How would you like to be cared for? Put yourself in my place.

As the United Nations points out, "the abuse of older persons is a global social problem affecting the health and human rights of millions of older persons around the world, and a problem that deserves the attention of the international community".

The Resolution adopted by the General Assembly on 19 December 2011 declares 15 June as World Awareness Day against Abuse in Old Age, a day of reflection and debate on intolerable behaviour that violates the most basic rights of people, especially those in situations of vulnerability, fragility and dependency.

Although international organisations have rightly described the abuse of the elderly as a major public health problem, it is also important to highlight the ethical significance of this type of behaviour, which is directed at people in a situation of fragility, dependence, cognitive deterioration, etc., in short, at a particularly defenceless sector of this society which we are building and to some extent enjoying every day.

The fact is that when we talk about the elderly, the very elderly, and in many cases their capacity to make decisions is very much reduced, we are dealing with a group of citizens with whom the threshold of tolerance with their daily life is excessively high. Many years ago we denounced the fact that situations that have become normal for this group of people would be unthinkable for other profiles of people: admission to institutions without their approval, organisation of daily life from a barracks model, continuous infantilisation in their social life, transmission of an image of social expenditure and burden on old age with an apparent academic basis...

Although the issue has recently begun to gain visibility, elder abuse is still considered a taboo subject, often a private matter that must remain hidden, and where the victim is often financially dependent on the abuser. Perhaps that is why it continues to be one of the least researched types of violence, absent from national surveys, and also forgotten or minimized in the gerontological planning of countries.

Mayte Sancho – Directora de Planificación de Matia Fundazioa

Today we spoke with Mayte Sancho, Director of Planning at Matia Fundazioa, to address this issue:

Q.- Mayte, on more than one occasion you have argued that discrimination is the basis for inappropriate treatment. In the same line, Alana Officer (of the WHO) talks about ageism as a type of socially accepted discrimination: "From a very young age we unconsciously internalize negative attitudes and stereotypes associated with old age that explain why older people often try to stay young and feel ashamed of getting old". Why is it so hard to socialise this kind of abuse? How can this view be changed?

Indeed, stereotypes, age discrimination and poor treatment are strongly related. I believe that the issue of "roles" associated with professional activity is one of the determining factors for these perverse associations.

When people retire, they lose their professional role, which gives meaning and space to their life. If we lose the function, the social role, we also lose part of our social value. In practice, this is the case and opens the way to treat a person differently. What if we start to think that a nurse is always a nurse and we keep her profession in our dealings with her? It would be worthwhile to have systematic observation on these aspects: how we communicate with a person when they tell us that they are "retired", when it seems that having been a seamstress, doctor, manager or plumber no longer makes sense and the "homogeneity" of age is imposed: we begin to speak up to these people, we try to help them when they do not need it, in short we infantilise communication, with all its consequences.

Q.- And in your opinion, what is the reality in the centres? Are the people living in them "well cared for"? Are the cases of malpractice isolated or are we facing an underlying problem, something systemic?

I believe that in general the care offered in residential homes for the elderly is correct. The professionals have sufficient skills to care properly.

But since we work within the framework of People-Centred Care, we try to go beyond what is technically correct. The reflection on people's dignity, challenges us every minute, especially because they need a lot of help, and also affective communication, interaction and this that qualitative research has identified as "putting oneself in their place".

In Matía, around this kind of slogan, we have produced a set of audiovisual materials that stage situations of treatment that can be improved, that do not constitute mistreatment, but that are far from what we could describe as good care. We have also recorded simple, everyday, multidimensional scenes of "good treatment". Good treatment has multiple manifestations, it is not unidirectional, but it is offered in coherence with the personality characteristics of each one, with total naturalness. With these materials and a small guide to their use, we are validating this initiative in our centres with excellent results.

What we see at first sight is that "the tolerance threshold" for inappropriate behaviour is clearly changing. And some behaviours are becoming extinct.

Some of these results will be presented in the Summer Course: "Good treatment and aging. Practical implications" which we are organising with the UPV and Zahartzaroa on 11 and 12 July in Donosti, and which I strongly encourage you to take part in.

Q.- Do you think that interventions of this kind should also be made in community settings?

Of course. Childhood is the best time for children to integrate equal treatment with the elderly into their behaviour. From mutual respect, but also from the equality and affection generated by feeling cared for every day by older people, their grandmothers and grandfathers. What better time than this stage in which care and "pampering" appear naturally in relationships.

I also believe that it is fundamental that in the most specialised professional environments, we review our behaviour and appreciation of older people, especially when they need help.

Today Matia is broadcasting a small video (THE BEST FOR HER) which clearly reflects what it means to behave without taking into account either the wishes or the opinion of people when making decisions that will change the course of their lives. It is terrible that these situations occur so often.....