Elder Abuse is everyone’s business. If you suspect that an elderly person may be the victim of physical, mental or financial abuse, please contact Tafta without delay.

At Tafta, we hear about cases through face-to-face contact, telephone calls and emails, often anonymous, where abuse is either suspected, alleged or witnessed. All suspected and reported cases are investigated immediately, and prompt action taken to protect vulnerable elders or remove them from abusive situations.

Signs and symptoms of elder abuse can be confused with the natural ageing process

Unfortunately, elder abuse is not always easy to identify. Old people bruise easily and may be covered in cuts and bruises if they are unsteady on their feet and bump into furniture, doors and walls. Those affected by memory loss or the onset of Alzheimer’s may be confused about what happened to them. In cases like this, it’s all too easy for abusers to deny wrongdoing … and to be believed.

Even worse, they may convince the victim that he or she is mistaken, adding to their feelings of doubt and helplessness. Elders may also be afraid to speak up if they are being abused by care givers or family members, because they’re worried about retaliation or making the situation worse.

To mark World Elder Abuse Awareness Day, Melaine Pillay, Social Work Supervisor at Tafta, shares a recent case history, which illustrates the challenges.

Financial abuse

Mrs. John is a 77 year old widow. She was living with her three adult children and totally dependent on them. Her only source of income is R1860 which she receives from her old age pension.

On Tuesdays and Thursdays, Mrs John used to visit her neighbour, Sally. They would share an afternoon cup of tea and watch their favourite soap opera together. During her last visit, Mrs. John mentioned that she had lost her SASSA card and could not remember where she had left it. The two laughed at Mrs. John’s ageing and possible memory loss. Sally volunteered to talk to Mrs. John’s daughter about the missing card.

She phoned the following day to ask the daughter to please help her mum find the card, as Mrs John seemed very worried that her memory was failing. The daughter’s response both surprised and concerned Sally. She became angry and snapped, “My mum’s financial affairs are none of your concern!” After that, Mrs. John’s visits to Sally stopped abruptly.

Causing trouble in the family

Sally didn’t want to cause any further trouble within the family, but she felt that someone should help Mrs John. She called Tafta Head Office to share her concerns, but wanted to remain anonymous. We immediately arranged for our area Social Worker to visit the home to assess the circumstances. She gave Mrs John a Mini Mental State Examination (MMSE) which indicated that Mrs John has a mild degree of impairment, resulting in some memory loss.

The old lady confirmed that her SASSA card had been missing for almost 4 months and she had asked her children to help her find it, without success. Mrs. John could not provide an accurate recollection of events and felt as though she was losing her mind. Our Social Worker was able to confirm that, owing to the onset of the mild cognitive impairment, Mrs. John’s children had taken her SASSA card and were using her pension for their own needs.

Physical health at risk

Her health had also deteriorated because she was not receiving adequate meals on time. Nor was she taking her chronic medication or visiting the hospital for her regular check-ups – a cycle often associated with older people who lose their autonomy owing to the onset of mild cognitive impairment.

Mrs John seemed to be afraid to speak openly as she did not want to upset her children. Her general demeanour was one of sadness and despair. Apart from feeling confused, she felt that she could not depend on her children and was now questioning her safe space.

Mrs. John’s children refused to meet with us and denied any knowledge of where her card was, but SASSA confirmed that the money was being withdrawn from the card immediately after each payment. Our social worker accompanied Mrs John to SASSA where the card was stopped and she was able to arrange for her pension to be paid directly into her bank account.

Thereafter,we arranged a formal assessment at Addington Hospital to ascertain the level of cognitive impairment and to ensure that Mrs. John receives the necessary medication and treatment to delay the progression of her condition.

Charges dropped

Mrs. John refused to press criminal charges, saying: “They are my children, I cannot punish them.” But she did agree that in order to feel safe and secure, she would like to live within the protected environment of a Tafta facility.

She now receives her meals and medication on time, is escorted to hospital for check-ups and participates in the programmes held at the wellness centre. She also participates in activities recommended by the attending Psychiatrist, aimed at stimulating her brain to continue functioning for as long as possible.

