Elder Abuse

What is Elder Abuse?

ELDER ABUSE IS ANY ACTION BY A FAMILY MEMBER, FRIEND, NEIGHBOUR OR PAID CARE-GIVER WHICH CAUSES HARM TO A SENIOR.

Someone who commits elder abuse usually has control or influence over the older person.
Victims of elder abuse often know and trust their abuser.
Most victims of elder abuse depend on the people who hurt them, sometimes for food, shelter, personal care or companionship.
Harm caused by a stranger may be criminal but is not considered elder abuse.
an older person’s self-neglect is also not elder abuse.

How can you recognize the signs of abuse?

Physical abuse: cuts, bruises, bites or burns, dehydration or lack of food, over-sedation.
Psychological abuse: withdrawal, depression, anxiety, fear of family members, friends or caregivers;
Financial abuse: missing personal belongings, sudden changes in a senior’s will or unusual withdrawals from a bank account;
Neglect: untreated bed sores, poor hygiene, inappropriate or inadequate clothing, lack of safety precautions.
Withdrawal, forced or voluntary, from community, social services, even family members; may be part of a family cycle of violence. If the elder abused a child, revenge may be an excuse for abuse.

Why does elder abuse happen?

Elder abuse happens when the abuser has power and control over an older person. The abuser may have

a drug or alcohol problem;
a history of anti-social behavior
mental health problems
stress as a result of life events;
stress of looking after an older person.

Why do victims seldom report elder abuse?

Some victims do not report elder abuse because they are:

afraid of what the abuser will do
completely dependent on the abuser for food, shelter and care;
afraid of being shipped to an institution
ashamed of telling anyone;
belief that no one can help them.

Why do family, friends or social services not report?

There are many reasons for not reporting suspected elder abuse:

they do not know who to speak to;
they do not know what can be done;
they just don’t want to get involved;
the older person asks them not to report it
they do not know that assault, theft, or neglect is a crime;
they may be afraid of what will happen once an abuse is reported;
they may fear that the older person will deny the abuse, and that nothing can be done unless the person admits being abused.

What do victims of elder abuse need?

Elder abuse victims need:

the abuser to stop the violence, exploitation, or neglect;
safety, shelter, access to financial resources;
other care options, such as home care so they are not dependent on the abuser;
emotional support, counseling, links to community;
information about the criminal justice system.

PERSONAL PREVENTION STRATEGIES

· TO ADDRESS ELDER ABUSE

Plan for the future: make a Will, designate a Power of Attorney and health care preferences.
Discuss preferences for future care and finances with family and friends in case you become frail. Clarify your expectations regarding the amount of family involvement in your care. (eg. If your son or daughter lives far away or has young children, do you expect him/her to be available 24-hours a day?) Clarify your expectations.
Make your own decisions about accepting or refusing health care services or about the opinions of others.
Be careful about agreeing to live with someone, especially if they have a history of substance abuse or psychiatric disease.
Consider carefully before accepting personal care in return for transfer of your property or assets.
Recognize that verbal harassment, humiliation, or neglect can be early signs of physical abuse.
Remain active and involved in social and community activities. Work to maintain or improve your relationships (with your children, friends) if necessary.
Take care of your own health and welfare. Do not allow your standards of self care to deteriorate.
Assert your right to be treated with dignity and respect.
Ask for help when you need it.

Currently, there are many different community agencies (often called silos) responsible for some aspect of elder abuse. These are:

No one sector can solve the problem - we need a multi-disciplinary approach and a cooperative strategy. Each group brings special expertise to the problem.

A recent study of 16 clergy from both conservative and liberal faiths, on dilemmas faced by the clergy around elder abuse, revealed constraints on their ability to act for the following reasons:

There are several important initiatives which faith communities might take to address the problem of elder abuse:

PARISH NURSE

1. What is a Parish Nurse?

A Parish Nurse is a Registered Nurse who functions as a staff member of a pastoral care team engaged in a ministry within a congregation and the community.

