CYIL vol. 10 (2019)

VERONIKA BÍLKOVÁ CYIL 10 ȍ2019Ȏ standards that should be applicable to care for older persons. States have to ensure that these persons have access to health and social care. They are to promote a holistic approach to care, which should “go beyond disease orientation and should involve /…/ total well-being, taking into account the interdependence of the physical, mental, social, spiritual and environmental factors”. 70 By the same token, health care should not be reduced to disease treatment but should combine “elements of preventive, curative and rehabilitative health treatment”. 71 Older persons should not be treated as passive recipients of care but should be given the possibility to participate actively in all decisions concerning health and social care. Informed consent should be required for any treatment or medical intervention. Finally, the care system should reflect the diversity of needs and preferences of older persons, offering various types of services (home care and institutional care, short-term care and long-term care etc.). While these standards stem logically from the provisions enshrined in general human rights treaties, it would be helpful to have them declared in a binding instrument that deals specifically with the human rights of older persons. D) Violence and abuse Elder neglect mentioned in the previous subsection can develop into elder abuse and even violence against older persons. 72 Elder abuse means “a single or repeated act or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person”. 73 It can be physical, psychological/emotional, sexual, or financial/material. According toWHO estimates, about 15.7% of older persons experience abuse, often at the hands of their relatives, caretakers, or other close persons. 74 Elder violence is an extreme form of elder abuse. It involves physical mistreatment of older persons and it usually takes place either at home (part of domestic violence) or in institutional settings (hospitals, hospices, prisons, etc.). Elder abuse leaves long-lasting marks on the bodies and/or souls of older persons, causing them harm and interfering with their dignity. While all older persons are vulnerable to elder abuse, older women are particularly at risk due to poverty, gender discrimination, and prejudices they often face. “The impact of gender inequalities throughout /…/ lifespan is exacerbated in old age and is often based on deep rooted cultural and social norms.” 75 In some societies, the abuse of older persons, and principally older women, is considered a taboo topic, especially if it occurs within the family. 76 There is, again, no special right to be free from elder abuse and elder violence. These practices however may interfere with the right to liberty and security, the right to private life, the prohibition of torture, and even the right to life. The global nature of the phenomenon and the need for global response to it was for the first time clearly acknowledged in 2002. In January of that year, the UN Secretary General issued a comprehensive report on the Abuse of Older Persons . 77 The report described the phenomenon and suggested some tentative ways of 70 UN, Vienna International Plan of Action, op. cit., Recommendation 2. 71 UN Doc. E/C.12/2000/4, op. cit., par. 25. 72 See also BONNIE, Richard J., WALLACE, Robert B. (eds), Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America, Washington: National Research Council, 2003. 73 What is Elder Abuse?, online at https://www.who.int/ageing/projects/elder_abuse/en/ (retrieved on 3 June 2019). 74 Ibidem. 75 UN Doc. CEDAW/C/2010/47/CG.1, op. cit., par. 11. 76 UN Doc. A/HRC/33/44, op. cit., par. 65. 77 UN Doc. E/CN.5/2002/PC/2, Abuse of older persons: recognizing and responding to abuse of older persons in a global context. Report of the Secretary-General, 9 January 2002.

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