Practice blog

Older people and domestic abuse - completing the jigsaw

How can we help older people living with domestic abuse? Join the conversation – Twitter Q&A with Age UK 1-2pm on Wednesday 31 August. 

Richard Powley is Head of Safeguarding at Age UK. In this thoughtful blog post he takes a look at what can be done to improve the help and support offered to older people experiencing domestic abuse.

A few weeks ago I was able to do my civic duty by taking part in jury service and, as I first went into the jury waiting room, it became clear that it had been set up for people who would be doing a lot of waiting around. As well as the usual piles of out of date magazines there were tables dotted all around with jigsaw boxes sitting on them. 

As a jury we couldn’t speak about the trial when we were in the waiting area. But the jigsaws let us talk to each other, without talking about the case, and they became the subject of intense discussion and competition.

Inevitably, as we came closer to the end of one 2,000 piece behemoth (a Venetian lagoon if you want to know) we began to realise, to our great dismay, that there were some crucial pieces missing. 

Looking into the issue of domestic abuse and older people this week, that image of gaps in a jigsaw came back to me. Some of the necessary legislative and operational pieces are in place to empower and protect older victims of domestic abuse, but they are just not joining up to create a coherent whole. The outcomes of this are much, much more serious than an incomplete picture of a picturesque lagoon. They can, in fact, be devastating. 

There is no doubt that a more coherent approach is needed. Domestic abuse does not go away with age, and its damaging impact certainly doesn’t lessen. For older people domestic abuse is a hidden issue with hidden victims, and it is not clear that the current law and practice is applied consistently or that it is able to respond effectively to the needs of older people.

So let’s look at a few of the missing pieces in a bit more detail:
 

Piece #1: Recognition
There is evidence from criminal cases, Domestic Homicide and Serious Case Reviews that domestic abuse issues for older people often go unrecognised, which means that protective or supportive measures that may have reduced the risks of harm are not put in place. 

The Domestic Homicide Review for Mrs Y, a 79-year-old woman killed by her husband found that she was not considered to be a potential victim of abuse, due in part to her age. Had the potential signs of domestic abuse been recognised and explored, then it may have been prevented. (Sunderland City Council)

Older people may also be particularly affected by what may be perceived as ‘low level’ individual incidents which can, as part of a longstanding pattern of cumulative abusive behaviour, have consequences that can equal or surpass any individual incident. 
 

Piece #2: Understanding
Specific risk factors for older people, including the development of health needs, retirement from work (resulting in increased contact), stress associated with caring roles and social or geographical isolation may place them at increased risk from domestic abuse. As we age our ability to recover from both mental and physical abuse can be adversely affected, and the impact of domestic abuse can be particularly profound for those who may be reliant on a partner to provide care and financial support.

Additionally, for some older people, there will be factors that may make them less likely to disclose domestic abuse. These include concerns about sharing information considered to be private, and embarrassment and shame about a situation of domestic abuse. Long term undermining of an individual’s self-esteem over many years could intensify these feelings.
 

Piece #3 Joined up approaches
For older people psychological, financial, physical and sexual abuse may trigger adult safeguarding rather than criminal justice and/or protective domestic abuse processes. It is important that the possibility of domestic abuse is fully considered in adult safeguarding enquiries involving intimate partners or family members. Issues of coercion, pressure and mental capacity also need to be carefully considered. Person centred approaches and the appropriate sharing of information and expertise across safeguarding partnerships will help this to happen. 

Consistent inclusion of older people’s needs and insights as part of local Multi-Agency Risk Assessment Conferences and Multi-Agency Public Protection Arrangements could also help to identify and reduce serious risks that may affect older people. 
 

Piece #4 Developing the law
The broadening of the cross-Government definition of domestic violence and abuse is very welcome, as is the new offence of controlling or coercive behaviour in an intimate or family relationship (Serious Crime Act 2015).  

