Article Information

Author:
Petria M. Theron1

Affiliation:
1School for Biblical Counselling and Church Ministry, Potchefstroom Campus, North-West University, South Africa

Note:
This article was initially a paper delivered at the Annual conference of the Society for Practical Theology on 23 January 2014 at the University of Pretoria. The article addresses the theme of the conference: Practical theology and human waste in Africa.

Correspondence to:
Petria Theron

Postal address:
Private Bag X6001, Potchefstroom 2520, South Africa

Dates:
Received: 10 Feb. 2014
Accepted: 24 May 2014
Published: 20 Nov. 2014

How to cite this article:
Theron, P.M., 2014, ‘Being treated like “waste” during the “golden years”, Practical-theological perspectives’, HTS Teologiese Studies/Theological Studies 70(2), Art. #2636, 9 pages. http://dx.doi.org/10.4102/
hts.v70i2.2636

Copyright Notice:
© 2014. The Authors. Licensee: AOSIS OpenJournals.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Being treated like ‘waste’ during the ‘golden years’: Practical-theological perspectives
In This Original Research...
Open Access
Abstract
Introduction
Elder abuse and neglect in the Potchefstroom area
   • Institution A and B: Privately owned retirement villages (mainly white residents)
   • Institution C: Old-age home belonging to a national organisation (residents from all races)
   • Institution D: Service centre for the aged (mainly white members)
   • Institution E: Day-care centre for the elderly (black members)
   • Institution F: Traditional white congregation with primarily older members living on their own
   • Concluding remarks
Understanding elder abuse and neglect
   • Individual factors
   • Interpersonal factors
   • Social-contextual factors
   • Societal (community) factors
   • The South African context
Biblical guidelines regarding the elderly
   • Good old age’
   • Honour, respect and love
   • Children’s relationship with their parents
   • Children’s responsibility to care for their parents
Prevention of elder abuse and restoration of human dignity for the elderly
   • Stereotyping and ageism
Conclusion
Acknowledgements
   • Competing interests
References
Footnotes
Abstract

The South African Government published the Older Persons Act no. 13 of 2006. The objectives of the Act are inter alia to maintain and promote the status, well-being, safety and security of older persons, to maintain and protect their rights and to combat abuse of older persons. This act is indispensable, as the elderly (people of 65 and older) form a growing segment of the South African population (4.767% in 1996 − 5.019% in 2011). They are in many regards extremely vulnerable, as they often face negative views regarding older people, experience discrimination, abuse, neglect and exploitation. Many atrocities are committed against them and one hears horror stories of older people who are abused and/or neglected by their own children and/or other people. One could almost say that these people, during their so-called ‘golden years’, are treated like ‘human waste’. I will investigate this phenomenon and attempt to interpret it within the South African context. I will then identify certain biblical guidelines to orientate one’s attitude towards old age and the elderly. To conclude, I will propose strategies to prevent elder abuse and restore human dignity to them.

Introduction

One of the outstanding tendencies of the 21st century is the ageing of the world population. In 2012, 11.5% of the global population was aged 60 or over and the expectation is that this will increase to 22% by 2050. Life expectancy in the developing countries will also increase from 68 in the period 2010–2015 to 74 during 2045–2050 (United Nations Population Fund [UNFPA] 2012:3, 7). The South African population is similarly ‘greying’. According to the 1996 census, the elderly (people of 65 and older) formed 4.767% of the population; it has increased to 5.019%, according to the 2011 census (Statistics SA 2001:20, 2011:9). Although this demographic data is important to policy-makers, it is equally important to know how older persons experience their so-called golden years1.

HelpAge International (2011:3, 6, 8–9) did a survey in 32 countries in Africa, Asia, Europe and the Caribbean, and spoke to 1265 people over the age of 60. Of these respondents 48% were of the opinion that the world is a better place for older people. This may be an indication that governments started to implement the 2002 Madrid International Plan of Action on Ageing (MIPAA). Through MIPAA, 159 governments committed themselves to advance health and well-being in older age and to ensure enabling and supportive environments for older people. However, 29% of the respondents in the HelpAge survey thought that the world is getting worse for older people. They mentioned, inter alia, the following needs: the introduction of pensions or the expansion of existing pensions, better and more accessible health care, policies to tackle discrimination against older people and affordable housing.

