How you can identify abuse and help older adults at risk

"It's Not Right!" Neighbours, Friends and Families for Older Adults

We have a shared responsibility to promote respect for all members of our society. Everyone has a role to play.

When people have trouble in their relationships, you may be the neighbour, friend or family member who can make a positive difference. If you are concerned that an older adult in your life may be experiencing abuse, this brochure can help you to recognize the warning signs so that you can help.

We also need to recognize the ways our society discriminates against older adults. "Ageism" is the term that describes attitudes and beliefs that cause people to treat older adults as if they were less important or less valued because they are older. These attitudes are a factor in abusive situations because they allow people to believe that they have the right to ignore, harm or control an older adult.

What is abuse of older adults?

The terms "elder abuse" and "senior abuse" are often used to describe the experience of older adults who are abused, usually by someone they know and often by someone they care about. It is abuse whenever someone limits or controls the rights and freedoms of an older adult. The older adult is unable to freely make choices because they are afraid of being humiliated, hurt, left alone, or of the relationship ending. Abuse causes harm to an older adult.

The World Health Organization (WHO) defines abuse of older adults as "a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person."

Who are the abusers of older adults?

Abuse of older adults often occurs within the family, by adult children or grandchildren. However, other relatives, friends, neighbours, paid or unpaid caregivers, landlords, financial advisors or any individual in a position of power, trust or authority can also be abusive. When a spouse is abusive, it is called domestic violence.

Who Is at Risk?

"I never thought it would happen to me." Abuse can happen at any age to any person.

There are a number of risk factors that may cause concern:

• Isolation —physical, social or cultural
• History of domestic violence
• Shared living situations
• Dependency on an older adult (for shelter or financial help)
• Addiction issues
• Depression and other mental health issues
• Cognitive impairment

How you can recognize abuse

Abuse happens in different ways, and usually becomes worse if there is no help of some kind. Older adults often experience more than one form of abuse. All abuse is serious and causes harm.

1. Financial Abuse

"My granddaughter moved in with me some time ago. I asked her to leave because she used my bank card to take money from my account a couple of times. She said she has no place to go. I feel guilty and let her stay, but I am afraid she will do it again."

"My younger sister lives with me since her husband died. I have worked hard and saved money for many years. She has threatened to end our relationship if I don't write a new will that leaves all of my savings to her."

"Last week, my son-in-law asked me to sign a power of attorney so that he could help with my affairs. He disagrees with the way I manage my money, and I have heard him tell my daughter that he thinks I am getting senile. I am a little afraid of him."

It is financial abuse if somebody tricks, threatens, or persuades older adults out of their money, property or possessions. Sometimes the abuser might influence or force the abused to change their will, sign a power of attorney, or the abuser might cash cheques without their knowledge.

2. Psychological Abuse

"I don't have a big family and have outlived most of my friends. My niece is the only family member I see regularly. She says I'm lazy and should be thankful that she takes time to visit me."

"My husband controls my every move. He tells me I am "too stupid" to make decisions or handle money. He won't let me see my friends anymore."

"My wife laughs at me in front of people because I can't manage zippers and buttons without her help. She tells people that I am "worse than a child" and that she would never let herself be so helpless."

It is psychological abuse if somebody threatens, insults, intimidates or humiliates an older adult, treats the person like a child, or does not allow them to see their family and friends.

3. Spiritual or Religious Abuse

"My daughter-in-law tells me that my spiritual tradition is "ridiculous" and she has convinced my son not to let my grandchildren come to ceremony with me any longer."

"My children are angry that I have made some large donations to a religious organization I support. I have overheard them say that they should "do something" to keep me away from the "religious fanatics." These people are not fanatics—they are my friends."

"My brother doesn't want me to go to church any-more. I am afraid to disobey him, but the fellowship and my faith are important to me."

It is spiritual or religious abuse when someone limits or restricts the spiritual practices, customs or traditions of an older adult. Abuse also includes using an older adult's beliefs to exploit the person, attacking the person's beliefs, or not allowing the person to participate in religious events and activities.

4. Sexual Abuse

"My husband has always been very controlling. He has never hit me, but lately he pressures me for sex. He won't let me sleep until I give in."

"My neighbour is a widower who brings my groceries because we both live so far out of town. Since my husband died he has started hugging and touching me even though I ask him not to. He calls it his "delivery fee.""

"My nephew and his girlfriend live with me. They have sex anywhere they please and don't close the door even when I am home. I have asked them repeatedly to be more private, but they laugh at me and call me a prude."

