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SAHRC launches report on challenges facing older persons

04 June 2015

Attention: Editors and Reporters

The South African Human Rights Commission has completed its national investigation into the challenges relating to the treatment of older persons. The purpose of the investigation was to work towards the formulation of effective responses to address the numerous human rights violations experienced by older persons.


The report focuses on systemic issues that have a direct impact on older persons, specifically in their experience of attempting to access their constitutional rights. The Commission recognises that older persons constitute a vulnerable group with unique and differing needs compared to those of other vulnerable groups, such as women, children or people with disabilities, and that they therefore deserve focused attention in order to address and resolve the rights violations currently being experienced by older persons.

Older persons continue to lack access to adequate health and basic education, suffer from gender discrimination and abuse, and are threatened with economic isolation with no prospect of securing employment.

Further, due to the country’s high unemployment rate, and as recipients of state-funded social grants, many older persons have become responsible for financially supporting their family members. This situation is further exacerbated by the impact of HIV/AIDS, and the fact that so many children are left orphaned by the premature death of their parents.

The report further highlights the concerning problem faced by older persons who reside in institutionalized care facilities such as places of retirement, frail care centers and in old age homes, who are often abused by those responsible for taking care of them.

In March 2013, the South African Human Rights Commission received a complaint from the South African Older Persons Forum (SAOPF) relating to the progress and implementation of a register detailing persons convicted of abusing older persons (or any crime or offence) by the Department of Social Development.

Prior to this complaint, the Commission’s approach to combating human rights abuses relating to older persons has included investigation of individual complaints, publishing statements condemning the rights violations experienced by older persons in response to media reports detailing such incidents, attending meetings and conferences with interested stakeholders that focus on issues affecting older persons, visit homes where older persons reside, and informing the public generally about rights violations concerning older persons. Still, notwithstanding these steps taken by the Commission, older persons continue to have their rights violated.

Many of these cases are still being reported to the Commission as well as the Department of Social Development, which holds the central mandate for the welfare of older persons in the country.

It was for these reasons that the South African Human Rights Commission decided to conduct a national hearing in 2013 to address these issues affecting the elderly. Several departments were identified as the most relevant in addressing the challenges surrounding the rights of older persons. The departments that made submissions during the hearings included The Department of Social Development (DSD), The Department of Health (DoH), The Department of Public Works (DPW) The South African Police Service (SAPS), The Department of Justice and Constitutional Development (DoJCD), The Department of Trade and Industry (DTI) and external stakeholders including The South African Older Persons Forum (SAOPF), and Age in Action, among others.

Recommendations


After careful analysis of both written and oral submissions made by various departments and stakeholders during the hearing, the Commission makes the following recommendations:

Legislative Reform

That the National DSD must propose to Parliament the amendment of the definition of residential facilities as stated in the Act within 12 months from date of receipt of this Report.
That the Department of Trade and Industry must, within 1 month of date of receipt of this Report, appoint a task team to investigate a new dispensation and legislation policy framework of housing of older persons that would provide protection of older persons, accreditation system code of practice and the appointment of Retirement of Housing Commissioner.
Budgetary Allocations and Funding Arrangements

That the National DSD must, within 6 months of date of receipt of this Report, provide a circular to ensure uniformity in funding of services to older persons in all provinces. This circular should prioritize issues of safety, staffing, nutrition, medicals.
That the National DSD must ensure that in the next budget cycle special ring-fenced funding allocation is allocated to residential facilities to ensure that they comply with health and safety standards in the Older Persons Act and National Building and Occupational Health and Safety Regulations.
That the National DSD must ensure that, in the next national budget cycle, the funding allocated for the implementation of the Act is ring-fenced for this purpose, and consideration be given to a 10% inflation increase on key line budget items.
That the DOH must, within 6 months from date of receipt of this Report, undertake a costing survey covering critical pharmaceutical and medical supplies for the care of older persons, including but not limited to, oxygen supply, food supplements, and incontinence products to all older persons.
That DOH must, within 8 months from date of receipt of this Report, consider a strategy for the supervision of care for frail older persons in communities.
Capacity Building

That the National DSD must develop a comprehensive database of all caregivers in communities, within 8 months of receipt of this Report, and provide intensive training for community caregivers in caring for older persons in their homes within 12 months thereafter.
That SAPs must within 8 months of date of receipt of this Report, undertake training of police officers on enforcement of the provisions of the Older Persons Act, and in particular on how the provisions of the Older Persons Act are linked to those of the Domestic Violence Act.
That DOH must ensure that within 8 months of date of receipt of this Report, all officials in the public and private health care sector are properly equipped/ trained in the Older Persons Act and the care of older persons. Care of the aged should be included in the curricula for all medical and nursing students.
Sector Regulation and Inter-Departmental Co-ordination

That DSD and DOH must, within 12 months of the date of receipt of this Report, devise mechanisms and measures to enhance the co-operation and co-ordination between the two Departments in order to ensure that standards and norms pertaining to care services as outlined in the Older Person’s Act are uniformly applied, taking into consideration the financial and cultural circumstances of older persons, including that age is not regarded as an illness and that Caregivers be more widely utilized in care services.
That the Minister of Social Development must ensure that, within 12 months of date of receipt of this Report, all organs of state work together to ensure implementation of the OP’s Act; in particular it is recommended that inter-sectorial collaboration among the various government departments such as the DSD, DOH and DOJCD be fostered in order to realise  the rights of older persons. This inter-governmental collaboration should be directed at improving information sharing, compliance, service delivery and effective monitoring and evaluation within the different provinces.
Public Participation and Community Awareness