Ferreira (2009:81−82) gives a perspective on the circumstances of older South Africans. The poor elderly has access to a regular social pension income, and pensioners are entitled to free treatment at public health-care facilities. However, health care is often unsatisfactory due to poor access. Although pensioners are entitled to placement in state-subsidised residential care facilities, these facilities are limited and family members have to look after their frail and sick parents at home, often without any financial help. The HIV/AIDS epidemic causes adult children to die early and grandparents are forced to look after their orphaned grandchildren, frequently without any financial support for this care. Studies show that pensioners regularly share their pension income with family and household members (cf. Makuyana 2013:5). Older women are extremely vulnerable, especially in the rural African patriarchal societies, where customary law is practised alongside Western law. According to customary law, a woman may not inherit her deceased husband’s property, and consequently she is at risk of exploitation, abuse and impoverishment.

The Older Persons Act no. 13 of 2006 (South African Government 2006) is indispensable in the quest to empower and protect the elderly, to promote and maintain their status, rights, well-being, safety and security, and to combat abuse of older persons. Unfortunately, despite laws and measures taken at international and national levels, incidences and reports on elder abuse are common. The elderly, who cannot defend themselves physically and whose houses are often not safe because of poor living conditions, are easy targets for criminals. As a result, they are robbed, often losing their pension money. They are assaulted, raped and murdered. Especially elderly women who live alone are increasingly in danger (Feni 2012:7; Mbuyazi 2013:2; Mdletshe 2013:8; Phandle 2013:5). What is even more shocking is the abuse of the elderly ‘within a relationship where there is an expectation of trust’, as stated in the definition of elder abuse by the non-governmental organisation Action on Elder Abuse South Africa:

… any act of commission or omission, intentional or unintentional that causes an older person to experience distress, harm, suffering, victimization or loss that usually occurs within a relationship where there is an expectation of trust. (Ferreira & Lindgren 2008:94)

Sheldon (2011:5) reports on one such case where a woman of 80 was locked up by her son in a tiny windowless room with no running water and no electricity for almost a year. She received food only every fourth day. Some children, even in rich families, convince their parents to go to old-age homes and to transfer their property to the children. In poor families, it often happens that the elderly are forced to hand over the pension money to the young ones. Violation of the human rights of older persons is increasing and one even hears of brutal rapes of the elderly by their own grandsons (Malatji 2013:20). The fact that older persons are sometimes abused by their own family members is alarming, when one considers that only about 4% of aged persons live in care-giving facilities. The vast majority of aged persons live with their families or on their own (Papp 2011:30). From the above, it is already clear that the elderly are extremely vulnerable, whether they stay on their own or with family members. Even older persons in care facilities are not necessarily safeguarded against abuse. One such case was reported on by Carte Blanche2. The 93-year-old woman stayed in a frail-care home near Johannesburg. She was taken to hospital with six broken ribs, a broken collarbone, a broken leg and a big cut on her head. When asked about her injuries, she said that when she did not do as the nurses instructed her, they would hit her, slap her in the face until she fell down and then kick her. When the nurses were asked about this case, they said the woman walks around and must have fallen and injured herself (Papp 2011:30).

Whom does one believe?

Cases like these cast a shadow over the so-called golden years. Instead of experiencing ‘enabling and supportive environments’, many older people are treated like ‘human waste’, to use the words of the theme of this conference. My central theoretical argument in this article is that ageism, which refers to peoples’ negative attitudes towards old age and the elderly, poverty and the breakdown in moral values are instrumental in elder abuse. By promoting values such as love, care, compassion, honour and respect, abuse can be countered and human dignity restored to the elderly. The practical-theological interpretation model of Osmer (2008:4) will orientate the methodology for this article. The first task in this model, the descriptive-empirical task, is to establish what the current situation is. I will report on findings obtained during a qualitative empirical research project conducted in the Potchefstroom area in 2013. In performing the second task, the interpretive task, I will make use of a literature study in an attempt to understand why this phenomenon is occurring, with specific reference to the South African context. Osmer’s third task is normative in nature, and I will attempt to identify certain ethical norms to guide our attitudes towards old age and the elderly. This will be done according to a reformational-theological paradigm3. I will conclude the article with the pragmatic task, where I will propose strategies to prevent elder abuse and restore human dignity to the elderly.

Elder abuse and neglect in the Potchefstroom area

In my endeavour to investigate the occurrence of elder abuse in the Potchefstroom area, I visited a selection of institutions (A–F) involved in caring for the elderly, to learn from their experiences, fully aware of the fact that staff members will probably give a positive report regarding the care given at their particular institutions. The questions therefore focused more on the experiences of the elderly in general.

