GLOBAL COOPERATION NEWSLETTER
October 2013
In this issue:
 Preventing Neglect, Abuse and Violence Against Older Women The Global Age Watch Index launched Investing in Women’s Employment is Good for Business Useful resources and links
 Featured article: Preventing Neglect, Abuse and Violence Against Older Women
By Patricia Brownell

Patricia Brownell, PhD, is Associate Professor Emerita of Social Service at Fordham University, New York, USA.
She is a Pioneer of the National Association of Social Workers (NASW), serves on the Editorial Board of the
Journal of Elder Abuse and Neglect, and has done research and published on elder abuse and the abuse of older
women. Dr. Brownell represents ICSW on the CoNGO Committee on Ageing/New York at the UN and chairs the
Sub-Committee on Older Women (SCOW).

In many societies older persons are one of the most vulnerable segments of the population.
Neglect, abuse and violence were identified at the Madrid 2002 Second World Assembly on Ageing
as important issues impacting the well-being of older persons, and older women in particular wereidentified as facing “greater risk of physical and psychological abuse due to discriminatory societal
attitudes and the non-realization of the human rights of women.” 1.
The Convention for the Elimination of All Forms of Discrimination Against Women (CEDAW)
affirms that violence against women is rooted in the historical and structural inequity in the power
relations between men and women. Gender-based violence is understood as a form of
discrimination that serves as a barrier to the realization of all human rights and fundamental
freedoms by women. CEDAW General Recommendation No. 27 specifically addresses theimplications for older women.2 Despite an abundance of evidence, albeit undocumented, the lack of
United Nations (2002): Report of the Second World Assembly on Ageing, Madrid 8-12, 2002.
2
Convention on the Elimination of All Forms of Discrimination against Women: Committee on the Elimination ofDiscrimination against Women (October 2010). General Recommendation No. 27 on older women and protection of their
human rights, CEDAW/C/2010/47/GC.1.
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specific data on neglect, abuse and violence against older women confounds efforts to identify thescope of the problem world-wide, including prevalence, risk factors, health consequences andcultural differences. Available data are contradictory and confusing, owing to the differingdefinitions, measures, and forms of abuse studied by researchers, policy makers and practitioners.
In the literature on the issue, three distinct theoretical frames could be identified as utilized byresearchers to delineate the field: intimate partner violence; social gerontology; and adultprotection.
Intimate partner abuse (IPV) refers to physical, sexual and psychological abuse (or the
threat of such abuse) and violence against women and girls that is perpetrated by intimate partners(including dating partners), acquaintances and even strangers in cases of sexual abuse. Using thistheoretical framework to examine the abuse of girls and women across their life course, researchers
have found that older women experience significantly less abuse than younger women, suggestingthat in this frame the abuse of older women is not a significant problem compared to thatexperienced by younger women and girls. The prevalence rate for the abuse of older women in the
IPV frame ranges from 1-2%.
A different picture of abuse and violence against older women emerges when examined within asocial gerontology frame. In this light perpetrator categories expand to include adult children andgrandchildren, other relatives, neighbors and friends, and caregivers. As in the intimate partner
abuse perspective, victims are assumed to live in the community, but may not necessarily have an
intimate partner relationship. Forms of abuse are also expanded in this frame to include, in addition
to physical, sexual and psychological abuse, also financial or material exploitation, and neglect.
Measures of psychological abuse may go beyond threats of physical or sexual violence to include
denigrating verbal abuse as well as non-verbal abuse in the form of social control behaviors likeisolating and ignoring (or even treating the older woman as a child). Where available, prevalence
data for the abuse of older women has been found to be as high as 25% .3
A third perspective on abuse and violence against older women assumes frailty and cognitive
impairment leading to high levels of care dependency, necessitating protection to avoid
victimization. The adult protection frame assumes that the vulnerability of the older women in thiscategory is based on their inability to care for themselves or even supervise care. Perpetrator
categories are expanded to include not only family members and neighbors but also formal
caregivers and other residents of care facilities as well. Neglect as a form of abuse is highlighted inthis frame, although sexual abuse by formal caregivers or other care facility residents is also ofconcern. This frame assumes that the victim may not be able to report abuse because of cognitiveor other impairments, so third party reports of abuse are utilized, creating some difficulty with data
accessibility. Gender-based prevalence data are largely unavailable up to now for older women inprotective settings.
The situation varies from one country to another. While identified forms of elder abuse are
well established in developed country research, including physical, sexual and psychological abuse,financial exploitation, and neglect, other forms of the abuse of older women are less commonly
identified in research and have not been well studied. These include harmful traditional practices,
particularly those that might be harmful to widows, and accusations of witchcraft, which in some
African countries are used as justification to harm or even kill older women. Studies on the abuse ofolder adults in institutional settings like care homes may not include measures of family rejection
and financial exploitation, particularly if the older adult is a widow and socially marginalized.
Luoma, M. L., Koivusilta, M., Lang, G., Enzenhofer, E., De Donder, L., Verté, D., Reingarde, J., Tamutienne, I., FerreiraAlves, J., Santos, A. J. and Penhale, B. (2011): Prevalence study of abuse and violence against older women: results of amulti-cultural survey in Austria, Belgium, Finland, Lithuania, and Portugal (European Report of the AVOW Project), Finland,
National Institute of Health and Welfare.
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Interviews with older women victims of abuse often reveal other reasons why they are notwell represented in domestic violence programs and in police reports. Older women report feelingunwelcome in domestic violence shelters, where programs for younger women with children
