The abuse and mistreatment of Aboriginal and Torres Strait Islander older people

Overview of research

The abuse and mistreatment of older people is a serious social, human rights, health and justice problem in Australia.

This research project focuses on the abuse and mistreatment of Aboriginal and Torres Strait Islander older people. It builds on our knowledge of the nature and prevalence of abuse and mistreatment in the National Elder Abuse Prevalence Study (Qu et al., 2021) commissioned by the Australian Attorney-General’s Department. It does this by providing a more nuanced understanding of the nature and dynamics of the abuse and mistreatment experienced by Aboriginal and Torres Strait Islander older people and how this differs from the general population in the context of ongoing colonialism and systemic racism and discrimination, together with intergenerational trauma.

The project, commissioned by the Australian Attorney-General’s Department, has been led by Professor Victoria Hovane and Ralph Mogridge with the support of the Australian Institute of Family Studies (AIFS).

The research gap

The National Prevalence Study was the first study to provide comprehensive data on the nature and prevalence of elder abuse for the general population in Australia. However, it was clear that more specific research was required to better understand the nature and quantum of abuse and mistreatment of Aboriginal and Torres Strait Islander older people.

To date, while there have been discrete studies on aspects of abuse and mistreatment of Aboriginal and Torres Strait Islander older people, there is limited nationwide data to measure how widespread it is within communities and how it is framed and understood by those communities.¹

Research design

This research project has been designed to contribute to addressing the research gap. A near-national project, it is the largest scale Australian research study undertaken with Aboriginal and Torres Strait Islander older people about the abuse and mistreatment that they experience in older age.

The exploratory, qualitative research design employed for this project best supported the culturally safe collection and analysis of data to build on our knowledge of the abuse and mistreatment of Aboriginal and Torres Strait Islander older people, with respect to this target population by:

1. supporting improved understanding of Aboriginal and Torres Strait Islander older peoples’ specific experiences of abuse
2. informing measures to address barriers to accessing services, programs and initiatives that address Aboriginal and Torres Strait Islander older peoples’ specific needs.

To ensure the cultural safety of participants and to uphold the principle of self-determination in research, this project has been led by Aboriginal researchers working in consultation with Aboriginal and Torres Strait Islander communities.

It comprises:

1. Community engagement specific to the fieldwork with identified ACCOs and ACCHOs in each state and territory in 2 phases:
   1. scoping relevant ACCOs and ACCHOs (n = 18) to inform them about the research and provide further information about getting involved
   2. detailed discussions with the interested ACCOs and ACCHOs (n = 12) about the specific arrangements for yarning circles and interviews, local cultural protocols that need to be followed, and the needs and requirements of each community.
2. Desktop review of Australian peer-reviewed and grey literature (published up until the time of the current project) on the abuse and mistreatment of Elders and Aboriginal and Torres Strait Islander older people and the abuse and mistreatment of older people in the general population. Informed by the Cochrane rapid review approach,² this comprised 30 in-scope studies and 15 items of broader academic research literature to provide essential context for understanding the abuse and mistreatment of Aboriginal and Torres Strait Islander older people. 
   The reporting of this component also incorporates analysis of data from the National Prevalence Study, including from Aboriginal and Torres Strait Islander older people aged 65 years and older who participated in the study (n = 85).
3. Yarning circles and interviews with Elders and Aboriginal and Torres Strait Islander older people with 190 women and men aged 50 years or older from across Australia, in each state and territory (including the Torres Strait Islands) except for the Australian Capital Territory (ACT). This comprised:
   1. 19 yarning circles with 181 people
   2. 8 interviews with 9 people.

Research aim and questions

The research aims and questions of this report were designed to improve our understanding of:

• the forms of abuse and mistreatment experienced by Aboriginal and Torres Strait Islander older people
• what causes it, who experiences it, who uses it, how it affects people, how people seek help for it, and how services respond to it.

This report presents the findings from this research project based on the yarning circles and interviews with Aboriginal and Torres Strait Islander older people, together with the desktop review and National Prevalence Study data. It includes case studies from the perspectives of these Aboriginal and Torres Strait Islander older people. It also identifies promising approaches to target responses to abuse and mistreatment for Aboriginal and Torres Strait Islander older people.

