Coping with Elder Abuse in Israel: The Multi-systemic Model

Israel, like many other countries, has to cope with the consequences of demographic changes in population size and composition. Israel’s population today is approximately 8.5 million people out of which people 75+ are close to 45% of the elderly population. 87% of them are community dwellers (Israel Central Bureau of Statistics 2014, http://www.cbs.gov.il/reader/newhodaot/hodaa_template. html?hodaa=201511257). This age cohort is the most vulnerable; many of them suffering from limitations in daily functioning and chronic diseases. About 18% of community-dwelling elders report of a disability or ADL difficulties. Studies show that family members provide 80–90% of care for disabled elders (Lowenstein and Katz in Handbook of social gerontology. Sage, London, pp. 190–201, 2010; Lowenstein in Old age and autonomy: the role of service systems and intergenerational family solidarity: final report. Oasis, 2003a, Lowenstein in Aging and gerontology in Israel. Eshel, Jerusalem, 2003b). Elder care can be a stressor and even a source of conflict in family relations. Due to care burden, the elderly population might be exposed to occurrence of abuse and neglect. Such data was collected in a National Community Survey starting in 2005 which indicated that elder abuse and neglect is a phenomenon, especially emotional abuse, financial exploitation, and neglect (Lowenstein et al. in J Elder Abuse Neglect 21(3):253–260, 2009; Lowenstein in J Elder AbuseNeglect 21(3):278–287, 2009, Lowenstein in Ageing Int 35(3):215–227, 2010). The Israeli society is a unique case among the worlds’ developed countries. It is a multi-cultural society, composed of Jews, Muslims, Christians, Druze Bedouin and Circassia societies, with traditional and modern cultures (Brodsky et al. in Elders in Israel, statistical yearbook. Mayers-Joint, Brookdale Institute of Gerontology and ESHEL—the Association for Planning and Development of Services for the Aged in Israel, Jerusalem, 2010). On the one hand, Israel is a modern country, on the other, religious, traditional, familial, and cultural values are strong. Families in Israel are the main source of informal support network (Habib and Tamir in Jewish aged in the United States and Israel: diversity programs and services. Springer, New York, 47–60, 1994; Lowenstein and Katz in Handbook of social gerontology. Sage, London, pp. 190–201, 2010). Most social services for the elderly in Israel are provided by welfare departments, which are located within local municipalities. Additionally, the health system is also a gatekeeper trying to prevent and treat. The main hypothesis in cases of elder abuse and neglect is that in order to stop or reduce it, we need to implement diversified community intervention methods. Hence, there is a need for accessible services to elders and their family members, to other professionals who work with elders and provision of direct treatment to victims and their aggressors (Alon and Berg-Verman in Gerontology 45(2–3):171–195, 2009). The data from the National Survey was presented at the Israel’s President House and at the Parliamentary Committee of Health and Welfare of the Israeli Parliament. It created a large media coverage and a call to develop special services for this population. Accordingly, unique models had been developed both within the social and health service systems. The chapter will describe and analyze the creation, development, and evaluation of some of these models, where there is also close collaboration with the legal system and other community service providers.