Shal­iza Has­sanali

Own­ers and op­er­a­tors of pri­vate geri­atric homes in T&T be­ware! Stiffer laws and penal­ties will be im­posed by Au­gust 2012, to pro­tect and safe­guard the coun­try's most vul­ner­a­ble, the el­der­ly, a pop­u­la­tion that num­bers in the vicin­i­ty of 156,000 or 12 per cent of cit­i­zens in the coun­try. The warn­ing comes from di­rec­tor of the Di­vi­sion of Age­ing Dr Jen­nifer Rouse as the Peo­ple's Part­ner­ship Gov­ern­ment moves to put laws in place to guard against peo­ple who are in­sti­tu­tion-housed and those over age 65. Un­der Of­fences and Penal­ties in the Homes for Old­er Per­sons Act 2009 reg­u­la­tions, Rouse said any li­censee, man­ag­er or em­ploy­ee of a home for old­er peo­ple who wil­ful­ly as­saults, ill-treats, ne­glects or ex­pos­es the el­der­ly and fails to pro­vide food, care or lodg­ing is li­able to a fine of $25,000 and im­pris­on­ment for two years.

Should the per­son con­tin­ue with his/her of­fence, a fur­ther $25,000 fine will be im­posed for every day or part there­of. The home own­er must al­so have ev­i­dence of li­a­bil­i­ty in­sur­ance in the sum of $100,000, which will re­quire high pre­mi­ums. The home­own­er's li­cence can al­so be sus­pend­ed, re­voked and the own­er dis­qual­i­fied for a pe­ri­od de­ter­mined by the court. An­oth­er re­quire­ment is the ra­tio of care­givers to res­i­dents at the home. Homes that are in dis­re­pair will be giv­en 90 days to put its house in or­der. "Fail­ure to do so, the min­is­ter can sus­pend and re­voke li­cences or close them down en­tire­ly. There will be no ifs or buts," said Rouse at her St Vin­cent Street, Port-of-Spain of­fice on Thurs­day.

Homes will al­so be as­sessed and in­spect­ed reg­u­lar­ly by a Fa­cil­i­ty Re­view Team to en­sure the phys­i­cal in­fra­struc­ture is ac­cept­able. "They have to be re­mind­ed that once a mat­ter be­comes an in­dictable of­fence, it is a straight case of jail. We are very se­ri­ous about this. So home own­ers be­ware! We are com­ing af­ter you if you are er­rant and delin­quent." The Act which was re­voked, re­pealed and is yet to be pro­claimed by Pres­i­dent George Maxwell Richards, will pro­vide for the li­cens­ing, reg­u­la­tion and con­trol of Homes for Old­er Per­sons. Once the Act is pro­claimed, Rouse said, the min­istry must have every­thing in place to pro­tect the el­der­ly, who have been sub­ject to abuse and ill treat­ment by mem­bers of so­ci­ety over the years.

Work­ing in tan­dem with Min­istry of Hous­ing

In the event that a home faces clo­sure, Rouse said, long term res­i­den­tial care will have to be es­tab­lished in tan­dem with the Min­istry of Hous­ing as an al­ter­na­tive mea­sure for ac­com­mo­da­tion. "The leg­is­la­tion will give a tran­si­tion pe­ri­od of at least a year. By then, all homes will have to come up to par, which is along best prac­tices. That first two years will be cru­cial. All home­own­ers must have a man­u­al so they can't say they did not know the re­quire­ments." Each home will be as­sessed on a code of con­duct and ethics, Rouse ex­plained. In the com­ing months, Rouse said, 15 qual­i­fied in­spec­tors will be em­ployed to mon­i­tor the coun­try's 84 un­li­cenced pri­vate homes and all-care fa­cil­i­ties in T&T.

Of the 84 homes, on­ly half are reg­is­tered with the Min­istry of Health. The in­spec­tors, Rouse said, will be giv­en pow­ers to vis­it res­i­den­tial homes with a Jus­tice of the Peace, po­lice, health work­er, so­cial work­er and Fam­i­ly Court rep­re­sen­ta­tives once a re­port of abuse is made to the Min­istry of Com­mu­ni­ty De­vel­op­ment un­der the new leg­is­la­tion. "The leg­is­la­tion will give us the back­bone and teeth for the in­sti­tu­tion­al fa­cil­i­ties, res­i­den­tial homes and the coun­try's eight se­nior cen­tres." Rouse ar­gued that T&T must look at abuse through so­cio-eco­nom­ic, cul­tur­al and sea­son­al fac­tors. Stat­ing that three per cent of the 156,000 se­nior cit­i­zens or 5,000 el­der­ly are in­sti­tu­tion housed, Rouse ad­mit­ted that the age­ing pop­u­la­tion rep­re­sents the fast­ing grow­ing group.