She has made many friends at Tafta and now has a bright smile whenever the Social Worker visits her to monitor her progress. She continues to enjoy her soap opera with new friends. Her old neighbour Sally often visits too.

Because Mrs. John misses her children, the Social Worker has reached out to them to visit her when they can. We will continue to reunify the relationship with them and provide the much-needed aftercare and reconstruction services the family require. It is also important for Mrs. John’s children to be educated on dementia and how this has adversely affected their mother, and how the disease will progress as she ages.

Act on suspicions

We are so grateful for caring neighbours like Sally, who act on their suspicions. Even if these turn out to be unfounded, it’s much better to be safe.

All suspected and reported cases are investigated immediately by our Social Workers in line with the Protocol on Management of Elder Abuse issued by the Department of Social Development.

The first step is for the Social Worker to visit the (alleged) victim in his or her
home to assesses the circumstances and living conditions. Based on this assessment, the following actions may be taken:

1. Medical assessment of the elder by a medical practitioner.
2. The victim, accompanied by the Social Worker, is encouraged to report the incident to the South African Police Services for criminal investigation.
3. If the perpetrator lives with the victim, arrangements are made to either remove the perpetrator with the assistance of SAPS, or alternate accommodation is secured for the older person.
4. The older person is assessed through the DQ98 (a Dependency Questionnaire) which indicates if the older person can live independently, requires Assisted living, or requires Frail care.
5. Based on the score of the DQ98, options regarding suitable facilities are explored with the older person.
6. The older person is placed in the relevant facility.
7. The Social Worker monitors the older person either in their home in the community or at the placement facility to ensure that he/she receives effective services to reduce the effects of the trauma and prevent any additional trauma.

Awareness programmes

As a preventative measure, Tafta also regularly runs awareness programmes on elder abuse in all communities, creating awareness and educating people about the referral structures and services available to both victims and perpetrators.

The Older Persons Act (Act 13 of 2006) stipulates in Section 26, that any person who suspects that an older person is abused must immediately notify the Director-General or a police official of his/her suspicion. Failure to do so is a criminal offence.

All suspected cases are lodged with the Department of Social Development, and forwarded to the Director-General, accompanied by a comprehensive Social Work report. Within 6 weeks, a supplementary Social Work report is submitted on developments that occurred since the initial investigation, the outcome of the investigation, and the interventions needed to protect the older person. Records are kept of all reported cases – to ensure continuity of services and the continued protection of the older person. These records also serve as a research tool to monitor trends that occur incidentally and geographically, and guide both future awareness campaigns and our intervention alternatives for any future cases.

Like child abuse, the abuse of vulnerable elderly people is particularly objectionable, and unlawful. When someone deliberately hurts a child or elder who is too weak or afraid to protect themselves, it goes against every sense of decency, humanity and compassion.

But, just as a new mother may be driven to lashing out after one too many sleepless nights, those caring for elders can also break under stress. Especially if their care goes unnoticed or is misinterpreted as trying to control the elder and they are subject to a constant stream of criticism from an older person suffering from deteriorating mental conditions such as dementia or Alzheimer’s.

Support for carers and elders

Whilst elder abuse can never be condoned, as a preventative measure, steps need to be taken to support those caring for complex older people and, if necessary, to find alternative care solutions to protect both parties.

In instances where vulnerable older people are abused by those whose job it is to look after them, there must be mechanisms for accountability and liability. We’ve seen far too many cases of older people with black eyes, or arms covered in bruises after being physically mishandled, sometimes deliberately, by their caregivers.

Proof

Unfortunately, the perpetrators often get away with the abuse by claiming that the elderly person fell or knocked themselves against a doorway or sharp object. Older people do bruise easily, and are prone to stumbling and falling. Even if the victim complains, he or she may not be believed; a convincing perpetrator will use the elder’s failing memory as proof that they don’t really remember what happened.

