ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Proposing a Bioecological Framework for Elder Abuse in India

Elder abuse is a documented issue around the world. India is no exception. Abuse in older adults is associated with significant increase in emergency department usage, hospitalisation, dementia and depression. An abused elder has a threefold higher risk of death. Nevertheless, elder abuse is ill defined, understudied and underreported. Concepts of elder abuse developed in Western contexts are difficult to generalise to the widely varying contexts of India. This article proposes a framework to study and theorise elder abuse in India. The proposed framework is based on the bioecological systems theory. The article aims to facilitate identification of elder abuse and stimulate discussion around this grave yet neglected issue in care of older adults in India.


In September 1975, the British Medical Journal published G R Burston’s letter on what he called “granny battering.” Burston describes the deliberate assaults on old people he sees in his clinic. He regrets the evident abuse as

a manifestation of the inadequate care we (doctors and other healthcare workers) as a profession give to elderly patients and their relatives who are left with the task of coping with them unaided and unsupported by us. (Burston 1975)

More than 45 years later, elder abuse remains nearly as prevalent, yet understudied, underfunded and underreported (Lett 1995 in Giurani and Hasan 2000). A phenomenon first documented in doctors’ narratives seems to receive the least attention from the medical profession. Indeed, in the United States (US), despite established association of elder mistreatment and poor health outcomes, only 1.4% of abuse cases reported to Adult Protective Services (APS) come from physicians. In a survey of APS workers, of 17 occupational groups, physicians were among the least helpful in reporting abuse (Lachs and Rosen 2017). In India, as Soletti and Bhatia (2018), in their study on perceptions of elder abuse note

The exception (to the perception of elder abuse) was a medical practitioner who felt that elder abuse does not happen in the Indian context and does not befit the Indian culture.

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Updated On : 2nd May, 2021


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