Abstract
Population ageing around the world has drawn increased attention to the issue of human rights of older people. Extended old age is a women’s issue, considering women’s longevity advantage over men. Gender inequalities across the life course often make women more vulnerable to violence, abuse and poverty in old age than men. The human rights framework provides a solid foundation to approach the issue of violence and abuse against older women. This article critically reviews the United Nations instruments, with a focus on the international movement to promote human rights of older women, and provides implications for global social work practice.
Introduction
In the past 30 years, increasing attention has been paid to the need to promote human rights of older people as population ageing has become a worldwide concern (United Nations (UN), 2011). Older people in industrialized as well as developing countries face numerous challenges such as poverty, age-based discrimination, vulnerability to neglect, abuse and violence and a lack of access to adequate health-care and geriatric services (UN, 2011). Extended old age is a women’s issue, considering that women have continued to show a longevity advantage over men. Women tend to live longer, but at the same time they experience an increased likelihood of impairment due to health declines (Johnson et al., 2005). Multiple disadvantages grounded in traditional gender roles, economic disparities and barriers to health and mental health services shape the ageing process of women (Patterson, 2004) and make older women more vulnerable to violence and abuse than their male counterparts. Older women are often subjected to discrimination based on the intersectionality of age- and gender-based biases and harmful customary practices such as widowhood rites (i.e. acts to cruelly punish surviving wives) (Amoakohene, 2004). Globally, older women are vulnerable to various forms of violence and abuse: for example, domestic and/or sexual violence and abuse, violence in circumstances following armed conflicts, forced migration or natural disasters and so on (UN, 2010).
The definition of violence against women by the UN is any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life. (World Health Organization, 2013)
In the United States, ‘elder’ abuse and domestic violence, in cases of older women, are defined differently by statute in every state. The federal definition of elder abuse, as it appeared in the 1987 Amendments to the Older Americans Act (OAA), serves as a guideline for all states regarding the following aspects: physical abuse, emotional abuse, sexual abuse, exploitation, neglect and abandonment (National Center on Elder Abuse, 2013). If fully implemented, the Elder Justice Act legislated as part of the Patient Protection and Affordable Care Act of 2010 may update the 1987 Amendments to the OAA in defining neglect, abuse and violence against older adults. However, it will still likely fall short of international conceptualizations of violence against older women, which includes elimination of harmful traditional practices against older women and widows, communal bullying invoking accusations of witchcraft and other supernatural attributes to behaviours of older women, and discrimination in access to services and treatment in private and public life.
The exact prevalence rates of violence and abuse against older women are hard to estimate because of varied definitions of abuse/neglect as well as old age (UN, 2013a). However, a recent study conducted in the European Union suggested that about 28.1 percent of older women in Europe had been exposed to at least one type of abuse (UN, 2013b). Given this high prevalence of abuse of older women, it is important to critically review the existing international instruments related to their human rights, and discuss and find ways in which these tools can be effectively used in global social work practice in order to provide protection and prevention services to older women. As the profession of social work becomes more international in scope, population trends around the world, such as global ageing, affect social work practice and policy internationally as well as nationally (Hokenstad and Roberts, 2011). Therefore, this article aims to critically review the nascent international movement to promote human rights of older women, primarily with a focus on the UN instruments, and to provide implications for global social work practice.
Overview of instruments to promote human rights of older women
Human rights are universal legal guarantees protecting individuals and groups against interference with fundamental freedoms, dignity and entitlements. They have an intrinsic value for all human beings and are founded on respect, dignity and worth of each and every person (UN, 2012b). Rights based on documents in history, such as the Code of Hammurabi and the English Bill of Rights, emphasized moral and civil rights.
Table 1 summarizes the UN instruments addressing human rights of older women. Human rights as defined by the United Nations Universal Declaration of Human Rights, developed under the leadership of Eleanor Roosevelt, is a comprehensive statement of fundamental human rights and freedoms adopted by the UN General Assembly in 1948 (Wronka, 2008). While the UN Universal Declaration of Human Rights was intended to be inclusive of all people, specific references to women and older people are limited to two articles: Article 16 on the right to marry and divorce, and Article 25 on the right to an adequate standard of living and security in the event of old age, widowhood and motherhood (UN, 2008b). Declarations in UN parlance are statements of principles that are legally non-binding for nations that sign onto them.
