Lynn McDonald, PhD
Professor, Faculty of Social Work
Director, Institute for the Life Course and Aging
Scientific Director, National Initiative for the Care of the Elderly (NICE)
University of Toronto
The term mistreatment of older adults generally refers to actions that cause harm or risk of harm within a trusting relationship. Elder abuse and neglect (the two forms of mistreatment) can happen to anyone in any family or professional relationship, in hospitals, in long-term care facilities or in a senior’s private home.
No one is exempt from mistreatment: it can affect people of all ages, genders, religions, races and ethnic origins. In Canada the problem has not been well understood because no one knew for sure how extensive the problem was, who was affected or why they were affected. Finding the answers to these questions will help us to better target the use of health and financial resources and to more effectively address the problem. Only recently have we added to our understanding of this unacceptable state of affairs.
In 2014–2015, the National Initiative for the Care of the Elderly (NICE; www.nicenet.ca) conducted a national telephone survey to estimate the prevalence of five forms of elder abuse in community-dwelling Canadians who were 55 years of age and older. A representative sample of 8,163 older Canadians completed the survey, which provided information about the rates of, and risk factors for, (1) neglect, (2) psychological abuse, (3) physical abuse, (4) sexual abuse and (5) financial exploitation. This study was the largest study of the prevalence of elder abuse ever conducted in the world and had some surprising results.
Elder abuse and neglect were not quite as widespread in the community as previously thought. About 7.5% of older adults, or 75 of every 1,000 older Canadians, were abused in the previous year. Looked at another way, approximately 695,248 older Canadians were abused in the last year. When neglect was added to psychological, physical, sexual and financial abuse, the number jumped to 82 of every 1,000 older people, or 8.2%, representing 766,247 older Canadian adults. The most common form of abuse was psychological or emotional abuse, which affected 2.7% of older Canadians daily or almost daily. Psychological attacks involved older adults being repeatedly criticized, yelled and shouted at or insulted. Financial abuse was the second most frequent form of elder abuse in Canada, affecting 2.6% of older adults. Financial abuse usually involved perpetrators trying to make the older person give them money or taking the older person’s money, possessions or property. Physical abuse was the third most common form of elder abuse and affected 2.2% of older people. Physical assaults usually involved people being pushed, shoved, grabbed or hit and insulted. Fewer older Canadians were sexually assaulted but still 1.6% of the survey respondents reported being sexually abused in the past 12 months. Lastly, 1.2% of older adults were neglected a few times or more in the last year; this usually involved not getting the help they needed with housework and meals. Very few of the older Canadians who participated in the survey were ill or very frail, most were in their sixties and early seventies and most had higher levels of education.
If you are on the lookout for elder abuse, signs of depression and abuse at earlier stages of life (childhood, youth, middle age) may be strong indicators that someone might be at risk for abuse. One of best defenses against elder abuse and neglect is for older adults themselves to be able to recognize the risks for, and signs of, mistreatment in their own dealings and in those of others. If you want more information, contact NICE, which has a wealth of “pocket tools” on elder abuse and neglect.