Responding to Elder Abuse and Neglect

Elder abuse includes actions that cause physical, mental, or sexual harm to an older adult. Neglect includes situations where a person or organization fails to provide services or necessary care for an older adult.  While financial exploitation is a form of elder abuse, we deal with it as a separate category (see here) given its pervasiveness and unique aspects.

Elder abuse and neglect can be broadly categorized into six categories:

  • physical: causing pain, injury or harm to health
  • financial: illegal or improper use of funds or assets, such as theft or fraud
  • psychological: infliction of mental anguish or suffering
  • sexual: non-consensual sexual activity or harassing sexual comments
  • neglect: refusal or failure to provide services or necessary care
  • self-neglect: failure to provide for their own essential needs that causes or is reasonably likely to cause within a short period of time, serious physical or mental harm or substantial damage or loss in respect of the adult’s financial affairs

[from the Adult Guardianship Act].


Institutional abuse or neglect

Institutional abuse and neglect is another category unto itself.  Older adults living in institutional care facilities may experience abuse that is a single incident of poor professional practice or part of a larger pattern of ill treatment. This may include:

  • Inadequate care and nutrition
  • Low standards of nursing care
  • Inappropriate or aggressive staff-client interactions
  • Overcrowding
  • Substandard or unsanitary living conditions
  • Misuse of physical restraints or medications
  • Ineffective policies to meet residents’ needs
  • Low levels of supervision.

From Elder Abuse is Wrong – Government of Canada

See our e-manual on Legal Issues in Residential Care for more information about and responses to Institutional Abuse.


Guiding Principles

The following principles from the Canadian Centre for Elder Law’s A Practical Guide to Elder Abuse and Neglect Law in Canada are meant to help professionals and volunteers understand and effectively respond to the rights of older adults who are abused, neglected or at risk:

1. Listen to the older adult
Elder abuse response should be grounded in the older person’s understanding of a situation or relationship—not other people’s views. Similarly, your response should focus on actions the older person identifies as being helpful, not invasive. This approach entails getting to know the older person, asking respectful questions, and doing a lot of listening.

Conversations will build rapport and trust, and help you and the older person to identify appropriate resources. Listening shows value for the older person’s experiences and ideas, and can help you develop a more healing power dynamic with the older person than the dynamics of control characterizing abusive relationships.

It is usually a good idea to speak privately with the adult at some point to make sure they are not being pressured by others, a dynamic known as undue influence. It is also important to respect the older person’s desire for support from people they trust.

2. Respect personal values
It is important to respect the personal values, priorities, goals, and lifestyle choices of an older person, and identify solutions and support networks that suit the older adult’s individuality. The same responses and resources will not work for everyone. Elder abuse is often rooted in a lack of respect for the older person, their values, and their choices, and so we must support the older person’s freedom of expression and identity.

3. Respect and support decision-making autonomy
All adults with decision-making capacity have the right to make decisions for themselves, regardless of age or disability, including decisions that other people might consider risky or unwise. While legal standards vary, decision-making capacity (or mental capability) refers to a person’s ability to understand relevant information and make a reasoned decision. Adults are presumed capable unless there is a court order or expert finding that the person is not capable of making a specific decision or type of decisions, for example, a guardian has been appointed.

Keep in mind that someone may be incapable of making one kind of decision yet capable of making others. Capacity can fluctuate, change from day to day, and can be influenced by many circumstances, such as stress. Some people cannot make decisions independently, but can make decisions with support or assistance from someone they trust. Always consider whether the older person needs support with decision-making, and explore whether their supportive decision-maker should be included in discussions.

4. Seek consent or permission
In most circumstances, you should get consent from the older adult before you take any action, including phone calls. Consent is an ongoing process. Check regularly to make sure that the older person is comfortable with how events are unfolding, and understands that they can change their minds. Abuse takes away a person’s sense of power and control, and can negatively impact self-esteem. Be conscious that your actions support the older person’s autonomy rather than taking more power away.