These findings may be used to inform the 5-year action plans that will be developed out of the new National Plan to End the Abuse and Mistreatment of Older People 2025–2035.

The definition of abuse and mistreatment applied in this project is the working definition for research that was developed for the National Prevalence Study.³ This definition, which is broader than the widely accepted World Health Organization (WHO) definition, is:

a single or repeated act or failure to act, including threats, that results in harm or distress to an older person. These occur where there is an expectation of trust and/or where there is a power imbalance between the party responsible and the older person.

The extended scope of this definition, to include circumstances where there is a power imbalance, facilitates the exploration of additional types of abuse and mistreatment that may be experienced by particular groups, such as LGBTIQA+ older people, and captures systemic issues and discrimination, which were included in this project as an additional type of abuse and mistreatment.

Quantifying prevalence and nature of abuse

There are important limitations and considerations in relation to determining the prevalence and types of abuse and mistreatment of Aboriginal and Torres Strait Islander older people in terms of both a comparison with the National Prevalence Study as well as the qualitative nature of this research.

The limitations of analysing data from Aboriginal and Torres Strait Islander participants in the National Prevalence Study relate to:

• Sample size: Although Aboriginal and Torres Strait islander older people were broadly sampled in line with their population representation, the analysis of outcomes for Aboriginal and Torres Strait Islander people is based on 85 survey responses, compared to 6,892 non-Aboriginal and Torres Strait Islander responses. Correspondingly, there are large confidence intervals associated with the estimates for Aboriginal and Torres Strait Islander outcomes, and analysis by gender was not possible due to the sample size becoming too small when separating men and women.
• Method: The method used in the National Prevalence Study was computer-assisted telephone interviews to landline and mobile phone numbers in 2020 and excluded those without access to a phone. This exclusion is particularly relevant to older Aboriginal and Torres Strait Islander people living in remote and regional areas and means the National Prevalence Study sample is unlikely to be representative of the overall Aboriginal and Torres Strait Islander population.
• Target population: The target population for the National Prevalence Study defined older people as aged 65 years and older who live in private dwellings (i.e. in community settings) and have the capacity to engage successfully in an interview. This age threshold contrasts with that applied in the recruitment of Aboriginal and Torres Strait Islander people for the yarning circles and interviews, which was 50 years and older. This age limit is consistent with the definition applied in national research and government health and aged care.⁴

With these caveats in mind, the National Prevalence Study analysis presented here nonetheless provides some useful context to describe the extent to which Aboriginal and Torres Strait Islander older people experience abuse, abuse types experienced and how these differ with the experience of non-Aboriginal and Torres Strait Islander people.

In relation to the data from the yarning circles and interviews, it is important to acknowledge that:

• The research design is qualitative and exploratory. It was not designed to capture prevalence and there are limitations when interpreting the data in reference to the National Prevalence Study data.
• Participants in the yarning circles talked about experiencing or knowing about several kinds of abuse and mistreatment that were happening in their communities, and not just directly to them.
• There are features of the abuse and mistreatment of older people that participants described which are specific to Aboriginal and Torres Strait Islander communities, and although experiences did sometimes differ between communities, challenges were not unique to particular locations.
• The Aboriginal and Torres Strait Islander older people participating in the study, particularly in the yarning circles, may not necessarily have felt comfortable to detail their individual concerns about, or experiences of, abuse and mistreatment in the group setting; and it was not possible to gauge whether all participants in the yarning circles agreed or disagreed with other participants’ shared views or experiences. This is reflective of the nature and dynamics of group discussions and needs to be acknowledged when interpreting the data.
• The qualitative methodology was developed to support a deeper understanding of the abuse and mistreatment of Aboriginal and Torres Strait Islander older people in a culturally safe way, rather than with a view to measuring its prevalence. For the purposes of facilitating a group discussion, participants were also permitted to reflect on the abuse and mistreatment that they or other Aboriginal and Torres Strait Islander older people in their community had experienced. Also, unlike the National Prevalence Study, the discussion of abuse and mistreatment in the yarning circles and interviews was not limited only to experiences occurring in the 12-month period preceding the fieldwork.
• Aboriginal and Torres Strait Islander older people participating in this research did not necessarily describe experiences of abuse and mistreatment in the distinct categories that Western research has ascribed to the 5 key types of abuse measured in the National Prevalence Study.
  • Therefore, the qualitative data does not ‘fit’ perfectly within the National Prevalence Study key types of abuse, not only because of the different methodologies noted above but also because the lived experience of Aboriginal and Torres Strait Islander older people does not necessarily match these 5 distinct key types. Types of abuse can be intertwined, and abuse and mistreatment can be conceived differently by Aboriginal and Torres Strait Islander peoples. This is discussed further in the Introduction (section 1.2.3, defining domestic and family violence) and in chapter 3.
  • Additionally, the types of abuse and mistreatment, and the abuse and mistreatment cannot be separated from the systemic factors affecting Aboriginal and Torres Strait Islander individuals, families and community and intergenerational trauma experienced over the life course.