It is sexual abuse if somebody forces an older adult to engage in sexual activity. This may include verbal or suggestive behaviour, not respecting personal privacy, and sexual intercourse.

5. Neglect

"My son suffered a brain injury when he was young and he has lived with me his whole life. He does help more now that I am no longer able to get around very well, but my daughter expects him to do everything and he just can't. She lives nearby but is very busy. I haven't been able to get out for groceries for over a week this time."

"My friend and I have lived together for ten years. My knees are bad and I haven't been able to share the chores of the house recently. She is angry about this and refuses to clean my part of the house or prepare food for me. She hasn't spoken to me in three weeks. I don't speak English very well and have no one else to talk to."

"I live in the basement of my brother's house. He is very successful and travels a lot. When he goes away he locks me in. He says he is afraid that I will wander off. Even though he leaves food and things to read, I get very depressed if he is gone for more than a couple of days."

Neglect occurs when someone withholds care, food and/or emotional support that an older adult is unable to provide for himself or herself. Sometimes people providing care do not have the necessary knowledge, experience or ability.

6. Physical Abuse

"My husband pulls my hair when he is angry and yells that I don't listen to him. He has always yelled at me, but he never used to hurt me."

"I am not as independent as I used to be. I need help with certain tasks. My daughter helps me, but I am ashamed to admit that sometimes she shakes me and even hits me."

"My younger brother and I live together. He has always had a temper. Recently when he was drinking, he pushed me against the wall a couple of times."

It is physical abuse if somebody hits an older adult or handles the person roughly, even if there is no injury.

Warning signs

If you suspect abuse, look for:

• Older adults who tell you they are being abused or hurt —believe them!
• Injuries such as bruises, sprains, broken bones, scratches, especially when the explanation does not fit the injury
• Changes in behaviour of the older adult such as depression, withdrawal, or fear
• Changes in regular social activity such as missing church or other social events
• Changes in living arrangements such as previously uninvolved relatives or new friends moving in
• Changes in financial situations such as cancellation of service (e.g. television, Internet, phone) because the bills are not paid, things "disappearing" from the house
• Signs of neglect such as no food in the house, being left alone for long periods of time, not having glasses or hearing aids that are needed, not having proper clothing

Warning signs

If you suspect abusive behaviour, look for:

• Controlling behaviour:
  • Not allowing older adults the right to freely make decisions and choices
  • Refusing to allow them to visit with anyone alone
  • Isolating them from friends and family
  • Using the "silent treatment" to control them
  • Not allowing them to use the phone
  • Disregard for their privacy
  • Locks on the outside of the bedroom door
  • Reading or withholding their mail
  • Handling all of the money
• Blaming the older adult for the abuse: "It's your fault that I pushed you!"
• A strong sense of entitlement: "I can do what I want! You owe me!"
• Treating the older adult like a child: "Do what I tell you!"
• Frequent arguments, name calling or threats
• Leaving a dependent person alone for long periods of time.

But how do you know if it is abuse?

It may be difficult to determine that abuse is taking place. Every situation is different. A warning sign does not automatically mean abuse is happening. Ask questions, seek advice from experts on abuse, avoid judgment and be respectful. Trust your instincts.

What You Can Do

Neighbours, friends and family members can learn to do three things:

1. See it! "It's not right!" Recognize the warning signs of abuse.
2. Name it! "That looks/sounds like abuse." Talk to the older adult.
3. Check it! "Is it abuse? What can I do to help?" Ask questions, check with experts about what to do next, check for danger—help with safety planning.

1. See it! Take your concerns seriously, learn the warning signs.

"I am worried about my friend who hasn't been to the Centre for weeks. The last time I saw her, she seemed very anxious."

2. Name it! Overcome your hesitation to help. Talk to the older adult you think may be abused (without the person you think is abusive present) about what you have seen or heard. Use non-judgmental language.

"I haven't seen you at the Centre for some time now, and I know how important it is to you. You seem upset. I miss seeing you."

3. Check it! Ask questions.

"Are you ok? Do you feel safe? Is there anyone hurting you or making you feel uncomfortable? What do you want to do? How can I help?"

If you have immediate concerns about safety, call the police.

See also

"It's Not Right!" Neighbours, Friends and Families for Older Adults

What you can do to keep yourself safe from abuse
What you can do when abuse or neglect is happening to an older adult in your life

For more information

To learn more on what the Government of Canada is doing for seniors or to find services and support in your province or territory, visit www.seniors.gc.ca and search for "Elder Abuse" or call 1 800 O-Canada (1-800-622-6232, TTY: 1-800-926-9105).