In some emergency situations, such as where a person has been assaulted and is unconscious, it will be appropriate to call 911 without consent.

5. Respect confidentiality and privacy rights
Know laws, policies, and codes of ethics that apply to privacy and personal information. In most instances, it is against the law to disclose personal or health information without prior consent. Sharing confidential information can harm an older adult’s sense of dignity, stop an older adult from trusting you, and damage other efforts to get help for the older adult. Where disclosure is required, you can explain the situation to the older person so they understand who is being informed of their situation.

6. Avoid ageism and ableist thinking
Be alert for ageist and ableist attitudes, and discrimination in access to services. Avoid stereotypes about older people, including about mental capacity, physical ability, and judgement. You should assume all older people are capable and treat them with the dignity and respect you would accord any adult.

7. Recognize the value of independence and autonomy
Honour and protect the adult’s independence as much as possible while at the same time helping the person to get the assistance they want. Abuse can rob a person of freedom and independence. Be conscious that your response does not further undermine personal freedom. This approach means asking the older person what they need, and learning about what kinds of supports they will welcome. Some older people will not reach out for help because they fear being forced to live in long-term care, or losing the right to make choices about their future.

8. Develop trauma-informed practice
Older people who have experienced abuse may have survived different kinds of trauma throughout their lives, including intergenerational trauma. These traumatic experiences will impact their brain development, their understanding of the world, and their needs for safety and healing. An awareness of the dynamics and impacts of trauma will assist you to provide meaningful support without causing further harm. Training in trauma-informed practice will also help you to be aware of, and respond appropriately to, your own experiences of vicarious trauma, which can arise out of hearing about older people’s experiences of abuse. Surviving trauma can also demonstrate resilience, and provide a lens of hope and recovery to bring to experiences of elder abuse or neglect.

9. Apply a holistic lens
Consider older people in a holistic manner in order to identify meaningful and welcome assistance and support. Be willing to look beyond the issue that brought the older adult to you, or that alerted you to abuse or neglect.

For example, consider whether the older person needs more appropriate housing or requires financial assistance, including help accessing pensions. If the person is providing care for another person, including an abuser, explore how the older person can be better supported as a caregiver. Consider whether the older person is an immigrant or refugee, a survivor of spousal violence, an Indigenous person, a trans person, or a person living with a disability, and how their identify and experiences might impact their needs. Consider dynamics of power that impact their safety and autonomy.

This approach will likely identify needs that are outside your scope of practice or expertise. As a result, it is very important to have up to date information about local agencies to which you can refer the older person for other kinds of assistance. Notice when collaboration with other service providers might help you to provide more comprehensive assistance.

10. Respect cultural values
Acknowledging, respecting, and integrating the cultural backgrounds, needs, and preferences of older people is part of applying a person-centered approach. Be curious about how a person mentions culture within their story of abuse, including identifying barriers and possible solutions. Recognize your own biases linked to culture.

Some people make sense of elder abuse as a continuation of domestic violence, rooted on patriarchal family relations. For some immigrants, a sense of family obligation or shame impacts the options available to them. Relationships linked to culture and family can also be a source of strength and support. Learning about an older person’s cultural identity and community can help you provide better services.

11. Respect relationships that matter
Be aware of the relationships that are important to the older person. Help preserve these relationships while offering safety planning strategies, if appropriate. Family and other caregiving relationships are extremely important to many older people. They may be concerned about the safety and well-being of a spouse, children, or grand-children, including their abuser, or may not want their abuser to get in trouble with the law. Addressing the needs of family and other dependents can be critical to helping an older person to feel comfortable accessing assistance and care for themselves.

12. Consider Indigenous experiences
Racism and colonization, including through residential schools, foster care, health care facilities, and the criminal justice system, have significantly impacted the lives of most Indigenous people. When assisting Indigenous older people, it is important to consider past physical, mental, emotional, or spiritual harm as well as their safety concerns related to health care providers, police, and other institutions. Indigenous community and culture can be a tremendous source of strength, resilience, and healing. Learn about the Indigenous communities where you work or volunteer, and consider Indigenous cultural humility and safety training for yourself and others within your organization.