There are also instances where victims of abuse feel inclined to protect their abusers with whom they have familial connections as they fear the consequences their caregiver may face. This results in many cases of elder abuse going unreported or being withdrawn by the victim.

Different types of abuse

But physical abuse is not the only form of harm suffered by older people. Any act (or lack of action) that causes harm or distress to an older person falls under the definition of elder abuse.

Abuse can be passive, where an elder who is dependent on others is neglected – left without food, water and medication, or left lying in soiled bedlinen – or even abandoned entirely by those responsible for his or her care. This can cause as much distress and suffering as physical abuse and even result in death.

Elders may be subjected to emotional and verbal abuse, where a pattern of degrading or humiliating treatment or words leads to feelings of rejection, isolation, worthlessness, oppression and depression. Elders may also be intimidated by threats and forced into doing something they don’t want to do – e.g. handing over their pension money.

In South Africa and other countries where poverty levels and unemployment are high, many elders are subject to financial abuse. Situations where an elder has his or her pension card stolen, or their bank account emptied by family members, are all too common. This is especially the case where the elder suffers from a condition like Alzheimer’s or Dementia and is unable to understand what is happening. Their possessions may be stolen, or sold without their consent, or they may be tricked into giving possessions away.

Most heinous of all is sexual abuse, where a vulnerable elder is violated for sexual or erotic gratification without their consent, and sometimes even without their knowledge or understanding.

How abusers get away with it

If the victim has a disease like Alzheimer’s, it’s all too easy for the abuser to refute any allegation of wrong doing and claim that the victim is talking nonsense. Elders in this position may endure years of abuse; either they are unaware of what is happening, or they start to doubt the validity of their recollections.

Even when victims know exactly what is going on, they may be too afraid to complain for fear of retaliation, ridicule, being abandoned, or making the situation worse. In cases where the abuser is a son, daughter or other close relative, elders may put up with it because they feel ashamed, want to protect the family or still feel affection for their loved one, and will find excuses for their behaviour.

Speak up

If you suspect that an elder is being subject to any kind of abuse, please speak out. It’s better to be safe than sorry. You are welcome to report cases anonymously to our social worker on 031 332 3721 or email intake@tafta.org.za.

Alternatively, you can contact your nearest police station or the Department of Social Development

Even those who have eaten healthily all their lives will find their dietary needs change as they advance into their 60s and beyond. We may not feel like we are ‘slowing down’, but our bodies definitely are! Being less active, losing muscle mass and the ageing process itself all contribute to slowing down our metabolism.

Weight gain

Which means that if our diet doesn’t change, we’re going to start gaining weight. Being overweight puts additional pressure on hearts and lungs, leading to an increased risk of heart disease, diabetes, certain cancers and breathing difficulties. So it’s important to adapt our eating habits to avoid piling on the kilograms as we get older.

Physical activity is important throughout life, but is especially beneficial for older people. Exercise improves a sluggish metabolism and helps maintain muscle strength. Weight bearing exercise, such as walking, jogging or dancing, helps maintain bone density to reduce the risk of osteoporosis. If you suffer from painful joints or arthritis, swimming provides many of the same benefits without causing further damage to knees, hips and ankles.

Weight loss

Conversely, some people lose weight as they get older. This may be caused by poor appetite, muscle loss, depression, or problems with their teeth. Illnesses like cancer, Alzheimer’s and dementia can also cause weight loss; so too can the drugs used to treat them and other medical conditions.

Weight loss resulting from lack of food or vitamins is just as unhealthy as weight gain. Being undernourished can weaken your immune system, make it harder to absorb medication, hinder wound healing, reduce muscle density, and make bones more brittle – increasing the risk of falls and broken bones.

Healthy nutrition for the over 60s is not just about eating less. It’s about eating properly to ensure our ageing bones, hearts, skin and other organs get the right nutrients to keep us healthy.

