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19 / 09 / 2014
NORMA’S PROJECT: Researching the sexual assault of older women in Australia
**Trigger Warning: Sexual Assault Content**
Sexual assault is one of the most under-reported crimes – the sexual assault of older women even more-so. ‘Norma’s Project’ hopes to change that – this research report was established to highlight the extent of, and to ultimately prevent, the sexual assaults of older women in Australia. The full research report is now available. For this edition of Sheilas, one of the researchers, Dr Philomena Horsley, has summarized the report’s findings, as well as including some real case studies. It’s a harrowing, but incredibly important read.
By Philomena Horsley
When discussing the sexual assault of women, most people envisage a woman of reproductive age. An attack on an old woman in an aged care facility is not an image commonly associated with the idea of sexual assault, nor is the rape of a 92 year old woman in her own home. The idea of older women as victims of sexual assault is relatively recent and little understood.
Norma’s Project is a research project conceived in response to the experience of Norma, an 83 year old woman with dementia, who was sexually assaulted by a male staff member while in respite care. In responding to Norma’s situation it became clear to her relatives that such assaults were not uncommon, just unheard of.
The bulk of research about sexual assault has focussed its attention on younger women. However, women over 45 years make up around 20% of those women sexually assaulted in Australia each year. These assaults occur in a wide range of contexts, settings and relationships. The lack of community awareness can be partly attributed to commonly held assumptions that older women are ‘unattractive’ and asexual. How, then, can they be the target of sexual assault? What is unimaginable and unacceptable becomes unsayable or invisible.
THE RESEARCH: What did we do?
Norma’s Project analysed the limited existing research on the sexual assault of older women. This was combined with the scant statistical data specific to Australia. For instance, there has been a 14% increase in compulsory reports to the Commonwealth Government of alleged sexual assaults of adults living in residential aged care services – a total of nearly 280 reports in 12 months.
We also used interviews and surveys to collect more information. Over 90 family members, community members and service providers from the health, aged care, justice and community sectors gave us accounts of sexual assaults of older women and their views about strategies for intervention and prevention (see examples below).
Domestic setting – family
We were working with a woman who was being repeatedly raped by her husband and there were three sons. She was trying to tell them what was happening to her, without saying the sexual violence part, and that she didn’t really want to stay in the home anymore because she just couldn’t manage it. She was in her 80s and really quite frail. Now the sons didn’t want to hear about it … In the end she was saying to them, ‘He wants sex all the time’, and the sons were going, ‘Well what’s the problem with that’ and then kind of joking about their father’s prowess at that age. And the reality is that the three sons and the husband were tied up in the property that they worked on. Two of the sons actually still lived at home and the males were all drinkers, and that was the behaviour that had gone on for a very long time. So clearly her first disclosure was to the sons and they were not empathetic and discounted and downplayed her fears and concerns. She was quiet for probably another year after that until the husband, who had dementia but was being prescribed Viagra, ended up with a case worker and the woman built some trust with this case worker and told her what was going on. Then she got an empathetic response. The way they were able to handle that was to involve the doctor and look at the unintended outcomes of him continuing to have Viagra, and also by getting him [into regular respite care] so the woman could have some kind of life. Eventually he went into care because of his dementia and the woman was able to carve out a bit of a safe life for herself at the home.
Domestic setting – in-home support
Some years ago, a male person employed by various private agencies to provide home support services in the community was suspected of sexual abuse of several vulnerable elderly women. Although this worker was not employed to provide personal care services, he had become a trusted worker for these women who all lived alone and had significant cognitive impairment. He had claimed to be a ‘male nurse’ and begun to undertake tasks of showering, bathing, etc. No details could be confirmed or substantiated, and the police advised that they could not act. Financial abuse was also suspected.
[A nurse] penetrated her with a tube of cream and aggressively used demoralising words to her at the time, like she was nothing and she was filthy and she deserved this. She reported it and it took great strength and courage for her to do that because the nurse was extremely aggressive. [It was a] female nurse. And [the older woman] had the courage of a lioness [to] make that report. She was devastated that there was very little the hospital could do … There’s no proof of sexual assault so they couldn’t terminate [the nurse’s] contract. But they took [the older woman’s report] seriously. Well, there was no evidence that the woman was assaulted. So they didn’t have grounds for dismissal. One person said, ‘I was sexually assaulted’. The other person says, ‘I never did that’. So there isn’t a lot that anyone can do because sexual assault is not a witnessed crime.
Residential Aged Care
A woman that we saw, she was in her 90s, and she became very unwell and confused suddenly. She had been saying to the Nursing Home Manager that a man had come into her room in the night and raped her but they sent her off to hospital saying ‘she’s confused’. And she was, she had a [urinary tract infection]. But the nurse on the ward rang us at the sexual assault service and said, ‘This woman keeps telling me she’s been sexually assaulted and I don’t know what to believe, but I feel like she needs to be heard’. So, our doctor and a counsellor went across and interviewed her and examined her, and she had occipital fractures of both hips, which was consistent with someone coming and lying on top of her. She couldn’t say who it was but, you know, she probably was sexually assaulted … [The nursing home] didn’t even think of it as a possibility; they only thought, ‘Oh, she’s confused’.
