Abuse of Older Manitobans: A Collaborative Framework and Action Plan

1. Abuse of Older Manitobans: A Collaborative Framework and Action Plan Moira Horgan – Jones Maggie Nishimura MANITOBA NETWORK FOR THE PREVENTION OF ABUSE OF OLDER ADULTS

2. Agenda for the day • Who we are and why we are here • Common understanding of the problem • Research and identification of issues • What needs to be considered • Who needs to do it • When

3. Who We Are • Manitoba Network for the Prevention of Abuse of Older Adults (MNPAOA) • Mission To act as a central point of contact for provincial efforts and to support regional and community initiatives to prevent abuse of older adults. • Vision Older adults in Manitoba will live in a safe environment of respect and dignity.

4. Network Goals • Support Regional and Community Efforts • Develop/Adapt Education and Training Resources • Raise Public Awareness • Encourage research and advise on issues relating to abuse of older adults

5. Network • Funded by the Seniors and Healthy Aging Secretariat • Led by and housed at MSOS • Over 30 partners and growing • Study of other Canadian Networks • Website • Building our Future

6. Project Goals • Create new partnerships across Manitoba and develop opportunities for new collaborations for existing Regional Community efforts • Create a provincial collaborative framework and an action plan that addresses the unique needs and priorities of the province’s regions to ensure a concerted effort in the prevention and intervention of abuse of older Manitobans. • Facilitate the process for knowledge transfer of Manitoba’s promising approaches, best practices lessons learned, inter-generational approaches, challenges, materials and resources among communities across all regions in Manitoba

7. A Little Bit of Trivia • Classical Greek culture supported euthanasia for the incurable old. • Some ancient cultures supported ritual suicide of tribal elders during drought so food and water could be reserved for the more productive young. • King Lear – Shakespeare writes about the king’s maltreatment by his sons.

8. Canadian History • 1973  Newfoundland passes  the Neglected Adults Welfare Act, creating a mandatory reporting obligation for “any person who has information which leads him to believe that an adult is a neglected adult...”. • Early mention of abuse & neglect in Canadian literature in the 1980s. Local service providers in some communities are beginning to identify family violence as an issue affecting older adults • 1990s Development of New Horizons and other Health Canada family violence prevention initiatives. These provide many Canadian communities with their first opportunity to explore abuse issues in later life. • 2000 Canadian Network for the Prevention of Elder Abuse is created as a legal entity. • 2002  Canada is the host location for the development of the Toronto Declaration on the Global Prevention of Elder Abuse.  Declaration is based on the recommendations of the United Nations International Plan of Action adopted by all countries in Madrid, 2002. • 2003 1st provincial senior abuse awareness campaign (Alberta). • 2004  (October 19) Ontario marks its first Elder Abuse Awareness Day.

9. Manitoba Achievements • 1999 Manitoba Law Reform Commission on Abuse • 1999 Establishment of an abuse line • 2001 Manitoba proclaims Protection for Persons in Care Act. • 2002 Establishment of a Manitoba Strategy on Abuse of Older Adults • 2003  Manitoba establishes "Expect respect"initiative to help raise awareness of abuse and promote respect of older adults in the province. • 2005 RESOLVE study • 2006WEAAD June 15th • 2006 Manitoba Network for the Prevention of Abuse of Older Adults (MNPAOA) is established • 2007 Establishment of a Safe Suite (A&O) • 2008 First Manitoba Conference • 2009 CAG in Winnipeg devotes one day to abuse issues • 2010 Building our Future – consultations and strategy for change

10. The field of prevention of abuse and neglect of older adults in Canada is lagging behind other areas of family violence prevention. It is largely the case that multiple small-scale projects and a few noteworthy larger programs exist in a patchwork of service delivery and under-coordinated effort. It is also far from being able to use practice standards such as are available for other fields (e.g. health). Promising approaches in the Prevention of Abuse and Neglect of older adults in Canada (2007) Canadian Network for the Prevention of Elder Abuse (CNPEA)

11. Prevalence of Elder Abuse • Actual incidence and prevalence of elder abuse is unknown and difficult to measure. • It is believed that 4 -10% of all older adults have been a victim at some time. • As part of an1999 study, 4000 older Canadians were interviewed to examine their experience regarding emotional and financial abuse as well as physical and sexual violence committed against them by children, caregivers and spouses.  • approximately 7% of seniors interviewed reported that they had experienced some form of emotional or financial abuse by an adult child, caregiver or spouse within the past five years • emotional abuse was reported most frequently • financial abuse was the second most reported form of abuse • almost 2% of older Canadians reported experiencing more than one form of abuse

12. Why so difficult to measure? • Vast majority (80%) of cases go unreported or unsubstantiated. • Definitions of abuse of older adults can differ from agency to agency, and person to person. • Subject to cultural interpretation

13. Definition of Abuse of Older Adults According to the World Health Organization, abuse and neglect of older adults can be a single or a repeated act. It can occur in any relationship where there is an expectation of trust or where a person is in a position of power or authority.

14. Consequences of Elder Abuse • Consequences are devastating and include: • Increased mortality and morbidity • Poor quality of life • Emotional distress • Loss of property and security

15. Ageism • Elder abuse is one of the most extreme forms of ageism • Ageism remains one of the least recognized forms of oppression • Ageism intersects with other forms of oppression (e.g. gender, race, class, etc.)

16. Vision Older adults in Manitoba will live in a safe environment of respect and dignity.

17. Issues • Education and Training • Public Awareness • Policy and Legislation • Senior’s Advocate • Reporting and Response • Research • Abuse line Services • Resources and Supports • Competency -decision making capacity

18. Education and Training Here we speak to the education and training of professionals working with older people: • Health care professionals • Law enforcement • Senior serving professionals • Banking industry • Retail i.e. Grocery, pharmacies, etc

19. Public Awareness Engaging the public at all levels we will need to reach them through all media forms such as: • Print • TV • Radio • Periodicals

20. Policy & Legislation • Policies are those actions adopted and pursued by a government, political party, organizations, corporations • Legislation is the law of the Province it usually has consequences if you break it. It requires members of the legislature to enact.

21. Senior’s advocate A mechanism for a Seniors’ Advocate to investigate, review investigative results, and decide on an appropriate course of action to remove or reduce the effects of the causes of distress affecting Older adults in Manitoba.

22. Research Identification of all areas where we need more information so that better actions, decisions and programs can be planned and implemented

23. Abuse Line Services Currently these services are available 8 – 4 at the Secretariat Some consider this inadequate

24. Resources and Supports Resources and supports are interlinked and include knowledge, information, materials, funding, tools etc

25. Competency & Capacity In this context we are considering the ability to make decisions; How do we determine if the older person is competent? If indeed there is competency is there physical capacity to act on the decision. Ultimately we are talking about venerability

26. Reporting and Response Reporting of abuse requires a means clearly understood by all Manitobans Response is the way we respond when abuse of older people is identified

27. Issues • Education and Training • Public Awareness • Policy and Legislation • Senior’s Advocate • Reporting and Response • Research • Abuse line Services • Resources and Supports • Competency -decision making capacity