Summary of United Nations (UN) instruments addressing human rights of older women
Conventions, on the other hand, are international treaties that are legally binding for those nations that ratify them. In 1979, a convention on women’s rights, the Convention for the Elimination of All Forms of Discrimination against Women (CEDAW), was established. However, no convention to date has been established to define the rights of older people (Doron et al., 2013). A set of principles for older people, the United Nations Principles for Older Persons, was approved by the UN General Assembly in 1991, laying out five rights-based categories: (a) independence, (b) participation, (c) care, (d) self-fulfilment and (e) dignity. However, these are non-binding. Two international plans of action, the Vienna Plan of Action in 1982 and the Madrid Plan of Action in 2002, were promulgated; these represent ambitious rights-based agendas to guide nations in preparing for the anticipated demographic shifts towards ageing of the world’s population (Calderon, 2013). Finally, a non-binding General Recommendation was approved by the UN General Assembly in 2010 that delineated specific rights of older women within the framework of the CEDAW (Begum, 2012). These include freedom from discrimination in employment, harmful traditional practices, violence and abuse, participation and health (UN, 2010).
In the following sections, we discuss the UN instruments wherein the rights of older women are mentioned. We present the UN instruments with special attention to how the rights of older women were identified and formulated in order to provide an understanding of the stages of development of human rights for older women.
Universal Declaration of Human Rights, 1948
While the Universal Declaration of Human Rights – proclaimed and adopted by the UN General Assembly in 1948 – lays out a set of fundamental principles of human rights for member nations, only Article 25 mentions old age as a specific category (UN, 2008b). This Article affirms the universal human right to a standard of living: Adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary social services and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. (p. 6)
In this Article, both old age and widowhood are identified as conditions associated with individual vulnerability and personal need. The next article articulates the right to education for everyone that shall promote ‘full development of the human personality’ (p. 9), and tolerance, peace and understanding between all groups and nations. Furthermore, Article 16 sets forth the right of women to marry and form a family without discrimination on any grounds and with equal rights with men during and after its possible dissolution. The declaration sets forth special entitlements based on different life stages, considering childhood, youth, motherhood and adulthood, omitting consideration of old age (UN, 2008b).
First International Plan of Action on Ageing, Vienna, 1982
In 1982, the First World Assembly on Ageing was held in Vienna, Austria, signifying the growing awareness on the part of world governments of the ageing of the world’s population (UN, 1982). The First International Plan of Action on Ageing (the Vienna Plan), emerging from this World Assembly, emphasized the role of governments in the protection of vulnerable elderly persons. In this document, older women were referenced only twice. The first reference was in relation to the issue of women and employment. This reference discussed governmental and non-governmental responsibilities for (a) older women living in poverty, particularly those in rural areas, and (b) the special needs of widows. Longer life expectancy raises the issue of women and employment as stated in two articles. Disadvantages in the workplace can mean, ‘An old age aggravated by economic needs, isolation, and with little or no prospects for paid employment’ (Article 45). Furthermore, in some countries, older women are affected by age discrimination in employment more than men ‘to remain in the labor force or to re-enter it because of age prejudice’ (Article 73).
Another reference to the struggles that older people face, related to changing family circumstances, was eroding family supports for older people. Traditional caregivers, that is, often younger women in the household, were ‘entering and remaining in the labor force for longer periods of time’ (Article 66). The instrument also references the need for policies to provide social insurance for women disadvantaged by having interrupted their career due to family responsibilities. More importantly, when implementing this Plan of Action, governments are called to consider the various needs of the ageing and to ‘Recognize that the ageing are not a homogenous group and to be sensitive to the wide differences and needs of the ageing at various stages of their lives’, particularly of those of older women who are among the most vulnerable (Article 89) (UN, 1982).