Healthy Nutrition for the over 60s – What to eat

• Try to eat something from each of these five main food groups every day:
  1. Protein (Meat, fish, eggs, lentils, nuts)
  2. Starch (rice, cereal, pasta, bread, oats, potatoes, noodles)
  3. Vegetables
  4. Fruit
  5. Dairy (milk, cheese, yoghurt)
• Keep bowels active by including plenty of fibre in your diet. Wholegrain cereals, bread, fruit, dried fruit, dried peas, beans and lentils are all excellent sources. Drinking plenty of water also helps prevent constipation.
• Mind your teeth! Nuts, grains and hard fruits can be difficult to chew, especially if you have dentures. Cooked and canned fruits and nut butters provide the same nutrients without the risk. If you love biltong, try the powdered version, sprinkled onto salads, soups or sandwich fillings.
• If you’re not very hungry, eat the protein part of your meal first. Protein is the building block of the body and essential for repairing and maintaining healthy cells. If your appetite is poor, rather eat five to seven snacks a day than trying to munch your way through two to three big meals. Or try to eat with other people. Turning meals into a social occasion makes it easier to finish the food on your plate.
• The risk of dehydration increases with age, so be sure to drink plenty of water and other fluids. You may not feel thirsty – especially if you’re not exercising – but you still need 6-8 glasses of water, juice or tea every day. Many elderly folk deliberately cut down on liquid intake because they worry about making it to the loo in time. Weak bladders are also part of growing older! However the dangers of dehydration are much more serious. Common symptoms include tiredness, poor concentration, weakness, low blood pressure, dizziness and increased risk of falls. In severe cases, dehydration can cause fainting, heart failure, rapid breathing, a fast, weak pulse and ultimately, death.

What not to eat (or only in limited quantities)

• Foods high in saturated fat (biscuits, pies, processed meats, pizza, fried foods, chips and other savoury snacks)
• Butter, cream and full fat milk. Choose low fat milk, yoghurt and cheese, unsaturated margarine and cooking oil.
• Too much salt increases the risk of developing high blood pressure. As we age, we tend to lose sensitivity to salty and bitter tastes, and spice up our food with extra salt. Rather season and cook with herbs and spices. Also limit your intake of prepared foods that are high in salt, e.g. bacon, ham, salami, savoury snacks, and sauces.
• Sugar creates energy ‘spikes’, weight gain and tooth decay. Sugar occurs naturally in most fruits; what you need to avoid are products containing added sugar, such as sweetened soft drinks, cakes, chocolate, sweets and peanut butter with added sugar.
• Alcohol – limit your intake to avoid damage to your liver and brain, and reduce the risk of some cancers. Drinking alcohol also increases the chances of accidents and injury.

Poor food choices

Older people may also make poor food choices because they are:

• Bored, lonely or depressed. If you live alone and don’t have absorbing hobbies to keep you occupied, frequent visits to the fridge or cupboard in search of tasty snacks can become a habit. Fair enough if you’re snacking on mini tomatoes and carrot sticks. But who does that? You’re more likely to be reaching for the biscuits, chips, sweets or chocolates!
• Living on a tight budget. Healthy food options like meat and fresh fruits are expensive. So if you don’t have much to spend, you’re more likely to fill up on bread, rice, potatoes, noodles and pasta. Whilst these foods leave you feeling satisfied, the feeling wears off quickly leading to overeating.
• Incapable. If you find it difficult to get out to buy groceries or stand at the stove … or you don’t know how to cook (e.g. your partner used to do all the cooking before he/she died) you simply might not be able to plan and prepare nutritionally balanced meals. Those who live alone may also find ‘cooking for one’ boring. This is where a service like Tafta’s Meals on Wheels makes all the difference. Properly balanced and freshly prepared meals are delivered to your door every other day, at a nominal rate. For more information, please email intake@tafta.org.za.

Topping up essential vitamins for healthy nutrition in later life

If you eat less or have digestive issues, you may be deficient in some important vitamins and minerals. Your doctor can perform tests and prescribe supplements if necessary. You can also top up essential vitamins through your diet.

