Once upon a time Before there was elder abuse

The term ‘elder abuse’ came into common use in the late 1970s. By consensus, it refers to mistreatment of older people by someone that person has reason to trust.

Reasons for trust include relationships with relatives and friends or stipulated through regulations governing a profession. Most organizations with mandates to prevent or respond to elder abuse continue to use versions of this definition.

The bigger issue concerns our understanding of elder abuse in historical and cultural contexts. We often hear that abuse of older people is rising as our population ages. We also hear that traditional values and traditional cultures respect older people more than modern culture does. Here are a couple of examples.

International students from the middle east, Africa and South America related in a panel discussion at my university that Canada is not an elder friendly country compared to their own. Families there, the students said, took care of elderly kin themselves. To put them into a home would be neglectful of family responsibilities. Another of my students recently told me that elder abuse was ‘simply impossible’ in traditional aboriginal culture of earlier times.

These examples suggest that older and simpler societies were prime times for old people, veritable Gardens of Eden for geriatric Adams and Eves. But were they?

I held my tongue on those occasions. The international students were young, middle-class and westernized. They spoke with idealism and that might preclude realism. So, what I want to explore here is whether in cultures we call traditional, including ‘once upon’ a time in our culture – with the term elder abuse unknown – was there elder abuse?

Let’s consider the words.

‘Elder’ derives from eldra and eldrost, words introduced by Anglo-Saxons from the kingdom of Mercia that existed from about 500 AD until the Norman conquest of England in 1066. Mercians mean ‘border people’ living around the River Trent. Because I’m from that part of the world, maybe my ancestors coined the word.

Abuse is a French term dating from the 14th century. The point made here is that nobody before the 1500s was ever able to utter the phrase ‘elder abuse.’

The first written words that convey the modern meaning of elder abuse were in an article simply titled “Granny bashing,” by AA Baker in the magazine Modern Geriatrics and GR Burston in a letter to the British Medical Journal, both appearing in 1975. Burston wrote a handful of letters and articles for medical journals from 1967-1975, mainly to do with self-poisoning. The 1975 letter appears to be his last publication and the only one to elicit lasting acclaim.

Here’s what he had to say:

“SIR, Hardly a week goes by without some reference in the national press or medical journals to baby-battering, and I think it is about time that all of us realized that elderly people too are at times deliberately battered. I have personal knowledge of cases in which it has been possible to confirm that elderly patients have been battered by relatives before admission to hospital, and in which there has been no doubt that the battering was deliberate. In other cases, assault at home has been suspected but could not be confirmed. This leads one to wonder how many of the elderly who, “fall down frequently, doctor,” do so because they are assaulted.

“Often the type of patient in whom the suspicion of battering must be very high has some mental impairment. While in no way condoning the battering of elderly people by their relatives, I am certain it is just another manifestation of the inadequate care we, as a [medical] profession, give to elderly people, and to their relatives who are left with the task of coping with them unaided and unsupported by us. It is hardly surprising, under these circumstances, that the battering becomes almost a natural consequence of the inadequate service. Perhaps general practitioners, in particular, and casualty officers especially, should become as conscious of granny-battering as they are now aware of baby-battering. Community nurses, health visitors, and social workers should also have this aspect of ‘caring for the elderly’ drawn to their attention.

-I am, etc., GR Burston.”

Burston’s letter covers a lot of ground.

Baker and Burston’s publications fell on fertile ground in North America where the passing of the Older Americans Act in the States laid the groundwork for most of its federal programs protecting the rights of older adults. This act is consistent with Amnesty International’s “Universal Declaration of Human Rights” that the United Nations General Assembly adopted shortly after World War II.

It is from this that concerns about elder abuse arose. Let’s repeat that because it’s important: concerns about elder abuse arose from those about human rights.

What are human rights? ‘Human rights are basic rights and freedoms that all people are entitled to regardless of nationality, sex, national or ethnic origin, race, religion, language, or other status,’ to quote from Amnesty International’s declaration. Were there examples of elder abuse – in our modern sense of the term – before our concerns about human rights?

I couldn’t locate any in an Internet search of newspaper archives. It’s probably a case of something unnameable falling below the radar of consciousness. Not having the words to name the concept, we simply don’t perceive its occurrence.

The earliest case of what we would now call elder abuse, that I was able to find, is from the Hartford Courant newspaper.