dominate, and older women do not feel that they are considered as entitled to services as womenof reproductive age. They also feel that adult protective services are not appropriate for them,because they do not identify themselves as frail and cognitively impaired. Aging service systems,
where they exist, may not offer crisis intervention services or trauma counseling. Older immigrant
woman cite language and cultural barriers as well. Older women express concerns about leaving
batterers, who may be older and ill, as well as reluctance to prosecute adult children andgrandchildren, who may suffer from mental illness or substance abuse problems. The police in somecountries may not regard the abuse of older women by aging batterers or adult children as a matterfor law enforcement. Psychological abuse, when experienced by older women, has been found toresult in physical health problems such as heart disease and joint pain, as well as mental healthproblems like depression and anxiety. However, psychological abuse that does not rise to the levelof a crime, such as menacing or stalking, may be trivialized by domestic violence programs or law
enforcement.
The prevention of domestic abuse and violence is an important public policy goal. The
strategies are many, ranging from public education to sanctions through the criminal justicesystem. Elder abuse prevention has lagged behind domestic violence prevention and, where it
exists, it has been conducted largely through aging service systems and non-governmentalorganizations. Criminal justice strategies have largely focused on those who place vulnerable adults
at risk. However, several trends are changing this. First, the world is aging, and women outlivemen, with more chronic health conditions that generate long-term care needs. Increasingly, frail
older adults live at home or in the community. Elder abuse has been given a higher profile throughmedia attention. Concerns about the fiscal viability of services, as older adults live longer on
pensions and social security or depend on extended family resources, which are often strained orinadequate, have sensitized the public to the impact of scams and other fraudulent schemes onolder adults, especially older women.
There are no nationally uniform response systems to address abuse and violence against
older women. However, professional organizations, agencies and municipalities at the national andlocal levels have developed innovative programs and initiatives to prevent the abuse of older
women in various service sectors such as health and mental health, social service, the criminal
justice system and housing. Programs and initiatives may target older women as part of a broader
campaign to prevent intimate partner violence against girls and women of all ages, to prevent
ageism, to protect widows, or to promote community health. It may also mandate the training ofworkers in health, institutional and care settings, so as to promote understanding of the neglect
and abuse of care-dependent older women and how to prevent it.
Interventions that address the neglect or abuse of older women include support groups thatare structured specifically for older women participants, domestic violence shelters for the disabled
and older adults that are accessible to the mobility impaired and have medication management
units and programming for disabled and older victims, specialized court programs that include
multi-disciplinary units with expedited access for older victims and specialized elder abuse units.
Others include specialized legal services for older women abuse victims, training and education for
professionals working with victims of abuse in later life, and programs for perpetrators. Treatment
programs for mentally ill and substance-abusing perpetrators are offered, with the added
advantage of garnering support for older women victims with adult children who want help, notpunishment, for loved ones who are also perpetrators of abuse, neglect or exploitation. Those
programs are more likely to be set up in developed countries than in countries that still developing
and struggling with scare resources.
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National legislative initiatives, when they exist, have largely been bifurcated between
domestic violence and aging or protective service approaches. Older women often fail to fit intoeither approach. When the problem is intimate partner abuse, older women may be referred toaging service programs, which often lack the capacity to address domestic violence among elder
spouse/partners. They may not meet the eligibility requirements for protective services for theelderly, if they are not physically or cognitively frail. Older women victims of abuse are likely to fall
between the cracks of a bifurcated legislative and legal system. In addition, laws related to theabuse and neglect of older women by family members or formal caregivers may be adopted but not
implemented.
Ending Violence against Women: From Words to Action, a United Nations study published in
2006, recommended that states carry out the systemic collection and analysis of data on violenceagainst women, ensuring that the data are disaggregated by age and gender, as well as by raceand disability. While violence against older women was not referenced by the UN General Assembly
Human Rights Council in its Directive (“Accelerating efforts to eliminate all forms of violence against
women: remedies for women who have been subjected to violence”, dated July 2, 2013), the final
Outcome Documents of the 57th session of the Commission on the Status of Women include theelimination of violence against older women as a recommendation.
An expert group will convene at the UN in New York City in November 2013 in order to begin
to address definitional and measurement issues, so as to obtain a clearer understanding of theprevalence of neglect, abuse and violence against older women across developing and developed
countries, and in traditional and modern societies. Among other issues to be discussed is the needto know more about evidence-based practices for the prevention of and intervention in the abuse ofolder women and how they can be strengthened. Finally, a review of laws related to the abuse ofolder women needs to be undertaken, including an analysis of their implementation and impact of
reduction and elimination of abuse of older women.
Population aging is a global trend that is changing economies and societies around theworld. 4 In 2012 people aged 60 years and older represented almost 11.5 percent of the global
population and by 2050 that figure is expected to double to 22 percent. Older women outnumber
older men: in 2012 for every 100 women aged 60 and above there were 84 men. For every 100
older women aged 80 and above there were only 61 men. The feminization of aging, representing
the intersection of age and gender, has important implications for policy as the world continues toage. It is time for neglect, abuse and violence against older women to become visible and to end.
Opinions expressed in the article are those of the author and do not necessarily reflect views of the
ICSW Management Committee.