• Calcium is essential for bone health and strong teeth, and you may need more of it as you get older to prevent loss of bone density and the risk of osteoporosis. Extra serves of low fat milk, yoghurt and cheese will help. For the over 70s, absorbing enough calcium from food may be inadequate and you may need to consider a supplement.
• Zinc helps your immune system and metabolism function. It’s also important to promote wound healing and may reduce inflammation. If you feel that you are not getting enough zinc, add a hard-boiled egg and a glass of milk to your daily diet.
• Vitamin E is believed to help lessen cognitive decline as we age. Eating just 30 grams of nuts a day will give you the vitamin E you need.
• Vitamin D is essential for keeping bones healthy. Known as the sunshine vitamin, Vitamin D is produced naturally by our bodies when our skin is exposed to sunlight. If elders don’t spend much time outside, they may not be producing enough. Top up on Vitamin D by including egg yolk, margarine, canned tuna or salmon and mushrooms in your diet.

The Older Person’s Grant – also known as the state old-age pension – is intended to help people who have reached retirement age, have stopped working, and who are struggling financially. If you are over 60 but still enjoy a regular source of income – from investments, rentals or a private pension – or you own assets over a certain amount, you will not be able to claim a pension from the state.

How much could I get?

If you qualify, you will receive monthly payments at the current level. This increases every year, by a very small amount. It’s currently R1 890 per month (or R1 910 if you are older than 75 years).

If you are applying for accommodation at Tafta, a state pension is one of the minimum requirements.

How do I know if I qualify?

You can apply for a state pension if:
1. You are a South African citizen, permanent resident or refugee, currently living in South Africa.
2. You are 60 years of age or older.
3. You do not receive any other social grant for yourself.
4. You do not live in a state institution (e.g. a state old age home or rehabilitation centre). If you live in a Tafta Home, this rule does not apply, as our homes are all owned and managed by our organisation.
5. You qualify in terms of the means test.
The first four criteria are pretty straightforward. But how do you know if you qualify in terms of the means test?

Minimum income

Because social grants are intended for people who can’t support themselves, the South African Social Security Agency (SASSA) looks at the income and assets of the applicant to determine whether or not they qualify.

If you are single, your total monthly income must not exceed R7 190. If you are married, you and your spouse will be assessed jointly and you will need to prove that your total monthly income is below R14 380. Even if you have no monthly income yourself, if your spouse earns R14 380 or more a month, you will not qualify for the old age grant.

If you have any dependent children who are earning any income (eg part time or piece work) you will need to disclose this as well, as part of your monthly income.

Your assets will also be taken into consideration. If you have assets worth R1 227 600 or more, you will not be able to claim the old age grant. If you are married, you and your spouse’s combined assets cannot exceed R2 455 200.

Can I apply if I am still working?

Yes, you can, provided your income is below R7 190 per month, and that your assets are less than R1 227 600.

I own a house worth over R1 million. Does this automatically exclude me from qualifying for an old age grant?

If you own any property, you need to declare this. However, if you live in the property you own, it will not affect the means test, which is based on your monthly income. If you and your spouse own a home worth more than R2.45 million, you may have difficulty in claiming the old age grant as you would be deemed to have the opportunity to downsize, and use the balance of the money to help fund your retirement.

How to apply

Either go to your nearest South African Social Security Agency (SASSA) office and complete a form in the presence of a SASSA officer, or you can apply online at www.services.sassa.gov.za.  There is no fee payable.

You will need to submit the following documents:
1. Your identity document and the ID of your spouse
2. Proof of marital status, eg. Marriage certificate, spouse’s death certificate, divorce order
3. Proof of income for yourself, your spouse (if married) and any dependent children
4. Proof of your assets, including the value of any property you own
5. Proof of private pension (if any)

If you don’t have access to the Internet and are too old/sick to go to the office to apply for a grant, it may be possible for a family member or friend to apply on your behalf (check with your closest SASSA office first). Alternatively, they may visit you in your home to complete the necessary paperwork. There is no charge to apply, so do not be misled by any unscrupulous individual who requests payment.

