Committee against Torture - 43rd session

Franciscans international recently submitted a commentary to the reports presented by France to the Committee against Torture (CAT). The Committee Against Torture is a body of 10 independent experts monitoring the implementation of the Convention against Torture.

FI’s comments focus on the mistreatment of older people in senior citizens’ homes in France. It describes the psychological, physical and other forms of mistreatment that they endure and the gaps of the national plan in the fight against ill-treatment. FI suggests in its comments ways to address these challenges and improve the national plan.

Implementation of the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment

Commentary by Franciscans International relating to the fourth to the sixth periodic reports submitted by France (CAT/C/FRA/4-6),in accordance with art. 19 of the Convention.

Mistreatment of elderly persons in institution.

October 2009

In 2007 in a sample of 496 calls received and concerning cases of the mistreatment of aged persons in institutions, ALMA (Allô Mistreatment of Aged Persons and/or Handicapped Persons, a pilot project, which enabled in 2008 the establishment of a national call number: 3977.) established that a minimum of 36% of cases were recorded in public institutions.[1] The same report states that in 67% of cases, mistreatment is carried out by care staff or non-medical staff. These figures show the extent of mistreatment of aged persons in France, both in private and public institutions. They also underline that while some of these are carried out by persons acting in a private capacity, often they are by persons acting in behalf of public agencies.

1. Types of mistreatment:

This mistreatment can take different forms, and constitutes degrading, even inhuman treatment in the meaning of the Convention against Torture. The worst cases of mistreatment can lead to the death of the victim, or to suicide.[2]

The following mistreatments were particularly found:

Negligence:[3] Not responding to residents’ medical needs, not responding to residents’ calls (or taking away the bell from ‘those who call too often’), not getting residents up or walking them, not allowing sufficient time for people to eat, or not helping them to eat when the person cannot do it for themselves, not changing dirty bed-sheets for several days, not completing the residents’ personal care, putting protectors on those are not incontinent so that they do not need to be accompanied to the toilet, leaving soiled protectors on incontinent persons, not finding residents’ personal effects, excluding residents from social activities…

Psychological:[4] Over-familiarity, reducing to an infantile state, pejorative nicknames, not knocking before entering a bedroom, not respecting a person’s privacy (particularly physical privacy), not speaking to a person particularly while caring for that person, shutting residents in a room for long periods, socially isolating a resident, leaving a resident in bed all day, refusing to give a resident their own clothing and dressing them in clothing belonging to others…

Financial:[5] making repeated demands for money, blackmail, theft, robbery with violence…

Physical:[6] Being discourteous to a person during personal care, spilling food or water on a resident, feeding a person too quickly, force-feeding a person, putting a person into a bath that is too hot, shutting a person’s mouth with sticking plaster on the pretext that their cries are upsetting staff, tying a person under the shower on the pretext that they are moving too much, pulling hair, kicking, sexual touching, rapes…

Civil[7] and other: Retaining identity papers, opening mail, not respecting the private nature of a visit, not respecting food or cultural requirements…

Added to this is the fact that it is sometimes difficult for families to make complaints about particular practices, because of the risk of reprisal against their relative, taking into account the shortage of places in institutions (“If you are not happy, all you have to do is take your relative out of the institution.”)

Professionals are, in some cases, dismissed by the hierarchy for bringing to light a situation of mistreatment.

1. The National Plan to Eradicate Mistreatment (2007)[8]

Public authorities have grappled relatively recently with their consciences on different types of mistreatment of aged persons resulting in France adopting a national plan to eradicate this phenomenon.

In particular this has resulted in the setting up of a national telephone platform in 2008 by the Secretary of State for Social Affairs (3977). Recently, heavy media coverage of cases of mistreatment (particularly the case of a private establishment, in Bayonne, finally forced to close its doors) resulted in the emergency number being overloaded. In these last few weeks, the call centre was receiving up to 100 calls per hour. By May 2009 Afbah (French Association for the Protection of the Elderly and Disabled) which manages 3977, was already apologetic because only 65% of calls could be handled.[9]

The plan also relies on the departmental structures that have the responsibility of implementing complementary measures and coordinating the placement of victims.

1. Franciscans International’s Recommendations

France must persist in its efforts to promote the protection of elderly persons, and work to eradicate mistreatment. This includes particularly taking the following measures:

-          Improving and coordinating the formation of care and non-care staff, so that they develop an appropriate attitude towards elderly persons, and identifying cases of mistreatment and lodging appropriate complaints;

-          Building up staff in establishments, and taking care that recruitment includes in selection criteria the issue of mistreatment;

-          Increasing the number of public establishments and the quality of life in those establishments;

-          When establishments have to close because of a decision by the departmental public services (DDASS : Directorate of the Department of Health and Social Affairs), putting in place measures to ensure the care of residents in other establishments, and actually renovating the original establishment to meet standards. In this way preventing situations of ‘mistreatment’ being allowed to continue to the detriment of aged adult residents;

-          Developing formation and training for those in charge of institutions, to provide an adequate response to cases of mistreatment and to protect those who lodge complaints of abuse;

-          Encouraging the staff of an establishment (from the management to the administrative and maintenance services, and going through care and social) to have a common position to create more cohesion;

-          Putting in place structures which foster greater collaboration and better communication between residents' families and staff;

-          Equipping the telephone platform 3977 with sufficient financial means to be able to respond to all calls;

-          Valuing more highly the role of elderly persons in society; encouraging by programs and campaigns a positive image of the aged person.