Responding to Elder Abuse and Neglect
This material contains information and guidance for practice. The information is not legal advice. In many instances it will be your obligation to ensure that an older adult gets legal advice as soon as possible.
All material provided is up to date as of August 31, 2010.
What is elder abuse and neglect?
Elder abuse refers to any actions that cause physical, psychological, financial or sexual harm to an older adult. Neglect includes situations where a person or organization fails to provide services or necessary care to an older adult.
Examples of elder abuse and neglect include:
• withholding medication
• overmedicating an older adult
• invading privacy
• misusing funds
• physical assault
• non-consensual sexual contact
• neglecting an older adult’s basic needs
• threats of harm
• causing or supporting social isolation
• inappropriately gaining access to an older adult’s money
• not getting appropriate consent
• harassment
• forced confinement
Sometimes, elder abuse and neglect results in a criminal offence.
How does elder abuse and neglect happen?
Elder abuse and neglect may occur at home, in the community or in institutions (e.g. hospitals, health care facilities and long-term care homes). A person might intentionally or unintentionally harm an older adult in any of these settings.
Ageism can lead to elder abuse. Ageism is an attitude towards older adults based on negative beliefs about aging and assumptions that older adults are weak, frail or incapable. Ageism can result in demeaning, discriminatory or dismissive behaviour.
How can personal support workers identify elder abuse and neglect?
Some hospitals and health authorities have developed diagnostic tools to help health care professionals identify elder abuse.
The National Initiative for the Care of the Elderly (NICE) has published user-friendly versions of the following tools:
•IOA: Indicators of Abuse
(byMyrnaReisandDaphneNahmiash)
•CASE: Caregiver Abuse Screen
(byMyrnaReisandDaphneNahmiash)
•EASI: Elder Abuse Suspicion Index
(byMarkJ.Yaffe,MaxineLithwick,ChristinaWolfson)
•IN HAND: An Ethical Decision-Making Framework
(byMarieBeaulieu)
These tools are available online at: www.nicenet.ca
Refer to the Charting Sheet: Responding to Elder Abuse and Neglect for a helpful way to document facts, concerns and risks related to elder abuse and neglect.
How should personal support workers respond to elder abuse and neglect?
The appropriate response towards an adult who is being abused or neglected is to offer the most effective, but least restrictive and intrusive support, assistance or protection.
This could involve assisting the older adult in connecting with support services, working with the older adult to form a supportive network, or notifying the appropriate authority about concerns of elder abuse. Any support for an older adult must recognize the older adult’s right to privacy and right to make decisions.
Refer to the brochures Confidential Patient and ClientInformation: Responding to Elder Abuse and Neglect and Mental Capacity and Consent: Responding to Elder Abuse and Neglect for more information.
Is there a legal obligation to notify someone else?
The laws are different in each province and territory. The legal obligation to respond to elder abuse or neglect will depend on:
• which province or territory the older adult lives in
• employment role or professional responsibility
• whether the older adult is living in the community or in care
• whether the older adult is in need of support or assistance,or is unable to care for himself or herself
In some provinces, personal support workers must notify a delegated person or government authority about elder abuse or neglect when an older adult is receiving assistance from a health care facility or living in a long-term care home. In other provinces, the person who operates the care facility is legally obligated to notify the patient’s representative, medical employees, funding program or health authority.
In some provinces and territories, personal support workers will need to notify an appointed person or organization when
an older adult is being abused or neglected and is in need of assistance or support, or is unable to care for himself or herself.
In some provinces, personal support workers also need to notify a designated person, organization or government authority when an older adult is at risk of abuse or neglect.
Refer to Summary of the Law in Each Province and Territory: Responding to Elder Abuse and Neglect for details of when to notify the appropriate person, organization or government body.
What about elder abuse and neglect in the workplace?
Employers cannot discipline or discharge a personal support worker for fulfilling a legal requirement to notify a designated person, organization or authority about elder
abuse, neglect or risk. Workplace policies should provide clear, practical guidance about when and how to respond to elder abuse and neglect.
This project has been supported by the Public Health Agency of Canada through the Federal Elder Abuse Initiative. The views expressed herein do not necessarily reflect the official views of the Public Health Agency of Canada.