At the turn of the twenty first century eighteen percent of the population, some 10.7 million people, were over pensionable age 4.5 million of these were over the age of 75. It is likely that by 2021 this will have increased to 12.2 million (Moore, 2002). It is certainly the case that in the last hundred years people's life expectancy has increased dramatically placing greater demand on the health service and on caring services generally. Many older people remain in their own homes and at some stage receive some kind of care to help them remain there. In England there are presently about 200,000 people in registered residential homes, 35,000 are in homes run by the local authority and 165,000 in independently run homes, there are a further 150,000 in nursing homes. For every 1000 people over retirement age six will be in residential care by the age of seventy five.
Giddens (1989) maintains that in the west there is less respect for the elderly than there is in more traditional societies. In spite of this lack of respect crime statistics tend to suggest that older people are the least likely to be the victims of crime (Ward et al, 1986). The marketisation of care, and the growth of private care homes means that there is some evidence to suggest that the elderly may be more at risk of abuse of their rights and criminal assault in residential settings than they are in their own home. This paper therefore, will investigate the notion that fear of crime among and against the elderly is dependent on locale.
Crime and the Elderly
The elderly are concerned about crime and about their ability to cope with the trauma, this is particularly the case for women. A Welsh study of older burglary victims in sheltered accommodation found that older people had more difficulty recovering from the event than did younger ones (Donaldson, 2003). However, figures from the British Crime Survey 2001, tend to suggest that the likelihood of being a victim of crime decreases with age. Burglary figures for 2001 show that in 1000 households of people aged between 16 and 24 17.6% had been burgled whereas in 1000 households with residents of 75 and over only 2% were burgled (Kershaw et al, 2001). In spite of this much of the recent crime initiatives have been targeted at the safety of the elderly. Some writers maintain that although crimes against older people are low they tend to worry more about crime and will say that they feel unsafe walking the streets. Chivite-Matthews and Maggs (2002) contend that both older and younger people are particularly concerned about the crime of mugging. Donaldson (2003) is of the opinion that this targeting may be a factor in attempting to persuade older people to remain in their own homes.
One of the reasons that crime reduction strategies are aimed at protecting older people is because most of us have a particular aversion to crimes against the elderly. Government have launched successive initiatives such as Safer Cities Programmes and Burglary Prevention strategies to combat the fear of crime amongst the old. Abbott and Sapsford (2005) maintain that in middle class neighbourhoods such initiatives are well co-ordinated and older people feel safer, in less well off localities it was found that they were not so well catered for and remained afraid of crime. Their research in Middlesborough found that one in three had been burgled in the last five years, a figure which is significantly higher than that given by the British Crime Survey. Clearly the fear of crime among the elderly is not entirely unfounded and may depend on where they live.
Donaldson (2003) argues that in some cases the fear of victimisation is so great that it prompts some older people to move from their own homes into sheltered, or residential accommodation. Given increasing concerns over abuse of the elderly the question has to be raised as to whether older people who enter residential care (particularly when concerned about crime) are going from the frying pan into the fire. While most crime prevention strategies are neighbourhood based there is increasing evidence to suggest that perhaps there needs to be more investigation of what goes on in 'care'. Are older people safer in residential accommodation or is 'care' a euphemism for garaging the old, taking their money and subjecting them to physical neglect and assault.
Older people are a marginalised group. Society sees them as no longer useful and yet greater consumers of health and other services (Moore, 2002). Those people who feel they can no longer cope alone, or whose relatives feel that they cannot go on caring for them at home, go into residential or nursing homes. The introduction of market forces into the care sector has meant that many of these institutions are privately owned and run for a profit. Even in council run homes people are expected to at least contribute to the cost of their care. The people who staff such places are usually overworked and underpaid and so some older people are at risk of neglect and abuse in a place that purports to offer care and safety.
Ford and Stepney () maintain that care provision is overshadowed by the desire to reduce costs and this has the effect of reducing choice for older people and thus disempowering them. The Community Care Act of 1990 shifted responsibility of care from central government to local authorities, ostensibly it was envisaged that this Act would increase consumer choice. What has happened is that some older frail people become socially disenfranchised and are placed in accommodation that is not the best and can put them at risk of neglect and abuse. Moore (2002) points out that some commentators have argued that a mixed economy of care and the move away from public provision to one that was based on profit making: would actually lower the standards of care, as profit rather than public service becomes the overriding motive(this) will lead to a narrowing of choiceclients being seen as receiving charity(and) the extent and the quality of services will differ from place to place (Moore, 2002:259).
Terminally sick older people are often discharged from hospital too early and put straight into nursing homes because under the terms of the Act they did not have the right to occupy a (free) NHS bed indefinitely (Ford and Stepney, ibid). As the number of NHS beds has declined so there has been a rise in the number of transfers of older people to nursing and residential care (and a corresponding growth in that sector) that carries with it a cost implication (South, 1999). Moving older people from hospital into nursing and residential homes has resulted in many of them dying soon after being moved (Neil and Williams, 1994). The death rate increased to such a level that by 1997 there were official enquiries as to the reason. Smart (1997) found that it was not often recognised that caring for dying people required special skills and conditions. Some of this is down to a lack of acknowledgement of older people's human rights and to a lack of inter-agency co-operation and mismanagement.
Jordan (2000) cites a case of a recently retired man who had a stroke and was discharged into a nursing home. He was unhappy and was transferred elsewhere his condition deteriorated and he had a further stroke staff made no effort to ensure that he was properly nourished (even though his brother had pointed this out and complained). The man died of starvation. Where patients are denied their rights to sufficient treatment and then transferred and often have their condition re-classified their rights are ignored. Concerns over cost and the failure to communicate effectively often results in the (albeit unintended) neglect and abuse of older people. This is the hidden face of abuse. In some care homes concerns for profit and staff working conditions mean that older people are at risk of intended neglect and physical abuse and assault. As a response to poor standards in care homes in 2000 the Government introduced the Care Standards Act. However, more recent stories of the abuse of older people in care who are force fed, suffer from unattended bed sores, and are brutally treated (Observer, 18th February, 2001) tend to raise questions of how the Government intends to enforce the levels of care referred to in the Act.
This paper has investigated older people's fear of crime and has assessed where that crime is most likely to take place. The marketisation of care has brought with it a host of problems, with no central control it is difficult to enforce a code of behaviour and standards yet clearly some older people in residential care are in need of protection. They are more likely to be a victim of crime in residential care than they are in their own homes. Slater (2002) has argued that policies surrounding care and the protection of older people in the care system are still evolving. It might then be argued that some kind of initiative designed to seek out and target areas of abuse should have the same kind of attention as do crime initiatives in the public arena as it is clearly the case that some older people in 'care' are at risk of criminal neglect and abuse.