However the Serious Crime Act states that these behaviours will be deemed to have had a “serious effect” where the victim either fears that violence will be used against them on “at least two occasions”, OR they have been caused “serious alarm or distress”. This means that controlling or coercive behaviour may not be caught in situations where the abusive behaviour is hidden (e.g. hidden financial abuse) or where, because of cognitive impairment, an individual does not fully appreciate the nature of the behaviour and experience serious alarm or distress. It may help protect those in such circumstances if this were changed to include serious alarm, distress or detriment. (CPS: Controlling or Coercive Behaviour in an Intimate or Family Relationship)

Putting these pieces in place, alongside approaches informed by the experiences and insights of older people, would be a significant step forwards in preventing harm. I warmly welcome the focus of organisations such as Safe Lives on this issue, the more we talk about it, the greater the chance of real progress. 

 

Find out more

Throughout July and August, we're focusing on domestic abuse as it affects older people. Join our free webinars, listen to our new podcast and more on the Spotlights webpage.

5 challenges older victims of domestic abuse face – and what you can do to help

Monsura Mahmud is a Domestic Abuse Prevention Adviser for the Silver Project, a specialist service for women aged 55 and over affected by domestic and sexual abuse. The project is run by Leading Lights-accredited Solace Women’s Aid and provides one-to-one support, as well as training professionals who come into contact with older victims.

The person sitting in front of you has taken the hardest step of all: they’ve told someone about the abuse they’re experiencing. Now they need your help to become safe.

In my last post, I looked at some of the reasons older victims can find it difficult to seek help. But what happens once they’ve found your service? These barriers don’t simply go away. If your client is over 60, the chances are they’ve been living with the abuse for a long time – maybe even decades. This might be the first time they’ve ever reached out for help.

At the Silver Project, we see this scenario all the time, but we also know that because of a range of factors linked to age – health, mobility, financial security and isolation to name a few – keeping your client engaged can make offering support even more challenging.

1. Health and mobility issues are affecting the victim’s ability to access services

It can take longer for older victims to get the right support because they can’t get out as easily, don’t have anywhere safe to go or don’t have access to a mobile phone. This may be exacerbated by the fact the perpetrator is also their carer.

How can I help?

  • Be flexible in where and how you provide support – hold drop-in and outreach sessions at places older women feel comfortable or can access more easily, like health centres, GP surgeries and day/community centres
  • Meet face-to-face wherever possible and ensure any communication meets their needs – for example, using minicom, videophone or interpreting services for hard of hearing or deaf service users
  • Visit clients in their own homes, where safe to do so, and arrange joint visits with other professionals if their presence is reassuring for your client
  • Be aware of refuges that can accommodate carers

Stepping into a large organisation can be very overwhelming when you’ve already been through so much. Just taking the time to explain the service and what they do made a huge difference.

2. The victim has limited eligibility for housing, legal or financial support

Older victims might require specially adapted homes to help them live independently. This can limit the options available to them, particularly in areas like London where there is a lack of housing and a long waiting list for adapted properties.

If they have savings or a home of their own it could mean they are not eligible for legal aid. Others may face financial hardship as leaving the perpetrator can require costly care options.

How can I help?

  • Know the housing associations which operate in your area – some offer the option to register directly without going through the local authority
  • Be aware of local solicitors/legal services that offer pro bono support. Ask whether they can visit clients at home or in a safe location.
  • Ensure staff are trained on the needs of older people, including pensions and benefits available to them
  • Remember that all older people and carers have the right to request a Community Care Assessment. This can be a good way to work jointly with social services.

Getting Legal Aid was difficult, but I couldn’t give up and had to stay positive. The Silver Project gave me the extra support I needed.

3. The victim is reluctant to leave or has complex needs which make it difficult to do so

Older victims typically live with abuse for many years before getting help. This could mean that it will take them longer to deal with the trauma or leave the abusive situation at all.

They may have complex needs such as dementia or use alcohol as a coping mechanism. This can mean that you’ll need to work with clients on a longer term basis and steps to safety, such as re-housing, legal advice and access to care, may take longer.

How can I help?

  • Respect your client’s autonomy and their right to make decisions in their own life. They will leave when they are ready.
  • Help your client plan for their future safety. What have they tried in the past to keep themselves safe and is it working? Do they have a place to go if they need to escape?
  • Feelings of isolation significantly affect older people’s quality of life. Explore options like befriending services, local activities and day/community centres to help address this.
  • Give clients as much relevant information and assistance as possible, without overwhelming them, to help them make informed choices about their future. Where possible, give options in writing.

