Since 2008, I have heard social workers complain on and off about the difficulty of acting on behalf of older folk who are suffering abuse from their own flesh and blood.
Many of the victims may not have the will or the voice to defend themselves against abuse. Some are beaten up, others endure withering taunts, yet others are victims of grave neglect, having been found delirious from a lack of food and water.
A recent study by Trans Safe Centre, Singapore's only voluntary welfare organisation which specialises in elder abuse, showed that sons made up more than half the abusers, daughters another fifth. The study, released to The Sunday Times last week, analysed data from nearly 100 substantiated cases, where there was documentary proof of the abuse or witnesses. The abuse occurred between 2009 and 2012.
Singapore sees a few hundred cases of elder abuse every year, but these numbers may well be the tip of the iceberg, given that there are more than 400,000 people aged 65 and above here.
The World Health Organisation estimates that between 4 and 6 per cent of older people in developed countries have been mistreated or abused at home. This includes all the major forms of abuse (see sidebar). By that calculation, there could be more than 160,000 older folk who are mistreated here.
Given the unique characteristics of the victims, the vast majority of cases may be unreported, say social workers. First, many victims may be too old and ill - and may not have the cognitive capacity - to complain or defend themselves. Yet others are loathe to complain against their children.
When a case is reported - usually not by the victim but by neighbours, friends or family members - the biggest difficulty social workers have is of access since the abuse is cloistered within the walls of private homes.
According to the Trans Safe study, in nearly three-quarter of all cases, the abuser lives with the victim and often refuses outsiders access. I have met many social workers who have this complaint.
Sometimes, even family members are not allowed to visit the victim.
In view of this, Minister of Social and Family Development Chan Chun Sing's recent announcement that Singapore will soon have a law to better protect vulnerable adults is welcome news indeed.
The law will give social workers and medical professionals the right to enter people's homes should they suspect abuse.
Early detection is also imperative.
Unlike previous studies which looked only at the demographic characteristics of the victims and abusers, the latest Trans Safe study has identified some useful risk factors that pre-dispose people to abuse. Elderly victims with mental illness or failing cognition are especially vulnerable to psychological abuse, abandonment and financial exploitation, the study found.
Abusers who are mentally ill or dependent on the elderly for income or shelter, meanwhile, are especially likely to abuse them financially and also subject them to psychological abuse by hurling taunts or insults.
Take Madam Tan, who is interviewed in the video here. Her unemployed son and his wife live with her in her three-room flat. In a teary interview she speaks of how her daughter-in-law knocked her head against an iron door grille till it bled. She also had her front tooth knocked outand fractured a finger. She says her son and daughter-in-law harass her constantly for money. She has begun proceedings to evict them from her flat.