Institution A and B: Privately owned retirement villages (mainly white residents)
The people staying in these institutions usually have sufficient funds to cover the costs of their daily living, or the children supplement their parent’s pension to enable them to stay there. The majority of the residents have good contact with their children, even if the children are living overseas. The children try to visit their parent(s) regularly, or they organise that friends visit their parent(s). One often finds that the children or family of one resident look after the needs of other residents, even after the death of their own family member. There are, however, children who seldom visit their parent(s). One reason may be that there is not a good relationship between the parents and their children, which may have been the case for many years. Another reason is that the parents are not happy to be in the care facility and feel that their children forced them to give up their homes and their independence. These people often withdraw and struggle with bitterness and guilt feelings about the past. Because they are frequently unpleasant company, other people avoid them. Some residents refuse to admit that they are frail and thus resist the help of care-givers.

Some of the residents experience discrimination in town by being called ‘names’ by young people that succumb to group pressure and treat the elderly without respect. Fellow citizens in town are not always sensitive to the needs of the elderly and do not help them sufficiently. The lack of empathy causes pain and feelings of rejection on the part of the older persons. The elderly is a soft target, as they cannot fend for themselves; therefore, these institutions have measures in place to protect the residents against abuse by the care-givers. The staff members are always on the lookout for signs of possible abuse, neglect or thefts. They urge their care-givers to treat the elderly with love, respect and patience. One institution admits that they struggle with care-givers who steal from the residents.

Institution C: Old-age home belonging to a national organisation (residents from all races)
Most of the residents who have sufficient funds have good contact with their children. Conversely, many of the residents who receive pension from the state do not have good contact with their children, often because the children are also struggling financially and cannot afford visits to the parent(s). Some of the residents admit that before they had come to the care facility, family members often misused their welfare grants.

When residents have Alzheimer’s disease, it is difficult to handle allegations of abuse, as the disease may cause patients to become aggressive. They might resist help from the care-givers and this may cause injuries. They could also accuse the care-givers falsely. However, allegations of abuse are always investigated, and if sufficient proof is found, the institution does not hesitate to act against staff members or care-givers.

Institution D: Service centre for the aged (mainly white members)
The aim of the service centre is to provide services to enable the elderly to stay in their houses as long as possible. Their members usually have the financial means to do so. The relationship between the elderly parent(s) and the adult children is not influenced by how far they stay from each other, but depends on the quality of the relationship between them.

A difficult phase in the lives of elderly parent(s) sets in when they cannot stay alone in their homes any longer. They often cling to their independence and might become very obstinate. By being assertive, they try to fight surrendering to old age. Adult sons often want to ‘fix’ everything. If they handle the situation wrongly, for example by ‘bullying’ or forcing their ideas on the parent(s), it may have harmful effects on the parent-child relationship. The elderly parents should be part of the decision-making process as far as possible.

Institution E: Day-care centre for the elderly (black members)
One woman (78 years old) takes care of 28 older people at a day-care centre. The centre is registered, but it gets no subsidy from the government. It is dependent on a small membership fee and donations from the community. When there are no funds available, the woman and her husband use their pension to cover the daily running costs. The centre has won a few prizes as best project and the woman uses the money to develop the centre further.

The members come to the centre from 08:00 until 15:30 during weekdays. They can have a shower there, get morning and afternoon tea and a cooked meal for lunch. While they are there, they are involved in activities that range from cleaning the centre, working in the vegetable garden, cooking and handiwork. They sell their vegetables and handiwork as an extra source of income for the centre. The old people who are able to come to the centre are doing well. They are looked after emotionally and physically. They are happy, enjoy each other’s company and experience meaning and purpose in their lives through their activities.

The centre also looks after old people in the community who cannot come to the centre due to old age and bad health. These people often live alone in appalling conditions and are extremely vulnerable to abuse, robberies and violence of all forms, including rape and murder, as their shacks are not secure. Sometimes the perpetrators are family members. Adult children often seize their parents’ pension. The members of the centre try to improve the shacks and to advance living conditions by providing beds, cupboards, gel-stoves and food. Unfortunately, the moment they leave, criminals/family members steal/take possession of furniture and provisions. Adult children are not always interested in taking care of the elderly parent(s), bathing them, cooking for them or taking them to the hospital or clinic when they need to see a doctor. The woman carrying on the work at this centre frequently finds old people who are physically in a bad condition because of neglect. Sadly, the reason for the neglect cannot always be blamed on the poverty of the relatives. Sometimes the centre must cover the cost of the funeral, as nobody else takes responsibility for the deceased.

She also finds many older people who are looking after orphaned grandchildren whose parents died because of HIV and AIDS. She assists the grandparent(s) to register the orphaned grandchildren to receive social grants, in this way alleviating some of the financial pressure to look after them. Previously, she could take some of the older people to an old-age home in town, but recently, a room is seldom available. Her biggest desire is a shelter where these old people can be looked after in safety.

