Introduction. Pulling Back the Curtain. Confronting abuse of older adults in our community

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1 Pulling Back the Curtain Confronting abuse of older adults in our community Domestic Violence Telehealth - Alberta Health Services Tuesday, April 20, 2010 Presenters: Brenda Hill, Senior Manager, Kerby Centre Eva Chan, Community Development Coordinator, Alliance to End Violence Agenda 1. Introductions 2. Elder abuse definition, types, indicators, risk factors, prevalence, and screening and assessment considerations 3. Current initiatives/projects in Alberta 4. Community Resources in Calgary and Alberta 5. Questions 6. Evaluation Introduction The Action Group on Elder Abuse (AGEA) is comprised of individuals and agencies concerned about the response to older persons experiencing abuse in Calgary. The purpose of AGEA is to build the capacity within the Calgary community to enhance and coordinate the response to the abuse of older persons. 1

2 Kerby Centre Kerby Centre offers over 150 programs and services to Calgary and District Seniors (55years+) Kerby Rotary House is a residential program offering a safe secure environment to senior men and women seeking refuge from abuse, seniors in crisis and those facing homelessness Kerby Centre offers a 24 hour crisis line at Kerby Centre offers consultation and presentations on Elder Abuse and Domestic Violence of Older Adults shelter@kerbycentre.com Seniors Population In Canada In 2007, seniors (those aged 65 years or older) accounted for 14% of the population. The seniors population is expected to exceed the population of those under 15 years of age by 2015; this will mark the first time in Canadian history that seniors outnumber children. This rate will continue to grow over the coming decades reaching nearly one quarter (24%) of the population by 2031.[i] [i] Family Violence in Canada: A Statistical Profile (2007). Seniors Population In Alberta Seniors made up 10% of Alberta s total population in By 2016, seniors will make up 14.5% of the total population in Alberta. [i] Consistent with the national projection, by 2026 one in five Albertans will be a senior. [ii] [i] Austin, Hartley and Donahue (2002.) Seniors in Calgary. Calgary: United Way of Calgary and Area. [ii] Alberta Seniors (2004). Fact Sheet: A Portrait of Alberta Seniors. Edmonton: Author. 2

3 Seniors Population In Calgary In 2006, people aged 65 or over made up 9.5% of Calgary s population. [i] By 2016, 14% of population will be 65 and over. (Durst 2005). [i] Calgary Civic Census (2006). Immigrant Population - Statistics In Canada, almost 19% of the immigrant population is over 65, with the national average of 12.2%. 7.2% of the senior s population is a visible minority, an increase from 6% in (Statistics Canada, 2001 Census) Immigrant Population - Statistics In Calgary Calgary ranked fourth in its ratio of visible minorities among major Canadian cities. In 2006, 39% (37,580) of all seniors living in Calgary were immigrants and/or refugees (City of Calgary, 2006). Over 1/3 (33,565) of seniors in Calgary had a non- English native language (City of Calgary, 2008). 3

4 What is abuse of older adults? Abuse of an older person (often referred to as elder abuse ) is any action or inaction by self, family, or others that harms the person or violates their rights. (Calgary Community Response to Abuse of Older Adults, 2009) Elder Abuse Types of Abuse 1. Physical Abuse 2. Sexual Abuse 3. Financial and Material Abuse 4. Psychological / Emotional Abuse 5. Neglect 6. Religious / Spiritual Abuse 7. Chemical / Medication Abuse (Adapted from Government of New Brunswick, Adult Victims of Abuse Protocols, September 2005) Elder Abuse 1. Physical abuse includes the bodily harm or pain caused by: Hitting / punching / Slapping Scratching Rough handling Inappropriate restraints/confinement Pushing Kicking Injuring with an object or weapon 4

5 Elder Abuse 2. Sexual behaviour directed toward an older person without that person s full knowledge and consent, such as: Sexual assault Sexual harassment Humiliating or painful sexual acts Unwanted sexual touching Elder Abuse 3. Financial or material abuse includes: Withholding of finances through deceit or theft Misappropriation or misuse of funds or property Forced sale of home possessions Forced change of will Abuse of trusteeship or power of attorney Elder Abuse 4. Psychological or emotional abuse is any act that diminishes the older person s sense of identity, dignity and self-worth. It includes: Use of threats Humiliation Forced social isolation Treating the older person like a child Inappropriate removal of decisionmaking power 5

6 Elder Abuse 5. Neglect is the intentional or unintentional failure to provide for the needs of someone. Active neglect - Intentional withholding of clothing, food, personal or health care, and leaving the older person in an unsafe place or in isolation. Passive neglect - Unintentionally not providing necessities because of lack of information, skill or interest. - Self-neglect reflects a change in cognition, by choice or by ignorance of the older adults to live in ways that disregard health or safety needs, sometimes to the extent that the disregard also poses as a hazard to others. Elder Abuse 6. Religious / Spiritual abuse involves: Control Manipulation Guilt and/or deception to enforce doctrinal position Refuse one the right to their own religious beliefs or practices Elder Abuse 7. Chemical / medication abuse is the misuse of medications and prescriptions. It includes: Withholding of medication Over-medication Not complying with prescription refills 6