UN Principles for Older Persons, 1991
The UN Principles for Older Persons, proposed after the Vienna Plan was promulgated, were adopted by the UN General Assembly in 1991, and nations were encouraged to incorporate them into their national plans (UN, 1991). A total of 18 Principles are sub-divided into five categories: the right to independence, the right to participation, the right to care, the right to self-fulfilment and the right to dignity and security, with freedom from abuse. Sub-divided into the category Dignity are the principles of an older person’s right to live in dignity and security and be free of exploitation and physical or mental abuse; and an older person’s right to be treated fairly regardless of age, gender, racial or ethnic background, disability or other status and be valued independently of their economic contribution. The principles were gender neutral, referring to older people as an inclusive body, and gender was omitted (Resolution No. 46/91).
Second International Plan of Action on Ageing, Madrid, 2002
Subsequent to the promulgation of the Vienna Plan and the adoption of the UN Principles for Older Persons, momentum built for a Second World Assembly on Ageing. This Assembly was held in Madrid, Spain, in April 2002, and out of it emerged the Political Declaration and Madrid International Plan of Action on Ageing (UN, 2002). The Madrid Plan emphasized empowerment of older people, as well as protection, and included more specific recommendations related to older women and widows than did the Vienna Plan.
The Madrid Plan addresses some gaps left in the Vienna Plan. For example, older women are specifically mentioned no less than 20 times in the Madrid Plan, in relation to employment and workplace discrimination, income disparities across the lifespan, caregiving provided (as well as received) by older women, the need for poverty reduction, disabilities, vulnerability to abuse, neglect and violence of older women and widows and media images (UN, 2002). Recommendations on how governments and non-governmental organizations (NGOs) can address these issues to increase the empowerment and well-being of older women are included throughout the Madrid Plan. A total of 193 member nations of the UN, including the United States, signed onto the Madrid Plan. While not binding, the Madrid Plan is an important vehicle for advancing an agenda that promotes the human rights of older women and widows.
CEDAW
The CEDAW is ‘an international bill of rights for women’ of all ages and girls (UN, 2012c). The CEDAW was adopted by the UN General Assembly on 18 December 1979 (United Nations Human Rights Office of the High Commissioner, 2012). The call for a treaty came from the First World Conference on Women in Mexico City in 1975. The CEDAW addresses discrimination against women as a human rights issue. The instrument emphasizes the intersectional approach that accounts for the simultaneous effect of discrimination as a result of women having multiple disadvantage statuses such as disability, marital or socio-economic status. Furthermore, the CEDAW invites nation states to monitor progress and submit periodic reports about the progress made in (a) ensuring the realization of equal rights for women, (b) preventing and prohibiting discrimination and (c) promoting proactive measures to accelerate de facto equality for them.
As of June 2012, 187 nations from all over the world called ‘States Parties’ ratified the CEDAW (UN, 2012c: 16). The Preamble to the Convention states that the elimination of discrimination against women and the promotion of equality between women and men are central principles of the UN, and constitute binding obligations under the UN Charter and other instruments. However, it grants no authority to the UN or any body other than States Parties’ discretion to enforce its provision. The states assume responsibilities in promoting equality and non-discrimination. However, the enforcement mechanisms of CEDAW are weak and are largely left to the discretion of the parties.
Discussion of two selected human rights instruments: Madrid Plan and CEDAW General Recommendation No. 27
We selected both the Madrid Plan and the CEDAW General Recommendation No. 27 for further discussions. The International Federation of Social Work (IFSW) and International Council of Social Welfare (ICSW) – two international social work NGOs that have global scope – cited them as human rights documents relevant to the practice of social work. These two instruments contain powerful and coherent policy recommendations for nations across the world and bring the stage of the dialogue for human rights of older women into the 21st century. They call for state governments to recommit to protecting older women in light of new realities and challenges. The instruments encourage the formation of new interagency cooperation in all aspects of ageing, ageing research and social solidarity between generations.
Political Declaration and Madrid International Plan of Action on Ageing – Priority area 3: Creating enabling environments; Issue 3: Neglect, abuse and violence
As previously discussed, the Second World Assembly on Ageing was held in Madrid, Spain, in 2002 to mark the 20th anniversary of the First World Assembly on Ageing in Vienna. The purpose of the gathering was to review the implementation of the recommendations set forth by the First World Assembly on Ageing and the Vienna Plan. The goal of the groups and the committees involved in the formulation of the Madrid Plan was to create a new plan of action that reflected the new social, cultural, political, economic and demographic realities of the 21st century. The Madrid Plan sought to extend and enhance the initiatives of the Vienna Plan, such as significantly mainstreaming ageing issues in all aspects of development, interagency cooperation and interdependence between generations (UN, 2000).