Institution F: Traditional white congregation with primarily older members living on their own
Most of the members are still independent, looking after themselves and their homes. Others make use of the services provided by the service centre for the elderly. Some of them are financially independent and others are dependent on the financial support of their children. The majority of these elderly members have good contact with their children, who visit them regularly. Although the adult children visit their parents, they do not always assume responsibility for the living conditions of their parents at home. A few elderly members are largely dependent on the financial and physical help of the congregation.

Concluding remarks
From the results of the empirical study, it is clear that the experiences of the elderly, whether or not they experience elder abuse and neglect, depend largely on their socio-economic circumstances. The following aspects became clear:

• It seems as if old-age life is easier for some groups in the South African population than for others. It may be that culture plays a role in people’s attitudes towards the elderly.
• The relationship between parents and adult children during the early years determines the relationship later.
• The financial status of the elderly influences their living conditions; whether they can afford a place where they are safe and cared for or are dependent on welfare grants and on their children to care for them.
• Poverty causes adult children and grandchildren to be dependent on the pension of the elderly parents.
• The breakdown in moral values and lawlessness make the elderly vulnerable to criminal activities and abuse.

Understanding elder abuse and neglect

The World Health Organization (WHO) (2011) considers any act that violates the human rights of the elderly, including physical, sexual, psychological, emotional, financial and material abuse, abandonment, neglect and serious loss of dignity and respect as elder maltreatment. Daichman (2005:325) mentions some theories or models that have been used through the years to understand elder abuse:

• situational model (overburdened care-giver)
• exchange theory (dependent elder)
• social learning theory (learned behaviour)
• feminist theory (imbalance of power in relationships)
• political-economic theory (marginalisation of elders).

Researchers have realised that a single theory cannot explain such a complex problem and have therefore opted for the ecological theory in order to understand why elder abuse occurs. This model proposes four broad categories4 of contributing or risk factors.

Individual factors
In this category, Henderson, Varble and Buchanan (2004:746–749) make a distinction between risk factors associated with the victim and those connected to the perpetrator.

Victim:

• Gender: Although both men and women are victims of abuse, women are physically weaker and thus more vulnerable to abuse.
• Age: The probability of abuse increases as people grow older, because they become physically and mentally impaired and therefore more dependent. Sufferers of dementia tend to be more aggressive in their behaviour towards care-givers. Even experienced care-givers who have proper training and understand the symptoms of dementia, acknowledge they sometimes experience anger towards the care recipient.
• Substance abuse: Because of substance abuse, the behaviour of the care recipient towards the care-giver may be unpredictable and insensitive, causing negative reactions from the care-giver. They may also be less aware of the quality of care they receive.
• Psychological problems: Depression, anxiety, apathy, self-blaming and excusing the behaviour of family members may cause victims to deny abuse or to withdraw socially. Social isolation makes older persons particularly vulnerable to abuse.

Perpetrator:

• Psychological problems: If the care-giver has psychological problems, it is more difficult to interact effectively with the care recipient and to control his or her anger or frustration. They may also have unrealistic expectations of the care recipient.
• Substance abuse: Because of substance abuse, care-givers find it difficult to regulate their behaviour towards the elderly care recipient. The care-givers are also under financial stress to maintain their alcohol or drug habit. The alcohol or drugs may weaken the judgement of the care-giver.
• Inadequate care-giving skills: Most care-givers are family members who are not trained to handle problem behaviour of the elderly, who may behave aggressively because of dementia. The behaviour of the elderly may be wrongly interpreted as stubbornness, and the care-givers may resort to aggressive means, because they do not know a better way to gain control of the care recipient (cf. Conradie, quoted by Ferreira & Lindgren 2008:101; Erber 2010:292).
• Stress: The care-givers may experience stress related to their occupation, parenting, marital issues, health problems or financial pressures. As the care recipient becomes more dependent, the care-giving also becomes more stressful (cf. Eliopoulos 2010:104; Erber 2010:291).
• Working conditions: Poor conditions, shortage of staff and the resulting staff ‘burnout’, low job satisfaction and low salaries are contributing risk factors (Conradie, quoted by Ferreira & Lindgren 2008:101; Erber 2010:292).

Interpersonal factors
Henderson et al. (2004:749–751) mention the following three factors that may cause elder abuse:

• Dependence: When care-givers are financially or emotionally dependent on the care recipient, there may be feelings of anger, impotence and frustration on the part of the care-giver, which may lead to abuse.
• Family conflict: Where there is a history of harsh discipline, child abuse, power struggles, personality differences or weak communication, ‘pay back’ may occur.
• Overcrowded living arrangements: Both parties may experience a lack of privacy and a sense of ‘invasion’, which may lead to tension and anxiety between the care-giver and the care recipient.