An older woman was in a retirement village. She’d recently moved there, and one of the guys who was in his own unit kept inviting her in for cups of tea, and she didn’t really like him but she felt sorry for him. You know the old story, women are supposed to look after people. So, she felt sorry that he was lonely and went in there to have a coffee with him. The next thing she remembered was waking up in his bed the next day and she’d been sexually assaulted. Now, she didn’t tell anyone. She was too ashamed … But less than a week later he suddenly died and she was so sort of shocked and traumatised by the whole thing that she came and sought counseling about that.
FINDINGS: Contexts and settings
The sexual assaults of older women remain largely unreported. This is often related to older women’s fear, shame, dependence, and their lack of knowledge about support options. In addition, many women from older generations will not define their experience as such, for example, when their husbands demand sex, or when there is unwanted touching of a women’s sexual parts or vaginal penetration involving objects other than a penis. As one Sexual Assault Service worker observed:
I guess the difficult thing for a lot of people, not just older women, is actually naming what has happened to them as being sexual assault … unless it was kind of a violent stranger rape or a rape with violence that involved the police and the hospital.
The contexts in which the sexual assault of older women occurs are in many ways ‘ordinary’ and commonplace. They occur in women’s homes, in health and aged care settings, and less commonly in public places.
The offenders are primarily men (and occasionally women) who are known to the victims. The majority occupy relationships of trust – commonly husbands/partners and other male relatives.
I have noted that sexual abuse is very rarely reported by older women, especially within longstanding relationships. Barriers to reporting or acting on sexual abuse are magnified for this generation who are often more private about sexual matters, ashamed, have strong commitments to perceived marital obligations, and often also wish to protect the perpetrator (and the wider family) from the indignity or consequences of prosecution. In my experience, it is also often suspected in a context of other controlling or abusive behaviour (Aged Care Service).
But, as they age, women often use a range of support services and are vulnerable to abuse perpetrated by staff working in the aged care and health sectors.
Many older people live on their own and so are dependent on other people for goods, services, transport and can’t always have the way of picking and choosing who is in their life (Family Violence Service).
There are particular concerns regarding the vulnerability of frail or confused older women. They appear to be particularly targeted by some offenders who see them as ‘easy prey’.
I suppose the obvious things are if they lose their mobility or they lose any of their abilities, whether they’re cognitive or whatever, they are more vulnerable and we do know that those who perpetrate sexual assault in a planned way pick their targets carefully … they target those who are less likely to be believed, less likely to be able to report any of the assaults (Sexual Assault Service).
Some people think that someone with dementia doesn’t matter and can’t be relied upon to tell the truth (Aged Care Service).
FINDINGS: Addressing the gaps
There is little in place in Australia that addresses the invisibility of this issue, the specific needs of older women who are victims, and the need for greater awareness among community and health services.
The research suggests that service providers, particularly those in the aged care and health care sectors, can improve their capacity to both respond and prevent to the issue of sexual assault of older women by providing staff training and revising their policies and practice. The development of stronger inter-agency connection and collaboration between the different sectors would also greatly assist older victims and their families.
A greater recognition of the impact of sexual assault on the health and well-bring of older women is also urgently required, particularly when research suggests it can significantly reduce the life expectancy of women in their seventies and eighties. In addition, the particular vulnerabilities of women living with disabilities, in rural settings and women from minority populations require more attention and research.
In bravely agreeing to report the assault and share her story, Norma instigated an important research project. Hopefully, it will be followed by other initiatives that will result in greater community awareness, the development of safer environments for older women, and more informed responses from service providers.
After the assault, Norma’s health deteriorated and she no longer felt safe at home. In 2011 she moved into permanent care at a local aged care facility where she is looked after by a team of dedicated staff. Norma’s dementia has worsened and her health is now fragile, but she remains happy, loved and safe.
Who are we?
Norma’s Project involves a team of researchers: Dr Philomena Horsley (University of Melbourne/La Trobe University), Dr Catherine Barrett (La Trobe University), Dr Rose Mann (University of Melbourne) and Dr Jean Tinney (National Ageing Research Institute). The research was funded by the Australian Department of Social Services and supported by Alzheimer’s Australia and the Council of the Ageing Victoria.
For more information, including copies of the full research report and an extensive literature review, check out the website: www.normasproject.org.au
Dr Philomena Horsley (University of Melbourne/La Trobe University) is part of a team of researchers behind ‘Norma’s Project’, which was established in December 2011 to prevent the sexual assault of older women in Australia. The project is based at the Australian Research Centre in Sex, Health & Society at La Trobe University and includes researchers from the National Ageing Research Institute and the McCaughey Centre/Centre for Women’s Health, Gender & Society at the University of Melbourne. The project is also being conducted in collaboration with Alzheimer’s Australia and the Council on the Ageing, Victoria and was funded by the Australian Government, Department of Social Services. For more information, check out the website, here.