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 The Act which was revoked, repealed and is yet to be proclaimed by President George Maxwell Richards, will provide for the licensing, regulation and control of Homes for Older Persons.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."