Prop­er­ty abuse most preva­lent

Em­pha­sis­ing that peo­ple over age 85 are more prone to abuse be­cause of their frailty, Rouse said this was so be­cause they are de­pen­dent on some­one else. Of all the abuse the el­der­ly are ex­posed to, Rouse said prop­er­ty abuse was the most preva­lent, fol­lowed by fi­nan­cial, emo­tion­al, ver­bal, sex­u­al, phys­i­cal and med­ical. Prop­er­ty abuse, Rouse dis­closed, oc­curs most of all by close rel­a­tives. "We are find­ing per­sons across the board who are al­most im­pris­oned in their own homes through their adult chil­dren, in-laws and rel­a­tives. They are now made to sign over their prop­er­ty un­der the guise that their rel­a­tives would take care of them."

Rouse said hav­ing signed over prop­er­ty the el­der­ly per­son is cart­ed off to the garage, now con­vert­ed in­to a one-bed­room flat, while the chil­dren would mi­grate or rent the pala­tial house. "Many of these cas­es are un­der re­port­ed. Some of the old­er per­sons be­lieve if they re­port the abuse they would be evict­ed and put in­to a home," Rouse stat­ed. Rouse spoke about se­nior cit­i­zens who signed over prop­er­ty and end­ed up in a home where a cheque is ten­dered for their care. "They don't re­ceive any vis­its or phone calls from their chil­dren which is, vir­tu­al­ly, aban­don­ment and ne­glect." In a mat­ter of weeks, Rouse said, the el­der­ly per­son would be­come with­drawn and reclu­sive.

Per­pe­tra­tors are well ed­u­cat­ed, known in so­ci­ety

The per­pe­tra­tors of the ill treat­ment, Rouse claimed, are well-known pro­fes­sion­als in the so­ci­ety who live in ar­eas like Mar­aval, Good­wood Park, Bay­side Tow­ers and West­moor­ings. "They are high­ly ed­u­cat­ed...maybe, too ed­u­cat­ed and as a re­sult, swin­dle their par­ents (out of) their prop­er­ties." In­sist­ing that most of the cas­es of abuse re­ceived at their of­fice in­volved prop­er­ty, ver­bal and phys­i­cal abuse. Rouse said: "We had cas­es of rich peo­ple cry­ing and telling us on the phone that they nev­er thought that their chil­dren would have done this to them. Their house is five and sev­en bed­rooms and three cars in the yard but they are all alone, their will so bro­ken."

El­der­ly bathed with cold wa­ter at 4 am

Rouse said they have vis­it­ed homes where the res­i­dents were fed half-cooked peas and rice dai­ly, the cup­boards were lay­ered with mould and mildew and gro­cery items in­fest­ed with wee­vils. "The phys­i­cal re­quire­ments of the build­ing were not there, the toi­lets non func­tion­ing, in­suf­fi­cient vents, over­crowd­ing and lack of pro­grammes to keep the el­der­ly oc­cu­pied. Just to make a prof­it they com­pro­mise qual­i­ty." Rouse spoke about one home bathing the res­i­dents four o'clock in the morn­ing with cold wa­ter. An­oth­er was in the habit of spray­ing naked res­i­dents in an open yard. "We did not have the teeth to deal with it but we sent pub­lic of­fi­cers from Health. We have not heard any fur­ther re­ports of it."

Dumped at hos­pi­tals for Christ­mas, Car­ni­val

Rouse said dur­ing Christ­mas and Car­ni­val the el­der­ly are dumped at pub­lic hos­pi­tals so rel­a­tives could par­ty and play mas. "Every year the doc­tors put out a bul­letin in the news­pa­pers ad­vis­ing peo­ple to come and col­lect their rel­a­tives. Two to three weeks af­ter Car­ni­val they are still in there. That is aban­don­ment, which is a form of abuse." Rouse said there are the sin­gle peo­ple who tend to ne­glect them­selves by not wor­ry­ing to bathe, eat or pre­pare a meal.

Sci­en­tists have shown that cou­ples who age to­geth­er take bet­ter care of them­selves. "That's why it's im­por­tant that they don't dis­en­gage from so­ci­ety." She al­so not­ed that the el­der­ly were now tak­ing care of the young who have been dy­ing from ve­hic­u­lar ac­ci­dents, homi­cides, the HIV/Aids virus, or drug ad­dic­tion. "It is call role re­ver­sal. In­stead of the young tak­ing care of the old, the green limes are falling."

Huge de­mand for care­givers

There is a huge de­mand for el­der­ly care­givers as T&T's age­ing pop­u­la­tion grows by leaps and bounds. Up to the be­gin­ning of this year, the Min­istry of Com­mu­ni­ty De­vel­op­ment-un­der whose min­istry the el­der­ly falls-had trained ap­prox­i­mate­ly 600 care­givers un­der the Geri­atric Ado­les­cent Part­ner­ship Pro­gramme (Gapp) to look af­ter the wel­fare of the se­nior cit­i­zens who are left un­at­tend­ed and un­su­per­vised. But due to the grow­ing de­mands for the ser­vice, Com­mu­ni­ty De­vel­op­ment Min­is­ter Nizam Baksh said he was mov­ing to ramp up the fig­ure to 1,000 through Cab­i­net.