It reported that: “Stanley Nixer, 44, of no established residence, accused of annoying his 82-year-old mother, was sentenced to four months in jail on Friday in Police Court by Judge Alfred F. Kotchen, on a charge of breach of peace.”

Hey Stanley, I bet you never thought that we’d be discussing you in Senior Care Canada half a century later. How’s that for lasting infamy! That’ll teach you not to annoy your mum.

Now let’s go back in history to simpler times – right back nearly three millennia. It was the era of myth and the place Greece. Even before Homer included him in epic works, the myth of Oedipus was a part of an oral storytelling tradition. He killed his father, married his mother and became king.

Even though Oedipus’s life is fiction, killing an elder for gain is a recurrent theme throughout history, as evident from nursery rhymes and folklore.

An unknown Greek author continued Oedipus’s story as follows: in old age, Oedipus became so outraged that his sons might plunder and divide his fortune that, “he prayed to Zeus and the other deathless gods that each [son] might fall by his brother’s hand and go down into the house of Hades;” which, of course, they did.

A happy family story it isn’t!

Retelling of the Oedipus myth has never stopped. In theatre and storytelling for all ages, it continues to resonate with our feelings and experiences of family conflict. Here’s an example of a nursery rhyme from Germany as recorded in 1841:

“Old man, go to sleep!Young man, find a wife!Throw stones at the old man, And apples at the young ones; Old man, go to sleep! Young man, find a wife!”

The meaning is clear. The father must die for the son to inherit and thus be able to marry well. Marriage is not just a love match but also an economic arrangement. Not having his father’s wealth when he needs it thwarts the son’s marital ambition.

Sigmund Freud built the discipline of psychoanalysis around a belief that Oedipal desires against our parents hide within all our psyches. Those desires, he asserted provocatively, are consistent with family behaviours around the globe.

To see if Freud was right, let’s leave ancient Greece and consider the treatment of old people in societies nearer to our time. We’ll start with folklore then look at scientific evidence.

Just one of many similar folktales is this German example published in 1863:

“The Sorbian Wends [a Slavic people] practiced the shameful and gruesome custom of ridding themselves of their old people who were no longer able to contribute. A son would strike his own father dead when he became old and incompetent. Or he would throw him into water. Or he would push him over a high cliff.”

That’s plain speaking, isn’t it? If an old parent becomes, what we now term, an economic burden, kill him. However, folklore is not fact. What is the factual evidence?

Anthropologists, scientists that study human culture, refer to societies that have traditional cultures as third-world, and in one quite recent study of 95 such societies found that geronticide (the killing of old people) was routine practice in 14%.

Another study found that 18% of traditional societies practiced geronticide and 84% neglected elders or routinely took away their property.

Societies that practice geronticide come from all parts of the world, including our own country, and mainly nomadic huntergatherers. The elders are killed when they become a drain on scarce resources.

In pastoral agricultural societies, geronticide is less frequent because the elderly can be occupationally useful. This confirms folklore evidence that killing older people is common when they become an economic burden.

Some traditional cultures practice a form of geronticide but call it something else. Although the killing of witches all but ceased in Europe after the 18th century – with the estimated 40,000 victims being mainly poor and elderly widows – the persecution of witches continues throughout Africa, parts of South America and even India.

Government statistics from the African country of Tanzania show 4500 accused witches killed in a decade, with the number of such murders rising during the past half-century. A recent study of 67 Tanzanian villages found that half of all murders from 1990-2000 were witch-killings. The frequency of killing witches – mostly done by relatives – doubled during times of near famine brought on by extremes in rainfall that cause either drought or floods. No such trend with hardship indicators exists for other types of murder. Again this suggests a link between the murder of unwanted people and hard times.

A 70-year-old Tanzanian woman accused of witchcraft recounts how she fled from her village and subsequently lived homeless near the railway station in the regional capital. It suggests that household misfortunes are prime motivations for witch killing:

“I ran away from home after being suspected of being a witch. … There were many deaths in the family … then rumor began to spread in the village that I was the one who killed them … My own children started to hate me, … some of them started taunting me as a witch. I tried to explain but they did not give me the chance to vindicate myself. I knew what would befall me in view of what had happened to others, for they were brutally killed. Thus, when … one of the grandchildren whispered to me that they were about to kill me, I left the same evening. … They had discussed the issue in front of the children and this saved my life. I have lived homeless for three years now, and though I love my family, there is no way of going back to face certain death.”

