually receives in an entire year. A fifth of calls related to domestic violence and many of those were from older people.

Asma Khader, the organisation’s CEO, said that most elder abuse went under the radar because victims had no access to a telephone or were afraid to speak out.

She said: “Often abuse is perpetrated by family members they are dependent on, they have no means to support themselves or they fear they would be threatened.”

Only 4% of cases of elder abuse are actually reported, according to the World Health Organization.

“Governments need to acknowledge that elder abuse exists and ensure that laws are in place and used to prosecute perpetrators,” said Georgina Veitch, the global adviser on violence and gender equality for HelpAge International.

Often the abuse is tolerated as older people who have been disproportionately hit by the financial impact of the pandemic are reliant on relatives for support. Those living in low- and middle-income countries are worst affected, especially women who were already socially and economically disadvantaged before the pandemic.

In India, a former school teacher in Bihar told how her income dried up as private tuition was suspended because of the pandemic.

Namita Mishra, 67, told a helpline for older people: “I can’t afford any rent, so I stay with my relatives who verbally abuse me. I have become a skeleton as I eat less in order to save food. I feel depressed and lonely as there is nobody to talk to and listen to me.”

There is no universal social security system in India and most older people have to work. But across the country, 65% of older people have lost their livelihoods and income due to lockdown, according to a survey of 5,099 people aged 60 carried out across 17 states. About 61% of those affected were from rural areas compared with 39% from cities. Regarding health, 62% of respondents reported suffering from chronic diseases and 42% reported a worsening health condition due to lockdown.

Rohit Prasad, the chief operating officer of HelpAge India, said older people risk being forgotten. “Most of them are unskilled, casual workers who earn a meagre daily wage to survive. These people were hit hard by lockdown … a coordinated action play by the government [is needed].”

The charity says it is vital governments do not discriminate against older people and put them at further risk of ill-health as strategies to exit lockdown are devised.

It raised concerns that people over 65 have been forbidden to leave their homes in places including Tunisia, Azerbaijan and many areas of Russia.

“Any measures to take us out of lockdown that restrict our rights must be based on scientific and medical evidence, not on age,” said Bridget Sleap, a policy adviser at HelpAge.

She added: “Containing the spread of the virus is a legitimate aim but we must not use a sledgehammer to crack a nut. Long periods of isolation are dangerous for older people’s physical and mental health.”