How long does it take before I start receiving my payments?

It may take up to 3 months to process your application, but if you are successful you will be paid from the date on which you applied. You will be issued with a SASSA card and can collect your payment at the post office, designated bank or other pay points (eg at supermarkets and some old age homes). You can also request to have the money deposited electronically into your bank or Postbank account.

You can use your SASSA card to pay for goods at the till, or to withdraw cash from till points in selected stores (e.g. Checkers) or any post office or ATM, without incurring any fees.

If your application is refused, you’ll get a letter explaining why it has been refused. If you feel that a mistake has been made, you can appeal the decision within 90 days of being notified.

For more information about qualifying rules, payout dates and district offices, please call the SASSA toll-free helpline on 0800 601 011.

With the entire country under Level 5 Lockdown, last year’s Mother’s Day was a bit of a non event, especially for older moms and grandmothers who weren’t even able to see their loved ones! This year, we have fewer restrictions, but the threat of Covid-19 is still ever present.

So how will you celebrate this special day? Here are some ideas:

Flowers
The traditional gift, much appreciated by most women, continues to be a favourite way of telling your mother how much you love her. If you won’t be seeing your mom on Mother’s Day, use an online florist service to surprise her with a beautiful bouquet.

Want a more practical gift? Why not consider ordering a nicely presented pot plant, along with a box of her favourite chocolate or cookie treats delivered to her door. Woolworths has some lovely options and delivery fees are reasonable.

Lunch out
While some people are still nervous of eating out at a restaurant, there are other safer options that mom is sure to enjoy. How about organising a picnic in an attractive venue like Mitchell’s Park or the Botanical Gardens? By May, the worst of Durban’s humidity is over and the likelihood of rain is less.

You can organise delicious picnic food yourself, choose ready prepared snacks from a supermarket, or order from a caterer that specialises in gourmet picnic baskets. Be sure to take a folding chair for older moms who might not be comfortable sitting on a picnic blanket!

Framed photo
If your mother doesn’t see you or her grandchildren very often, a family photograph of you and the kids is something she can treasure for years. Pick out a pretty frame and add a special message on the back, telling her how much you all love and appreciate her. Even better, get everyone in the photo to add their own special message.

Pamper time
Moms of young children, in particular, appreciate a little “Me” time. Again, not everyone is comfortable visiting a spa or treatment centre during the Pandemic. But a thoughtful home spa ‘kit’ – think scented candles, fragrant bath foam or fizzy bath bombs, exfoliating scrub, face mask or eye patches, luxury body lotion or butter, a pretty nail polish – maybe even a dinky of wine and a magazine! Plus of course a good couple of hours to relax and enjoy everything, which could mean Dad taking the kids out for a while.

Getting away from it all
While travel options are limited, there are still opportunities for active moms to enjoy a change of scenery and some healthy exercise in the fresh air. From a simple walk or bike ride at the beach, followed by breakfast in an open air café, to a weekend away – this is a thoughtful and most appreciated gift.

Plus you’ll have the satisfaction of knowing you’re helping one of our worst hit sectors, the hospitality industry, to recover from the devastating economic effects of the pandemic.

Gift someone else in her name
Making a donation to a worthy cause in honour of your mom is a lovely gift for the mom who has everything. What causes is she passionate about? Disadvantaged children? Animals? If you’re not sure, consider a donation to Tafta so that an elderly mother or grandmother who may be alone and forgotten this Mother’s Day can feel special too.

Some time with you
For older moms, especially, the best gift of all is just to be able to spend some time with you. If your mother lives in an old age home, there may be restrictions on visiting. Make sure you understand the consequences of taking her out for a visit or family meal at a restaurant (e.g. she may have to spend time in isolation afterwards).

If you are unable to visit mom, the next best thing is a phone call. If mom is a little forgetful and difficult to talk to on the phone, take some time beforehand to recall special memories of happy times you’ve spent together and discuss these during the call.

Finally, if you are a mom yourself – Happy Mother’s Day from all of us at Tafta!