Remedies


911 Calls

The safety of the older adult is of paramount importance in any abuse and neglect situation.  911 should always be called if immediate safety is an issue.If you are unsure how serious an incident is, police advise to still call 911 and they will advise whether or not to call the non-emergency number (e.g. 604-717-3321 for Vancouver)


Safety Plan

A safety plan may include a change to an element of an older adult’s environment or their relationship which could result in the elimination of the role of the abuser or context of the abuse. Consider:

  • Home visits, telephone contact, contact with other family and friends, regular appointments
  • Secure assets (e.g. hide emergency money somewhere outside home.)
  • Give copies of important documents and keys to trusted friends or family members
  • Plan escape by packing a bag of extra clothing, medicine and personal aids (glasses, hearing aids)
  • Keep phone numbers of friends, relatives, shelters or other trusted individuals handy.

See our ebook Understanding and Responding to Elder Abuse Section C.4 for more information on assisting older adults to take action.

[see below for more information on this resource]

The plain language handbook Roads to Safety is also a comprehensive resource covering legal issues that older women may face when they have experienced violence.

It explains rights and options, using stories to illustrate the legal information

[see below for more information on this resource].


Assault Charges & Peace Bonds

An older adult can lay assault charges, or apply for a peace bond.  More information on this is available from the Dial-a-Law script # 217 – Applying for a Peace Bond and Filing Assault Charges


Family Law – Protection Orders

Part 9 – Protection from Family Violence of the Family Law Act deals with protecting “at risk family members” from family violence.   Either an at-risk older adult or someone on their behalf may seek a section 183 protection order under this Part.  Looking at the definition of “family member” in s. 1 of the Act, the older adult could get a protection order against:

  • their spouse, including common-law spouse;
  • the biological parent or guardian of their children;
  • any person who lives with them and is related to their spouse (in-laws); and
  • their own children, whether their children live with them or

The definition of “family violence” is broad enough to cover any form of influence or abuse of an older adult by a related person above.  The court considers not just physical violence, but where there is a pattern of emotional or psychological abuse that constitutes “a pattern of coercive and controlling behaviour” toward the older adult.  The psychological and emotional abuse of  an at-risk family member includes unreasonable restrictions on, or prevention of, a family member’s financial or personal autonomy.

“family violence” includes

(a) physical abuse of a family member, including forced confinement or deprivation of the necessities of life, but not including the use of reasonable force to protect oneself or others from harm,

(b) sexual abuse of a family member,

(c) attempts to physically or sexually abuse a family member,

(d) psychological or emotional abuse of a family member, including

(i) intimidation, harassment, coercion or threats, including threats respecting other persons, pets or property,

(ii) unreasonable restrictions on, or prevention of, a family member’s financial or personal autonomy,

(iii) stalking or following of the family member, and

(iv) intentional damage to property, and

(e) in the case of a child, direct or indirect exposure to family violence;

Note that a person can still seek a family law protection order even if there is a concurrent criminal proceeding relating to the same incident (FLA, s. 184(4) (d)).

Note as well that there must be a family relationship – a section 183 protection order could not be sought against a third party caregiver. Protection would have to be by other means, such as a peace bond (see comparison chart below) or notice of trespass.  This is in part to “avoid the implication that the caregiver is a family member (in particular, a common law spouse) and thus has certain rights to support and property.”  – quoted from the CLE BC Practice Point “The Incapable Spouse – Part X – CLE- BC.


Protection Orders & Peace Bonds Compared

Family Law Protection Orders

Peace Bonds

INITIATING PROCESS

Family Law Protection Orders

The process is initiated by a family member at risk from family violence or by a person on his or her behalf, at the B.C. Provincial Court or the B.C. Supreme Court under the Family Law Act.

