The aged care system has a number of problems. But there's one that has been silenced for too long.

December 4, 2023

Content warning: This story discusses sexual assault and could be triggering for some readers.

When Dr Catherine Barrett was first told that 50 sexual assaults are reported in aged care per week, she wasn't surprised.

For years Dr Barrett worked as a health nurse unit manager in residential aged care. During that time, she saw first-hand that sexual abuse in aged care was a problem rarely dealt with — let alone acknowledged.

This was 28 years ago. And still to this day, the statistics are grim.

In Australia, we only know of one older woman who has gone public with her story of sexual assault.

"Her name was Margarita Solis," Dr Barrett tells Mamamia. "One day I picked up the phone from beautiful Margarita, who was 95 at the time, and she told me she had been sexually assaulted last year in a retirement aged care service. The man who sexually abused her was the acting manager of the service, who was later convicted."

Margarita went public with her story in 2018, and said not being believed was one of the hardest things.

Margarita Solis. Image: Supplied by Lisa White Photographer.

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"Initially, I just blamed myself because I let him in. When I told another manager [about the sexual abuse] I knew she didn't believe me because her whole attitude said: 'Come on this is our friend and he wouldn't do that'," Margarita said in a film about her story.

Before her death in 2019, Margarita did a significant amount of work in this space by sharing her story, presenting at the National Elder Abuse Conference, and her case being looked at by the recent Royal Commission.

Dr Barrett says that working alongside Margarita fueled her passion to amplify the voices of other older women who are victim-survivors.

"Given Margarita's story is likely the only one we have on the public record, it shows we haven't yet been able to create safe spaces for older women to share their stories and teach us what we need to do to help them be safe."

At the Royal Commission into Aged Care Quality and Safety, the statistics of sexual assault in these environments were called "a source of national shame". The reality is that the rates are most likely higher (taking into account the assaults that aren't reported on).

The Royal Commission certainly put the issue on the agenda. But as for action, it's mostly being pushed for by leading advocacy bodies.

In a recent research report commissioned by the Department of Health, staff from 178 residential aged care homes were asked to rate the impact of sexual assault incidents on residents. 58 per cent of the staff said the sexual assault had no impact on the victim.

"When I saw that finding come out, it made my heart sink," Dr Barrett tells Mamamia.

"That is so disrespectful for people to assume that the sexual assault of older women doesn't have an impact. Of course it does. The problem with that statement is it doesn't motivate people to want to prevent it. And it doesn't motivate people to put strategies in place for recovery."

Watch: #OlderWomenCount Campaign Video. Post continues below.

Video via Celebrate Ageing.

Statistically speaking, older women impacted by a cognitive impairment like dementia or those who have a high level of frailty are particularly vulnerable.

When it comes to data around who the perpetrator usually is, it's vague. But the most common scenarios are someone who works in the aged care facility, a fellow resident or sometimes a visiting family member.

Like with any woman, being believed can be an uphill slog. For older women who have shared their stories with Dr Barrett, she says the resounding theme is that they feel discredited or ignored.

"The response can be really frustrating — 'Oh she has dementia, or she must have a UTI, maybe she misconstrued a clinical procedure or intimate care being given, she must have delirium, he wouldn't do that he's a family man, she's an older woman why would he be interested?' It's ignorance, really. And it's similar to what lots of young women face, for example, 'What was she wearing, did she have too much to drink, was she flirting with him?'"

When it comes to older Australians and the topic of sex and consent, Older Women's Network's (OWN) CEO Yumi Lee said it's a topic we can find challenging to navigate.

"Many older people today may find it difficult to talk about [consent] because they grew up at a time when attitudes towards sex and consent are really different to what it is today," she said recently.

"If you're talking about older people from culturally diverse backgrounds this could be even more pronounced and there's a lot of shame and taboo associated with sex. Consent should not be seen just as a younger person's conversation, even though it's very much depicted that way in the media. It should be an older person's conversation, too."

This sentiment rings clear when you consider that half of Aussie women aged 70 to 75 have reported having sex in the past year, as per the Australian Longitudinal Study on Women's Health.

As Dr Barrett notes: "Older people don't simply stop becoming sexual beings. Residential aged care providers need education on older people's sexuality and to ensure everyone knows their sexual rights and the need for consent and boundaries."

After deciding to finish up her career in nursing, Dr Barrett turned to academia and advocacy to try to get this issue to the forefront of public consciousness. Now it's slowly but surely being recognised.

10 years ago, Dr Barrett founded Celebrate Ageing, a not for profit combatting ageism and building respect for older people. She said it's been hard but gratifying work.

Dr Catherine Barrett. Image: Supplied.

Now we come to the pivotal question — what needs to be done to implement change and reform on this issue?

OWN's Yumi Lee said "entrenched ageism" plays a role in the barriers older women face to access justice. For Dr Barrett, she says reform will come down to a few factors.

One is as simple as listening — acknowledging the stories and listening to what older people say and what action they want.

Second is education. We need to understand that sexual assault in aged care settings does happen, and that it does have an impact. It's also important to know the indicators and warning signs of perpetrators.

Third is providing support to those who have been abused. Recently the Older Persons Advocacy Network — which is one of the peak bodies in this field — has stepped up to the plate, Dr Barrett saying the network has said "they want to do something to prevent sexual assault" following the findings from the Commission. It's a step in the right direction.

"We needed that leadership from a peak CEO standing up and saying this is not okay," she says to Mamamia. "Just like with the issue of family violence, it takes a collective effort from advocacy groups, the federal government, our additional peak bodies, the system and us as individuals."

The fourth point is the need for older people, particularly older women, to be respected in society. This was something that prior to her death, Margarita Solis had been passionate about fostering. As she said in her film, it's support from other women that can make the biggest difference.

It's a response like this that makes Dr Barrett want to keep pushing forward — for reform, a change in attitudes towards older women and to help those who are victim-survivors.

"Older people are the best cohort and they are my favorite people, by far. We need to keep listening to the voices of older women, because this issue is everybody's business. We are all responsible for creating cultural change."

Australia's Aged Care Minister Anika Wells was contacted by Mamamia for comment on this article. If/when we receive such comment, we will include it in this article.

For more from Celebrate Ageing you can follow their website here, and you can hear more about their Elder Leadership Academy here.

The Elder Abuse Helpline is available on 1800 ELDERHelp (1800 353 374), and the Older Persons Advocacy Network can be contacted on 1800 700 600. If this has raised any issues for you, or if you just feel like you need to speak to someone, please call 1800 RESPECT (1800 737 732) – the national sexual assault, domestic and family violence counselling service.

Feature Image: Getty.