Serious case review into death of woman, 81, after alleged attack by husband, 88, recommends more education on issue
The death of an 81-year-old woman following an alleged assault by her 88-year-old husband has triggered a major inquiry that has lifted the lid on the hidden world of domestic violence among old people.
Mary Russell died of a bleed to the brain following a "domestic-related" incident at her home in Leigh-on-Sea, Essex, in October last year. She had made eight 999 calls over the preceding seven months.
Essex police force's major investigation team launched a manslaughter inquiry, but in April this year the CPS decided that there was not enough evidence to prosecute her frail husband, Albert, who has since died. He was interviewed under caution following the incident. The couple had been married for 56 years at the time of Mrs Russell's death.
Information passed to the Guardian about the inquiry, a serious case review, has highlighted how little is known about domestic violence involving old people, and how easy it is for professionals to miss the signs. The inquiry found that because the couple were elderly and frail, police were inclined to treat the domestic violence allegations as a social care issue rather than possible crimes.
The different agencies involved in the case failed to communicate adequately with one another. Despite Mrs Russell's repeated 999 calls, the emergency teams that arrived at the house had no knowledge of previous callouts. Domestic violence incidents tend to escalate over time, so this lack of prior knowledge was highlighted as a particular cause for concern.
Mrs Russell had considerable contact with agencies including police, social services and health professionals in Southend. She first reported domestic violence to the police in 2003 after a neighbour saw her standing on her doorstep with blood pouring from her nose, saying she had been assaulted by her husband. On one occasion she reported that her husband put his hands around her throat. Various cuts and bruises were documented when she reported injuries.
In May 2010, Mr Russell was arrested in relation to the alleged domestic violence incidents and taken to Southend Police Station. He admitted assaulting his wife on two occasions, and was cautioned and returned home.
Although Mrs Russell's reports of violence intensified in the months leading up to her death, she rejected offers of help. Services are constrained by the fact that adults with mental capacity, as Mr and Mrs Russell were deemed to be, cannot be legally prevented from putting themselves in dangerous situations.
Mr Russell alleged that Mrs Russell had also been attacking him, and reported punches behind his ears and lacerations from her nails.
The serious case review involved health, social care and police professionals in Southend. As the name suggests, these inquiries are only conducted in the most serious cases. A total of 96,000 cases where adults were thought to be at risk were referred to adult safeguarding services in England in 2010/11, according to provisional statistics from the NHS Information Centre ? just 80 of them resulted in serious case reviews. Half of these involved elderly people.
The report recommends that police improve their understanding of domestic violence in old age. It calls for a cross-agency response to these situations and for research to be carried out into domestic violence in old age.
Police are planning to introduce training next year to help officers recognise and respond appropriately to such situations.
Chief constable Carmel Napier of Gwent Police, the Association of Chief Police Officers' lead on domestic violence, said: "We have to recognise the complexity of the problem of older people and domestic violence.
"We need to accept that it's really unusual for people to phone the police and to understand the extra vulnerability of old people to domestic violence because of their frailty, lack of mobility and the medication they may be taking."
Deborah McIlveen of Women's Aid, said: "In our experience, older women face additional barriers accessing services. People do not expect those over 60 to be experiencing domestic violence. But we have been contacted by older women who have lived with violence throughout their marriage. We would like to see more action from both statutory and voluntary organisations working with older people to address the issues and make it easier for those affected to access information and support."
There is no legal obligation for serious case reviews to be made public, but an executive summary of the inquiry report regarding Mrs Russell's death is expected to be published early next year.
Southend-on-Sea Borough Council's corporate director for adult and community services, Simon Leftley, said: "The recommendations of the review have yet to be considered by our local multi-agency safeguarding board.
"While the investigation concluded that the incident leading to this tragic death could not have been predicted or prevented, it has highlighted areas for learning, particularly in respect of gaining a better understanding of the prevalence of domestic violence among older people and in developing appropriate strategies to manage risk in these cases.
"In many cases, particularly with the victims of domestic violence, many adults will refuse any offers of help or assistance. While we must respect the right of adults to make independent decisions about their lives, we also need to ensure that there are appropriate checks and balances in place.
"We believe the prevalence of domestic violence among older people is higher than people think and we hope that our review will assist other authorities and agencies facing similar challenges."
A spokesman for Essex police force said: "We take all domestic abuse seriously, including that involving older people, and recognise the additional risks that frailty, loss of mobility or onset of dementia can pose.
"We try to identify the potential risk at all domestic incidents that we attend in order to best safeguard people from further harm.
"We work closely with colleagues in other professions to ensure that those most at risk of harm are offered support and appropriate interventions in a co-ordinated and sensitive way.
"Domestic abuse between older people is often less widely recognised in the community but the outcomes can be equally as tragic as for other age groups."