Elder Abuse Lecture Slides PDF

Elder Abuse: What you need to know Julie Hebert Inspector/Investigator Retirement Homes Regulatory Authority Why is this important? There are no car chases in Elder Abuse… Population by age group Population by sex and age group, by province and territory (Number, both sexes) All ages 0 to 14...

Elder Abuse: What you need to know Julie Hebert Inspector/Investigator Retirement Homes Regulatory Authority Why is this important? There are no car chases in Elder Abuse… Population by age group Population by sex and age group, by province and territory (Number, both sexes) All ages 0 to 14 15 to 64 65 and older Canada 38,005,238 6,014,289 24,982,362 6,835,866 Ontario 14,734,014 2,280,177 9,801,581 2,594,358 Note: Population on July 1. Source: Statistics Canada, CANSIM, table 051-0001. Last modified: 2020-07-01. Just because it isn’t a crime, it can still be a “police” matter Role of the police • The Police have an important role in the response to elder abuse. The Policemust havebe anaware important in the forms response to elder • They of therole different of abuse andabuse. know what actions are Theyrequired. must be aware of the different forms of abuse and know what actions are required. • The knowledge and application of various legislation pertaining to seniors, is The knowledge and application of various legislation pertaining to seniors, is required, required, to address certain seniors’ issues. to address certain seniors’ issues. • The Police service seniors to have some knowledge of the family The Police thatthat service seniors needneed to have some knowledge of the family dynamics dynamics assisting a senior, especially from a culturally involved wheninvolved assistingwhen a senior, especially a senior from aa senior culturally diverse diverse community, such as; culture, beliefs, language and family hierarchy. community, such as; culture, beliefs, language and family hierarchy. • Police services in Ontario are experiencing an increase in crimes, abuses quality Police services in Ontario are experiencing an increase in crimes, abuses and and quality of of life issues involving seniors. life issues involving seniors. Specialized police unitsunits are required and and are being formed, to effectively investigate • Specialized police are required are being formed, to effectively investigate these matters. these matters. What is Elder Abuse? The World Health Organization (WHO, 2004) defines elder abuse as: “a single or repeated act, or lack of appropriate action, occurring in any relationship where there is an expectation of trust that causes harm or distress to an older person”. Types of Elder Abuse • • • • • • • • • • Roughly 7.5% of seniors report being a victim of crime each year 2.6% report Financial abuse 2.2 % report Physical violence 2/3 of victims are female 1.6% Sexual abuse 1.2% Neglect Psychological abuse tied to all of them Violence against seniors and their perceptions of safety in Canada (statcan.gc.ca) Latest study done in Canada 128,000 senior victims of violence in 2019, 76% of those were physically assaulted • Elder abuse does not discriminate. • It can occur in any community. • Any older adult, regardless of income, health, culture or ethnic background can be a victim. • The senior victim can be living in the community or an institution. Who are the suspects? • Family members, care-givers, strangers • In 2020, nearly two-thirds (64%) of senior victims of policereported violence were victimized by someone other than a family member or intimate partner. Acquaintances were implicated for more than one in four (28%) senior victims of violence while one-quarter (24%) of senior victims were victimized by stranger. • Senior women who experienced police-reported violence were twice as likely to have been victimized by an intimate partner compared with senior men (16% versus 7%). • For financial crime, there is the victimization by strangers through scams but familial financial abuse though theft by power of attorney type crimes Profiles of victims of abusers VICTIMS • May be widowed or living alone • May be socially isolated • May be under the control or influence of the abuser • May have some degree of physical impairment or mental incapacity • May have been an abusive parent • May have difficult personality traits ABUSERS • May be the adult child or spouse • May have substance abuse problems • May have a history of mental illness • May have emotional problems • May be dependent on the older person for assistance • May be resentful of caregiving role Why Is Elder Abuse Seldom Reported? • Afraid of repercussion, family member may threaten to socially abandon them• Completely under the