Primary Care Resources - Elder Abuse

Elder abuse comes in various forms.  Abuse can be a single or repeated act or even a lack of appropriate action that causes harm or distress to the older adult.  Elder abuse is seen in relationships where the older adult has an expectation of trust with the care provider/family member/other trusted individual or partner.(4)

Why it is important

  • Under-reporting, confusion about what constitutes elder abuse, a general lack of awareness, among other factors have made it a challenge to report prevalence of elder abuse; based on the available data, it is estimated that 4% to 10% of older adults in Canada experience some type of abuse (1)

Common Causes

  • Financial abuse (the most common form of elder abuse, theft or misuse of the person’s money or property)
  • Physical abuse (physical pain or injury willfully inflicted, unreasonable confinement and punishment causing physical harm, withholding physical necessities)
  • Sexual abuse (sexual activity or contact resulting from threats or force without the elder adult’s consent)
  • Psychological or emotional abuse ( infliction of mental anguish, provoking fear,  intentional isolation)
  • Neglect (can be either intentional or unintentional and occurs when the care-provider fails to meet senior’s needs)
  • Abuse can be perpetuated through a number of factors such as gender, race, religion, age discrimination, geographic location, economic status (2)

Key Considerations

  • Steps can be taken to prevent elder abuse in hospitals, primary care and long term care: understand elder abuse, recognize elder abuse, learn the law, develop strategies and interventions (e.g. use resident-centered care, use therapeutic relationships as preventive strategies),  understand and improve workplace factors that may contribute to abuse (3)
  • Risk factors for elder abuse include cognitive impairment, physical dependency,  isolation, inability to express wishes,lack of choice and economic vulnerability (1)
  • Signs and symptoms of elder abuse: social withdrawal, depression, fear, anxiety, unexplained physical injury, lack of necessities, unusual banking activity (2)• Long-term Care Homes Act: offers a progression of operational measures starting with screening, orientation and training of staff and volunteers; the development of zero- tolerance policies for abuse and neglect; the identification of responsive behaviours which may lead to resident-on-resident violence; and appropriate responses including the use of specialized behavioural units; a scheme for mandatory reporting of abuse and neglect in long-term care homes and whistle-blower protection, including protection from retaliation against any long-term care residents/their families/ friends/substitute decision-makers (5)
  • If you suspect an patient is being abused, support the individual, report the incident and follow institution’s producers
  • Consult ONPEA’s Core Curriculum and Resource Guide, an interactive eBook for those who work with seniors. This guide provides information on elder abuse, how to effectively take action, and on networks, organizations and resources.  The guide can be downloaded here:
    http://www.onpea.org/english/trainingtools/corecurriculum.html

References

1. CNA. (2013). Elder Abuse. Retrieved March 19, 2014 from:
    http://www.nurseone.ca/Default.aspx?portlet=StaticHtmlViewerPortlet&ptdi=661

2. RNAO. (2011). Elder Abuse. Retrieved March 19, 2014 from:
    http://rnao.ca/sites/rnao-ca/files/Elder_Abuse_Article_-_RN_Journal_Sept-Oct_2011.pdf

3. The Ontario Network for the Prevention of Elder Abuse. (2014). Forms of Elder Abuse.
    Retrieved March 19, 2014 from:  
    http://www.onpea.org/english/elderabuse/formsofelderabuse.html

4. Webb, G. (2013). The Prevention of Abuse and Neglect in Ontario Long-Term Care Homes.
    Retrieved March 19, 2014 from:
    http://www.advocacycentreelderly.org/appimages/file/Prevention%20of%20Abuse%20&%20Neglect