Battling Elder Abuse in Hong Kong

Elder abuse is a pervasive and often underreported problem globally. Hong Kong is no exception to this trend. In the past 20 years, report numbers have consistently fallen between 300 and 600 cases annually. However, studies on elder abuse in Hong Kong consistently suggest that the prevalence of elder abuse is much higher; with up to 27.5% of study participants recounting some form of mistreatment, suggesting high dark figures. This is particularly worrying given Hong Kong's aging population: As of 2021, almost one fifth of the Hong Kong population was aged 65 or above. Despite this demographic trend, and very similarly to most modern societies, elder abuse rarely receives widespread public attention in Hong Kong. The low report rates of the abuse as well as recent developments in abuse patterns stress the importance for Hong Kong citizens to remain vigilant and to engage in a bigger conversation around elder abuse.

A variety of factors give rise to elder abuse as a widespread social issue: Elderly people are a particularly vulnerable group as they are often isolated, lack functioning social support systems or experience a decline of physical or mental function. The abuse can take many forms. In China and Hong Kong, the most prevalent forms of elder abuse are physical, psychological, financial, sexual abuse and neglect. Women present as more vulnerable to elder abuse than men in both China and Hong Kong.

Often, the abuser is simultaneously the person in charge of caring for the victims. The intentions behind such abuse are not always purely exploitative or intentional. While financial or sexual abuse indicate the intentional exploitation of the victim, other forms of abuse such as emotional or physical abuse and neglect often stem from care giver overwhelm or wider family conflict. The abuse may develop gradually, making it hard for the victim, their abuser or their wider social environment to recognise the abuse at first.

Recognising the abuse is not the only challenge. The reporting of elderly abuse presents as particularly problematic. Victims of elderly abuse very rarely self-report the abuse they suffer. Reasons for this are social isolation, dependence on the abuser, feelings of shame, fear of retaliation, or, in cases of grave illness, the physical or mental inability to recognise or report their mistreatment. Equally, family members or other witnesses often resist reporting elder abuse for fear of causing conflict, damaging social or family relations or overreacting to a misunderstanding. Compared to other types of abuse, the dark figures in elder abuse are estimated to be exceptionally high.

A recent study on the changes in elder abuse patterns throughout the Covid-19 pandemic recently published in the Asian Journal of Gerontology and Geriatrics compared over 3700 cases of elder abuse and suggests that, while the number of elder abuse cases in Hong Kong did not significantly change, the abuse patterns did. The proportional share of physical abuse showed an increase (70.5% as compared to 65.9%) and that of financial abuse decreased (9.8% as compared to 16.2%) Further, the study presented evidence for an increase in spousal abuse (61.8% as compared to 54.7%). In times of lockdown, the mistreatment of elderly people in their homes has become ever more difficult to detect: Since the outbreak of Covid-19, the perpetrators of elderly abuse are statistically closer to the victim, the abuse has become more corporal, and the spaces in which the abuse occurs has become more secluded. While the pandemic seems ‘overcome’ for most, many vulnerable elderly people may remain trapped suffering abuse. While there are increasingly effective mechanisms in place to prevent or stop elderly abuse through the work of front-line social workers, the initial identification of victims often relies on the attentive eye of the citizen.

First, there are warning signs citizens are recommended to watch out for. For instance: Does the elderly person seem depressed or withdrawn? Are they isolated from their wider family? Do they have unexplained bruises or injuries? Have there been unexplained financial expenses? Or do they appear poorly groomed, dehydrated, or incorrectly medicated? Some of these signs may be difficult to monitor.

Second, It can further be helpful to take a general interest in elderly relatives, to engage in meaningful conversation and regularly check on their wellbeing. Simply spending more time with an elderly loved one can be a powerful mechanism in preventing or recognising their abuse: Not only does it help address other pressing issues such as geriatric loneliness and depression but facilitate the successful and timely identification of abuse victims as an important first step in alleviating their suffering.

Third, engaging in a wider societal conversation around elder abuse may increase awareness of the problem and drive report and self-report numbers. Leading researchers on elder abuse consistently warn that the available information on elder abuse in Hong Kong, as well as globally, is just the tip of the iceberg and that elder abuse does not receive the attention it deserves for effective and meaningful intervention. A more widespread societal recognition of the problem as well as the knowledge of resources for victims or witnesses of elder abuse could facilitate the change an aging Hong Kong and some of their most vulnerable citizens need.

If you suspect or witness abuse, or would like to receive further information on the issue of elder abuse in Hong Kong, please contact the Hong Kong Social Welfare Department (2343 2255) or visit their website at https://www.swd.gov.hk/en/index/ .