EDITORIAL: Elder abuse in a super-aged society

Discussions about the implications of Taiwan’s demographic structure primarily focus on economic factors — from the shrinking workforce and under-enrolled schools to a financially strained healthcare system. However, less attention has been paid to costs that are more difficult to quantify.

The latest data from the Ministry of Health and Welfare revealed that the number of reported cases of elder abuse in Taiwan rose to 26,684 last year from 20,182 in 2022 — a 32 percent increase in just three years.

The figure might seem reasonable considering that the proportion of people aged 65 or older is growing, with Taiwan officially becoming a super-aged society last year. However, a bit of math dispels that reasoning. In the same three-year period, Taiwan’s elderly population grew by about 15 percent, meaning that reported cases of elder abuse rose at a disproportionately faster rate.

Before considering how to address this issue, it is important to understand what elder abuse entails: inflicting physical, emotional, psychological and financial harm on older people, as well as neglect. Age, gender, health, finances, family dynamics and culture can all affect risk.

Aside from the obvious physical and psychological harm caused to victims of elder abuse, more severe cases can lead to reduced quality of life or even death. A lack of data makes it particularly difficult to address, especially for countries with a higher proportion of elderly people such as Taiwan.

Government efforts to raise awareness and promote the 113 domestic violence hotline, alongside population growth, likely explain some of the increase.

However, elder abuse is underreported worldwide, and many cases in Taiwan are likely still going unnoticed, partially due to the cultural and family pressures that can discourage people from seeking help. Research suggests that elder abuse is most often reported by third parties rather than victims themselves.

More than 85 percent of reported cases involved the victim’s descendants or spouse. Older people might be reluctant to report family members due to embarrassment, shame or fear that their abusive family member would stop supporting them.

Many working children in Taiwan also financially support their elderly parents, and sometimes even act as their primary caregivers. The overwhelming pressure as a result of these compound responsibilities can lead to resentment and might give rise to conflict or abuse.

The Ministry of Health and Welfare has also said that financial abuse can coincide with psychological and physical violence, particularly if adult children depend on their parents’ money.

However, one issue with relying on third-party reporting to address the issue is that it requires that a third party can detect signs of abuse in the first place. Physical injuries might be visible, but emotional abuse, financial control and neglect are harder to identify. Older people who are socially isolated, have dementia or depend on their abusers for daily care can be especially difficult to reach.

The rise in reported cases suggests that government awareness campaigns have been successful to some extent. However, greater emphasis must be placed on identifying and addressing the underlying causes of abuse.

Financial insecurity, gender inequality, the demands of long-term caregiving and unresolved family conflicts can all create conditions in which abuse is more likely to occur. Expanding access to long-term care services and counseling, respite care and practical caregiver training would help families manage the demands of care before they become crises. At the same time, it is essential to fundamentally challenge the cultural stigmas surrounding family conflict that discourage people from seeking help.

It is equally important that elderly people be given more opportunities to participate in community activities and maintain social connections, making it easier for others to notice when something is wrong. Local governments, community organizations and neighborhood networks should cooperate to ensure that elderly residents are not socially isolated.

The authorities should continue to publicize the 113 hotline, promote awareness of the signs of abuse and make clear that neighbors, friends, relatives and caregivers can report suspected abuse even when victims cannot. Local agencies must ensure reports receive timely follow-up and elderly people have access to social workers and legal assistance.

As Taiwan’s population continues to age, the demands on families and the systems meant to support them will only become heavier, as will these risk factors. Addressing elder abuse requires a collective effort, with families, communities and government agencies all playing a role in protecting the vulnerable.