The Madrid Plan has served as a guide to member states on their roles and responsibilities for upholding and enforcing the rights of older persons. It includes three priority areas for action: (1) older persons and development, (2) advancing health and well-being into old age and (3) ensuring enabling and supportive environments. Of most relevance to this article is ‘Priority area III, Issue 3: Neglect, abuse and violence’. Elder abuse – as an issue of concern for older people, particularly older women – had not yet come to public attention in the early 1980s, and therefore this topic was not addressed in the Vienna Plan in 1982. To the extent it had, it was framed as a social problem that affected the care of dependent frail elderly. Elder abuse was also seen as a problem to be addressed by professionals in the fields of gerontology and geriatrics. However, this perspective had changed significantly between the First and Second World Assemblies on Ageing. By 2002, neglect, abuse and violence against older persons were understood to take many forms – physical, psychological, emotional and financial – and occur in every social, economic, ethnic and geographic sphere (UN, 2002). It was also recognized that older women faced a greater risk of physical and psychological abuse, not because of dependency and high care needs, but because of discriminatory social attitudes and the non-realization of human rights of women (UN, 2012a). The agenda on ageing reflected in the Madrid Plan from the Second World Assembly on Ageing was rights-based. It was the first time that the question of ageing was linked to the framework of human rights and economic development by governments from all over the world; however, the responsibilities and commitments reinstated by the Madrid Political Declaration are still not legally binding for the participating states (UN, 2002).
The section of the Madrid Plan that focussed on elder abuse (Priority area 3, issue 3) also focussed most specifically on abuse of older women. While it acknowledged that professionals need to recognize the signs and symptoms of abuse, it also reflected the growing awareness that elder abuse manifests differently in diverse societal contexts. In many countries in Africa, widowhood, for example, is associated with decreased social status and culturally accepted and enforced vulnerability to abuse, discrimination, violence and forced marriage to relatives of the deceased (Amoakohene, 2004; Maluleke, 2012). Furthermore, in some developing countries, traditional and customary practices can result in the abuse of older women; for example, in some African countries, older women are also more vulnerable to forms of communal bullying, such as witch-hunting violence (Maluleke, 2012). Societal norms as well as familial customs and structures are recognized as potentially harmful to older women and widows.
The media were also identified as powerful conveyors of social messages about older people, particularly older women. In Issue 4: Images of ageing, recommendations include the need to promote a positive image of older women’s contributions to increase their self-esteem (UN, 2002). For example, in Canada, older adults are recognized by the federal government for their volunteer work, which created a National Senior Day and annual Prime Minister Volunteer Award, as an effort to combat ageism and to promote positive images of older adulthood (Government of Canada, 2012).
The Madrid Plan includes provisions for follow-up through world governments and the collaborations between those governments and NGOs. NGOs include research institutions like universities, to determine the extent to which the Madrid Plan was implemented through changes in laws, social institutions and in other ways. The UN Commission on Social Development was identified as the entity responsible for the review and appraisal of the implementation of the Madrid Plan (UN, 2002). There are some successful examples of the implementation of the Madrid Plan at national levels. In Finland, a national campaign of multiple governmental agencies promoted a more positive view about the economic contribution of older workers, which resulted in an increased retirement age and the reform of the pension system (UN, 2008a). In Uganda, an inter-governmental, multi-ministerial commission formulated policies addressing ageing issues in various domains such as health, nutrition, HIV and social protection. An inter-governmental commission also promoted cross-border cooperation, research and exchange of best practices between countries in South America (UN, 2008a).
CEDAW – General Recommendation No. 27 on older women and protection of their human rights
As noted earlier, the CEDAW Treaty Committee has adopted 29 General Recommendations to date, and this article focuses on the discussion on General Recommendation No. 27 on older women and protection of their human rights. General Recommendation No. 27 references, in its introduction, previous commitments to older women’s rights such as the Vienna International Plan of Action on Ageing and the UN Principles for Older Persons (UN, 2010). The purposes of General Recommendation No. 27 are (a) to promote the rights of older women, (b) to identify the multiple forms of discrimination that women face as they age and (c) to outline the content of the obligations to be assumed by States Parties with regard to ageing with dignity and rights. General Recommendation No. 27 includes policy recommendations aimed at mainstreaming responses to the concerns of older women into national strategies, development initiatives and positive action so that older women can fully participate in society.