When he took up of­fice last year, Baksh said there were ap­prox­i­mate­ly 400 care­givers, which he in­creased to 600. "There has been a num­ber of re­quests for care­givers who work five days per week. We have peo­ple in the thou­sands wait­ing for care­givers." Baksh said his min­istry has em­barked on a faster train­ing pro­gramme for care­givers un­der Gapp. The care­givers are trained at two lev­els for six months. "I told them we have to step up on the train­ing to deal with the de­mand. They will be ready by next year."

Care­givers ill treat­ing the el­der­ly

Not­ing that some re­ports have reached his desk with care­givers ill treat­ing and abus­ing the el­der­ly, Baksh said this was one is­sue he will not tol­er­ate. "It is not an alarm­ing rate. But you do have some com­plaints of abuse com­ing in. Once I re­ceive a com­plaint I will talk to the di­rec­tor and re­quest a feed­back." Should any care­giv­er be found guilty of abuse, Baksh said he will put it in the hands of the po­lice. "Af­ter that, I will fire them. The abuse comes in all forms, phys­i­cal, men­tal, or ne­glect." The min­istry, Baksh said, were cur­rent­ly ex­am­in­ing the le­gal con­di­tions of work for care­givers.

T&T's age­ing pop­u­la­tion grow­ing

T&T's age­ing pop­u­la­tion is ap­prox­i­mate­ly 156,000 or 12 per cent of the to­tal pop­u­la­tion. This fig­ure is ex­pect­ed to dou­ble be­tween 2000 and 2050, from ten per cent to 21 per cent. A pop­u­la­tion is con­sid­ered to have aged when the pro­por­tion of peo­ple aged 60 years and over ex­ceeds ten per cent to 12 per cent of the pop­u­la­tion. Da­ta ob­tained on the liv­ing con­di­tions of Old­er Per­sons 1999, showed that fe­males out­num­bered males among the 65 years and over age group. The life ex­pectan­cy for T&T's males stand at 68 years, and 73 for fe­males. Baksh said the Unit­ed Na­tions Madrid In­ter­na­tion­al Plan for Ac­tion on Age­ing (2002) es­ti­mat­ed that glob­al­ly the pro­por­tions of per­son aged 60 years and old­er is ex­pect­ed to dou­ble be­tween 2000 and 2050, from ten per cent to 21 per cent.

In de­vel­op­ing coun­tries such as T&T, the old­er pop­u­la­tion is ex­pect­ed to in­crease four fold dur­ing the next 50 years, Baksh ex­plained. Pop­u­la­tion age­ing gen­er­al­ly re­sults from the com­bined ef­fect of low fer­til­i­ty and mor­tal­i­ty rates and net mi­gra­tion, he ex­plained. Based on a 1999 sur­vey in T&T, it was found that amongst old­er peo­ple who were dis­sat­is­fied with their lives, lone­li­ness was rat­ed the third most im­por­tant prob­lem they face af­ter health and eco­nom­ic prob­lems. The min­istry re­cent­ly record­ed 527 peo­ple over the age of 90. Of the 527, 57 were cen­te­nar­i­ans, Baksh said, while 492 were be­tween the ages 95 to 99. "There were just call-ins, we don't know the ac­tu­al fig­ure which I sus­pect could be more." Baksh said due to the in­crease in the age­ing pop­u­la­tion there has been an over­whelm­ing de­mand for el­der­ly care, which they must ad­dress.

Some homes lack stan­dards

But while not­ing that he was work­ing fever­ish­ly to ex­pand on care­givers, Baksh said at­ten­tion must be paid to the way homes op­er­ate. Many of them, Baksh said, func­tion as a busi­ness rather than pro­vide a ser­vice. "Some lack stan­dards and up­lift­ment." In some in­stances, Baksh said, care­givers eat the el­der­ly's food. "If they ask for some­thing the care­givers would not give them."

Since the Di­vi­sion of Age­ing was put un­der his min­istry six months ago, Baksh has ad­mit­ted to re­ceiv­ing re­ports of el­der­ly abuse. Baksh said plans are in the pipeline to open homes that will cater to the needs of the work­ing class and those who have things to do dur­ing the day. "They (pub­lic) can drop off the el­der­ly for one day to take care of busi­ness. This has nev­er been in­sti­tut­ed be­fore. The el­der­ly would be in a set­ting where they can feel com­fort­able."

Abuse hot­line com­ing

In the near fu­ture, Baksh said the min­istry will es­tab­lish an el­der­ly abuse hot­line. "I am look­ing at a hos­tile plan to deal with the age­ing pop­u­la­tion. The pub­lic-main­ly the younger ones-must be ed­u­cat­ed and sen­si­tised to help the old­er ones. We have to re­mem­ber that we will all get old one day."