 The Global Age Watch Index launched
The Global Age Watch Index was launched by HelpAge International on 1 October 2013—the UN
International Day of Older Persons. It is the first global index to rank countries according to thesocial and economic well-being of older people. The Index provides a measure of 13 different
indicators across the four key domains of income security, health status, education andemployment, as well as aspects of the enabling environment already identified by older people as
being of utmost importance to them.
Aimed at broadening the way the needs and opportunities of older persons are understood, theIndex goes beyond the adequacy of pensions and other income support, which, though critical,
often narrows policy thinking and debate regarding the needs of that age group. The above
United Nations Population Fund and HelpAge International (2012), Ageing in the Twenty-First Century: A Celebration and A
Challenge, New York & London
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approach is based on an application of human development methodology to the construction of anindex of the well-being of older people.
Developed and constructed from international data sets drawn from the data collected by theUnited Nations, the World Bank, World Health Organization, International Labour Organization and
the Gallup World Poll, the Index challenges countries in every part of the world. The report’s
ranking of countries in terms of the needs and opportunities of older people shows that a country’s
GNP neither guarantees a good living for older people nor is it an obstacle to improving theirsituation. Older people in poorer countries often have better lives on average in several key
respects than do those in somewhat richer ones. The Index thus serves as a challenge togovernments and community groups to raise their sights as to what is possible. As the number andproportion of older people rises in many countries, the importance of those lessons cannot be
overstated.
Created by a small team of experts, the Index has benefited from a global advisory panel of morethan 40 independent experts on ageing, health, social protection and human development. The
Index will be developed over time to expand from its current number of 91 countries to all UN
Member States.
In the spirit of the global call for the “data revolution” to “leave no one behind” in the post-2015
development framework, it is hoped that the Index will become a central reference point forgovernments, employers, civil society, communities, families and older people themselves in orderto ensure a culture that does not discriminate on the basis of age. A culture in which thecontributions of older people to their economies and societies are recognized and supported is one
that “leaves no one behind”.
The online discussion organized after the launch of the Index by the HelpAge network, withassistance provided by various partners including ICSW, confirmed substantial support for thecreation of such an index; in particular,
empirical analysis andmany participants reiterated the crucial importance ofageing-specific policies that are evidence–based. At the same time, given

