Ontario Network for the Prevention of Elder Abuse Conference

Ontario Network for the Prevention of Elder Abuse Conference

November 2011

Making Ontario the Best place in the World to Grow Old: What will that look like and how do we get there?

Joe Bornstein PhD, Chair, Ontario Gerontology Association

Dr. Bornstein is concerned about negative stereotypes. Here are a few facts. Every 7 seconds a Canadian reaches 50. Within a group we become more different from one another within the group as we age. Therefore we must plan today for what seniors will want, whether it be senior centres or access to the ‘Y’.

Older adults may be seen as old, frail or wise. The idea that we are a burden, demonstrated by the downgrading of the New Brunswick credit rating because the population was considered too old, must be challenged. We must change the conversation, e.g. one doctor’s attitude that he would treat a 55 year old differently from a 75 year old, because the latter’s life has less value. It is not true that a larger number of seniors will make society worse. There are many groups promoting positive ageing. Seniors are a force to be reckoned with since we are healthier, still the largest contributors to taxes and a very large voting bloc.

There needs to be a vision:

to set a clear path to build towards
to create a society which benefits from the wisdom of older personsbecause it will take time to create change
to inspire collective action
to change the conversation e.g. from deficit to asset, from old society to new age structure

(Apparently the Liberal platform included some vision and not just policies on health and long term care.)

How do we get there over the next 10 to 20 years? We need to involve the public and private sectors and non-governmental organizations, applying multi-generational input, as well as social and traditional media.

e.g. in the employment sector:

government could reform retirement pensions, payroll taxes and retraining programs
the private sector could offer HR solutions, new multi-generational job roles, training and mentorships
NGOs could deliver unemployment services, mentorship and anti-discrimination services

Some visions from those who heard the presentation were:

all needs and facilities within a neighbourhood
effective local transportation
provide more educational opportunities
welcome older people to the workforce
senior resource centre
eliminate the income gap
ability to live towards your potential

Obviously there is a lot in which we could be involved to bring such a society about by

creating innovations
social activism and creation of a movement
engaging older workers and employers
helping shape a positive image

Operation Peacock – A Celebration of Elder Vibrancy

This was a community partnership between ONPEA, local senior artists and Big Brothers, Big Sisters. Funding was provided by the Government of Canada New Horizons for Seniors Program. Older artists worked with younger artists in a variety of media to create a combined piece of art. At the conclusion of the project, the art was auctioned and proceeds went to ONPEA’s Seniors’ Safety Line.

Asking the Right Questions, Listening with a Critical Ear!

This session highlighted how, when elder abuse cases come to the attention of authorities, making connections that count is paramount to preserving seniors’ rights. It clarified why collaboration and communication with and amongst clinical and law enforcement professionals can make the difference in leading cases to the judicial system. Keynote Speakers, Dr. Michael Pollanen, Chief Forensic Pathologist for the Province of Ontario and Detective Sergeant Joel Kulmatycki of the Toronto Police Service, described in great detail the case of the death of an elderly woman, for which her son was convicted of manslaughter by abuse and neglect. They were joined in a plenary session by Linda Reimer, a Forensic Nurse and Mike Newell, Crown Attorney, Durham Region, who spoke to the role of health care providers in assessing forensic abuse markers and how the use of medical evidence is instrumental in laying charges and prosecuting cases of elder abuse. In the case of Mary Noseworthy the crux of the matter seemed to be that support workers were never able to get into the house or speak directly with the elderly victim, who was suffering from a combination of medical and neurological conditions exacerbated by physical abuse and neglect. They stated the need for professionals to recognize the indicators of abuse, a Response Team in the community, consisting of a forensic nurse, social worker and police officer, and emergency beds for elder abuse cases. As a result delegates were able to judge the importance of these inter-working relationships, which would ensure a coordinated community response to elder abuse.

