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Policy Brief - January 2024

Sexual Abuse Against Older People in NHS Hospitals

The original research into this topic in 2021 was inspired by a lady called Valerie Kneale. Valerie passed away in Blackpool Victoria Hospital in November 2018, initially thought to be due to a stroke.

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"Older victims of abuse were locked in and left behind". Hourglass feedback to module 10 (impact on society) of the COVID-19 inquiry roundtable.  

Human ageing is imbedded within social factors, social relationships, and social constructs, and linked to ideas around the wider community and the self; until death happens - everyone grows older and old, but our notions around ageing are steeped in assumptions and stereotypes. 

Overarchingly, Hourglass has a neutral view on the proposed Terminally Ill Adults (End of Life) Bill. We understand and support the need for older people to be able to make choices regarding their own lives and deaths and have autonomy over decision making in this sphere and any others.

Economic abuse is one of the most common types of abuse in later life. Economic abuse is a crime and should be treated as such. Suffering economic abuse as an older person can have life changing effects, leading to trauma, mental health problems, and even death.

Economic abuse is a crime, and older people are key victims and victim-survivors of such abuse. But this abuse and the costs to the victim, society and the economy are hidden and all too often ignored.

Should victim support services focus solely on the victims of crime? Or can investigating perpetrators of abuse and violence help organisations better support victim-survivors and prevent abuse?

The Hourglass Manifesto outlines the overarching measures which Hourglass believes the governments should adopt in order to create a Safer Ageing Society by 2050.

Economic Abuse is a complex yet common form of exploitation encompassing financial harm, and an abuser or perpetrator restricting a person’s ability to acquire, use, and maintain money or other economic resources.

The overarching principle of the charity is that older people experience the same forms of harm and abuse as all other demographics, including financial/economic, physical, sexual and psychological abuse as well as neglect and discrimination. The organisation seeks to protect and support older people at such times of need.

This briefing assesses movements, issues, and legislation in Scotland concerning safer ageing and the protection of older people from all forms of harm, violence, abuse, and neglect. 

Sexual abuse and violence against older victims is underrecognised and underreported. Ageist attitudes about sexuality are barriers to understanding and help-seeking. There is a lack of wider public understanding and awareness.

Abuse and violence against older male victims is underrecognized and underreported. Male specific factors can be barriers to seeking help or support. Lack of health and support services tailored to older male victims. Social isolation and fear of judgment for older male victims of abuse.

The cost of living crisis has concerning implications on the economic and physical wellbeing of older people in the UK.

Around 2.1 million (18%) pensioners in the UK currently live in poverty, and one million of these older people live in severe poverty (below 50% of the median), as well as this, 11% of older people are in “persistent poverty” having spent three years out of any four-year period below the poverty line.

Predatory marriage is a form of economic abuse, wherein marriage is a cover for exploitation and economic gain. It can have a devastating psychological and mental health impact on family members and friends of the victim.

After a year and a half of living through lockdowns, being isolated from families, friends and loved ones, being confined to homes, stark new findings from Hourglass show that older people, at heightened risk from the virus, social isolation and neglect, have been deprioritised by government and beyond.

There is an absence of regular, comprehensive data on violence and abuse of older people in the UK. The response to abuse in older age sits between the domestic abuse response, hate crime monitoring and adult safeguarding, creating a diffuse and conflicting data landscape. 

Older adults face barriers to domestic abuse support services and mental health support services. ‘Ageing well’ has been a guiding principle in relation to older people’s mental health. National data on suicide show a second peak in prevalence in later life. This particularly applies to men over 75.

Public awareness and professional understanding of domestic abuse of older people needs to be improved. Public information campaigns need to reinforce the reality that domestic abuse can aﬀect people of all ages and the risk doesn’t stop when someone reaches 65.

Under present legislation in England, situations may arise where a social worker cannot access an adult at risk to conduct a private interview where there is suspected abuse.

An analysis of Hourglass and Hodge Bank's economic abuse survey.

This research was inspired by a lady called Valerie Kneale. Valerie passed away in Blackpool Hospital in November 2018, initially thought to be due to a stroke. However, a post-mortem examination found Valerie had in fact died from internal haemorrhaging due to severe vaginal injuries.

Criminal justice outcomes for all older victims of crime need to be improved. The current system deters and intimidates older people at all stages of the process, from reporting and investigation through to prosecution and sentencing.

Age should be included as a protected characteristic in hate crime legislation in all four nations of the UK. Such a step is important to keep the topic of abuse and crime towards older people high on the agenda and provide additional protection for victims.