2. What does a Parish Nurse do?

Some activities include:

interprets the role of faith in well-being in the church and the community;
offers support and encouragement during times of crisis and celebration;
focuses on health promotion and disease prevention;
provides referral information, advocacy and coordinates services;
encourages and facilitates congregational participation in ministry.

3. Why implement a Parish Nurse Ministry?

Congregations which embrace the healing role understand the link between health and faith as part of their mission. Parish Nursing helps to emphasize the wholeness of body, mind and spirit.

4. How does a Parish Nurse Ministry function?

A congregation established a Health committee.
the Health Committee advises and works with the clergy and the Parish Nurse to develop, implement and evaluate programs and services in response to identified needs.
the Parish Nurse may also advise members of a congregation on health matters.

5. How does the congregation/Community benefit?

Unique programs are developed for individuals/families and groups in the congregation to interpret the relationship between faith and health. This activity models the whole person approach to health and wellness. Benefits include:

increase understanding between faith and health

enhance the ability of the church to respond to needs in the church

support healing, caring ministries

6. What other Opportunities are there for Parish Nurse Ministry?

Church-related community groups may involve a Parish Nurse in their activities (e.g. out-of-the-cold program, seniors’ groups, youth groups) to highlight health issues. Abuse of older persons may benefit from the interventions of a Parish Nurse. Several congregations may band together to hire a Parish Nurse to serve the needs of several smaller congregations.

Restorative Justice

Older adults are often reluctant to disclose that they are being abused and very reluctant to initiate any interventions. Repeatedly, they indicate that they would rather live with the abuse than risk losing their relationship with a trusted family member, friend, or caregiver. Society’s response is fragmented; institutions are unable to respond holistically.
What is restorative justice?

Restorative justice considers abuse to be a violation of the whole community, of people and relationships rather than a violation of the law. It focuses on what needs to be healed, what needs to be repaid, what needs to be learned about the crime and what needs to be strengthened to prevent it from happening again.
How does restorative justice work?

The traditional retributive justice system works like this: If a son has removed or stolen $40,000 from his mother’s bank account, he is thought to have violated a law. As a result, he is charged with theft. A Crown prosecutor tries him and if found guilty he is punished according to a set of prescribed standards. The focal point of this approach is to establish guilt or innocence and to administer appropriate punishment.

Using the restorative justice model, the mother and her supporters (could include family members, clergy, nurse) the son and his supporters (siblings, clergy, probation officer) and community members are brought together, by a trained facilitator, to search for solutions. Each person tells his or her story of what happened and of the impact of the event. This group of people reaches a consensus on:

· Why the abuse happened

· What can be done to repair the harm

· What can be done to prevent it from happening again

The process is not an attempt to avoid justice. Rather, it is a form of justice that holds the person who has done the harm accountable and focuses on healing and prevention of further abuse.
Why is the faith community integral?

The restorative justice model is grounded in community. Too often our society has taken a fragmented approach to problem solving. This model reasserts the damage done to the whole community when injustice happens. This method is uniquely suited to faith communities able to provide support to both the harmed and the person who did the harm and to address the underlying causes of abuse for long-term prevention.
Is this method being tried anywhere?

In Waterloo Ontario the Trillium Foundation is funding a Restorative Justice Approaches to Elder Abuse Project coordinated by the Community Care Access Centre of Waterloo Region. The Project Director is Arlene Groh. She can be reached at 519 883-5500 ext. 6115 or email: agroh@ccacwat.on.ca.


