REACHING OUT I FEATURE
Community network works with elderly to prevent abuse – or to find best route to justice
Network offers help to vulnerable seniors.
WITH LITTLE FANFARE and plenty of buy-in by local organizations, an impressive network of community support has developed to lessen the risk of elder abuse in Waterloo Region. An estimated 10 to 15 per cent of the elderly suffer some type of abuse. Financial abuse, including withholding pension cheques, forgery and forced changes to wills, is the most common. However, neglect, confinement, failure to provide adequate food, heat and equipment such as hearing aids, verbal bullying as well as physical abuse such as slapping or pushing also constitute elder abuse. Educating older people is the key to prevention. And in intervening to stop elder abuse, what’s different is that the victims themselves, with support, direct the response to their abuse. Only in clear cases of criminal activity, such as fraud or sexual assault, do cases wind up in the traditional justice system. Other approaches, based on the principles of restorative justice, are more acceptable to the elderly and are used in more than 90 per cent of cases. Volunteers and professionals working in the field are passionate about prevent- ing elder abuse, which is highly personal because the abuser is most often a family member.
Community response really got started with the formation of a Gerontology Interest Group in the early 1980s. Thirty years later, Waterloo Region has a volunteer committee on elder abuse whose mandate is public education and awareness. Members help get the message out in talks to local groups and responding to questions left on a call-in line.
They’ve also organized two free eight-part seminars for the elderly on how to protect themselves. Just seven or eight people attended the first seminar, but they were such a close-knit group by the final class that they continue to meet monthly on their own. Another set of talks, titled Empowering Seniors, will be held this fall.
And for 11 years, the Harmony Interage Theatre Troupe has performed short plays about elder abuse for audiences in seniors’ homes, universities, colleges and community groups. Viewers are encouraged to join the drama and try to steer the story line to a happier conclusion. Every scenario is a combination of real-life events and “it’s very powerful,” says Jennifer Jackson, a local pioneer in elder abuse who is one of the actors. Audience members are sometimes in tears by the end.
Most notably, the Waterloo-Wellington Community Care Access Centre and Waterloo Regional Police share the cost of the two-person Elder Abuse Response Team, made up of an access centre nurse/ consultant on elder abuse and a detective. Jointly they investigate reported cases.
Jackson, who took medical training in the United Kingdom, had been hired by Conestoga College in 1986 to develop a post-graduate certificate program in gerontology. While researching the topic, she began reading about elder abuse in material from Massachusetts and the U.K.
Members of the Gerontology Interest Group decided to conduct a telephone survey of nursing homes and people working with seniors. Everyone wanted more detail. A symposium on what the law says about elder abuse, including legal definitions, followed. In 1992, inspired by a group in London, Ont., the Waterloo Region Committee on Elder Abuse was formed.
Since 2000, an inter-agency group including police, the Crown attorney’s office, Community Care Access Centre and other services has met periodically to review cases and discuss what more needs to be done.
Heightened awareness is vital to preventing elder abuse. Arlene Groh, a retired >>
>> access centre case manager who volunteers in restorative justice and the elder abuse committee, says that as she learned more, she realized that as a nurse she had seen elderly people suffering from neglect in hospital emergency wards, but didn’t know enough to recognize it as abuse. Screening tools have since been developed for health-care professionals.
Based at Mosaic Counselling Centre in Kitchener, the Elder Abuse Response Team investigated 150 cases of elder abuse in 2012, and were consulted about another 50 to 60 possible cases.
For five years, since Groh retired, Community Care Access Centre nurse Elizabeth Nieson has been the team’s elder abuse consultant. Detective Dave Haughey has worked with her full-time for two years. They take direct referrals, usually from concerned family members, and also help community organizations decide if conditions they see constitute elder abuse.
Very few elderly voluntarily disclose abuse, Jackson says. It may be a neighbour who prompts an investigation because they’ve seen an elderly person wandering outside at 2 a.m. Sometimes an access centre contact picks up on a problem and reports it.
People reporting suspected elder abuse are told to tell the alleged victim they’ve called and ask him or her to talk to the response team. Sometimes they have to negotiate, but Nieson and Haughey do see most victims in person. They wear street clothes and arrive in a van to take away some of the fear of meeting with police. On occasion, a parish nurse is also present.
If a victim’s personal safety may be at risk, they insist on investigating. “Victim direction is important, but if personal safety is involved police have a responsibility to respond,” Nieson says.
A large majority of the cases are elderly people living in their own homes, or with a relative. Seventy to 80 per cent are women and most commonly the problem is financial, perhaps with the abuser exercising a power of attorney unchecked.
Investigating elder abuse is time-consum- ing because the cases are complex, Groh says. Stereotypes of frail, dependent victims are “absolutely wrong.”
Even healthy elderly people can be isolated from friends, the community or a church, so the abuse goes unnoticed, Jackson says. There have been cases of elderly people trapped in their own homes, surrounded by walls of junk, because a live-in child is a hoarder.
“I’ve seen a schizophrenic son off his meds and taking care of his mom. It’s not pretty,” Groh says.
Only seven per cent of the elderly live in long-term care or retirement homes where staff are required by law to report suspected abuse. Generally abuse in institutions is physical, carried out by an employee, but those cases make up a small fraction of the total number investigated.
Especially with people abused by a relative, “we provide options and referrals; they let us know what they want to do,” Nieson says.
In some cases, elderly people know they are being taken advantage of, but are unwilling to act for fear of further damaging a relationship they value beyond any other. “How do you admit that a child you raised is abusing you,” Jackson says. A victim may also fear losing the support of other family members.
Nieson says in such cases, the response team helps them establish boundaries and figure out possible responses if the abuser
crosses the line of acceptable behaviour. A Community Care Access Centre social worker sometimes is part of those discussions, helping to determine the victim’s tipping point and how to respond when that’s reached. Talking through the problem is both an investigative tool and a way to equip victims to defend themselves. Part of the solution might be to stop living with the relative in question. Or an elderly person can be coached to set boundaries, such as telling the son or daughter they’ll give them X dollars a month and no more. Today’s elderly grew up in a more conservative time, and may have more money than their children do. That can feed a child’s attitude that the parent’s money is going to be theirs someday anyway, so why not start using it now. Some have been given a broad, sweeping power of attorney. As a result, the elder abuse committee now tries to educate lawyers about where such documents can lead.
Talking to the abusive relative can be enlightening, Nieson says. They simply may not understand an elderly person’s needs, which explains why their physical care is inadequate. Or they may not understand what power of attorney means, and that it should not be used unless or until the parent is incapable of making informed decisions for themselves. In her book, A Healing Approach to Elder Abuse, Groh writes that restorative justice considers abuse primarily as a violation of people and relationships, secondly as a violation of the law. The process may bring the victim and offender together with one or two facilitators to talk about the impact of the abuse, how to repair the harm and minimize future harm, or it may involve a larger circle of people, including supporters of the victim and abuser. The process may take months, but the goal is always that the elderly person and the abuser feel respected and heard, that arrangements are in place to protect the victim, and that the final agreement is workable and helpful to healing the relationship.