New Thinking for Older Adults across the

Continuum of Care

This was the theme of an inspiring keynote speaker, Dr. Samir K. Sinha, MD, DPhil, FRCPC, Director of Geriatrics, Mount Sinai and the University Health Networks. He is also Professor of Medicine, University of Toronto and the Johns Hopkins University School of Medicine. Hospitals are a hostile environment for older people e.g. 4 a.m. blood work and meals on an 8 a.m., 12 and 5 p.m. timetable as well as immobility and depersonalization, which leads to the loss of 5% of function on a daily basis. They often suffer from malnutrition, dehydration and cognitive dysfunction, which lead to a depressed mood and negative expectations. Dr. Sinha described how he had initiated new thinking for older adults across the continuum of care at Mount Sinai, which has transformed the current traditional paradigms of care. Some of these reforms include identification of seniors at risk, the use of Geriatric Emergency Management nurses, a redesign of the Emergency Department with more bathrooms and recliner chairs and available therapy on weekends. This team approach with an embedded CCAC Coordinator, in association with Mobile Long Term Care Emergency Nursing, and follow up at home contribute towards positive outcomes of hospitalization for older adults and the system as a whole. Length of stay has decreased, the percentage of patients returning home has risen and catheter utilization has greatly decreased.

If this is what one geriatrician can do in one hospital, that alone is a convincing argument to support RTO’s Charitable Foundation to create a new Chair in Gerontology.

A Senior Helping a Senior: Every Story Can Create Change

His Honour Judge J. Andre Cousineau (retired) described the personal story of an elderly woman friend who lost her rights and decision-making powers when she was deemed incapable in hospital and was transferred to a secured unit in a Long Term Care Home. He revealed the financial abuse she experienced by her daughter and how the system failed to support her. The advocacy efforts of him and a small group of concerned neighbours enabled her to regain her rights and move back into the community. This story exemplified the importance of community collaboration and the education of health care professionals and communication between them and the legal system.

The Counterpoint Project: Resources to Enhance Practice

Krista James, the National Director, Canadian Centre for Elder Law, spoke of the Counterpoint Project to help health care and social service providers negotiate the various legal and ethical challenges in elder abuse prevention and response. This project was funded by the Division of Aging and Seniors, Public Health Agency of Canada, under the Federal Elder Abuse Initiative. These tools are available on their website but many practice challenges remain due to many variances in the laws across the country. Many are factsheets aimed at administrators, nurses or personal support workers but there are also brochures on mental capacity and consent and confidential patient and client information.

Workshop Sessions

Social Support at High Speed: Connecting

Online Caring Networks

TYZE is a company, which has created a method of connecting with a caring network of family, friends and health professionals, with the purpose of supporting a senior needing care. It allows for coordination of care, contributes to improved outcomes and even reductions in the cost of care. The presentation was made by health care professionals from St Elizabeth, a LTC home, who explained that the set up and management can be done by staff or family, but there are strict privacy protocols. A research project is currently underway to examine the feasibility of using it in the community. The cost of an ad-free network is $130 but there is no limit to the number of participants.

Age-friendly Cities: A Strategy for the

Prevention of Elder Abuse

The premise was that practitioners need to understand the root causes of elder abuse such as ageism, social isolation, depression and dependency and engage in social action to address them. A certain amount of societal and systemic abuse includes seniors living in poverty, inadequate housing, fiscal constraints for health and social services, the social roles of the elderly being devalued and the lack of emergency housing. The World Health Organization is promoting the idea of Age-friendly Cities, which have three pillars: participation, health and security. Your community may have already started down this road “design for the young and you exclude the old; design for the old and you include everyone” as has the City of Waterloo, from whom the presenters came. If they have not this might be a project for your city with help from the Ontario Senior Secretariat and the Ontario Trillium Foundation.