Overview of key findings

Forms of abuse and mistreatment experienced by Elders and Aboriginal and Torres Strait Islander older people

Aboriginal and Torres Strait Islander older people experience a broad range of abuse and mistreatment.

This includes each of the 5 forms of abuse and mistreatment analysed in the National Prevalence Study.

Data from the National Prevalence Study show that 23% of Aboriginal and Torres Strait Islander older people aged 65 years or older reported experiencing at least one form of abuse, compared to 15% for non-Aboriginal and Torres Strait Islander older people in the same age range.

Table 1: Reports of different types of abuse reported by participants in the National Prevalence Study

Notes: Reports are of experiences of abuse or mistreatment in the 12-month period preceding the survey in 2020. Data are from the National Prevalence Study participants aged 65 years or older based on a sample size of 7,000 CATI survey. This table includes 95% confidence intervals with an upper and lower bound, and the value for the population is expected to fall between these bounds with a 95% degree of confidence.

The difference in overall rates of abuse and mistreatment between the 2 groups appears to be driven by greater reporting of psychological abuse for Aboriginal and Torres Strait Islander older people (23%), compared to 12% for non-Aboriginal and Torres Strait Islander older people. Rates of neglect were also doubled for the Aboriginal and Torres Strait Islander sample (6% cf. 3%).

The responses for the other National Prevalence Study types of abuse (financial, physical and sexual abuse) were broadly similar, particularly when accounting for the small sample sizes of Aboriginal and Torres Strait Islander older people.

Noting the limitations of this research outlined in the previous section, insights in relation to the 5 National Prevalence Study abuse and mistreatment types drawn from the 27 yarning circles and interviews show financial abuse and psychological abuse were the most frequently discussed of these 5 forms.

• Frequencies of financial and psychological abuse discussions were similar for women and men and across locations. More than three-quarters of yarning circles involved these discussions, and financial abuse and psychological abuse were frequently mentioned together.
• Approximately half of the yarning circles and interviews discussed physical abuse, with this discussed in about half of all location types and slightly greater proportion in metropolitan locations compared to regional and remote locations and slightly more often in women’s yarning circles and interviews.
• A very small number of yarning circles and interviews raised concerns about neglect, with this raised slightly more by women. There were no differences across location areas.
• Sexual abuse was raised in a very small number of yarning circles and interviews and only in relation to other Aboriginal and Torres Strait Islander older people that participants knew and somewhat more raised by men. There were no differences across location areas.

In addition to those 5 types of abuse, Aboriginal and Torres Strait Islander older people uniquely experience different forms of abuse and mistreatment that reflect the cultural context of Aboriginal and Torres Strait Islander communities and the influence of institutions on their lives:

• institutional and systemic abuse (abuse Aboriginal and Torres Strait Islander older people experience in their interactions with institutions, systems and services)
• ‘humbugging’ (repeated requests or demands for money or resources, with harassment sometimes accompanied by threats)
• resources abuse (the older person’s food, fuel or time taken by other people without paying for or replacing the resource, including taking resources without asking the older person).

