Identifying Elder Abuse

Margaret's Story (emotional and psychological abuse)

Leaving her home to move in with her daughter and her family was supposed to be the best thing for Margaret. Her son-in-law Tom had always made Margaret feel a little uneasy, but she adored her daughter and grandchildren. Sadly, Margaret's move only confirmed that her instincts about her son-in-law had been right.

Tom was always good to Margaret when her daughter was around. But as soon as others were out of ear-shot, Tom's verbal abuse and intimidation would begin. He called her stupid and mocked the way she moved or talked. He would tell her that she disgusted him and that she had better watch her step or he'd send her to a home. He threatened that if Margaret were to breathe a word of what he said to her daughter, he would deny it, take all of her money, and leave her to the wolves.

Margaret's daughter has become puzzled as to why her mother has become so withdrawn. She refuses to leave her room except for meals, and even then she hardly eats and rarely speaks. Her daughter wonders why her mother would shut down like this in such a loving environment, but assumes that she's just adjusting and will come around. Her husband agrees completely…

Peter's Story (physical and emotional abuse)

Peter wanted to remain living in his home, but he really needed someone to help him with his day-to-day care. His niece Mandy had always loved her Uncle Peter, and since she was between apartments, it was decided that she would move into his home and assist him with his daily tasks.

Mandy tried her best, and she could be very kind at times, but other times she would lose patience with how slowly Peter moved and sometimes shove him out of the way if she was in a hurry — resulting in more than one tumble and bruise. Mandy tried to be patient, but often her frustration lead to insults, name calling, and door slamming.

Neighbours had heard the shouting and Peter's sharp cries of pain from time to time. One of these neighbours was finally compelled to call the police when she heard Peter's continual cries through the bathroom window. Police found Peter on the floor of the bathroom with a shattered hip and a head wound. He had been left on the floor in pain for some time after Mandy, frustrated with having to help him with his personal hygiene, pushed him off the toilet seat and stormed out of the house.

Janet's Story (financial abuse)

Janet appreciated her grandson helping her to run errands. Since her husband's death, simple things like getting groceries or going to the bank had become difficult for her. Her grandson Nicholas had offered to help, and for a while it seemed like the perfect arrangement. Nicholas would take her to the bank and wait while she deposited her pension cheque and withdrew the cash she needed. Nicholas then drove her wherever she needed to go to do her shopping.

As winter approached, Nicholas told Janet that it would probably be much easier on her if he just did the errands for her while she stayed warm and cozy at home. Because he had been so helpful for so many months, Janet thought nothing of signing her cheques over to her grandson, who would make her purchases and deposit the rest in her account.

It took several months for Janet to realize that Nicholas had not, in fact, been depositing the balance of her pension into her account. He did her shopping as needed, but pocketed the difference, causing Janet's account to dwindle. It wasn't until a cheque she had written to cover her insurance had bounced that Janet realized that her grandson had been helping himself to her pension.

Typically, elder abuse may be defined and identified as any action or inaction by a person(s) in a trusting relationship that causes harm and distress to an older adult.

Types of Elder Abuse

Elder abuse and neglect can take several forms, with individuals often experiencing more than one type of abuse at the same time. National and provincial statistics indicate that the two most identified and reported types of elder abuse are financial and psychological.

Financial Abuse

The misuse of an older person's funds or property through fraud, trickery, theft or force, financial abuse can include, but is not limited to:

• the misuse of money or property;
• convincing an older person to buy a product or give away money;
• stealing money or possessions;
• misusing bank or credit cards;
• misusing joint banking accounts;
• forging a signature on pension cheques or legal documents; and
• misusing a power of attorney

Psychological or Emotional Abuse

Often taking the form of verbal aggression, humiliation, isolation, intimidation, threats, or inappropriate control of activities, psychological or emotional abuse diminishes the identity and self-worth of older people. It can also provoke intense fear, anxiety, or debilitating stress. Psychological or emotional abuse can include, but is not limited to:

• removal of decision-making power while the person is competent;
• withholding affection for manipulative purposes;
• refusing access to grandchildren;
• denying privacy in institutions;
• controlling activities;
• forcing older people to do degrading things;
• treating them like children;
• attacking their self-esteem; and
• intentionally frightening them

Physical Abuse

Physical abuse is the use of physical force causing discomfort, which may or may not result in bodily injury, physical pain, or impairment. Older persons who are subjected to rough handling or mistreatment are the victims of physical abuse, which can include, but is not limited to:

• slapping;
• shaking;
• pushing;
• kicking;
• punching;
• striking with an object or weapon;
• deliberate exposure to severe weather;
• unnecessary physical restraint;
• forced confinement; and
• failure to provide adequate health care

Medication Abuse

The misuse of an older person's medications and prescriptions, medication abuse can include, but is not limited to:

• withholding medication;
• overmedicating;
• sedation; and
• not complying with prescriptions refills

Source: Abuse and Neglect of Older Adults – Resource and Training Kit for Service Providers, Health Canada 1994

Sexual Abuse

All unwanted forms of sexual activity, behaviour, assault, or harassment to older persons is elder sexual abuse. Sexual abuse can include, but is not limited to:
verbal or suggestive behaviour;

• lack of personal privacy;
• unnecessary help with dressing/hygiene;
• fondling;
• unwanted sexual intercourse; and
• being forced to commit degrading acts

Neglect

Whether intentionally (active) or unintentionally (passive), neglect occurs when failing to provide older persons with basic necessities or care. Neglect can include, but is not limited to:

• failure to provide a safe, warm, and comfortable place to live;
• denial of social contacts and/or interaction;
• failure to provide personal hygiene;
• failure to provide proper food or clean clothing;
• failure to provide aids for daily living (hearing aids, walkers, canes, wheelchairs, etc.);
• failure to prevent physical harm; and
• abandonment or desertion

Self-neglect, while not technically considered abuse, is also a significant concern. It involves cases whereby older adults, by choice or ignorance, live in ways that disregard their health or safety needs, and can in some cases pose a hazard to others.