That the SASSA must, within 3 months of receipt of this Report, embark on an extensive public awareness campaign in the media providing the public with information on available services and the availability of grants-in-aid to older persons.
That the DOH must ensure that, within 6 months of date of receipt of this Report, HIV/AIDS programmes targeted at older persons are introduced to enable screening and counselling for those infected with the HIV/AIDS virus. Educational material accessible in all the (11) eleven languages should be printed to spread awareness about the disease amongst the older population.
That the DOH must provide copies of all material on the identification, prevention and early detection of abuse of older persons to community centres, within 3 months of date of receipt of this Report.
That the DTI, in considering an application for exemptions in Article 10 of Act 65 of 1988, must consult with the local community including local authority before granting such exemption.  This consultative process must be included in the applicable regulatory framework.
Service Delivery Enhancement

That the SASSA must introduce specific measures to ensure safety and protection of older persons at pay points and specifically against exploitation by micro-lenders within 6 months of date of receipt of this Report.
That SASSA must introduce urgent measures to stop the illegal practice of withholding older person’s ID documents as sureties for micro-loans should be instituted no later than 3 months from date of receipt of this Report.
That National DSD must ensure that all funded residential care facilities are registered by end of 2015 and the new ones are registered by the end of 2016.
That the Department of Home Affairs must develop a strategy and a set of procedural guidelines to expeditiously address the applications of older persons who do not have identity documents by the end of 2015.
That the Department of Health must establish, within 12 months of date of receipt of this Report, an integrated medical care system including mental illness, primary health care, untimely discharge from hospital and the proper understanding of medical staff in private and public health sector relating to Older Persons Act be implemented.
That Department of Health must establish, within 12 months of date of receipt of this Report, measures to ensure uniformity in service provision and practice in cases of the regression of an older person’s mental illness based on the nursing care plan and the IDP. It is recommended that such residents be moved from frail care centers into state psychiatric facilities to stabilize their condition before transferring to a frail care center. The Psychiatric hospital/ clinic must provide psychiatric staff to supervise the ongoing treatment of psychiatric residents in the frail care facility.
That the DTI should adopt special procedures, within 3 months of date of receipt of this Report, to protect the interest and rights of older persons in the handling of consumer complaints lodged by older persons before the Consumer Protection Tribunal.
Regulation

That all private and non subsidized care services as defined in the Act should be registered by 2016.
All community based support services, whether state funded or not, are registered by 2017.
Enforcement

That Nursing Council must amend disciplinary procedures, within 3 months of date of receipt of this Report, to take into account of the rights and interests of the older person victim.  In particular, the right of the older person to participate in the investigation hearing, be represented and be advised of the outcome of the proceedings should be included in the procedures.
That the DOJ must ensure that the Sexual offences register, with specific reference to older persons and the National register of abuse of older persons are linked  within 3 months of date of receipt of this Report in order to bring all offenders into the accountability net.
Reporting Obligations

That the DOJ must submit a progress report to the Commission on the functioning of the specialized unit on the promotion of rights of vulnerable groups with specific reference to older persons within 6 months of date of receipt of this Report.
That the National DSD must submit a report to the Commission within 3 months of date of receipt of this Report indicating to what extent they have ensured that all nursing and social work staff regardless of whether they are state, private or NGO staff are being financed in terms of the Bargaining Council.
That the National SAPS must submit a Report to the Commission, within 3 months of date of this Report, on how many police officers have been trained on the National Instructions of 2014 in the last 5 years.
That the SA Nursing Council must submit a Report to the Commission, within 6 months from date of receipt of this Report, on options to reinstate Gerontology as a core competency in curriculum of Advanced Nursing Practice.
That the DOJ must provide the Commission with a Report within 6 months of date of receipt of this Report on the current status of accessibility of Courts to Older Persons, and time-bound measures and plans that are in place to ensure equality of access of persons with disabilities to justice.
That the DOJ must submit a progress report to the Commission on public awareness programmes and training of law enforcement agents and court officials on the Older Person’s Act within 6 months of date of receipt of this Report.
That the DOH must submit a status report to the Commission, within 3 months from date of receipt of this Report, on the appointment of sessional doctors to provide medical services to retirement care facilities.
That the SAOPF must furnish the Commission with a copy of the Research Report on  the abuse of older persons within 3 months of date of receipt of this Report.
That the SAPS must  generate and furnish to the Commission a station by station report, within 6 months of date of receipt of this Report, on the number of older persons abuse cases per annum since 2010 to 2014 according to the following format:
a)      number of cases reported;

b)      number of cases investigated;

c)       the outcomes of cases investigated; and

d)      including the reasons why cases were not finalized.

That the DTI and Department of Housing provides a Report to the Commission, within 3 months of date of receipt of this Report, with respect to the execution of its statutory responsibilities with respect to the Housing Development Schemes for Retired Persons Act 65 of 1988, (HDSRP) and the steps they have undertaken to protect the right to housing of older persons.
That SALGA must provide a full Report to the Commission on the state of local government housing for older persons which includes compliance with the Older Persons Act within 3 months from date of receipt of this Report.
That National DSD must provide a report to the Commission, within 3 months of date of receipt of this Report, on the implementation of the Indigent Policy; which should include the steps taken to make the Policy accessible and applied to indigent persons uniformly.
That SALGA must provide a report to the Commission, within 3 months of date of receipt of this Report, on the extent to which rebates for older persons in respect to local authority taxes are applied uniformly

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