Social-contextual factors
• Stereotyping: The portrayal of older people as frail, weak and dependent may increase abuse (WHO 2011).
• Ageism: Discrimination against people based on age, without taking into account their individual talents and capacities, may take place (Shamy, quoted by Louw 2008:509). Ageism becomes visible in myths, intergenerational conflicts and the glorification of youth. It demonstrates people’s negative attitudes towards older persons and the ageing process. The result is that the elderly are devalued, not respected and marginalised by society (Daichman 2005:328).
• Migration of young people and the erosion of family bonds (WHO 2011).
• Inheritance laws: When the husband of an older woman dies, she may not inherit the property. It is seized by the family and she is exposed to abandonment and poverty (WHO 2011).
• Finances: If the care-giver is a family member, he or she may struggle with the financial burdens of children who are still at home, be prone to a low income and stagger under the the high costs of the care recipient’s medication (Henderson et al. 2004:749–750).

Societal (community) factors
• Inadequate social support for the care-giver: The support of family or friends may reduce the burden of care-giving and help the care-givers to cope with the stress. Without it, they have no privacy and no time for themselves, which may increase the experience of stress, depression and anger.
• Inadequate social support for the elderly: They experience social isolation, which may lead to depression and more health problems (Henderson et al. 2004:750).

The South African context
From the examples given in the introduction and the results of the empirical study, it is clear that many of the above-mentioned risk factors are also applicable to our South African context. There is also an indication that older people living in black communities are more vulnerable to abuse. Keikelame and Ferreira (quoted in Ferreira & Lindgren 2008:101–102) mention different types of abuse that are common among the elderly black population, namely physical abuse (beating), emotional or verbal abuse (discrimination, hurtful words, intimidation), accusations of witchcraft, financial abuse (extortion of pension and other assets, exploitation, theft), sexual abuse, neglect, lack of respect and systemic abuse (dehumanising treatment at health clinics, pension pay points and government offices). A study done by Mosaval and Ferreira (quoted in Ferreira & Lindgren 2008:102) in Muslim communities showed that physical and sexual abuse are less common. However, financial and verbal abuse and perceived disrespect are common. It seems that in South Africa the decline in moral values, widespread poverty and high levels of unemployment with the accompanying lawlessness, crime and violence, contribute further to the occurrence of elder abuse.

Biblical guidelines regarding the elderly

The Word of God gives ample guidelines on how we should think about old age, how the elderly should be treated and on children’s responsibility towards their parents.

‘Good old age’
In his covenant with Abram, the Lord said, ‘You, however, will go to your fathers in peace and be buried in a good old age’ (Gn 15:15). The Hebrew word śêbâ [to be old] usually indicates that it is God who blesses a person with a long life, and even if the body fails, God will never forsake the elderly (Nsiku 2006:841; Wegner 1997a:1232; cf. Ps 71:18; 92:12−15; Is 46:4). The Hebrew word ‘rk carries the meaning that one’s days can be lengthened, and the passage of Deuteronomy 5:33 makes it clear that the power to do this lies in the hands of God, when he tells his people, ‘[w]alk in all the way that the Lord your God has commanded you, so that you may live and prosper and prolong your days.’ There is a direct link between a long life and obedience to God’s laws (Thompson & Martens 1997:517; cf. Dt 5:16; 1 Ki 3:14; Pr 10:27; 16:31). The book of Job confirms that a long life is a blessing and the reward for a godly life (Longman III 2012:130).

The Wisdom literature carries the same message (Nel 1997:131). The passage in Proverbs 3:2 states, ‘… for they [my teaching and commands] will prolong your life many years …’ Job exclaims, ‘[i]s not wisdom found among the aged? Does not long life bring understanding?’ (Job 12:12). The Hebrew word yāšîš portrays old age in this passage in a very positive light, because it is the time when people have gained great wisdom. Wisdom is the result of a lifetime of observing and evaluating the actions of God (Wegner 1997b:553).

Honour, respect and love
For the people of Israel, it was natural to respect and honour the elderly among them (Hess 2008:757; Longman III 2012:202; Parry 2010:151; Tidball 2005:243–244; cf. Lv 19:32). Wegner (1997c:1136) gives three reasons for their attitudes:

• God blessed them with a long life because of their righteous lives.
• they have gained knowledge and wisdom from which others can benefit.
• they are valuable sources of oral history and traditions (important in a largely illiterate community).