Peace Bonds

The process is initiated by a complainant who reports an incident to the RCMP or the local police.  The police officer will send a report to Crown counsel, who, in turn, will see if there is enough evidence to apply for a peace bond.  If there is, Crown counsel will lay an information under the Criminal Code.

MADE AGAINST

Family Law Protection Orders

An order can only be made against a “family member”, which includes:

–       Married or common-law partner

–       Parent or guardian of the person’s child

–       A person who is related to and lives with the person or any of the above-stated persons

–       The person’s child

Peace Bonds

A peace bond can be obtained with regard to  any person, also known as the ‘respondent’ (does not have to be a “family member”).

FOR PROTECTION OF

Family Law Protection Orders

An order can be made for the protection of:

–       The applicant

–       The applicant’s child

–       Any family member of the applicant

Peace Bonds

A peace bond can be made for the protection of:

–       The complainant

–       The complainant’s married or common law partner

–       The complainant’s child

–       The complainant’s property

PROOF REQUIRED

Family Law Protection Orders

To obtain an order, the applicant must show that his or her safety and security is or is likely at risk from family violence carried out by another family member (FLA, section 182).  Family violence is defined under section 1, which includes physical and sexual abuse, attempts to same, as well as emotional and psychological abuse.  The fact that a family member has a history of returning to the residence of the violent family member does not preclude the making of a protection order against the latter member.

Peace Bonds

To obtain a peace bond, Crown counsel must show that the complainant fears for his or her safety, and the safety of his or her spouse and child.  Courts do not grant peace bonds for non-violent harassment (R v. Balfour, 1984 Carswell BC 2522).  The fact that a complainant has a history of returning to the residence of the respondent (i.e. be a spouse or family member) may show that he or she does not fear for his or her safety, resulting in denial of a peace bond.

PROCESS

Family Law Protection Orders

An application for a protection order may be heard with or without notice or on short notice.

Peace Bonds

Once an information is laid by Crown counsel, the police officer will issue an arrest warrant or summons to the respondent, who will have to appear and respond to the peace bond application in court.

LAWYER REQUIRED?

Family Law Protection Orders

The applicant may apply to court for a protection order with or without a lawyer, although a lawyer is recommended.  The applicant has to pay the lawyer’s fees unless he or she is eligible for legal aid.

Peace Bonds

The complainant does not need a lawyer to apply for peace bonds because Crown counsel will be in charge of the process.  However, Crown counsel acts for the interests of the government, not the complainant.

LEGAL EFFECT OF ORDER

Family Law Protection Orders

A protection order is a court order, a breach of which is a criminal offense under section 127 of the Criminal Code.  The order is contained in the Protection Order Registry for ease of police enforcement.

Peace Bonds

A peace bond is a court order, a breach of which is a criminal offense under section 127 of the Criminal Code.  The peace bond is contained in the Protection Order Registry for ease of police enforcement.

DURATION OF PROTECTION

Family Law Protection Orders

protection order lasts up to one year unless the judge orders otherwise (FLA, section 183(4)).

Peace Bonds

A protection order lasts up to one year unless the judge orders otherwise.

FEE REQUIRED?

Family Law Protection Orders

There is no fee to apply for a protection order at the Provincial Court. NOTE – there is a fee to apply to the Supreme Court.

Peace Bonds

There is no fee to apply for peace bonds.

ENFORCEMENT

Family Law Protection Orders

A family law protection order from the B.C. courts can only be enforced by local police and the RCMP in B.C. as the FLA is a provincial statute.  If the family member for whom the protection order is granted moves to another province, he or she will have to register the order or apply for a new order at the new location.

Peace Bonds

A peace bond can be enforced by police and the RCMP anywhere in Canada because the Criminal Code is a federal statute.


Application to Family Court

The PCFR Form 1 titled “Application to Obtain an Order” with accompanying instructions can be downloaded at Application to Obtain An Order – Family Court.  The form is straightforward, and you can fill it online and then print it.  You fill out the applicant’s information (name, date of birth, address, phone and email) and the opposing party’s information (name, address).  You are applying for protection orders (check that box).