Do ordinary Tanzanians feel bad about putting their older kin through such misery?

Quite the contrary: witchcraft is a tangible reality to them and part of their religion. Just as witchcraft was a tangible reality and part of their religion for European and North American witch killers two centuries before.

To ordinary Tanzanians, witches are criminals and just as dangerous as thieves and murderers. As stated in a recent BBC television broadcast: “In those communities, if you kill a witch it is not really considered a crime. It’s like you are doing something for the community.” Not surprisingly the number of arrests and convictions of witch killers are close to nil.

In this country, we neither killed nor exiled unwanted old people to live homeless in big cities. Instead, we put them in parish poorhouses, of which 250 existed across the country in the 1940s. Poorhouses denied all hope and dignity for their destitute and mainly elderly residents.

Life there was deliberately harsh, with rudeness and beatings common occurrences. Residents worked disproportionally hard in return for food and shelter, with the little medical care provided by “pauper nurses” who were mainly elderly female residents. The last of these workhouses closed soon after World War II. Their replacements, now called long-term care homes, although not without issues are markedly more humane.

Although the parish councilors responsible for poorhouses are long dead, what would they have said about the treatment of old people in those places? Most likely, if asked, that tough living conditions discouraged malingering at public expense. Like the Tanzanian villagers, they did their duty in the best interests of the community.

Finally, no discussion of elder abuse is complete without mentioning behaviours of aberrant individuals.

The most prolific serial killer in recorded history – with respect to the number of officially verified murders – is Dr Harold Shipman, a general practitioner from the north of England.

He committed 218 proven murders, with 32 more strongly suspected. All the victims were his patients; the majority elderly women, all given lethal injections of the drug diamorphine.

Shipman’s killing spree lasted from 1971-1988, a period that encompassed the first use of the term elder abuse.

Why did he kill?

It’s difficult to know because he denied every murder until his suicide by hanging in Wakefield jail. Although he forged medical records to indicate a patient’s poor health prior to death, there was only one case where he committed forgery for personal financial gain; that was forging a will bequeathing him a sum approaching one million dollars.

So what can we conclude?

First, let’s acknowledge that physical, financial and emotional abuse of older people is a dark stain on the fabric of our culture, as is the neglect of their needs. Social advocates reasoned that we should try to remove this and similar stains, resulting in the International Declaration of Human Rights half-century ago.

This declaration means that an old person has the same rights and freedoms as anyone of any age, which challenges global cultural traditions as old as our species. Only since the 1970s have countries like Canada tried to eradicate elder abuse. This experiment – because that is what it is, a social experiment to change human nature and values – is without precedence in human history.

Second, killing, brutality, banishment, theft and vilification of unwanted old people occurred in traditional cultures past and present. Here unwanted old people are seen as unproductive members of society whose assets their heirs feel entitled to; if disowned by family they become a burden to strangers. This group is at high risk especially during hard economic times. Even today, financial abuse is the most frequent form of elder abuse.

Third, the number of reported cases of abuse and neglect is likely to increase. Such increase is inevitable, as the population of Canada gets bigger and older. The number of cases should also increase as we become more vigilant about detecting elder abuse and if we become more effective in responding to it.

This raises thorny questions about the severity of abuse. Some cases reported today went unreported a decade ago for two reasons: what people thought of as abusive has changed; we are now better able to respond to abusive behaviour. Consequently, the profile of abuse cases today is what it neither was nor likely will become.

To wrap this all up, an unasked question follows directly from the title. “Once upon a time before there was elder abuse:” was there elder abuse?

The answer is an unequivocal yes. There was elder abuse to the most extreme degree – murder, theft, vilification, banishment.

What is unimaginable today is that such behaviours were socially acceptable and socially approved.

Now that there ‘is’ elder abuse – meaning we acknowledge it – our country, by comparison, is a safe and supportive haven for Adam and Eve grown old. That is because we uphold principles of human rights and freedoms for people of all ages and we try to enforce them.

They are principles that help control the worst in our nature.

In efforts to combat elder abuse, we still have far to travel and must be aware of falling back, but should congratulate ourselves for having come this far.