If one turns to the New Testament for guidance on how the elderly should be treated, one of Jesus’ sayings is very applicable. He taught, ‘[i]n everything, do to others what you would have them do to you, for this sums up the Law and the Prophets’ (Mt 7:12). It is also known as the ‘Golden Rule’. The Greek word oun at the beginning of verse 12 can be translated as ‘therefore’, thus indicating that what follows is a summary of the Sermon on the Mount. Jesus added that it is actually a summary of the whole Law. If one follows the Golden Rule, you fulfil the essence of the teachings found in the Bible (Evans 2012:169–170; Turner 2008:211). The answer to the question of how older persons should be treated is thus apparent. We need to treat them the way we would like to be treated when we will be old: with love, care, compassion, kindness, gentleness, patience, honour and respect (Col 3:12−14).

Children’s relationship with their parents
The most well-known passage regarding children’s relationship with their parents is probably the fifth of the Ten Commandments, which says, ‘[h]onour your father and your mother, so that you may live long in the land the Lord your God is giving you’ (Ex 20:12). In the ancient world, respect for parents and other family authorities were of paramount importance, and to care for them was regarded to be virtuous (Clifford 2002:329; Milgrom 2004:221). According to Kaiser (2008:482), ‘honour’ implies that children should consider their parents highly, care for them and show them affection, respect and fear. This corresponds with the passage in Leviticus 19:3, where it is stated that everyone should ‘respect his mother and father’. This commandment is indispensable for a healthy society, Tidball (2005:236) argues, as parents form the most elementary unit in society and are primarily responsible to introduce their children to God. Goldingay (2010:81) agrees with Tidball and states that if parents are not honoured, the existence of society is at risk. This indeed happened to Israel later, when they were taken into captivity. Kaiser (2008:482) draws the attention to the passage of Ezekiel 22:7 and 15, where the captivity is linked, in part, to the nation’s failure to honour their parents.

Hess (2008:748) observes that these biblical commandments to honour and respect one’s parents are also directed at adult children and their responsibility to look after their parents’ material needs. Biddle (2003:112−113) is also of the opinion that adult members of the community are addressed in this commandment, and by caring for the previous generation, the current generation sets an example for the subsequent generation to follow. If a child is disobedient to this commandment, for instance by cursing his or her father or mother or by treating them with contempt, severe consequences are not only felt by the individual (Ex 21:17; Lv 20:9; Dt 27:16; Pr 20:20), but by the community as well, opening the possibility for all sorts of sexual misconduct among families (Hess 2008:762; Willis 2009:175). As Milgrom (2004:255) explains, a breakdown in the responsibilities towards one’s parents can easily lead to a breakdown in other relationships as well.

In the book of Proverbs one finds several passages, some of which are quite graphic, that clearly stipulate how parents should not be treated. It is described as foolishness if a man ‘despises his mother’ (Pr 15:20) and a shame and a disgrace if a man ‘robs his father and drives out his mother’ (Pr 19:26). If a child ‘mocks a father’ and ‘scorns obedience to a mother’, his or her ‘eyes will be pecked out by the ravens’ and ‘will be eaten by the vultures’ (Pr 30:17). The Old Testament’s message to children is unambiguous: parents should be honoured, respected and cared for. The examples of Joseph (Gn 45:10−11; 47:11−12), Rahab (Jos 2:13), Ruth (4:15) and David (1 Sm 22:3) are worthy of imitation.

Children’s responsibility to care for their parents
In the New Testament, Jesus Christ set the example of honouring and caring for his mother by making sure that she would have male protection and support after his death (Jn 19:25−27; Neyrey 2007:309). This is in sharp contrast to the Pharisees who tried to escape their responsibility to care for their elderly parents by using the word ‘Corban’. Jesus says to them in no uncertain terms that in doing so, they nullify the commands of God, in particular the command that everyone should honour his father and mother (Mk 7:9–13; Bette et al. 2000:239).

The apostle Paul also quotes the Decalogue in his instruction that children should obey their parents (Eph 6:1–3, cf. Col 3:20). He even adds the promise, ‘… that it may go well with you and that you may enjoy long life on the earth’. Perhaps he says this to portray the message that adult children are still the offspring of their parents and that they should continue to obey and honour them, although the acts of obedience are different because of changing circumstances (Cohick 2010:144).

As in the case of the ancient Jewish world, it was expected from children in the Greco-Roman world to respect and obey their parents. This obligation continued, even when children themselves became adults (Best 2004:562–563). Even if there were an age limit on obeying one’s parents, Stott (1999:243) argues the command to honour one’s parents would have no age limit. When children honour their parents, there will be no neglect, because they will put their religion into practice and care for their ageing parents and grandparents (1 Tm 5:4). Paul’s message is that Christianity starts at home. He goes further and says, ‘[i]f anyone does not provide … for his immediate family, he has denied the faith and is worse than an unbeliever’ (1 Tm 5:8). This forceful statement must be understood in the light of the fact that Paul found himself in a non-Christian society where the virtue of caring for one’s parents was upheld. He gives the ultimate reason why children should care for their parents, concluding, ‘… for this is pleasing to God’ (1 Tm 5:4; Mounce 2000:280–281).