7 Risk Factors History of spousal abuse Family dynamics (intergenerational family violence) Isolation Troubled relatives, friends or neighbours Inability to cope with long-term caregiving (caregiver stress) Ageism and lack of knowledge about the aging process Tolerance of violence in the society (Kinnon, 2001; Murphy, 1994) Elder Abuse in Ethno-cultural Communities Challenges and barriers: Language barriers Social isolation Financially Dependant Emotionally Dependant Cultural Taboos (Abuse in Ethno-cultural & New Immigrant Communities Department of Community Service Government of Nova Scotia) Barriers to Disclosure Fear: of being punished, institutionalization, rejection by family members, losing their caregiver, reflect poorly on family, etc. Love for the abuser Lack of / or Impaired Understanding Shame and / or Guilt Unaware of Resource Options Acceptance of Abuse as Normal (Edmonton Elder Abuse Intervention Team, Abuse and Neglect of Older Adults Resource and Training Kit for Service Providers, Health Canada 1994) 7

8 Prevalence of Elder Abuse Who is abused? Any older person may become a victim of abuse. Both men and women, regardless of culture, race, religions, and social and economic groups can be victims of abuse. Prevalence of Elder Abuse Who abuses? A family member is the most common perpetrator of abuse against older adults including spouses, adult children, grandchildren or other family member (Wahl & Purdy, 2002). Most family violence against seniors is committed by an adult child and homicides are most likely committed by an adult male child. [i] [i] Family Violence in Canada: A Statistical Profile (2007). Prevalence of Elder Abuse In Canada Police-reported violence against seniors increased 20% between 1998 and [i] The 2004 GSS data revealed that half (49%) of violent incidents against seniors did not come to the attention of police. [ii] [i] Family Violence in Canada: A Statistical Profile (2007). [ii] Family Violence in Canada: A Statistical Profile (2006). 8

9 Prevalence of Elder Abuse In Alberta Since 1998, more than 5,000 allegations of abuse and neglect have been reported under the Alberta Protection for Persons in Care Act (PPCA) - the majority of allegations involving abuse of seniors in long-term care facilities. [i] 18 percent of 800 Albertans surveyed stated they knew a senior who experienced abuse. [ii] [i] Alberta Seniors and Community Supports (2009). [ii] Omnibus Survey, Alberta Elder Abuse Awareness Network (2003). Prevalence of Elder Abuse In Calgary In 2009 the Kerby Rotary Shelter responded to an average of 80 calls per month from individuals experiencing abuse. [i] 24 percent of 400 Calgarians surveyed stated they knew a senior who experienced abuse. [ii] [i] Kerby Rotary Shelter (2009). [ii] AGEA Urban Tracker Survey (2008). Screening and Assessment Considerations THE What to When to How to What to When to How to What to (What are the indicators of abuse? What could you do in your current position if you suspect abuse or became aware of abuse? What resources are available in your community to address this abuse?) When to (When to ask? When to assess? When to intervene?) How to (How to ask? How to assess? How to intervene?) 9

10 Screening and Assessment Considerations Safety / Immediate danger Competency / capacity Older adults - willing or unwilling to act Safety plan Case scenarios Calgary Initiative Action Group on Elder Abuse has identified several focus areas for its work. They include: 1. Coordination of services 2. Ongoing Training 3. Public Awareness and Engagement 4. Research and Best Practices 5. Government Policy and Relations 6. Further Develop Partnerships 10

11 Pulling Back the Curtain Confronting abuse of older adults in our community Initiatives in Alberta Alberta Elder Abuse Awareness Network Alberta Council of Women s Shelter Elder Abuse: A Guide for Community Prevention and Intervention Project Hidden in the Cultural Fabric project Initiatives in Alberta Alberta Council on Aging 11

12 Community Resources in Calgary Immediate danger 911 Kerby Elder Abuse Line Ph: (403) Seniors Help Line Ph: (403) Calgary Police Service - Non-emergency: Elder Abuse Team, Domestic Conflict Unit Outreach services for adults 55+ (East Outreach, North/West Outreach, South Outreach, Central Outreach and City-wide Chinese Outreach) Resources in Alberta Alberta Elder Abuse Awareness Network Alberta Seniors and Community Supports s/elderabuse Resources continued Seniors Canada Public Service Announcement Elder Abuse: It s time to face the reality 12

13 Resources to take Brochure: Elder Abuse: It s Time to Face the Reality URL: ang=eng&geo=106&cid=154 Provincial and Territorial Resources on Elder Abuse resource list Additional resources on Elder Abuse: ng=eng&cid=161 Resources to take Service Provider Screening Guide for Elder abuse ices_resources/elderabuse Resources to take Older Adult Resource Inventory 13

14 Resources to take Older Adult Resource Inventory (violence related) 24-hour Senior Help Card AGEA Elder Abuse Resource Manual Face It: Elder Abuse Happens Bookmarks Website: On-line resources Alberta Elder Abuse Awareness Network Website: Alliance to End Violence Website: Canadian Network for the Prevention of Elder Abuse Website: International Network for the Prevention of Elder Abuse Website: National Clearinghouse on Family Violence Website: Seniors Canada, Government of Canada Website: Questions 14

15 Evaluation Thank you 15

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