Elder Abuse in Canada PDF - Durham College

Copyright This presentation and all its content is copyright and is owned by Durham College or its Licensors (2022)....

Copyright This presentation and all its content is copyright and is owned by Durham College or its Licensors (2022). Elder Abuse in Canada H&H II – WEEK 4 © Durham College or its licensors 2022 Learning Objectives After completing this module, you will be able to demonstrate the following: Identify key indicators of physical, emotional, financial and sexual abuse of the older adult. Describe the nurses role in identify and addressing elder abuse Describe how to advocate for an older adult experiencing elder abuse. H&H II – WEEK 4.2 Explore online and community resources related to elder abuse.  Elder Abuse in Canada Stats & Trends Elder Abuse Most instances of abuse are committed by family members Elder abuse is "any action by someone in a relationship of trust that results Older women experience abuse in harm or distress to an older person. Neglect is a lack of action by that person in a relationship of trust with the same result." more than older men Older women usually experience (Touhy et al., 2019, p. 365) abuse by spouses and children Elder abuse involves any form of physical, emotional, financial, sexual abuse Older men usually experience and neglect abuse by children and close The most common forms of elder abuse in Canada are emotional and financial friends abuse. Individuals with cognitive Prevalence impairment are at higher risk for abuse than those who are not Approx 5-10% of older adults in Canada have experienced some form of abuse. cognitively impaired. © Durham College or its licensors 2022 © Durham College or its licensors 2022 Physical Abuse Impact of Elder Abuse Definition Actions Indications Consequences of elder abuse include Using physical force against a Hitting, punching, slapping, Unexplained injuries (bruises, physical trauma, diminished self worth, person without the person's pushing, biting or throwing the burns, bites, fractures) reports of feeling unsafe and an consent. It can cause pain, older person Untreated medical problems increase risk of early death. injury or impairment Burning the person History of "accidents" Confining the person, including Signs of over or under use of the use of unnecessary medications Older adults can experience increased restraints Wasting hospitalization, economic costs, Throwing objects at the older Dehydration person exposure to additional health interventions and lost productivity. Touhy et al., (2019). Ebersole & Hess' Gerontological Nursing & Healthy Aging. Elsevier Canada. Table 22.1. p. 365 © Durham College or its licensors 2022 © Durham College or its licensors 2022  Emotional Abuse Financial Abuse Definition Actions Indications Definition Actions Indications Using words or actions to Threatening Fear, anxiety, withdrawl Acting without the Misuse of power of attorney Standard of living is control, frighten, isolate or Depression older person's consent Theft inconsistent with with Blaming, insulting, lying erode a persons’ self respect in a way that benefits income or assets Deciding what the person can do or Cowering the abuser at the Misusing control over a person's funds by not providing them for the person's benefit Theft or missing property not do Reluctance to talk openly expense of the older noted Not keeping promises person through Pressuring the person to provide financial Fearful interaction with Unusual or inappropriate threats, intimidation, support Humiliation caregiver activity in bank accounts or deceit. most forms Making the person sign a legal document Alienating others from the older Family or caregiver talking Forged signatures on of financial abuse are Overcharging for services person on behalf of the person and cheques crimes Making fun of the persons heritage, not allowing privacy Failing to relay loans Overdue bills traditions, or religious or spiritual Pressuring the person to sign over house Missing mail beliefs or property Constant yelling Touhy et al., (2019). Ebersole & Hess' Ge rontological Nursing & Healthy Aging. Touhy et al., (2019). Ebersole & Hess' Gerontological Nursing & Healthy Aging. Elsevier Canada. Table 22.1. p. 365 © Durh am College or its licensors 2022 Elsevier Canada. Table 22.1. p. 365 © Durham College or its licensors 2022 Neglect Sexual Abuse Definition Actions Indications Definition Actions Indications Failing to adequately provide failing ot provide adequate Unkemp appearance Direct or indirect involvement in Coercing an older person Pain, bruising & bleeding in necessities of care for a nutrition, personal care or a Inappropriate or dirty clothing sexual activity without consent through force, trickery, threats genital area dependent or older person clean, warm, safe environment Signs of infrequent bathing or other means into unwanted Withholding medical services sexual activity. Unhealthy living conditions or treatments Dangers or disrepair in home Victimization of older adults Failing ot provide proper who cannot consent environment needed supervision Hoarding Failing to prevent physical RNAO (2014). Preventing & Addressing Abuse and Neglect of Older Adults. harm Lack of social contact Toronto, ON. RNAO. Appendix D. No regular health care appointments Touhy et al., (2019). Ebersole & Hes s' Gerontological Nursing & Healthy Aging. Elsevier Canada. Table 22.1. p. 365 © Durham College or its licensors 2022 © Durham College or its licensors 2022  Scams Scams are a form of financial abuse Scams play on older adults emotion and fear. Older adults are often targeted because they are easily accessible, more trusting and polite, and