Prevention of elder abuse and restoration of human dignity for the elderly

The International Network for the Prevention of Elder Abuse (INPEA) and the United Nation’s World Health Organization launched the World Elder Abuse Awareness Day on 15 June 2006. Further, on 09 March 2012, the United Nations General Assembly established June 15 as a United Nations International Day (United Nations 2013). This may be an indication of a growing global awareness of elder abuse (Biggs & Lowenstein 2011:97). From the examples of elder abuse cited in the introduction, the results of the empirical study and the literature study, it is clear that the South African elderly primarily live in three settings where they are cared for by family members or care-givers to a greater or lesser extent. They can live independently within the community, with family members or in facilities for the elderly. Sadly, abuse occurs at the hand of strangers or criminals, family members and care-givers in all three settings. Prevention strategies should therefore be directed at all the possible scenarios of abuse to protect the elderly, to ensure enabling and supportive environments and to restore their human dignity. In 2010, the Department of Social Development issued the ‘Protocol on Management of Elder Abuse’ to serve as guidelines for government officials, NGOs and communities in their quest to protect and empower the older persons against abuse and neglect. The Protocol makes it clear that prevention is everybody’s responsibility and an interdisciplinary approach is necessary (Department of Social Development 2010:3, 5–6). Regrettably, some of the prevention strategies are unavailable to many of the most vulnerable because of a lack of financial resources.

Living independently:

• Measures suggested by Marriah (2010:1) to make the homes of the elderly safer: Carry a panic button around the neck. Install burglar bars, security gates and sensor lights. Have dogs on the property, close security gates diligently and maintain good contact with the neighbours. Never employ workers from the street.
• To prevent robberies on pension payout days, the elderly should open bank accounts (Marriah 2010:1).
• Membership of a service centre for the aged or a day-care centre: The elderly are cared for emotionally and physically and enjoy socialisation. They experience meaning and purpose in live through activities. Moreover, abuse can be detected more easily.
• Financial independence: It largely eliminates the possibility of abuse and neglect; people should therefore start early to provide for their retirement.

Relationships:

• Parents’ responsibility: A loving and caring relationship between parents and children starts when children are small; it is a long-term investment and probably the best safeguard against abuse.
• Adult children’s responsibility: The biblical guidelines are that adult children should honour, respect and care for their parents.
• Shared decision-making: As far as possible, elderly parents should be part of the decision-making process regarding their future. By considering them, they feel valued and respected, and this will probably ensure cooperation with drastic changes.
• Golden Rule: It ensures that older people are protected and treated with human dignity.

Care-giving:

• Care-givers, family members or professional people need to receive training in order to handle care recipients with dementia or Alzheimer’s disease, because these patients often resist help or act aggressively.
• Staff members should watch their care-givers for signs of substance abuse, psychological problems, stress, depression and anger.
• The working conditions of the care-givers should be improved to ensure job satisfaction.
• If the care-giver is a family member, other family members should support him or her and arrange that they are regularly relieved from care-giving responsibilities.
• Taking the care recipient to a day-care centre may alleviate the stress of the family care-giver (Erber 2010:291).

Society’s role:

• Befriend older people, visit them regularly and be vigilant for signs of abuse (Papp 2011:30).
• Physical abuse: Although the elderly bruise easily, look out for ‘abnormal’ bruises, for example around the neck or wrists.
• Psychological abuse: Give attention to sudden changes in behaviour, quietness, social withdrawal, an unwillingness to speak in front of the care-giver, problems with sleeping and eating or unusual lack of self-esteem.
• Financial abuse: Lack of funds, unpaid bills, sudden changes in the will or missing personal property may be indicators.
• Counselling: Many of the elderly have unresolved issues and conflicts from the past. They may struggle with bitterness, guilt feelings, grieve, loss or depression.
• Lend a helping hand to an elderly person wherever you encounter them and treat them with respect and dignity.
• Become involved with centres for the aged and support them.
• Awareness campaigns: Citizens should become more involved in the fight against elder abuse, like the bold effort of a group of more than 100 senior citizens who marched with their walking canes and crutches through the streets of King William’s Town to demonstrate against elder abuse by criminals and family members alike. They asked for regular patrols at old-age homes, tough punishment for rapists, more old-age centres and more efforts from government to improve the living conditions of the elderly (Kimberley 2011:3). Aspects that need attention are for instance the development of a charter of the rights for older persons, legislation to give the elderly greater say, the formation of forums for the elderly and consultation with the elderly on ‘their’ issues (Department of Social Development 2010:23).
• Generational Intelligence (GI): GI refers to the ability of ordinary citizens ‘to place themselves in the position of a person of a different age or in what has been designated as a different generation’. It entails a growing awareness that one is influenced by age and generation; an understanding of other people based on similarities and differences between generations; a critical awareness of the values underlying social assumptions regarding generations and adult ageing; and a willingness to demonstrate one’s generational awareness through actions. People with GI are capable to look at an issue from alternative age perspectives and are willing to fight ageism by building intergenerational bridges (Biggs & Lowenstein 2011:1, 10, 41).