	ELDER ABUSE AND THE CHURCH
	What is Elder Abuse? ELDER ABUSE IS ANY ACTION BY A FAMILY MEMBER, FRIEND, NEIGHBOUR OR PAID CARE-GIVER WHICH CAUSES HARM TO A SENIOR. Someone who commits elder abuse usually has control or influence over the older person. Victims of elder abuse often know and trust their abuser. Most victims of elder abuse depend on the people who hurt them, sometimes for food, shelter, personal care or companionship. Harm caused by a stranger may be criminal but is not considered elder abuse. an older person’s self-neglect is also not elder abuse. How can you recognize the signs of abuse? Physical abuse: cuts, bruises, bites or burns, dehydration or lack of food, over-sedation. Psychological abuse: withdrawal, depression, anxiety, fear of family members, friends or caregivers; Financial abuse: missing personal belongings, sudden changes in a senior’s will or unusual withdrawals from a bank account; Neglect: untreated bed sores, poor hygiene, inappropriate or inadequate clothing, lack of safety precautions. Withdrawal, forced or voluntary, from community, social services, even family members; may be part of a family cycle of violence. If the elder abused a child, revenge may be an excuse for abuse. Why does elder abuse happen? Elder abuse happens when the abuser has power and control over an older person. The abuser may have a drug or alcohol problem; a history of anti-social behavior mental health problems stress as a result of life events; stress of looking after an older person. Why do victims seldom report elder abuse? Some victims do not report elder abuse because they are: afraid of what the abuser will do completely dependent on the abuser for food, shelter and care; afraid of being shipped to an institution ashamed of telling anyone; belief that no one can help them. Why do family, friends or social services not report? There are many reasons for not reporting suspected elder abuse: they do not know who to speak to; they do not know what can be done; they just don’t want to get involved; the older person asks them not to report it they do not know that assault, theft, or neglect is a crime; they may be afraid of what will happen once an abuse is reported; they may fear that the older person will deny the abuse, and that nothing can be done unless the person admits being abused. What do victims of elder abuse need? Elder abuse victims need: the abuser to stop the violence, exploitation, or neglect; safety, shelter, access to financial resources; other care options, such as home care so they are not dependent on the abuser; emotional support, counseling, links to community; information about the criminal justice system. PERSONAL PREVENTION STRATEGIES · TO ADDRESS ELDER ABUSE Plan for the future: make a Will, designate a Power of Attorney and health care preferences. Discuss preferences for future care and finances with family and friends in case you become frail. Clarify your expectations regarding the amount of family involvement in your care. (eg. If your son or daughter lives far away or has young children, do you expect him/her to be available 24-hours a day?) Clarify your expectations. Make your own decisions about accepting or refusing health care services or about the opinions of others. Be careful about agreeing to live with someone, especially if they have a history of substance abuse or psychiatric disease. Consider carefully before accepting personal care in return for transfer of your property or assets. Recognize that verbal harassment, humiliation, or neglect can be early signs of physical abuse. Remain active and involved in social and community activities. Work to maintain or improve your relationships (with your children, friends) if necessary. Take care of your own health and welfare. Do not allow your standards of self care to deteriorate. Assert your right to be treated with dignity and respect. Ask for help when you need it. How can the church respond to the need for help? 1. What is the Problem? Currently, there are many different community agencies (often called silos) responsible for some aspect of elder abuse. These are: elders themselves who often have self-help groups/programs to deal with loneliness, isolation and family problems; social workers whose focus is primarily on the victims and how to rescue them; health workers (in Ontario, the Community Care Access Centre - CCAC) whose role is to care for the physical health of the patient; the police whose role is to determine if a crime has been committed and, if so, what to do about it; the housing sector where an abused senior might need to seek shelter; the government, both municipal and provincial, whose role is unclear. the church which is often the only agency to deal with the whole family No one sector can solve the problem - we need a multi-disciplinary approach and a cooperative strategy. Each group brings special expertise to the problem. 