It's always good to see a familiar face. You can build a rapport and don’t have to keep repeating your story again and again.

4. The perpetrator is elderly or has health issues of their own

We often see cases where the perpetrator has dementia or memory loss, or conditions which are known to make them violent. The perpetrator may be viewed as vulnerable and not capable of serious harm. A criminal justice response may be seen as inappropriate, and could result in an inadequate or unsuitable response by professionals.

How can I help?

  • Where possible and safe, look for support services for the ‘vulnerable’ perpetrator as this may be the only way to ensure the victim’s safety
  • Recognise that your client may want to maintain the relationship and help the abuser. You must always support any decision they make.

In my experience, the best way to engage is to listen carefully and give all the support and resources you can.

5. The abuser is the victim’s adult child or grandchild

We find that victims in these cases are even less likely to report the abuse to the authorities. This is often because they still love their child and want them to get help. They may worry about being alone or even blame themselves for the abuse because of how the child was raised.

The perpetrator may also have complex needs, such as mental ill-health or problematic alcohol or substance use. However, unless they are a risk to the community, you may find that services are reluctant to intervene.

How can I help?

  • For the reasons outlined above, the options for clients in these situations can be limited. However, wherever possible, explore alternative solutions with your client – for example, we found that women were happier if a neighbour reported the abuse to the police, so we worked with them to agree a code word with a trusted neighbour.
  • Speak to other local domestic abuse services to find out about their experiences of this type of abuse. What worked for them?
  • Link in with specialists such as drug and alcohol services, housing and social care. If the person causing the harm is under 18, find out if there is a Young People’s Violence Advisor (Ypva) working locally.

You were always ready and willing to help, no matter what. You gave your time to listen – always.

Whatever challenges your clients face, it’s essential that you build strong partnerships with the services your client is already using. We work closely with local Age UK groups, as well as adult social care, care homes and sheltered accommodation, health services, the police and the fire service. Share information whenever appropriate, and visit the client together if it makes them feel more comfortable. By working together, you’ll achieve far greater outcomes and, ultimately, help more older victims to become sustainably safe.

Find out more

Throughout July and August, we're focusing on domestic abuse as it affects older people. Join our free webinars, listen to our new podcast and more on the Spotlight webpage.

It's our right to be safe at any age. How can we make it easier for older victims to get help?

Monsura Mahmud is a Domestic Abuse Prevention Adviser for the Silver Project, a specialist service for women aged 55 and over affected by domestic and sexual abuse. The project is run by Leading Lights-accredited Solace Women’s Aid and provides one-to-one support, as well as training professionals who come into contact with older victims.

In many ways, the impact of living with domestic abuse is the same for all victims – regardless of age. Everyone worries about not being believed, or having to live with the stigma of abuse. They worry about what will happen to them financially, if the abuse will get worse or what might happen to the perpetrator if they do speak out.

But for older victims, this fear can be exacerbated by a number of other factors. As professionals, being aware of these barriers allows us to better understand their fears and, as a result, take a more flexible and creative approach to support.

Older victims might not recognise what’s happening as abuse

It goes without saying that there is no ‘typical’ victim of abuse. But it’s normally younger women or families who are portrayed in leaflets, posters and campaigns. This is matched by a wider lack of services and resources which take into account the unique needs of older victims.

“I’m not sure whether I knew I was experiencing abuse. It’s sometimes difficult to distinguish… it’s a very large word. There is financial, mental, verbal, economic and so much more. Some is invisible to the eye. Some has happened and some is still going on. It’s not always physical.”

They may be reluctant to talk about it

Generational attitudes towards relationships mean some older victims might accept the abuse as “the way it’s always been”. Older women may be from a time where it was not socially acceptable to talk about problems in their relationships; where women’s roles were confined to the home and divorce or separation were taboo.

This reluctance to talk about abuse can be exacerbated by victim-blaming among some professionals, which can be even more prevalent when a victim has lived with the abuse for a very long time. Too often, professionals make excuses for the abuser instead (“It can’t be that bad if she’s stayed with him that long”).

They don’t know about the help that’s available….

Services open and close so frequently, and the support that’s out there varies from one area to the next. If older people don’t have access to the internet or the skills to use modern technology, how will they know where to get help?

