By Yvonne Lipianin
To try and put the work we’re doing in our Health Justice Partnership in context, I thought I would tell the story of one of the patients I assisted at our new Health Justice Partnership at St Joseph’s Hospital, who gave me permission to share her story and who I will refer to as Margot.
Margot is a 73 year old woman who was admitted to hospital late last year suffering a relapse of schizophrenia. As Margot’s condition improved, the team in the geriatric psychiatry unit learned of an agreement that she had reached with her son to allow him and his family to come and live with her. The team’s concerns about this arrangement grew as Margot began to make comments about her son’s controlling and aggressive behaviour, and these concerns were confirmed in a family meeting with Margot and her son in which staff witnessed him verbally abuse, insult and demean his mother in front of them.
Following this meeting, the social worker encouraged Margot to seek legal advice from me. Initially Margot was reluctant, however she eventually agreed to do so and I spoke to her on several occasions. For the sake of her grandchildren Margot did not wish to renege on the agreement with her son, however over the course of a number of advice sessions she became increasingly resolute that she was tired of her son’s abuse and she did want things to change. She agreed to put in writing a number of conditions on which she was permitting him to live with her – including that he must respect her property and her privacy, and speak to her civilly at all times – and require that he sign it before moving in with her.
This legal intervention served to both empower Margot and educate her about her legal rights, and to put her son on notice that his behaviour was unacceptable and if it continued, would not go unchallenged.
What I like about Margot’s story is that it highlights both the complexity of the issue of elder abuse, and the way the HJP model can benefit someone in Margot’s position. Because I am here three days per week and I can be flexible as to how and when I see patients, the health team had time to build Margot’s confidence to the point that she was willing to talk to me, and I was able to come back multiple times, allowing her time to build trust in me, and to consider my advice. The health team and I worked together to reinforce the message that Margot did not have to endure her son’s abuse and that she could take action, and it was rewarding watching her grow increasingly empowered over the course of her admission.
Margot’s story also demonstrates that elder abuse is complex, and there is not often going to be any quick fix. It often involves complicated family dynamics, and conflicting emotions on the part of the older person, including anger, hurt, betrayal and shame on the one hand, but also love, responsibility, and loyalty towards family members on the other. I can’t promise you that Margot has not endured any more abuse from her son since she was discharged from hospital. What I can tell you however, is that she left hospital understanding that she didn’t have to put up with the abuse, that she had taken action to put an end to it, and that if she needs more help to stop the abuse, she knows where to find it.
This post has been adapted from Yvonne’s speech at the St Vincent’s Health Network Sydney Health Justice Partnership launch.