In order to better understand the human voices behind the data, and hear the lived experiences of older people during the pandemic, subsequent lockdowns and periods of restrictions, Hourglass commissioned a UK-wide poll seeking the views of older people.

Psychological or emotional abuse involves threats of harm, bulling and harassment and other behaviours or acts of coercive control which deliberately try to scare, humiliate, isolate or ignore an older person. Such abuse can also relate to acts that may contravene the human rights of older people, such as the restriction or prevention of older people meeting their religious or cultural needs.

Physical abuse is any intentional act or behaviour causing injury, trauma or other physical suffering or bodily harm. This includes instances of fabricated or induced illness or causing an older person to become unwell.

Sexual abuse involves any non-consensual sexual act or activity perpetrated against an older person. Such acts can include rape or attempted rape, sexual assault, involving an older person in making or viewing sexual imagery against their wishes, indecent exposure, inappropriate sexual harassment, sexual teasing, innuendo, or non-consensual masturbation.  

Neglect occurs when a person deliberately withholds, or fails to provide, suitable and adequate care and support needed by an older person. It may be through a lack of knowledge or awareness, or through a deliberate decision not to act when they know the older person in their care needs help. Neglect can negatively impact the health and well-being of an older person.

Economic abuse is where someone in a position of trust interferes in an older person’s ability to acquire, use or maintain their finances. It is always a crime but not always prosecuted.

Domestic abuse, or domestic violence, is any incident of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members, regardless of their gender or sexuality.

Hourglass Safer Ageing Index is a groundbreaking research project to assess the current state of ageing, examine policy and identify barriers to achieving safer ageing for all older people in Greater London.

Hourglass Cymru's Safer Ageing Index is a groundbreaking research project to assess the current state of ageing, examine policy and identify barriers to achieving safer ageing for all older people in Wales.

Hourglass Northern Ireland's Safer Ageing Index is a groundbreaking research project to assess the current state of ageing, examine policy and identify barriers to achieving safer ageing for all older people in Northern Ireland.

The Safer Ageing Index for England, which suggests significant issues in the South West and North of England, underlines that addressing the needs and challenges faced by the growing population of older adults is crucial in creating a Safer Ageing Society. This includes providing adequate housing options, healthcare services, social support, and combating social isolation to ensure a better quality of life for older people across England.

The idea of safe houses and housing support to assist those experiencing domestic abuse in the UK was first developed in the 1970s. At the time, domestic abuse was still a hidden form of harm dealt with behind closed doors, martial rape was legal, and support services were almost non-existent.

The continued public health restrictions and lockdowns introduced to combat COVID-19 pose an acute threat to older people by undermining human rights and exacerbating their risk of abuse.

Every year, more than a million older people are physically, emotionally, financially or sexually abused in the UK. This is a truly damning indictment of how our society views and values older people.

Sexual Abuse Against Older People in NHS Hospitals

UK Covid Inquiry: Hourglass Feedback

Ageism: Paving the Way for Abuse and Violence

Hourglass' View on the End of Life Bill

Policy, Practice and the Law

The Economic Abuse by the Numbers

Understanding the Perpetrators of Abuse

The Hourglass Manifesto

The Economics of Abuse 2024

Sexual Abuse Against Older People in NHS Hospitals

30 Years Anniversary of Safeguarding

Issues and Movements Concerning Safer Ageing

Sexual Abuse of Older People

Older Male Victims – Stereotyped Harm?

Cost of Living Crisis: Pensioners in Poverty

Poverty in Later Life: Structural & Interpersonal Violence?

Predatory Marriage: What Can We Do to Prevent it?

Safer Ageing Index Part 1: Last in Line

The Implications of Data Collections

Suicide and Self-Harm Among Older Adults

Domestic Abuse of Older People

A UK-Wide Approach to Adult Protection

Economic Abuse Awareness

Sexual Abuse Against Older People in Hospitals

Improving Justice Outcomes for Older People

Should Age be a Protected Characteritic?

Older Voices of the Pandemic

Psychological Abuse

Physical Abuse

Sexual Abuse

Neglect

Economic Abuse

Domestic Abuse

The Safer Ageing Index - London

The Safer Ageing Index - Wales

The Safer Ageing Index - Northern Ireland

The Safer Ageing Index - England

Abuse & Housing Support: A Protective Measure?

Safer Ageing Policy in a Pandemic UK

What Does Growing Old in the UK Look Like?

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