Under part 1, “Orders and Agreements”, check the appropriate box.

Part 2 may not apply if you are not asking for orders regarding guardianship, parenting arrangements and contact time with children.

It is good practice to attach another sheet and label that as “Schedule A”, where you tell the judge

  1. The orders you are seeking – You can use the sample in Appendix B (Schedule 5 of the Notice of Family Claim) or Appendix C (Part 1 of the Notice of Application titled “Orders Sought”)
  2. The facts in support of your application – You can use the sample in Appendix C (Part 2 of the Notice of Application titled “Factual Basis”)

Isolation

Isolation can be a significant factor in abuse and neglect situations. If the older adult is better connected, the abuse or neglect or self-neglect may abate or stop.  The older person or caregiver may be isolated and lack social contacts or support. The following are the different types of isolation:

  • Physical isolation – for example, leaving an older adult who requires care alone for significant periods of time.
  • Social isolation – for example, not allowing an older adult to see friends or engage in social activities such as attending community centre events.
  • Emotional isolation – for example, not engaging with the older adult or responding to their emotional needs.

Check with your local seniors’ centre or find a Community Response Network in your community for community resources to overcome social isolation.  Some elder abuse can be described as ‘bullying’ behaviours.  Most bullying stops when it is brought out into the light of day.


Resources


Seniors First BC Resources

This online ‘e-book’ contains:

  • a good review of elder abuse: what it is; types; risk factors; how to identify it; about abusers; barriers to asking for help; family stressors and elder abuse.
  • BC government programs and community services available for older adults who are abused and neglected;
  • guide to working with older adults who have been abused including communication techniques and sensitivity to cultural factors
  • assisting to take action- safety planning and the criminal justice system; and,
  • list of resources

A one pager that sets out:

    • what to look for (indicators of abuse or neglect);
    • interview strategy;
    • possible interventions including:
      • education
      • a safety plan and
      • coordination and
    • consultation help phone numbers.

Criminal and Non-Criminal Abuse and Neglect Wheel

A graphic setting out various criminal and non-criminal forms of abuse and neglect.

Useful for discussing when the criminal justice system is and is not a remedy.

A graphic setting out the various players in the community and in the justice system who might respond to abuse and neglect of vulnerable adults


Canadian Centre for Elder Law Resources

The Canadian Centre for Elder Law’s website offers a Practical guide to Elder Abuse and Neglect Law in Canada.  The guide provides the following:

  • defines elder abuse and neglects;
  • guiding principles for best practice;
  • lenses for inclusive practice;
  • laws on reserves;
  • information on federal laws;
  • and a glossary of terms.

Public Guardian and Trustee Resources:

A review of Part 3 of the Adult Guardianship Act.  A discussion of the roles of DAs, how the PGT works with DAs, and Community Response Networks.

Information about how the PGT assesses the situations of vulnerable adults.


PGT DECISION TREE

A flow-chart (or ‘decision tree’) setting out options in responding to abuse and neglect situations.  Includes a chart on the reverse setting out roles of police, Designated Authorities and the PGT: governing legislation; why would you call/:where should you call?: what can you expect?; and, actions may include…

There are  five videos about the decisions reviewed in the decision tree:


Vancouver Coastal Health Authority

has created material that describes elder abuse, neglect and self neglect.

Their website lists the indicators for abuse.

These indicators and the re:act manual are for Vancouver Coastal Health employees but are a good reference for anyone helping older adults.


Dial-A-Law

Information on financial help (OAS/GIS?CPP, Allowance, Welfare, SAFER, EI, VA, tax credits etc), elder abuse, and financial and medical affairs (this last section deals with wills, powers of attorney, mental incapacity, transferring a home to a child, and lending money to family members).


BC Government Resources:

Webpages:
Fact Sheets:

Canadian Government Resources:

From the Family Violence Initiative of the Department of Justice Canada. A booklet for older adults who may be suffering from abuse by someone they trust.  Also available in html on this webpage: Elder Abuse is Wrong – webpage