control of the abuser and dependent on him/her for basic needs (physically/mentally incapable), • Fear of institutionalization, many seniors are afraid of being placed in a nursing home or a retirement home. • Concern that abuser will be incarcerated/get criminal record • Guilt/shame, either that they fell victim, or that their children deceived them • Misconception that police/social agencies cannot help • Unaware of resources within the community • Cultural/Ethnic values or beliefs Physical abuse Any act of violence causing injury or physical discomfort, includes sexual assault, assault, assault bodily harm, assault with a weapon, manslaughter and murder Includes over and under medicating Under medicating for profit-Increase in medication thefts by caregivers Over medicating to gain compliance Signs and Symptoms Could occur in private residential or retirement home/nursing home settings Don’t assume that a person in a facility can’t be a victim Unexplained injuries, unusual bruising, seniors may bruise more easily due to medication issues, look at where the bruise occurs, type of bruise Fear of care-giver or family members in attendance-often won’t be allowed to speak for themselves Lack of personal aids, like walkers, hearing aids, glasses Over or under-medicating-senior may seem to be in pain all the time, or maybe they seem overly drugged Bruises in various stages of healing, burns or bites Alopecia and bleeding scalp from hair pulling Untreated medical problems History of “accidents” Signs of over and/or under medication Sexual assault Wasting, dehydration Possible Charges • • • • • • Assault ( Sec 265 CC ) Sexual Assault ( Sec 271 CC ) Forcible Confinement ( Sec 279 CC Murder ( Sec 229 CC ) Manslaughter ( Sec 234 CC ) Could be other charges laid as well depending on the circumstances Financial Abuse • Theft by POA-it is not civil! C.C. 331,332-theft by power of attorney • Power of attorney for Care can only be invoked if the person has been deemed incapable • Power of Attorney for finances can be invoked as soon as it is signed. • Substitute Decision Makers Act • Have to keep your finances separate • Can only spend the money for the care of the elderly person • have to keep records of how money is spent • Person does NOT have to be deemed incapable for POA for finances to take effect • A person can abdicate their power of attorney if they choose, • A new POA can be signed/changed at any time as long as the person is capable • They are NOT registered anywhere • Ontario Office of Public Guardianship and Trust can take over • Seniors are often the victims of scams-trusting generation • A widowed senior living alone is most likely to be targeted. • Often have more savings and assets, • SCAMS-Little Black Book of Scams, put out by the Competition Bureau http://www.competitionbureau.gc.ca/eic/site/cbbc.nsf/eng/03074.html • Available in PDF form in different languages • Be careful of “check on well-being” calls!!!! • “sucker lists”, once you are on one, you are on all of them Remember most seniors are victimized financially by family members Signs and Symptoms • Suddenly not able to pay bills that were previously not an issue • Excessive ATM or debit card use • Bank statements no longer sent to senior’s home • Unnecessary repairs, or new equipment that may not have been needed (hot water tank, furnace) • Mail starting to pile up, remember most seniors still do banking in person and by mail • Often making excuses for why they have to loan family money • Abrupt change in Will, Power of Attorney or financial documents - senior may not understand implications Criminal Code Charges • Fraud s. 380 REMEMBER Section 380 CC includes the offence of: defrauding the public or any person whether ascertained or not, of any property , money, valuable security or service • https://www.ontario.ca/page/yourrights-when-signing-or-cancellingcontract • Theft by Power of Attorney CC s 331 • Theft CC 332 • Extortion CC 346 • Forgery CC 366 Son leaves elderly mother destitute after wiping out her million-dollar nest-egg Roman Kaziuk didn’t quite sell his own mother – but he did the next worst thing. Capping a criminal record highlighted by 69 fraud convictions, Mr. Kaziuk conned his 88year-old mother, Feliksa Kaziuk, out of her million-dollar retirement nest-egg. As a direct result, Ms. Kaziuk lost two condo apartments she owned in Oakville, Ont. and ended up in a Salvation Army shelter for the destitute. Her son also emptied her bank account, stole her car and ran up huge debts on her credit cards. In sentencing Mr. Kaziuk last week to 10 years in a penitentiary – triple the length of time that the Crown had requested – Ontario Court Judge Lesley Baldwin