Specific areas of concern include the right of older women to live lives of dignity, free of abuse. For example, Concern No. 14 states that older women may face neglect as they may be perceived as burdens to their families, and widowhood and divorce further exacerbate this form of elder abuse. While the general recommendation highlights the need for governments to address neglect of older women, it does not specify whether government or family has the primary responsibility for preventing or stopping neglect. This is a type of issue that must be determined by political process based on cultural values and practices. However, Concern No. 16 stresses that gender stereotyping as well as traditional and customary practices can have a harmful impact on older women’s lives, particularly those with disabilities, and can also result in physical violence and psychological, verbal and financial abuse (UN, 2010). Clearly, cultural norms and practices that have this outcome must be changed if older women’s human rights are to be protected. Concern No. 27 states that older women are particularly vulnerable to exploitation and abuse, including economic abuse when their legal capacity is deferred to lawyers or family members (UN, 2010). Furthermore, Concern No. 28 draws attention to the struggles of older women in polygamous marriages. In such marriages, although discouraged and prohibited in most countries, older wives may be neglected for no longer being able to give birth or being economically active.
Concern No. 29 highlights the important contributions that older women can and do make to society, communities and families. Nations are encouraged to take all appropriate measures including legislation to eliminate discrimination against older women, to ensure dignity for their old age and to participate fully in society. Violence against older women is cited as a particular problem, and States Parties have an obligation, according to Concern No. 37, to draft legislation recognizing and prohibiting domestic, sexual and institutional violence against older women, including those with disabilities (UN, 2010). Furthermore, it emphasizes that States Parties have an obligation to investigate, prosecute and punish all acts of violence against older women, including those ‘committed as a result of traditional practices and beliefs’ (UN, 2010: 6). Concern No. 38 requires States Parties to pay particular attention to violence suffered by older women in armed conflicts and to the plight of older women when addressing sexual violence, displacement and conditions of refugees. Finally, Concern No. 51 and 52 identify identifies the rights of older women in marriage and family life to property and inheritance when divorced or widowed, and the need for legislation ending discrimination against older women to protect them from material abuse and financial exploitation.
International women’s movement
In the 1960s, the international women’s movement raised consciousness about the patterns of discrimination against women and the need for social recognition of women’s empowerment and agency (Sen, 1999). By the 1970s, women were actively organizing and effectively lobbying for changes in laws, attitudes and social institutions, so that the role of women in society could be changed and broadened. It is no accident that demands for recognition of the human rights of older women are intensifying at this point in time. Young women – who participated in the women’s movement of the 1960s and 1970s – are now ageing and beginning to expand and redefine our understanding of old age as a time of continued transformation and participation. Still, there is a gap in the response of the international women’s movement to the issues related to the human rights of older women.
The two instruments reviewed here – the Madrid Plan and the CEDAW General Recommendation No. 27 – provide a compatible and strong interrelated set of strategies for addressing abuse of older women and widows from a rights-based perspective. They also reflect the maturing of the elder justice movement, including a rights-based platform for older women that has come from both ageing and women’s movements. Together, they can transform national and international responses to the plight of older women in a way to build capacity by strengthening the participation of older women in families, communities and society. Human rights instruments, specifically the Madrid Plan and the CEDAW General Recommendation No. 27, offer opportunities for advocates, NGOs (including universities and governments) to expand and target laws, interventions and scholarship to improve understanding of and response to the human rights of older women worldwide. The challenge is that neither the Madrid Plan nor the CEDAW General Recommendation No. 27 is legally binding. They reflect ‘soft law’, not ‘hard law’ (Doron et al., 2013).
