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Recognizing Abuse of Older Adults

Providing care to an older person can be a challenging but rewarding experience. Education and support services are critical in preventing and addressing abuse and neglect and promoting overall wellness.

Guiding Principles

The Government of Saskatchewan set out the following principles to guide policy and programming for older adults. The spirit and intent of many of these principles are already reflected in our laws and serve as a helpful starting point for any interactions with older adults in our communities.

Dignity - being treated with respect regardless of the situation and having a sense of self-esteem.

Independence/Self-Determination - being in control of one's life, being able to do as much for oneself as possible and making one's own choices.

Participation - remaining integrated in society, getting involved, staying active, taking part in the community and being consulted and having one's views considered.

Fairness - having one's real needs, in all their diversity, considered equally to those of other people regardless of age, gender, racial or ethnic background, disability, economic or other status.

Safety and Security - having adequate income as one ages and having access to a safe and supportive living environment, including freedom from fear and exploitation.

Self-Fulfillment - being able to pursue opportunities for the full development of one's potential with access to the educational, cultural, spiritual and recreational resources of society.

Recognition - achieving inter-generational recognition and respect for contributions of older persons.

-Saskatchewan's Provincial Policy Framework and Action Plan for Older Adults, 2003

Types of Abuse

Issues of power and control underlie all abuse situations and the most vulnerable people are at the most risk. Older victims of abuse often know the people who hurt them. Many victims are dependent on their abusers for food, shelter, transportation, personal care or companionship.

Abuse of older adults is an act or behaviour by anyone, including a caregiver or stranger, which results in harm to an older person's wellbeing or safety. Caregivers are often family members, but include anyone who provides care to the older person in their own home or a care facility.

Many victims live in their own homes or with relatives. Others may live in assisted-living complexes, private care homes and long-term care facilities.

Isolation and abuse go hand in hand. Most abused older adults are isolated from their friends, neighbours and other family members. Often the abuser controls the situation by refusing visitors or phone calls or making the victim unavailable.

While isolation and dependence puts older adults more at risk, abuse can happen to any person regardless of race, religion, background, income or age. Abuse of older adults may take the form of financial abuse, emotional abuse, physical or sexual abuse, or neglect.

Financial abuse
may involve forcing a person to sell their personal belongings or property. It may also involve pressuring them to pay for products and services that are not needed. Stealing a person's money, pension cheques or possessions, or withholding money that is required for daily expenses are other examples. Theft, fraud, forgery, extortion and the wrongful use of a power of attorney are also forms of financial abuse.

Emotional abuse involves humiliating, insulting, threatening or controlling behaviour. Abusers may socially isolate an older person or threaten to have them placed in a facility. Abusers may also unnecessarily restrict or remove an older person's decision-making powers.

Physical abuse includes things like slapping, pushing, kicking, shaking, misuse of medication and forced confinement. Forced confinement may include things like not allowing an older person out of a room, bed or chair for extended periods of time. It also includes sexual abuse such as inappropriate touching during personal care routines, sexual comments or sexual activity without the adult's consent.

Neglect may involve abandonment or withholding things such as food, personal care or medical attention.

Signs of Abuse

Signs of financial abuse include...

  • money or valuable personal items missing without explanation
  • going without food, clothing or other necessities that the older person should be able to afford
  • unexplained lack of cash on hand
  • failure to pay rent or bills on time
  • sale or transfer of the older person's property without the older person's knowledge or understanding
  • unexplained withdrawals from financial institutions
  • unusual changes to documents such as a power of attorney or Will
  • prepared or executed documents and agreements involving the older person that they don't understand or are not aware of
  • lack of independent advice concerning questionable financial decisions

Victims of physical abuse, neglect or emotional abuse may show signs of...

  • depression, fear, withdrawal, anxiety or passivity
  • unexplained or new fear of family members, friends or caregivers
  • unexplained physical injuries
  • malnutrition or dehydration
  • changes in personal hygiene and grooming
  • untreated pressure sores or abrasions
  • over-sedation

Any signs and symptoms should be taken seriously and investigated. What sometimes seems to be self-neglect or apathy may turn out to be abuse. If the abuse or neglect is unintentional, education and support can be offered; if the abuse or neglect is intentional legal remedies are available.

The Abusers

Abusers may have a family history of violence or hold onto negative stereotypes of older or disabled adults.

In the community, family members are responsible for the vast majority of elder abuse and neglect. The abuser may rely on the older adult for money or a place to live. The abuser may be a caregiver who can no longer handle the stress of looking after the older person. Stress can become unmanageable when the caregiver is not equipped to provide care or has limited resources and little or no personal support.

The caregiver may not understand the effects of illness or medication on the older person. The abuser may have psychological difficulties or alcohol or substance abuse issues. Personal problems in their own life can also contribute to the stress and lead to abuse of a vulnerable victim.

In institutional settings such as assisted-living complexes, private care homes or long-term care facilities, abusers are likely to be frustrated staff members who are not able to do their job properly. Staff may become frustrated because they have poor training or are overworked. Abuse such as theft and assault can occur, but in these settings abuse tends to take the form of neglect, poor personal care and abrupt or disrespectful treatment.

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