ranked Mr. Kaziuk as belonging in a despicable class of his own. “Not even the notorious Bernie Madoff was guilty of destroying his own mother, as Mr. Kaziuk has repeatedly done,” Judge Baldwin said, referring to the New York-based investment adviser who bilked millions of dollars from his clients. Mr. Kaziuk, he added, “has wiped her out financially and broken her heart.” The judge said Mr. Kaziuk is an out-and-out psychopath who lacks any redeeming qualities or hope of rehabilitation. Neglect • Passive neglect- senior fails to care for themselves, may not have the resources financially or mentally/physically to care for themselves • Self neglect-Person’s inability to provide for their own essential needs because of physical infirmity or inability to make sound choices due to addiction, mental illness and/or cognitive impairment. • REFER THEM TO AGENCIES!!!!!- Home and Community Care Support Services • ; Alzheimer’s Society, “COAST TEAM” (mental health liaison in police service); Social Services, Diogenes Society (hoarding • Passive neglect by care giver-many seniors don’t have the skills to look after ailing spouse, making meals, personal hygiene, wound care • AGAIN REFER TO AGENCIES!!!!! Overt Neglect • • • • • • • • • Failure to attend to basic personal needs Food and water Required medications Shelter, hygiene, clothing Physical aids – hearing aids, eye glasses, dentures Exercise and social interaction Lack of attention, abandonment, undue confinement Inadequate supervision or safety precautions Withholding medical services or treatments • Possible Criminal Charges- Criminal negligence CC 220, 221, Failure to provide necessities CC 215 • Bed sores, dehydration • Beware the Brussel sprouts Signs of Neglect Uxbridge man Kevin Plein sentenced to 18 years in deaths of mother, sister DURHAM -- An Uxbridge man has been sentenced to 18 years in prison for his role in the deaths of his frail mother and intellectually challenged sister, crimes characterized by prosecutors as grotesque breaches of trust. Kevin Plein showed a callous disregard for the welfare of his sister Cindy and mother Erika, who died months apart, Superior Court Justice Hugh O’Connell observed as he delivered his reasons for sentencing Wednesday, Jan. 21 at the Oshawa courthouse. “The reason Cindy Plein and Erika Plein are now in marked graves is because of him,” the judge said during a lengthy and scathing assessment of Mr. Plein’s culpability. Mr. Plein, 51, was found guilty last June of manslaughter in the death of his mother and criminal negligence in Cindy’s death. Cindy, 48, died in June 2009 after severe burns she suffered at the family’s Altona home went untreated and became infected. Erika was 72 when she died in April 2010 of starvation; court heard she weighed between 60 and 70 pounds at the time of her death. Duty of Persons to Provide Necessaries Section 215 C.C.C. 215.(1) Every one is under a legal duty (a) as a parent, foster parent, guardian or head of a family, to provide necessaries of life for a child under the age of sixteen years; (b) to provide necessaries of life to their spouse or common-law partner; and (c) to provide necessaries of life to a person under his charge if that person (i) is unable, by reason of detention, age, illness, mental disorder or other cause, to withdraw himself from that charge, and (ii) is unable to provide himself with necessaries of life. Psychological • Often tied to all other forms of abuse • Can be the most damaging form of abuse • Keeping family members away, subjecting senior to threats or stalking, belittling • Includes threats to do harm, unwanted institutionalization, harassment, abandonment, removal of decision-making ability • Criminal charges could include Criminal Harassment , Utter threats , Intimidation Indicators • • • • • • Fear Anxiety Depression Withdrawal Reluctance to speak openly Fearful interaction with caregiver • Caregiver speaking on behalf of the senior and not allowing privacy Retirement Homes Regulatory Authority • RHRA is a not-for-profit agency that is independent of government, answers to the Minister Responsible for Seniors • Retirement Homes Act and O.Reg 166/11 fall under the Provincial Offences Act • The RHRA regulates, educates and enforces the regulation and care standards established by government for the increased protection of seniors in retirement homes across the province. • Our mandate is to improve the lives of residents in retirement homes • The Act sets out a Residents' Bill of Rights. Operators of retirement homes must respect and promote these rights. They must also post these rights in the home and ensure staff members receive training about these. In Ontario, all