most have money and assets Scam education for older adults should include: Resist pressure to act immediately and don’t buy on impulse Watch out for products promoted by “prizes” or “free trips” Nursing Assessment & Implications Before buying or investing, check with family and friends or attorney Do not give your credit card over the phone unless you are sure who you are giving it to. Hang up and call your credit card company and speak to the fraud department H&H II – WEEK 4.3 Do not give personal information over the phone Always check email addresses and don't click on links you are unsure of. If in doubt call or email the person separately to ask if they send you the link © Durham College or its licensors 2022 RNAO (2014). Preventing & Addressing Abuse and Neglect of Older Adults. Toronto, ON. Touhy et al., (2019). Ebersole & Hess' Gerontological Nursing & Healthy Aging (2nd ed.). RNAO. p.103-104 Elsevier Canada. p. 370 © Durham College or its licensors 2022 Assessment of Abuse Nurses must be sensitive and alert to signs of abuse in each interaction with an When abuse is suspected or confirmed: older adult. Use an interprofessional approach Signs to be Aware of: Unexplained bruising or fractures Consider if law enforcement needs to be involved Missed appointments without explanation Was a criminal code violated Injuries that do not align with the history and physical assessment. Follow jurisdictional laws regarding mandatory reporting Family member’s change in normal behaviour or speaking for the older adult. Consider consent and privacy when working with capable adults An assessment should be done to determine the “immediate safety of the victim; Capable older adults’ decisions need to be respected the desires of the victim, if capable; and supports available to reduce the persons risk" (Touhy et al., 2019, p. 369). Capable Older Adults RNAO Decision Tree "Reporting abuse or neglect of mentally capable adults may be Decision tree needs to be tailored to the type of abuse, the sector, the scope of practice of the inappropriate, and reporting harms without their consent may care provider and relevant laws be a breach of the older adults' right to make their own Collaborate with the older adult, family (if decisions and their right to confidentiality. When reporting appropriate) when making decisions. abuse is not required or appropriate, nurses and other health RNAO BPG - Preventing Abuse & Neglect of Older Adults care provider should determine what other supports can be Community Resources offered to the older adult, such as providing emotional support Region of Durham, Advisor-Seniors' Safety: 905-668- 7711 ext. 2460 or referrals to appropriate resources" (p. 34). Durham Regional Police, Seniors Support Co- ordinator: 905-579-1520 ext. 1865 Seniors CRIMESTOPPERS: 1-800-222-8477 RNAO BPG: Preventing & Addressing Abuse and Neglect of Older Adults (Appendix I)  Institutional Abuse Institutional abuse refers to any form of abuse that occurs within healthcare Institutional institutions, such as Long Term Care (LTC) facilities, hospital or retirement homes Abuse There are 2 types of institutional abuse Resident-to-resident abuse H&H II – WEEK 4.3 Staff-to-resident abuse Resident-to-Resident Abuse Staff to Resident Abuse Staff-to-resident abuse Recent studies found that up to 41% of residents experience some form of Any form of abuse that exists between a staff member and a resident and occurs within a trusting, therapeutic resident-to-resident abuse relationship. Older adults are at risk because they are isolated and dependent on staff for caregiving. Resident-to-resident abuse there is the potential for harm to both residents Factors influencing abuse The same power dynamic is not usually at play as it would for other forms Institutional Factors: If an organization has poor or ineffective leadership, inadequate staffing levels, high burnout or turnover or where intimidation of staff is permitted, then this often translates to resident abuse. of abuse. Staff Factors: Staff are more likely to be abusive if they experience workplace stress, dissatisfaction with This form of abuse does not occur within the context of a therapeutic work, emotional exhaustion, job pressures, inexperience, lack of knowledge about older persons, negative relationship. attitudes such as ageism, personal problems, a personal history of abuse, alcohol or substance misuse and deficiencies in communication skills or problem-solving Nursing Implications Resident Factors: Aggressive, hyperactive, or responsive behaviours; dependency regarding activities of Separate residents involved daily living; a history of previous abuse; social isolation; and impaired communication all put residents at higher risk for abuse Follow other institution policies for mandatory reporting (Touhy et al., 2019, p. 369). Nursing Implications Mandatory Reporting Nurses must be routinely trained and updated on prevention and Mandatory reporting exists within the Long Term Care assessment of elder abuse. sector This education should include the following: If a staff member suspects any form of abuse they MUST Ageism report to their supervisor Residents' rights Abuse, neglect, and the factors that contribute to them Staff members' responsibilities to report abuse Staff Supervisor MoHLTC +/- Police Relevant laws Positive care approaches Managing responsive behaviours Whistle-blower protection policies must be in place Fostering a safe and healthy work environment Institutional Abuse Please watch this video and complete the Practice Activity on DC Connect RNAO: Reporting Suspected Abuse and Neglect, Whistle- blowing Protection https://www.youtube.com/ watch?v=jwt-i0XpJuo