The data from the yarning circles and interviews place a greater emphasis on the experience of institutional and systemic abuse than was evident in the research literature contained in the desktop review, with that research tending to focus on financial abuse and humbugging. Specifically:

• Of the 27 yarning circles and interviews, 22 discussed institutional and systemic abuse, while financial abuse in the forms of humbugging and resources abuse was raised in 25 and 15 yarning circles/interviews, respectively.
• Men and women discussed institutional and systemic abuse in similar proportions although women raised these concerns in slightly more yarning circles and interviews than men and raised slightly more often in metropolitan locations than other locations.
• Men’s and women’s yarning circles and interviews raised humbugging in similar proportions although men raised these concerns in slightly more yarning circles than women, and discussions were similar across locations although in slightly greater proportion of metropolitan and remote yarning circles compared to regional yarning circles. However, women who did raise humbugging sometimes discussed the issue in more depth (and frequency) within an individual yarning circle than men.
• Humbugging was one of the most consistently referred to themes in yarning circles and interviews. The connections between humbugging and emotional and verbal abuse emerged in near unanimity when humbugging was raised.
• Resources abuse was raised slightly more often in women’s yarning circles and interviews than men’s and this issue was raised slightly more often across metropolitan and remote locations than regional locations.

The contextual backdrop relevant to the abuse and mistreatment of Aboriginal and Torres Strait Islander older people is made up of the ongoing impact of:

• colonialism and intergenerational suffering and disadvantage arising from loss of family, children and culture
• racism and discrimination
• associated factors such as:
  • lateral violence and other everyday expressions of trauma, such as high levels of substance use
  • disconnection from culture and decreased respect for Elders with the breakdown in the system of reciprocity and the fracturing of traditional family and community structures for caring, wellbeing, boundaries and behaviour regulation
  • disadvantaged living conditions and lifelong stress and trauma.

Implications

The breadth of these experiences of abuse and mistreatment indicates that prevention and response services must be able to address the experiences of Aboriginal and Torres Strait Islander older people of:

• the 5 forms of abuse examined in the National Prevalence Study, as well as
• the different forms of abuse and mistreatment specific to Aboriginal and Torres Strait Islander older people.

This illustrates the importance of flexible, Aboriginal and Torres Strait Islander-led prevention and response activities that are place-based and involve localised decision making about their design, development and implementation. These activities also need to be adaptive to the numerous and overlapping forms of abuse and mistreatment that can be experienced by Aboriginal and Torres Strait Islander older people.

Societal and community factors in the cases and context of abuse and mistreatment

The effects of colonisation and colonialism, racism and discrimination are profound and enduring, and they shape how a range of forms of disadvantage and harm are experienced by Aboriginal and Torres Strait Islander people, including the abuse and mistreatment of older people. Three-quarters of yarning circles and interviews raised racism, with concerns about the ongoing effects of colonialism specified more than one-third of the time.

Intergenerational trauma emerged in three-quarters of yarning circles and interviews as part of the context for abuse and mistreatment over the life course of Aboriginal and Torres Strait Islander older people. Due to the experience of intergenerational trauma and disadvantage and discrimination across the life course, Aboriginal and Torres Strait Islander people face living conditions that put them at greater risk of experiencing abuse and mistreatment – including economic, food and housing insecurity, as well as factors such as earlier ageing and poor health.

According to traditional cultural practices, Aboriginal and Torres Strait Islander people are bound by the system of reciprocity. It ensures that resources and caring are shared among families and communities, so everyone is looked after, and families and communities survive and thrive. However, this practice can be eroded and is problematic when it becomes one-sided or inconsistent.

Relatedly, many Aboriginal and Torres Strait Islander people are disconnected from their culture, with the fracturing of knowledge and understanding of key elements of culture due to the fracturing of families and connection to culture as a result of ongoing colonialism. Several of the behaviours that participants spoke about in their experience of abuse and mistreatment were linked to the loss of respect and where the reciprocal obligations within families that are associated with caring for Aboriginal and Torres Strait Islander older people were not observed.

Implications

The forms of abuse and mistreatment experienced by Aboriginal and Torres Strait Islander older people are often interconnected and overlapping in nature, and reflect the ongoing impact of colonialism, racism and discrimination and cannot be disentangled from these societal and community factors.

