We would like to share the experience as doctors working in a small island nation, Malta, where, one of the first effective measures was that the elderly population (65+) were asked to self-isolate at home, being among the most vulnerable group.1 In cases where the offspring, even as adults, especially if they are single, tend to live with their parents (for a number of reasons, including economic advantages), cases of domestic violence towards the elderly have increased.2 This is especially the case where the elderly persons who were previously able to go out to work part-time or frequent their social circles, such as the church or other community support, then were not able to continue this ‘for their own protection’ in view of the risk of falling ill from COVID-19.
This does highlight that domestic violence, be it to the partner, the parents, grandparents or the children, is an extremely relevant risk during a pandemic and its socially disrupting response of self-isolation at home. Whilst the first incidence of domestic violence may have actually occurred during this particular situation, it is more likely that the underlying problem of domestic violence was actually already there, and was just aggravated by the fact that the victim no longer had access to the normal ‘safety net’. In the initial phases of the pandemic, where everyone (including social workers, psychologists, support agency workers) was encouraged to tele-work and the systems to carry this out were not yet in place, telephone helplines and clinics were temporarily unmanned. The COVID-19 helpline was one of the first to be accessed by such abused elderly people, as a cry for help when faced with such an inescapable situation. National statistics may fail to detect any rise in reporting, as victims may be more resilient and reluctant to come forward. A mobile application has been launched which the victims can use to call for help.3
As had been highlighted by Keynejad et al.,4 domestic violence becomes even more of an issue in low- and middle-income countries, besides in high income countries, calling for an urgent need for psychological interventions, especially to vulnerable groups like the elderly. COVID-19 pandemic has left many victims – not only those unfortunate ones who have died as a direct cause of the infection, but even those who lost their channels for getting help due to social isolation and disruption, even if temporary.