The rights of older persons are captured by various international documents, but international attention should focus on advocating for the advancement of comprehensive ‘binding’ instruments that can offer older women real protection (Rodriguez-Pinzon and Martin, 2002; Tang and Lee, 2006). Comprehensive, legally binding instruments such as an International Convention on the Rights of Older People and international forums represented by the UN could create pressure for the implementation of national legislations, monitoring of progress and a legal avenue for individual complaints for older people around the world (Tang and Lee, 2006). Furthermore, the proponents of such an instrument suggest that nations across the world would take positive responsibility for promoting equality and non-discrimination in old age, and would consider protecting this group similarly to other vulnerable groups like children or women (Tang and Lee, 2006).
Discussion and implications for social work practice
Human rights are fundamental to the social work profession. Social workers practising in their home countries or abroad are committed to promoting ‘social change, problem solving in human relationships, and the empowerment and liberation of people to enhance well-being’ (International Federation of Social Workers, 2013). The International Executive Committee of IFSW and the Board of International Association of Schools of Social Work (IASSW) have initiated a discussion for the introduction of human rights in the definition of social work. In addition, the National Association of Social Workers’ (NASW) ([1996] 2008) Code of Ethics urges social workers to ‘Act to prevent and eliminate domination of, exploitation of, and discrimination against any person, group or class on the basis of … sex, and … age …’ in Section 6.04. Social and Political Action (p. 8). The IFSW is also committed to promoting the well-being of older adults worldwide through policy change, programmes, services and research (Hokenstad and Roberts, 2011). Articulating and framing the needs and challenges faced by older women – through the lens of human rights – give social workers an opportunity and an arena to fight for their rights at all levels of practice, particularly in developing countries where older women are even more vulnerable to various types of violence and abuse (Cox and Pawar, 2013).
Social workers can use the UN instruments to promote human rights of older women in the following ways. First, obtain your government’s commitment to the implementation of the Madrid Plan and the CEDAW General Recommendation No. 27, which provide a framework and guidance for government to enact adequate policies and resource allocations (UN, 1991). When working with government, it is important to do ‘gender mainstreaming’ because a gender-neutral approach to abuse prevention and protection could make older women invisible in policy implementation (UN, 2013a). Second, raise awareness and build public support for this movement. Social workers need to be aware of the importance of the role of public and social media in raising awareness, and use them wisely to bring public attention and support to the issue. It is also highly recommended that social workers include the younger generation in this awareness-raising campaign/project to promote intergenerational solidarity as well as public understanding of the continuum of abuse across the life cycle of women (UN, 2013a). Third, utilize the UN instruments to develop a platform for analysis of the progress made by government. It is vital to collect and archive evidence of violations of human rights as well as progress made towards the implementation of the Madrid Plan and the CEDAW General Recommendation No. 27 in each country and community. As previously stated, there are limited available data on the violence and abuse against older women (UN, 2013a); social workers need to includes research component in their advocacy work.
The following two resources are also available to social workers: (a) UN Independent Expert on the Rights of Older Persons and (b) HelpAge International’s resource guide for strengthening older people’s rights. The UN Human Rights Council appointed the first Independent Expert on the enjoyment of all human rights by older persons in May 2014 (UN, 2013c). This Independent Expert is a great resource for social workers. For example, social workers can send and receive information about activities promoting human rights of older women from the Independent Expert, and call upon government to cooperate with the Independent Expert and to invite the Independent Expert to the country to assess the implementation of existing international instruments (UN, 2013c). In addition, HelpAge International (2010) has developed a resource guide for ‘promoting dialogue on creating a new UN Convention on the Rights of Older Persons’, which includes specific strategies for NGOs (available at http://www.helpage.org/what-we-do/rights/strengthening-older-peoples-rights-towards-a-convention).
The human rights framework for old age is important in the field of international social work, considering the critical contributions of the profession to the international movement of human rights, and in securing human rights for people in communities of practice (Healy, 2008). In this context, social workers need to play an important role in implementing the Madrid Plan and the CEDAW General Recommendations nationally as well as globally, while approaching ageing issues from the lens of human rights to be able to set the stage for their protection.
Footnotes
Funding
Moon Choi is supported by New Faculty Development Grants from KAIST. The content is solely the responsibility of the authors and does not necessarily represent the official views of KAIST and University of Kentucky. None of the authors have any conflicts of interest to report regarding financial support for research, consultantships, or other holdings with respect to this research.
Author biographies
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