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Is Violence Against Elderly a Neglected Issue? Building State Violence Prevention Capacity through the Preventing Elder Abuse and negleCt initiativE (PEACE)

The issue of elder abuse and neglect (EAN) poses a significant public health and social problem to many societies facing an aging population. Given the enormous health, social and economic costs associated with EAN, there is a dire need for evidence -based immediate actions on elder abuse. However, there remains great paucity in research, practice, and policy dealing with this pervasive issue in many parts of the world (Dong, 2012). Systematic reviews yielded only a handful of studies focused on elder abuse incidence and its causes (Sooryanarana et al, 2012). The dearth of evidence-based intervention and outcomes research in this area (Choo et al, 2013) suggests that more systematic and rigorous research are needed internationally.

In Malaysia, very little is known about this problem in the local context due to lack of specific data available on elder abuse and neglect in the country. Malaysia is likely to reach an ageing nation status by 2035 with the number of people above the age of 60 reaching 15% of the population. Socioeconomic changes, rapid economic growth, and massive migration of younger populations to urban areas have brought about substantial changes in traditional values and greatly weakened the family's perceived obligation of caring for their elder members. The lack of financial support and dependence on children make older persons in Malaysia a vulnerable population for elder abuse and neglect (EAN). In addition, there is no specific law addressing elder abuse and neglect in this country.

Prevent Elder Abuse and Neglect Initiative (PEACE) is a 5-year program which attempts to strategically advance elder abuse and neglect research and services through a statewide effort. The PEACE first target the elderly population in the state of Negeri Sembilan for a period of 5 years starting from 2014-2019. The PEACE program employs a coordinated multistep approach involving various stakeholders (such as Department of Health, Department of Social Welfare, Police, community, NGOs and academia) with the aim to build partnerships, fostering community empowerment and promoting social protection for the elderly population. The PEACE program is developed to increase capacity building, surveillance, intervention and research activities relating to elder abuse and neglect. A series of programmes would be introduced, implemented and evaluated.

There are 6 major components in PEACE;

1.  Profiling the nature and characteristics, risk factors and consequences of elder abuse and neglect in Malaysia

2. Examine the role of social capital (such as social networking, social support, loneliness, social isolation and living arrangement) in preventing EAN.

3. Provision of education and training to health, social service providers and police in the State to increase professionals who can identify abused elderly and provide victims with proper management and quality services.

4. Support and train family caregivers who provide care for elderly

5. Improving systems by capacity building, development of Clinical Practice Guidelines, Standard Operating Procedures and service infrastructure for management of EAN.

6.   Policy and legislative analysis to identify the gaps in current existing family laws relating to EAN and propose amendment and/or introduction of specific laws to address elder abuse and neglect to protect elderly rights.

The evaluations of the PEACE programmes attempt to measure beyond knowledge and behavioural change but examine whether various programmes have an impact on actual recognition and reporting outcomes and return of investment.  An ongoing community household survey, pilot training of health care providers and surveillance in the State is currently undergoing.