Turkey Pulse

Some elderly Turks face silent, slow killers: Abuse and neglect

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Article Summary
By 2050, 20% of Turkey's population will be over the age of 65, but social taboos prevent people from publicly addressing elder abuse and the specific needs of the elderly.

A story about a car killing a Turkish worker as he pushed a cart down a road three years ago garnered attention largely because the victim was an 87-year-old grandfather still in the workforce. Today in a number of industrial districts in the country manual laborers with deep wrinkles on their faces and hands can be seen. It's routine to see elderly men working eight to 10 hours a day.

More than 20% of Turkey's population has income levels below the official hunger threshold, and many of the elderly have no choice but to work.

One business owner who employs three elderly porters around Istanbul's Grand Bazaar area told Al-Monitor, “I wanted to do a good deed. Old age is prevalent here and no one wants to hire grandpas. I wanted to be a good Muslim.” But his neighbor laughed at him and said, “You are a miser! These [elderly] guys work at half the market rate; they are cheaper than Syrians. That's why you hire them.”

In a brief encounter, the elderly men — ages 72 to 88 — all told Al-Monitor they had to keep working or go hungry.

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One said, “My son-in-law took my house. My daughter doesn't want me around. I will work until I collapse on these streets.” The man had fresh, deep cuts in his calloused hands from holding the ropes of his load. When asked why he was kicked out of his own house, tears came to his eyes. “I was on medication and, I don’t know, one day I wet myself, so my son-in-law beat me," he said. "I left. I have dignity.”

Especially with the recession deepening, more senior men can be spotted working in the underground economy — mostly collecting trash, cleaning houses or carrying loads.

Older women also continue working. In 2017, the ruling Justice and Development Party (AKP) initiated a “grandmother project” that promised a salary of 435 liras (around $75) per month for those taking care of their grandkids younger than 3. The pilot project was set for one year by the Ministry of Family and Social Services and had 105,000 applicants. But applicants had to be younger than 65, which didn't help the elderly. Older women have fewer job opportunities than men or younger women. They are the most likely group to experience abuse or neglect.

Turkey is aging, slowly and quietly.

Yesim Gokce Kutsal, a medical doctor, is president of the Geriatric Sciences Research and Application Center at Hacettepe University and director of the Turkish Geriatric Society. She told Al-Monitor that Turkey's population of people over 65 reached 7.2 million at the end of 2018. That's 8.8% of the total. She said that in 2009, the percentage was 6.8%. "By 2023 we expect this rate to be 10.2%. According to UN criteria, if a country has 8% to 10% elderly, it's considered old; if it has more than 10%, it's considered very old.”

All around the world aging populations are increasing, and the Population Reference Bureau in Washington predicts that by the year 2050, 21% of Turkey's population will be age 65 and over.

Most of the talk about domestic abuse in Turkey is focused on that suffered by children and women. However, elder abuse has also been becoming a bigger problem, particularly as the number of the aged increases.

In Turkish culture, the elderly are to be respected and revered as a valuable member of the family. In most television shows they're presented as an amiable member of the extended family. However, the reality isn't always as pleasant. A 2015 study estimated that 4% to 10% of Turkey's elderly suffer abuse and neglect.

Al-Monitor contacted rest homes for the elderly, health care workers at homes or convalescent care facilities and relatives of the elderly to understand the situation. All the involved parties agreed with scholars that most abuse goes unreported or underreported because it is considered a private “family matter.” Women with low income and those who are widowed or divorced are at the highest risk among all the elderly to face neglect and abuse. Family members, spouses and children are most likely to be the culprits.

A nurse working at an upscale private rest home in Ankara told Al-Monitor, “Most of our guests are financially well-to-do and are educated. Their kids and grandkids or close relatives don't pay enough attention to them. We don't see physical abuse victims often, but there are cases where the family members acting as caregivers will intentionally or unintentionally skip or change dosage of the patient’s medication."

The nurse added that neglect of their personal hygiene is a top issue the elderly complain about. She said that in her 15 years of service at the facility, almost all of her patients have said they are there because they feel like they are a burden on their families.

It's often difficult to verify claims of abuse by elderly people who suffer memory loss or those who are fragile or accident-prone. Kutsal said, “Any facility working with the elderly should conduct an initial psychiatric evaluation prior to accepting them." Signs of emotional abuse and the recovery process must be followed closely.

Kutsal said the Turkish Geriatrics Society, as a member of International Association of Gerontology and Geriatrics-IAGG, provides training courses for medical personnel so they can recognize different types of abuse and neglect.

“There is no standard protocol [among medical professionals] to detect abuse, and doctors aren't expected to receive routine training to recognize signs of abuse, which could lead to low levels of reported cases," she added.

There are several red flags that could potentially signal emotional and/or physical abuse. The most obvious signs include weight loss, dirty clothes or hair, repetitive injuries and unexplained bruises, scars, burns or bedsores. Signs that sometimes are overlooked as indications of neglect or abuse include changes in behavior, agitation or withdrawal, depression or fearfulness.

A doctor working at a private rest home highlighted another issue: “Many of the elderly could continue living independently or cohabit with their extended families with simple adjustments at home, such as a handle by the bathtub and toilet for them to lift themselves up independently, or soft shoe-like slippers to minimize falls. Most of our patients suffer accidents at home and that frustrates their families simply because they don't know how to handle it.”

Along with private rest homes, there are also those funded by the government. In both cases, the guests have to pay, but the costs are significantly cheaper at state-funded facilities. If the elderly guest is self-sufficient, the expenses will be even lower. Still, a goodly number of Turkish cities have no facilities for elderly care. Kutsal said 136 rest homes are government-run, 21 are operated by local municipalities and 29 by nongovernmental organizations. There are also 169 privately run rest homes. These facilities are for people who are self-sufficient. Kutsal said there are also 435 convalescent care homes for those who need around-the-clock care. She emphasized that it is important for government agencies to regularly monitor these homes and make sure all standards are met.

Loneliness is a major issue for the elderly who opt to live alone and can do so. Without a proper circle of family and friends they can become easy prey for internet and phone scams. Former criminal lawyer Zafer Yilmaz told Al-Monitor, “They prey on lonely people, asking them to pay for fraudulent services. There are con artists who pose as potential brides for widowed elderly men. These are just scams to take elderly retirees' life savings. In some cases, we have seen hours of phone conversations between the criminal and the victim. Most of the time, it's the relatives that report the case to police.”

Elderly abuse and neglect rarely make it onto politicians' agendas. However, with its aging population, Turkey will have to break this taboo and start finding better ways to help the elderly on financial, sexual, physical and emotional levels. Raising public awareness is crucial for detecting or prevent elder abuse.

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Found in: citizens, social injustice, turkish economy, poverty, abuse, social services, elderly

Pinar Tremblay is a columnist for Al-Monitor's Turkey Pulse and a visiting scholar of political science at California State Polytechnic University, Pomona. She is a columnist for Turkish news outlet T24. Her articles have appeared in Time, New America, Hurriyet Daily News, Today's Zaman, Star and Salom. On Twitter: @pinartremblay

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