…Or have been let down in the past

If the abuse has been going on for a number of years, it’s likely that victims will have attempted to get help in the past. But if at every turn they fail to get the support they need, many may simply give up.

It took some time for me to access support. I started out by searching on the internet and I called several numbers. I was very isolated. It took a lot of persistence but eventually I found the Silver Project.

They may have health or mobility needs

Older women are statistically more likely than younger women to have health problems, reduced mobility or other disabilities which means their situation makes them more vulnerable to harm. This could also mean a loss of ability to communicate clearly if they’ve suffered a stroke, heart attack, have hearing loss or have experienced other chronic disorders. It could also mean they’re more isolated – both physically and socially.

Too often, professionals don’t consider domestic violence as an issue for older victims, and therefore don’t ask about it. They may assume that injuries, confusion, depression etc are the results of age-related conditions.

Another common barrier among those victims with health or mobility needs is that the perpetrator of the abuse is also their carer. This can lead them to become further isolated from friends, family and support. This is especially the case for victims who have depended on the perpetrator for much of their lives. They may also make threats to put the victim into a care home if they tell anyone about the abuse.

Family and friends aren’t supportive

Some adult children will be supportive of their parent and encourage them to leave or seek help. But others can create barriers by expecting women to stay, continuing to assume the carer role to an elderly father. The responsibility they place on themselves to be the carer of the abusive partner or child can also be too much.

They think it’s too late

We know that older victims are much more likely to live with abuse for prolonged periods of time. The thought of having to give up the home they’ve lived in for many years, leaving behind pets and treasured possessions, can be too much. After a lifetime of contributing to the family business, homes or other assets, many fear they will be left with nothing. And, too often, life can get in the way – the death of family or friends, birth of grandchildren, retirement, moving house – and victims can feel the time isn’t right to seek help.

Most of our lives have been settled, we would hope – working, raising a family, and so on… There is more emotion involved as you have a long history. There is just so much more at stake.

Find out more

In her next blog, Monsura examines some of the additional risk factors facing older victims and offers tips on how professionals can best support them.

Throughout July and August, we're focusing on domestic abuse as it affects older people. Join our free webinars, listen to our new podcast and more on the Spotlight webpage.

Marac peer review: my experience

This year, SafeLives launched a new peer review process to help local Maracs share expertise and get independent feedback on how they’re doing.

Thien Nguyen Phan, part of the Marac coordination team at Standing Together Against Domestic Violence, shares her experience as a peer reviewer.

In October 2015, SafeLives approached the team at Standing Together to pilot the new peer review process. Needless to say, we were thrilled!

We also agreed to trial the new Marac review tool – which replaces Marac self-assessment – so we could see the full benefits of the peer and Marac review processes together. One of the highlights of the ‘old’ self-assessment process was having our Marac Development Officer, Natalie Blagrove, visit us and impart her wealth of everything Marac, but the new Marac review tool looked decidedly attractive: interactive, user-friendly and quick.

What most motivated us to take part in the peer review pilot was the opportunity to get together with fellow Coordinators and experience first-hand how their Maracs work. We were really looking forward to seeing what we could learn from one another and the prospect of developing something useful for us all to use.

Getting started

Briony Redman, Standing Together’s Marac Data and Quality Assurance Officer, led on our participation in the pilot. From the first meeting with SafeLives on 6 November, things moved fast. Two of our Maracs, Haringey and Westminster, received observation visits from independent peer reviewers before going on to complete the online Marac review questionnaire. Meanwhile, Standing Together observed Camden and Wandsworth Maracs as peer reviewers. All reviews, peer review feedback reports and evaluation forms were submitted to SafeLives a month later.

The whole pilot was very well-organised from the start by SafeLives, who ensured everyone was linked in with one another as effectively as possible, and that we all had access to the right tools and resources.

As a peer reviewer, I found the guidance well-explained, supportive, and easy to use. The observation tool had been designed so I could carry out my review case-by-case with plenty of space to record notes. This meant that I had everything I needed when it came to writing up my observation report and could give Camden Marac specific examples of what they were doing well, as well as suggesting particular areas for development.