the multi-dimensional and dynamic nature of this measure, concerns were expressed by theparticipants regarding the methodology used in the creation of the Index, including the composition
and weights used. It was also argued during the discussion that the indicators in each domain could
be expanded and made more specific. Additional indicators that could show if a society is ageinclusive or not, thereby providing a “litmus test” regarding existing ageism and/or negative
stereotypes of ageing, might be also helpful. Most participants agreed that the debate during theonline discussion itself was useful, as it raised awareness as to the paucity of data in certain areasof ageing-specific policies and will encourage policy-makers, experts and society at large to better
understand the data that are available.
For more details please see: http://www.helpage.org/global-agewatch/
 Investing in Women’s Employment is Good for BusinessCompanies that invest in women’s employment gain an important comparative advantage-- that is
the main conclusion of a report prepared by the International Finance Corporation ( IFC)—themember of the World Bank Group focused exclusively on private sector development. This report—
Investing in Women´s Employment: Good for Business, Good for Development—is the first result of
the WINvest ( Investing in Women) initiative launched by the World Bank group in 2012 and aimed
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at expanding opportunities for women as leaders, entrepreneurs and employees. The IFC reportdraws on members’ experiences and encourages business to tap and manage female talent inemerging and developing markets. Employment that leads to higher wages and greater decisionmaking for women is beneficial to society in numerous ways, including positive influences on theways households spend money on children’s nutrition, health and education The case studies
provide vivid examples of how leading companies have benefited by investing in policies that
support women employees.
Despite the ample evidence that gender equality has a transformative effect on productivity andgrowth, women’s full economic and productive potential remains unrealized in many countries
around the world. The data provided in the report demonstrate that women continue to beunderrepresented in formal and higher value-added employment. That is happening,
notwithstanding the fact that, globally, women’s education levels have increased and educatedwomen now earn more than their uneducated peers; according to the report, the persistence ofgender gaps in labor-market participation and wage levels remains a cause of concern.
When women and men alike participate fully in the labor market, economic growth is more robust
and sustainable. The ultimate goal of the IFC research is to help companies better understand andcapture the business case for supporting women’s employment, and provide insight into theapproaches that work best.
For more details please go to:
http://www.ifc.org/wps/wcm/connect/topics_ext_content/ifc_external_corporate_site/ifc+sustainab
ility/publications/publication_report_investinginwomensemployment
 Useful resources and links.
ICTs and the Health Sector : Towards Smarter Health and Wellness Models
According to a recently released OECD study, health and wellness are an increasingly important
topic of discussion, because of social and demographic changes in member countries, the rise inchronic diseases, and the need to improve the efficiency and quality of healthcare delivery. The
future sustainability of health systems will depend on how well governments are able to anticipate
and respond to efficiency and quality-of-care challenges. Determined action is required, as well as
willingness to test innovative care delivery approaches. A whole new world of possibilities using
mobile phones and the Internet to address healthcare challenges has opened up. The potential ofmobile devices, services and applications to support self-management, behavioral modification and"participatory healthcare" is greater than ever before.
For more details please go to: http://www.oecd.org/sti/ieconomy/ict-and-the-health-sector.htm


The Global Partnership for Development: Achievements and Obstacles

The MDG Gap Task Force Report 2013 released by the United Nations, entitled, “The Global
Partnership for Development: The Challenge We Face,” tracks delivery on commitments listed
under Millennium Development Goal 8—the global partnership for development— including aid,
trade, debt relief, access to essential medicines and access to new technologies.
To deepen the global partnership of UN Member States, international organizations, civil society,the private sector and others, the report makes many recommendations, including ones for
stopping tax evasion, strengthening manufacturing safety standards, dealing with unsustainabledebt and improving financial regulation and the rules for global trade, while also asking all partners
to live up to their commitments already made in support of achieving the MDGs.
For more details: http://iif.un.org/content/global-partnership-development-challenge-we-facePage 6 of 7

The content of this Global Newsletter may be freely reproduced or cited provided the source isacknowledged. Views do not necessarily represent policies of ICSW.
Newsletter Editor: Sergei Zelenev, Executive Director
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Entebbe, Uganda
Phone +1 718 796 7417, E-mail: szelenev@icsw.org, icsw@icsw.org
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