2. What are the constraints on clergy? A recent study of 16 clergy from both conservative and liberal faiths, on dilemmas faced by the clergy around elder abuse, revealed constraints on their ability to act for the following reasons: some clergy are not aware of the problem or how to address it; clergy don’t know the community resources or how to access them; some clergy overwhelmed by social problems; elder abuse just one more; clergy often have long-term relationships with a family and loyalty to it; confidentiality: for the abused/the abuser/the congregation/ the community; confidentiality is difficult to manage in a faith community; elder abuse can split a family and a community; this increases if the abuser is a prominent member of the community. ageism which often devalues older people, especially women; ambivalence around abuse as a “crime” 3. Possible responses There are several important initiatives which faith communities might take to address the problem of elder abuse: clergy, rather than social workers, may need to construct the problem as a holistic, family issue, given their responsibility for the whole family; clergy may need to reexamine how their resources, of both time and money, are allocated in the church (Are the young being unfairly served?); all agencies need to acknowledge diversity in the construction of the problem and its solution - “think outside the box”. clergy, as spiritual leaders, may need to take responsibility for coordinating the agency silos, perhaps into a multi-disciplinary team; clergy may be in best position to redefine the problem in a different way 68% OF ELDERS REPORTING ABUSE SAY THEY WOULD CONFIDE IN THEIR MINISTER IF IT WERE SAFE TO DO SO! PARISH NURSE 1. What is a Parish Nurse? A Parish Nurse is a Registered Nurse who functions as a staff member of a pastoral care team engaged in a ministry within a congregation and the community. 2. What does a Parish Nurse do? Some activities include: interprets the role of faith in well-being in the church and the community; offers support and encouragement during times of crisis and celebration; focuses on health promotion and disease prevention; provides referral information, advocacy and coordinates services; encourages and facilitates congregational participation in ministry. 3. Why implement a Parish Nurse Ministry? Congregations which embrace the healing role understand the link between health and faith as part of their mission. Parish Nursing helps to emphasize the wholeness of body, mind and spirit. 4. How does a Parish Nurse Ministry function? A congregation established a Health committee. the Health Committee advises and works with the clergy and the Parish Nurse to develop, implement and evaluate programs and services in response to identified needs. the Parish Nurse may also advise members of a congregation on health matters. 5. How does the congregation/Community benefit? Unique programs are developed for individuals/families and groups in the congregation to interpret the relationship between faith and health. This activity models the whole person approach to health and wellness. Benefits include: increase understanding between faith and health enhance the ability of the church to respond to needs in the church support healing, caring ministries 6. What other Opportunities are there for Parish Nurse Ministry? Church-related community groups may involve a Parish Nurse in their activities (e.g. out-of-the-cold program, seniors’ groups, youth groups) to highlight health issues. Abuse of older persons may benefit from the interventions of a Parish Nurse. Several congregations may band together to hire a Parish Nurse to serve the needs of several smaller congregations. Restorative Justice Older adults are often reluctant to disclose that they are being abused and very reluctant to initiate any interventions. Repeatedly, they indicate that they would rather live with the abuse than risk losing their relationship with a trusted family member, friend, or caregiver. Society’s response is fragmented; institutions are unable to respond holistically. What is restorative justice? Restorative justice considers abuse to be a violation of the whole community, of people and relationships rather than a violation of the law. It focuses on what needs to be healed, what needs to be repaid, what needs to be learned about the crime and what needs to be strengthened to prevent it from happening again. How does restorative justice work? The traditional retributive justice system works like this: If a son has removed or stolen $40,000 from his mother’s bank account, he is thought to have violated a law. As a result, he is charged with theft. A Crown prosecutor tries him and if found guilty he is punished according to a set of prescribed standards. The focal point of this approach is to establish guilt or innocence and to administer appropriate punishment. Using the restorative justice model, the mother and her supporters (could include family members, clergy, nurse) the son and his supporters (siblings, clergy, probation officer) and community members are brought together, by a trained facilitator, to search for solutions. Each person tells his or her story of what happened and of the impact of the event. This group of people reaches a consensus on: · Why the abuse happened · What can be done to repair the harm · What can be done to prevent it from happening again The process is not an attempt to avoid justice. Rather, it is a form of justice that holds the person who has done the harm accountable and focuses on healing and prevention of further abuse. Why is the faith community integral? The restorative justice model is grounded in community. Too often our society has taken a fragmented approach to problem solving. This model reasserts the damage done to the whole community when injustice happens. This method is uniquely suited to faith communities able to provide support to both the harmed and the person who did the harm and to address the underlying causes of abuse for long-term prevention. Is this method being tried anywhere? In Waterloo Ontario the Trillium Foundation is funding a Restorative Justice Approaches to Elder Abuse Project coordinated by the Community Care Access Centre of Waterloo Region. The Project Director is Arlene Groh. She can be reached at 519 883-5500 ext. 6115 or email: agroh@ccacwat.on.ca.
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