This has implications for the design, development and implementation of effective prevention and response activities that are place-based and involve localised decision making, and which are holistic and deal with the underlying causes and contextual factors. Prevention and response activities that address fractured family and kinship systems, cultural knowledge and the practice and modelling of reciprocal obligations, in their local context, are enablers of holistic measures that address these underlying causes and contextual factors.

Individual, relationship and family factors for people who use abuse and mistreatment

A range of individual, relationship and family factors were identified within all the research components, as often being present for people using abuse and mistreating Aboriginal and Torres Strait Islander older people.

These were: substance use, gambling and financial hardship, followed by being a younger family member of the older person, and living with lateral violence in their family and community. The use of drugs and alcohol and engagement in gambling were raised in three-quarters and one-quarter of the yarning circles and interviews, respectively. Financial hardship often overlapped with alcohol and other substance use and gambling, alongside financial abuse. Concerns were also raised about the challenges younger family and community members experience and a lack of respect for Elders and Aboriginal and Torres Strait Islander older people linked to abuse and mistreatment, along with some people living with lateral violence in their family and community. These factors highlight the challenges facing families and communities characterised by intergenerational trauma, grief and poverty.

For participants in the National Prevalence Study (including non-Aboriginal and Torres Strait Islander respondents):

• the use of alcohol and other substances, gambling and financial hardship were also characteristics present for people abusing and mistreating them
• overall, younger people, typically sons and daughters, were most commonly nominated as engaging in abuse and mistreatment, specifically financial abuse, physical abuse and psychological/emotional abuse, to a statistically significant extent.

Participants commonly described threats, humbugging or pressuring Aboriginal and Torres Strait Islander older people for money to support substance use or gambling. When coupled with Aboriginal and Torres Strait Islander older people’s sense of reciprocal obligation, these behaviours led many to feel stressed and distressed.

Demands for money to support substance use or gambling by family members were linked to additional pressure on Aboriginal and Torres Strait Islander older people to provide support with food, giving family access to their car, or for other forms of financial support.

Implications

As with the societal and community factors, these findings show that abuse and mistreatment of Aboriginal and Torres Strait Islander older people cannot be separated from individual, relationship and family factors and the context in which abuse and mistreatment is used.

As such, culturally safe and holistic responses are important in relation to the coping mechanisms identified in the research literature included in the desktop review and yarning circles, including substance and other addictive behaviours, and in relation to experiences of racism and discrimination. These are important considerations for policies and strategies such as the National Plan activities.

Specific engagement with people using abuse and mistreating Aboriginal and Torres Strait Islander older people is required to develop a deeper understanding of perpetration and the range of people engaging in this behaviour. This will better inform the development of prevention and response activities for Aboriginal and Torres Strait Islander older people.

Individual, relationship and family factors for people experiencing abuse and mistreatment and its effects

Some Aboriginal and Torres Strait Islander older people may be at greater risk of abuse and mistreatment in circumstances involving individual, relationship and family factors where there is an imbalance of power or where the older person’s independence is reduced.

This dependence or power imbalance was identified where the Aboriginal and Torres Strait older person had:

• health conditions and support needs (including disability or other health challenges e.g. dementia), that led to dependence on others such as family, carers or friends for support and decreased independence, and may be accompanied by isolation
• family and cultural responsibilities involving obligations to look after family and others in the community and share resources, including financial resources
• lower income and disadvantaged living arrangements, associated with economic insecurity and financial stress, food insecurity and housing insecurity, overcrowded living arrangements or homelessness.

Risk factors for abuse and mistreatment include a lack of access to services and community connections or otherwise being isolated or separated from support networks, which can be exacerbated in rural and remote locations.

The impact of abuse and mistreatment includes stress and mental health decline, feeling unsafe, tiredness and lack of sleep, poverty, loneliness, isolation and loss of relationships.

Implications

The identification of some Aboriginal and Torres Strait Islander older people as being at greater risk of abuse and mistreatment because of personal, relationship and family factors highlights the need to address compounding disadvantage with measures that respond to health, housing and financial stress, as part of abuse prevention and response activities.

