SINGAPORE - There was a small increase in the number of elder abuse cases in 2022, with one common factor behind such abuse being caregivers overwhelmed by the demands of looking after a dependent elderly family member.

In 2022, there were 370 elder abuse cases seen at family service centres (FSCs), up from 338 in 2021 and 283 in 2020. 

The FSCs, which are run by social service agencies and offer a range of help services for families, handle low-risk cases, a spokesman for the Ministry of Social and Family Development (MSF) told The Straits Times for World Elder Abuse Awareness Day on Thursday.

This day has been designated by the United Nations to raise awareness about the abuse of seniors.

High-risk cases, where the senior is facing immediate danger to his safety and well-being, are handled by the MSF’s Adult Protective Service (APS). Ms Crystal Lim, assistant manager at APS, said the service usually intervenes only as a last resort when all other options are exhausted.

In 2022, APS investigated 114 cases involving vulnerable adults aged 65 and older. This is up from 96 such cases in 2020, but slightly fewer than the 120 cases in 2021.

A vulnerable adult is a person aged 18 and older who, because of his physical or mental infirmities, or disabilities, is incapable of protecting himself from abuse or neglect.

The third category of cases is those with moderate to high risk. These are handled by the three protection specialist centres – Care Corner Project StART, Pave and Trans Safe Centre.

These social service agencies specialise in tackling family violence, and handled 49 cases in 2022, up from 45 in 2021 but fewer than 71 in 2020.

The MSF spokesman said: “There has been a slight increase in the number of elder abuse cases over the years but the trend has remained stable.”

Ms Kristine Lam, principal social worker at Care Corner Project StART, said that more reports made to the FSCs islandwide may signal an increase in the awareness and willingness of the elderly to seek help. There are 48 FSCs here.

APS’ Ms Lim said the abuser is typically the senior’s caregiver, such as their children or spouse.

The stress the caregivers face from the demands of caregiving, and their own mental health conditions, are common factors behind the abuse, she said.

“When the stress gets too overwhelming, some may resort to physical violence or neglecting the elderly person’s care needs,” she said. “Or the caregiver may suffer from depression and they react to stresses in an inappropriate manner, which leads to abuse.”

Son gave his father one meal a day

Ms Lim explained that elder abuse takes on multiple forms, such as physical, psychological and emotional abuse.

There are also cases where the caregiver neglects to provide medical care and to see to the senior’s basic needs, like food.

One case that a social service agency had alerted APS to was that of an elderly man in his 90s, who was bed-bound and suffered from severe dementia.

He was found to be severely malnourished, as his son neglected to care for him.

The son, who was his sole caregiver, gave his father one meal a day and failed to give him enough water to drink. Although the family receives financial aid, the son said he was saving that money for his father’s hospital bills or funeral expenses.

He also gave his father a shower only once in a few days, or as infrequently as once a week, Ms Lim said.

She said the man’s mother used to care for his father until she died, adding: “The son said he felt very overwhelmed as he did not know how to care for his father. He also did not have a good relationship with his father in the first place.”

APS worked with its community partners, and they persuaded the son to send his father to a nursing home.

His relationship with his father has since improved, now that he is no longer so burdened by the caregiving responsibilities, Ms Lim said.

One of her biggest challenges in protecting these vulnerable seniors is that they usually do not want the authorities to intervene. 

She said seniors are reluctant to report the abuse, as they fear their relationship with their loved ones would be severed if they sound the alarm.

They worry about who will care for them if they report their caregiver. They also fear the violence will get worse if their caregiver finds out they told on them, she added.

Ms Jamie Soo, lead social worker at Montfort Care, said caregiving takes a huge toll on caregivers’ lives and finances, and some of them are unable to cope with the stresses of caring for a dependent senior round the clock.

She said: “Some caregivers feel that they have no outlet to vent, and they vent it (their anger) on the senior when the stresses accumulate.

“They may not know their actions can be seen as abuse. And so, providing support to caregivers is crucial.”

The MSF spokesman said providing early intervention not only helps the seniors, but also gives knowledge and assistance to overwhelmed caregivers and family members who may unintentionally cause harm to the seniors they are caring for.

“The MSF will continue to work closely with our community partners to step up efforts to protect the elderly from abuse and neglect,” the MSF spokesman added.

If the public suspects an elderly person is abused, they can show empathy and care for the senior, the MSF spokesman said.

They can encourage the senior to seek help by calling the National Anti-Violence and Sexual Harassment Helpline on 1800-777-0000, or make a report on their behalf.