retirement homes must have a licence from the RHRA to operate • Approximately 750 licensed homes in the province of Ontario • Retirement home is a residential facility which is occupied by 6 or more persons 65yrs of age and older, not related to the operator, and in which 2 or more care services are made available Inspections • Routine inspection • Mandatory reporting inspection• s.75 A person who has reasonable grounds to suspect that any of the following has occurred or may occur shall immediately report the suspicion and the information upon which it is based to the Registrar: • 1. Improper or incompetent treatment or care of a resident that resulted in harm or a risk of harm to the resident. • 2. Abuse of a resident by anyone or neglect of a resident by the licensee or the staff of the retirement home of the resident if it results in harm or a risk of harm to the resident. • 3. Unlawful conduct that resulted in harm or a risk of harm to a resident. • 4. Misuse or misappropriation of a resident’s money. 2010, c. 11, s. 75 (1). • Complaint inspection • 77(2) inspection, 77(1) Why is this important to you? • Homes are required to notify the police if they suspect an incident of abuse or neglect that may constitute a criminal code offence has occurred • The home must do their own investigation. If their investigation would interfere with yours LET THEM KNOW!!!!! • The RHRA works closely with the police • Inspections vs investigation-warrant vs no warrant Fixing Long Term Care Act • Fixing Long Term Care Act, 2021 and Ontario Regulation 246/22 (Regulation) made under the LTCHA came into force on April 11, 2022 • Revamped after issues in COVID came to light but several aspects have remained the same. • Residents’ Bill of Rights • There must be a written policy to promote zero tolerance of abuse and neglect of residents. This policy must be communicated to all staff, residents and substitute decision-makers. • The appropriate police force must be notified immediately of any alleged, suspected or witnessed incidence of abuse or neglect of a resident that the Home suspects may constitute a criminal offence. Resident to resident abuse • • • • You are not doctors….. Police role is to protect the public Serious consequences if charges are not laid 29 long-term care residents killed as a result of violence by another resident in Ontario nursing homes since 2014 • GLTCRCwww.http://www.mcscs.jus.gov.on.ca/english/DeathInves tigations/office_coroner/PublicationsandReports/GLTC/20 13-14Report/GLTCRC_201314.html#appendix Investigation Most charges dropped in fraud trial of door-to-door salesman The fraud allegations against door-to-door salesman Dennis Lee continued to deteriorate Thursday, with the prosecutor conceding there is not enough evidence to convict the man on most of the charges he faces. At the onset of the trial this week, Pratt said he would not be calling any evidence related to some charges because the alleged victims have either died or are too ill to testify. Lee’s trial Thursday heard from a final Crown witness. A Kingsville woman testified Lee came to her home to clean an air purifier she had purchased through another salesperson. Later, Lee sold her a second unit for $1,500 and she signed an $880 contract for him to service both machines. When the unit he sold her broke down, she tried to call Lee. His phone was not in service. Indigenous Senior population • 2019 census showed there were 82,690 indigenous seniors in Canada • The RHA and the LTCFA doesn’t apply on indigenous land BUT • Reach out to your seniors and congregate care settings • Develop relationships with community leaders to advocate for your senior population • Consult with other agencies if required, “it takes a village” • You have a responsibility to keep the senior up to date on the investigation • Support the victim and supply information about the legal system • Ensure they are safe, have shelter and financial resources • Safety plans, education • Contact other family or friends to support them Community Agencies • Senior's Safety Line 1-866-299-1011 • Office of the Public Guardianship and Trust 416-327-6348 or 1-800-3660335. • Advocacy Centre for the Elderly 1-416-598-2656 (legal advice/ support) www.acelaw.ca • Abuse in Long Term Care-Ministry of Long-Term Care at 1-866-434-0144 • Abuse in Retirement Homes-Retirement Homes Regulatory Authority 1855-275-7472 • Elder Abuse Ontario-www.elderabuseontario.com • Alzheimer’s Society-www.Alzheimer.ca • Home and Community Care Support Serviceswww.healthcareathome.ca Our Family members are getting older and you are too! Questions? [email protected] 55 York St Suite 700 Toronto, ON C-1-416-618-1434 T-1-855-275-7472