This again indicates the need for culturally safe and holistic responses to address the underlying individual, family and relationship factors, with these responses being community-designed and led so that activities are underpinned with the Aboriginal and Torres Strait Islander world view and focusing on building on their strength and resilience.

Seeking help for abuse and mistreatment

Most people who experience abuse or mistreatment do not seek help or advice.

• Almost two-thirds (62%) of participants in the National Prevalence Study indicated that they did not seek help (including non-Aboriginal and Torres Strait Islander participants).⁵
• Data from all research components suggest that many Aboriginal and Torres Strait Islander older people who participated in the research do not report or seek help and do not use the specialist elder abuse services that are available in each state and territory. It is noted that the semi-structured interview schedules included questions about help-seeking behaviours and experiences of services, along with questions about available supports in the community. Where necessary, additional prompts were sometimes necessary to seek further insight into whether Aboriginal and Torres Strait Islander older people would use specific services, including telephone helplines.
• Overall, participant responses to these questions about help seeking often centred around the roles of local and dedicated Aboriginal and Torres Strait Islander services and their satisfaction levels with the provision of that support (discussed further in chapter 8 to improve service responses). Some participants reflected on the presence or absence of culturally trained staff and culturally sensitive practices across general services (e.g. medical and health). Some also shared insights into how these factors influenced their willingness to access existing specialist elder abuse services or Aboriginal and Torres Strait Islander specific supports.
• However, many of the participants in the yarning circles and interviews described the support that they receive from their local ACCOs who help them to feel valued and connected but also help with practical things such as transport.

More specifically, some things that encourage help seeking include:

• physically safe environments away from the person using the abuse or mistreatment
• connecting with trauma-informed, culturally safe services that are Aboriginal and Torres Strait Islander-led (including service providers the older person already engages with) and that have staff trained to support them to identify abusive behaviour and to encourage people to feel safe to disclose
• linking of relevant services to facilitate access to support
• connecting with community who come together to support those experiencing abuse and mistreatment
• Aboriginal and Torres Strait Islander role models who are community champions against abuse and mistreatment.

Barriers to seeking help were based on systemic issues and on family or personal concerns and included:

• not identifying behaviour as abuse or mistreatment
• experiencing and/or fear of experiencing shame
• a lack of access (including geographic location and technology) to culturally safe services that can assist with the identification of, and response to, abuse and mistreatment
• loyalty to families and communities and not wanting to invoke police or legal responses or otherwise harm relationships
• protection of personal, family and community privacy
• lateral violence including threats of violence or neglect or pushback from family or community
• a lack of information about, or knowledge of, where to go for help or whether they are eligible for help
• not trusting government systems and service providers that may be identified as potentially providing relevant support services.

Implications

The findings from the yarning circles and interviews suggest that consultation with Aboriginal and Torres Strait Islander communities should be prioritised in any government or sector activities to explore effective ways to harness the factors identified as encouraging help seeking, such as communication, acceptance and safety, while minimising barriers such as inaccessibility, fear and shame.

Any consultation should prioritise local decision making through the design, development and implementation of place-based Aboriginal and Torres Strait Islander-led services that can encourage help seeking for abuse and mistreatment. This consultation may inform the action plans from the next National Plan or a specific strategy to address the abuse and mistreatment of Aboriginal and Torres Strait Islander older people.

Improving service responses and education: repair, strengthen and empower

Consistent with findings that encourage help seeking, participants identified that improvements to service responses need to:

• empower Aboriginal and Torres Strait Islander communities to develop strengths-based, community-led and delivered solutions and services that are culturally centred, holistic, flexible, solution-focused and non-judgemental. More specifically:
  • ACCOs play an important role and they need to be supported to do this work in the community to ensure these supports and services can be sustained. This may involve longer term models of engagement and flexibility in funding arrangements that reflect the complexity and more costly service provision in rural or remote locations.
  • Holistic and wraparound service provision was identified as critical. Participants told us that to help the Elders, young people and parents would need to be helped too.
• build awareness and knowledge of what abuse and mistreatment is in culturally appropriate ways, with improved education and skills development for both younger and older community members, as well as the development of targeted programs for those using abuse and mistreatment
• ensure culturally safe responses within mainstream systems and support services that can be tailored, flexible and inclusive in their approach to meet the unique and intersectional needs of different individuals including:
  • information and education about abuse and mistreatment
  • culturally safe access to legal and non-legal (e.g. social workers) services and professionals
  • the placement of service providers trained in culturally safe service provision in mainstream systems and services such as hospitals and other health care settings
  • strengthening the obligations of financial institutions to protect and intervene in financial abuse, including making it harder for other people to access older people’s funds
  • coordinated service provision that supports collaboration and information sharing between practitioners.

More broadly, participants in the yarning circles and interviews emphasised the importance of services that help repair and strengthen connection to family, community, culture and Country. This includes services that:

• are structured in a way that facilitated connections between Aboriginal and Torres Strait Islander older people, as well as with support services, and support intergenerational connection.

Participants in yarning circles and interviews spoke of the importance of supporting ‘upcoming Elders’ and younger people to identify and respond to abuse and mistreatment. This includes exploring effective mechanisms for targeted education and awareness-raising activities for people at risk of - or engaging in - abuse and mistreatment, to understand its nature and impact.

Implications

The yarning circle and interview data, together with the desktop review, show the importance of Aboriginal and Torres Strait Islander-led design and implementation of prevention and response activities that are by Community and for Community.

Collaborative engagement with ACCOs and ACCHOs would support localised decision making, and facilitate the design, development and implementation of place-based, specialist elder abuse services and/or other services to address the needs of Aboriginal and Torres Strait Islander older people (e.g. health and aged care).

As distinct from mainstream specialist elder abuse services, place-based Aboriginal and Torres Strait Islander-led services would enable tailored, holistic service provision that addresses both the specific and underlying needs of Aboriginal and Torres Strait Islander older people, including support that acknowledges the ongoing impact of colonisation and ongoing colonialism and intergenerational trauma and grief. They would also support wraparound services to address other underlying family and community needs (e.g. substance and other addictions).

Co-design of services and supports with communities would better facilitate the delivery of coordinated and holistic support services by Aboriginal and Torres Strait Islander organisations and staff to the older people, families and communities that need them in a way that addresses the underlying causes of the abuse and mistreatment.

However, community fatigue will need to be avoided with the cycle of consultation, both in relation to the amount of consultation and the lack of effective responses to, or implementation of, the community’s repeated feedback. Participants in this research suggested that there be policy guidance on respectful engagement with Elders and Community which could operate as a starting point for future consultation. This approach may include planning priorities for consultation to avoid repeat engagement and fatigue and may also involve a central record for consultations. Guidance from research and ethical protocols regarding participant burden and the relevance and beneficence of research for participating communities – including those provided by the AIATSIS Human Research Committee – may be considered in this regard. Communicating with participants about how the research has informed the action taken is a critical part of this process too.

Conclusion

This near-national project is the largest scale Australian research study undertaken with Aboriginal and Torres Strait Islander older people about the abuse and mistreatment they experience. Importantly, it has been led by Aboriginal researchers to ensure the cultural safety of participants and to uphold the principle of self-determination in research.

A key finding of this research is the consistency of experiences of abuse and mistreatment across vastly different Aboriginal and Torres Strait Islander communities in a broad range of locations across Australia. This consistency in themes in the yarning circles and interviews show that Aboriginal and Torres Strait Islander people, while they vary significantly in cultural practices, language and identities, share experiences of oppression and structural racism and ongoing discrimination that impact their lives negatively and exacerbate and contribute to the causes of abuse and mistreatment of their older people. This overarching theme was the first, and one of the most recurrent abuse types discussed for both men and women in the yarning circles.

Given the unique experiences and impact of colonisation and ongoing colonialism, intergenerational trauma and disadvantage, it is not possible to consider the abuse and mistreatment of Aboriginal and Torres Strait Islander older people in the same framing as that of the broader population.

As such, the abuse and mistreatment of Aboriginal and Torres Strait Islander older people is an issue that has specific features and contextual factors that are causative of the abuse and mistreatment. These must be considered in developing mechanisms for change in prevention, intervention and response.

To appropriately appreciate the depth of the impact of these experiences on Aboriginal and Torres Strait Islander older people, it is important to understand their unique place in Australia as the First Peoples of this country, who remain resilient despite their experiences of ongoing colonialism and oppression.

Important in framing the issue of the abuse and mistreatment is a need to understand that participants’ own narratives also emphasised issues such as the abuse and mistreatment of Elders. It also must be understood within the context of the profound impacts of unhealed intergenerational trauma and grief. Further, Aboriginal and Torres Strait Islander older people carry a lifetime of stress from ongoing colonialism, racism and systemic discrimination, exacerbated by restriction from access to resources across successive generations, giving rise to intergenerational poverty and disadvantage.

Despite experiences of oppression, the Aboriginal and Torres Strait Islander older people who participated in this research spoke at length about the importance of families, their experiences of cultural connection, identity, cultural values and the richness that their connectedness brings to their lives. They emphasised the strength of their communities and the importance of healing.

To uphold the traditionally respected position of Elders and older people in Aboriginal and Torres Strait Islander culture, any proposed solutions should come from the communities themselves.

Therefore, a specific strategy tailored to the needs of Aboriginal and Torres Strait Islander people is required to ensure the history of structural racism and ongoing discrimination and oppression that underpins the abuse of Aboriginal and Torres Strait Islander older people is incorporated into culturally appropriate solutions.

This research also identified promising, strengths-based approaches for targeted responses to, and for Aboriginal and Torres Strait Islander older people. To facilitate reforms in these areas of support, participants echoed the sentiment of those with disabilities and other minority groups, ‘nothing about us without us’. They emphasised the importance of their voices being front and centre of any response and that there must be recognition of community diversity and needs across the country. As noted at various points in this report, there now needs to be consultation regarding the design, development and implementation of Aboriginal and Torres Strait Islander-led services and responses to meet their specific needs. There will also need to be consultation with communities and their Elders to support the identification of research priorities from the perspectives of Aboriginal and Torres Strait Islander people.

¹ Hill, T., & Katz, I. (2019). Insights into abuse of older people: Analysis of Australian Bureau of Statistics datasets. (SPRC Report 3/19). Sydney: Social Policy Research Centre, UNSW Sydney. doi.org/10.26190/5c7494f7499b9; Kaspiew, R., Carson, R., & Rhoades, H. (2016). Elder abuse: Understanding issues, frameworks and responses (Research Report No. 35). Melbourne: AIFS; McEwen, J., Carson, R., Kaspiew R., De Maio, J., Horsfall, B., Brijnath, B. et al. (2024). Evaluation of the National Plan to Respond to the Abuse of Older Australians: Final report (Report). Melbourne: AIFS; Roe, K., & O’Hara, E. (2022). Research into the mistreatment of older Aboriginal Australians: 2022 report. WA Strategy to Respond to the Abuse of Older People (Elder Abuse) 2019–2029. Perth: Government of Western Australia.

² The rapid review guidelines provided by Cochrane support a stepwise hierarchy of article inclusion based on methodology and peer review and this informed the approach taken in this current research project: Garritty, C., Gartlehner, G., Kamel, C., King, V. J., Nussbaumer-Streit, B., Stevens, A. et al. (2020). Cochrane rapid reviews: Interim guidance from the Cochrane rapid reviews methods group. Journal of Clinical Epidemiology, 130, 13–22.

³ Kaspiew, R., Carson, R., Dow, B., Qu, L., Hand, K., Roopani, D., Gahan, L., & O’Keeffe, O. (2019). Elder abuse national research – Strengthening the evidence base: Research definition background paper (Report). Melbourne: AIFS.

⁴ See e.g. Australian Institute of Health and Welfare [AIHW]. (2024). Older Australians. Cat. no: AGE 87. Canberra: AIHW. www.aihw.gov.au/reports/older-people/older-australians/contents/population-groups-of-interest/indigenous-australians; Aged Care Act 2024 (Cth).

⁵ Qu, L., Kaspiew, R., Carson, R., Roopani, D., De Maio, J. A., Harvey, J. et al. (2021). National Elder Abuse Prevalence Study: Final report. Melbourne: Australian Institute of Family Studies, p. 83.