“It’s Not Right!” Neighbours, Friends and Families for Older Adults

Margaret McPherson of the Centre for Research in Education against Violence against Women and Children took participants through a power point presentation aimed at making neighbours, friends and families of older adults able to identify abuse and be able to take safe and effective action. It was developed by the Ontario Senior Secretariat but was designed to let a local volunteer presenterdeliver it. It would be necessary to take a one hour training before being available to make presentations in their communities. The materials have been designed to teach three things everyone can do: SEE it! NAME it! CHECK it! Risk factors and warning signs are explained and how to handle an intervention with safety and respect. It seemed to me that becoming a presenter to community groups would be a perfect role for RTO members.

This power point presentation would be an excellent tool for every RTO District’s Member Services, Wellness or Program Committee.

Understanding theRetirement Homes Act 2010: Protection Measures on Elder Abuse

Regulations in this area have now been proclaimed by the Ontario Government, which means they are in force. They are much more prescriptive with regards to the reporting, especially by all personnel in retirement or LTC homes, of any signs of abuse whether it be physical, emotional, verbal, sexual, neglect or financial. They include consumer protection for seniors living in a retirement home residence, a license to operate, protection from abuse and neglect, meeting standards to operate, Residents’ rights and financial protection. The standards proclaimed must be followed to keep a license. The Retirement Homes Regulatory Authority(RHRA) will administer the Retirement Homes Act, license homes, conduct annual inspections and ensure compliance. The Act describes all forms of abuse in detail and states that all actual or suspected incidences of abuse must be reported to the Registrar of the RHRA. An inspection must be made to investigate and police may be involved as needed. The Act also provides for staff qualifications, staff and volunteer training and Whistle Blowing Protection. Members of the general public also have a role to play. If they see or suspect abuse or neglect, they can also report to the RHRA Registrar. They should be aware of the resident’s Bill of Rights and should participate in the Residents’ Council if they are family members and try to keep seniors connected with their community.

Fraud and Elder Abuse

The RCMP Mass Marketing Fraud and Identity Theft in Canada department is commonly known as ‘Phonebusters’. It is a government funded group composed of RCMP and OPP officers, Competition Bureau and volunteers, many of whom are seniors, who take reports of fraud as well as counsel to prevent it. They operate from CAFC, the Canadian Anti-Fraud Centre in North Bay. They are an intelligence gathering outfit fighting cybercrime. Although there are victims all over the world most are in Canada and the USA. Senior ‘Buster’ Brock Godfrey and Constable Jennifer George, RCMP Milton Detachment gave the workshop. This was an information workshop to allow participants to know what services were provided and how we could arrange presentations for our members. However, I did hear of a fraud, which I’d never heard of before, involving gift cards. Without going into a long story, just make sure that on the back of any gift card you buy there is a special shiny strip with wavy lines. Without it the card may not be valid when redeemed. Any workshop they put on for your district would be very specific about the types of fraud and how individuals could protect themselves.

This list only represents a few of the workshops presented. Many were aimed at mental health issues or at the health professionals and personal support workers who were present. The list made available did show that there are projects being undertaken to assist particular communities such as First Nations, the Chinese, Spanish and LGBT Seniors’ Communities. One focused solely on the role of the Public Guardian and Trustee.

Contacts

Ontario Network for the Prevention of Elder Abuse

(416) 916-6728

Seniors Safety Line 1-866-299-1011

Dr. Samir K. Sinha

The Counterpoint Project – Canadian Centre for Elder Law

Social Support at High Speed

Age Friendly Cities

Arlene Groh RN BA, Chair, City of Waterloo Age Friendly Cities, Mayor’s Advisory Committee

Elizabeth Nieson, Elder Abuse Response Team

“It’s Not Right!”

Understanding the Retirement Homes Act 2010

Fraud and Elder Abuse

CAFC (PhoneBusters) 1-888-495-8501

R. Brock Godfrey SeniorBuster

Cell: 705-733-4626 Res. 705-436-4384

(available for presentations)

RCMP Scams and Frauds

RCMP Internet Safety Tips

Better Business Bureau Canada (links to top 10 scams)

Page 1 of 8