Stereotyping and ageism
De Beauvoir (quoted in Biggs & Lowenstein 2011:99) says, ‘[b]y the way in which society behaves towards its old people, it uncovers the naked and often carefully hidden truth about its real principles and aims.’ I agree with Biggs and Lowenstein (2011:99) that elder abuse can only be prevented if the core problems in society are addressed, like the breakdown in moral and family values, the lack of respect for the elderly, the lack of respect for the sanctity of life, ageism and stereotyping. To address these core problems, the church, education system, media and government should support each other and work together.

• Church: It has the platform to address ageism and to restore family values and family bonds. I agree with Shongwe (2012:17) that the church should speak out against evils in the socio-political, economic and cultural spheres.
• Education system: Society needs to be made aware of the ageing process and that nobody will escape it. Treating the elderly with respect and human dignity should also be included in the educational curriculum (Daichman 2005:328).
• Media: Ageing should be portrayed in a positive manner. This can break stereotypes down (Daichman 2005:328).
• Government: Expanding welfare grants, ensuring accessible health care, providing more care facilities for the elderly and making affordable housing available must receive attention. The police and juridical system should act effectively against perpetrators. Officials at clinics, pension pay points and government offices should treat the elderly with dignity. Customary laws that cause abuse, for example the inheritance laws in some cultures, should be reviewed. In this the traditional leaders have an important role to play (Daichman 2005:329; Department of Social Development 2010:26).

Conclusion

The South African population is, in accordance with the global tendency, ‘greying’. Many of these people, instead of experiencing the ‘golden years’ of retirement, are exposed to terrible suffering due to abuse, neglect and exploitation. The abuse is administered by family members, care-givers or criminals. When adult children seize their parent’s pension money, care-givers hurt care recipients, or elderly women are raped and killed, something is drastically wrong in society. Researchers agree that there is a decline in moral and family values. The empirical study also indicates that the socio-economic circumstances of the elderly and the quality of the parent-child relationship that had been established when the children were small, greatly determine whether older people are victims of abuse or not. The ecological theory, with its four categories of risk factors, offers a further explanation why elder abuse occurs. Mention is made of individual, interpersonal, social-contextual and societal factors.

The biblical perspective on old age is that it is a blessing from God and a reward for a godly life. The elderly should therefore be respected, honoured and treated with love, compassion, kindness, gentleness and patience. On the adult children lies the responsibility to care for their parents. The focus should not only be to prevent elder abuse, but also to restore their human dignity. The elderly should be protected against abuse, but enabling, supportive environments where they can live in safety should also be ensured. A few strategies are proposed, such as safety measures for independent living, training to improve the level of care-giving, membership of centres for the aged or day-care centres, counselling and awareness campaigns. Churches, the education system, media and government have an important role to play to counter stereotyping and ageism. Old age should be a time to look forward to, not to be feared.

Acknowledgements

Competing interests
The author declares that she has no financial or personal relationship(s) that may have inappropriately influenced her in writing this article.

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Footnotes

1.It is interesting to note that no entry entitled ‘golden years’ is found in the Oxford English Dictionary, but The free dictionary (n.d.) describes it as ‘the years of retirement, normally after the age of 65’ or ‘the time of life after retirement from active work’. The ‘golden’ probably refers to the attitude portrayed in sayings like: ‘The older I get, the less I care about what people think of me. Therefore the older I get, the more I enjoy life ...’ (Wisdom quotes and stories n.d).

2.The South African investigative journalism television programme was shown in September 2010.

3.The point of departure of the reformational-theological paradigm is the recognition that the Word of God, the Bible, originated through the inspiration of the Holy Spirit and that it is authoritative (http:// www.nwu.ac.za/theology-reformed-foundation, viewed 02 December 2013).

4.The WHO (2011) also uses these categories to compile their list of risk factors.



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