Combining the peer review and Marac review processes

Both the observation report and the Marac review tools are structured around the 10 Principles of an Effective Marac. This means that the feedback the Marac receives through the peer review process can be easily incorporated into the Marac review too.

At my home Marac, we shared the observation report with our representatives before we began the Marac review. It gave everyone an extra perspective on the things we were doing well and the areas that needed improvement, and meant we were extra prepared when it came to the full review.

A new point of view

I was with Camden Marac for less than a morning but learned so much from the observation. I had so many burning questions that I wish I could have spent more time there. There was so much to appreciate, so much to absorb!

But the biggest highlight of the peer review process has been seeing another Marac at work – hearing the different actions being offered, finding out about invaluable local resources and picking up some great tips.

And there was something more. Being a peer reviewer helped me realise how far the Marac process has come in the last decade.  Seeing all those Marac representatives coming together, not always with the perfect information, not always with the perfect action plan, but with such an unmistakeable desire to talk to one another and work together, helped me realise how much has been accomplished, despite all the challenges that remain.

As I completed my observation report, principle by principle, point by point, I realised that no matter how different each Marac may look on the surface, our ambitions are always the same: to make victims safer. Our resources may differ, but we share the same struggles. Our practices may vary, but we share the same principles. It’s hard to think how different things might have been without the support and tools that SafeLives has offered. But all we’ve achieved would’ve been impossible without the dedicated and hardworking Marac professionals who made it happen – and I’m delighted that being a peer reviewer gave me the opportunity to see them at work.

SafeLives is inviting all Maracs to take part in the new peer review scheme. And if you’re due to complete a self-assessment you can also find out more about the Marac review process – or even combine the two. To find out more, go to safelives.org.uk/review.

Tags: 

What happens when a victim moves areas? Top tips for stress-free Marac transfers

As part of the team behind SafeLives’ Knowledge Hub, it’s my job to answer some of the tricky questions professionals working with victims of domestic abuse face. Recently, a few areas have been in touch about Marac-to-Marac transfers, and how to share information when it becomes known that a Marac victim has moved.

Victims and their children living with high-risk abuse can fall through the gaps when they move areas, so it’s crucial we all play our part in keeping them as safe as possible.

When we know that a victim has moved out of a Marac area it’s essential that we let the new area know and support the victim’s future risk management by supplying any relevant information – such as previous minutes and action plans. It’s also really important that Marac reps speak to their counterparts in the old area.

Receiving a case

Coordinator
If you receive a transfer from another area, you should request information such as previous minutes and action plans if they are missing.  Ensure it’s made clear on the agenda where the case has been transferred from.

Chair
Check Marac representatives are liaising with their counterparts in other areas. Where gaps or issues are identified, follow local protocol to address or escalate as appropriate.

Idva
Liaise with the previous Idva and ensure an appropriate handover happens as early as possible, clarifying the current situation and risks.

Marac representatives
Liaise with your counterpart in the old area. Gather any information they might have and, where relevant, share it at the meeting.

Transferring a case

Coordinator
If you are transferring a case to another area, follow SafeLives' recommended practice - send all the relevant information you have, including previous minutes and action plans.

Chair
Ensure that the case is discussed in line with SafeLives recommended practice and transferred as appropriate.

Idva
Identify and liaise with Idva in the new area, hand the case over and ensure the new Idva is aware of the current situation and risks.

Marac representatives
Liaise with your counterpart in the new area, share all relevant information with them so that the case can be appropriately discussed at their meeting.

I’ve been at many a Marac where a transferred case cannot be fully discussed because no-one has made contact with their agency’s counterparts. I can’t stress how important this is. We are doing a disservice to victims if we are not able to share information, identify risks and action plan appropriately.

For more comprehensive guidance, take a look at our Marac-to-Marac flowchart. We’ve also prepared some answers to frequently asked questions about the Marac transfer process. And to make it really straightforward, there’s even a Marac transfer form for the referring area to use.

Whatever your role, our team of experts is here to offer help and advice on all aspects of the response to domestic abuse. We can also work with you to develop multi-agency approaches like Marac and Mash, offer advice on commissioning domestic abuse services, and support you to deliver local scrutiny panels focused on improving outcomes for families affected by domestic abuse.

To find out more and get in touch, go to safelives.org.uk/knowledgehub.

Tags: