ARCHIVED - October 2009 - Gender-Based Analysis of Elder Abuse

Elder Abuse E-Bulletin

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Welcome to the first edition of the Public Health Agency of Canada's Elder Abuse E-bulletin, a quarterly e-newsletter for those interested in addressing and preventing the abuse of older adults in Canada. This e-bulletin is produced by PHAC, as part of its role under the Federal Elder Abuse Initiative (FEAI), in an effort to facilitate and enhance knowledge sharing among key stakeholders on the progress and achievements of PHAC's elder abuse activities^*. It is also an opportunity to highlight other initiatives, recognizing the multi-sectoral and multidisciplinary nature of a public health approach, which includes consideration of prevention, detection and intervention strategies and their impacts on the determinants of health.

For more information on the Government of Canada’s elder abuse initiatives, visit seniors.gc.ca or call 1-800-O-Canada (1-800-622-6232). For people using a teletypewriter device (TTY), call 1-800-926-9105.

We want to hear from you – please send your comments and feedback to our editor at: ncfv-cnivf@phac-aspc.gc.ca.

^*Note: The terms ‘abuse of older adults’, ‘elder abuse’ and ‘abuse of seniors’ are used interchangeably throughout this e-bulletin.

Elder Abuse in Canada: A Gender-Based Analysis

Gender-based analyses and considerations within policies, programs and practices related to elder abuse are of central importance to the Federal Elder Abuse Initiative (FEAI). As a key partner of the FEAI, the Public Health Agency of Canada (PHAC) completed a contextual gender-based analysis (GBA) of elder abuse in Canada. It includes guidelines for creating and evaluating bias-free, gender- and culturally-relevant policies and practices¹ to respond more effectively to the needs of both older men and women in situations of abuse.

In her research paper, "Elder Abuse in Canada: A Gender-Based Analysis", commissioned by PHAC’s Division of Aging and Seniors (DAS) under the FEAI, Peggy Edwards selected eight gender dimensions for examination: incidence and prevalence; characteristics of victims and perpetrators; effects on health; feminization of aging and care; factors that precipitate or prevent elder abuse; screening and diagnosis; programs and interventions; and, legislation and protective services. Ms. Edwards explored each in terms of known and unknown factors as they relate to the determinants of health in order to determine whether men and women are as likely to benefit from current policies, programs and legislation.

Despite numerous challenges, which included a significant lack of available data combining age, sex and diversity, a number of key findings emerged to inform the public health component of the FEAI in the development of tools and resources for public health practitioners. For example, many current elder abuse screening and assessment tools are based on research that has a relative scarcity of information about older men's experiences of abuse. These instruments also generally do not account for the fact that older women and men may differ in their tendency to report abuse and in how they interpret questions about abuse.

Another important aspect of the paper was the inclusion of guidelines for creating and evaluating bias-free, gender- and culturally-relevant policies and practices based on access, inclusion and benefits. The proposed template also incorporated key principles from The BIAS FREE Framework developed by M.A Burke and M. Eichler, the gender-based guidelines recommended by Status of Women Canada and Health Canada, as well as the Native Women’s Association of Canada’s policy paper on Culturally Relevant Gender-Based Analysis.

For more information or to obtain a copy of the research paper, contact Marie-Lynne Foucault at 613-952-1723, or marie-lynne_foucault@phac-aspc.gc.ca

1. Health Canada's GBA policy states that GBA frameworks should be overlaid with a diversity analysis.

Federal, provincial and territorial partners working towards the prevention of the abuse of older adults are invited to highlight their initiatives as well as provide information, updates and other news.

International Observance of the 4th Annual World Elder Abuse Awareness Day

On July 5th, leaders convened in Paris, France to discuss events and initiatives, progress, obstacles, and the overall state of elder abuse awareness, prevention and intervention in countries throughout the world. Led by the International Network for the Prevention of Elder Abuse (INPEA), the organization that initiated World Elder Abuse Awareness Day (WEAAD), this event coincided with the International Association of Gerontology & Geriatrics Conference.

All of the presentations at the Paris event have been uploaded to the WEADD website. For INPEA's Global Reports 2009 of events recognizing World Elder Abuse Awareness Day, click here.

Alberta

The Government of Alberta has partnered with the Alberta Elder Abuse Awareness Network (AEAAN) to create tools for front-line service providers, caregivers and seniors to address abuse of older adults. In 2009, a Service Provider Screening Guide for Elder Abuse was developed to help front-line staff assess suspected cases of elder abuse. In 2008, a Financial Abuse Fact Sheet for service providers and an information card for seniors, It’s Your Money: Protect yourself from financial abuse, was developed to provide information on how to prevent financial abuse. These tools, along with Federal/Provincial/Territorial materials, were distributed to organizations across Alberta and are available online at www.seniors.alberta.ca by following the elder abuse link.

Manitoba

The Seniors and Healthy Aging Secretariat (SHAS) continues to provide leadership to a province-wide, multidisciplinary Elder Abuse strategy. This strategy includes a provincial toll-free seniors abuse line, education and awareness initiatives, the development of community-based networks and funding to community partners including Age & Opportunity which provide support services for older adults affected by this issue. The following is an update of SHAS initiatives:

• The Manitoba Network for the Prevention of Abuse of Older Adults (MNPAOA), a provincial, interdisciplinary elder abuse network, was established in 2007 to raise awareness of elder abuse through public education, professional training and service coordination. The MNPAOA is currently in the process of building their website and increasing their membership.
• The elder abuse safe suite initiative was established in 2006 to provide a safe haven for older adults living in Winnipeg and who are leaving an abusive relationship. Since then, SHAS continues to assess opportunities to expand the program to other regions of the province.
• SHAS is consulting on the expansion of a learning module on elder abuse, “Across the Generations”. This learning module is an innovative intergenerational program targeted to grade five students to encourage positive attitudes towards aging.

• An Inter-Jurisdictional Protection Strategy Working Group was recently formed to develop a comprehensive protection strategy for vulnerable adults living in the community, including older adults in Manitoba. This working group includes SHAS and other government departments.
• At the annual provincial celebration of World Elder Abuse Awareness Day on June 15th, 2009, the elder abuse video “It’s Everybody’s Business” was officially launched.
• SHAS supports the expansion of The Police Academy: Older Adults Division program, developed in 2007 to empower older adults with information on safety and security issues (including elder abuse). SHAS anticipates this new initiative will become an innovative way to further increase awareness and the education of elder abuse.

For more information on Manitoba's Elder Abuse Strategy, go to: www.gov.mb.ca/shas

National Clearinghouse on Family Violence

The National Clearinghouse on Family Violence (NCFV) is operated by the Public Health Agency of Canada on behalf of the federal Family Violence Initiative. The NCFV offers resources on family violence, including overview papers, reports, discussion papers, handbooks and videos on family violence issues. Please see the What's New page to preview recently released resources on abuse of older adults, including:

• Elder Abuse: It’s Time to Face the Reality
• World Elder Abuse Awareness Day (Kit): Abuse Hurts At Any Age
• World Elder Abuse Awareness Day (Folded Poster) – Abuse Hurts At Any Age

To order, please visit the NCFV website or call 1-800-267-1291.

Department of Justice Canada

Justice Canada recently produced resources on the abuse of older adults, including the paper Abuse of Older Adults: Department of Justice Canada Overview Paper, and four brochures to assist older adults in identifying potential fraud: Door-to-Door Sales Fraud, Credit Card Fraud, Investment Fraud and Lottery Fraud. Click here to preview these resources, or call the Family Law Information Line of the Department of Justice at 1-888-373-2222, to order hard copies of the brochures.

Prevention of Elder Abuse Policy and Program Lens

The Ontario Seniors’ Secretariat partnered with the Elder Health Coalition to develop the Prevention of Elder Abuse Policy and Program Lens, an easy-to-use checklist to provide a standardized approach to assessing policies, practices and programs on the prevention, detection and response to elder abuse. The lens also assists organizations to seek solutions and develop action plans that promote policies, practices and programs which support the rights, dignity and safety of older adults. Click here to download a copy of the lens from the Ontario Seniors’ Secretariat.

October 22 to 23, 2009 - Ageing Safely Forum "Working across sectors to prevent violence & abuse of older people," Adelaide, Australia

The Ageing Safely Forum will bring together key policymakers and service providers from a range of sectors to focus on developing and implementing effective interagency protocols to address the abuse of older people in their homes. The forum aims to: facilitate a national discussion between government and the service sectors on good practice protocols; create a necessary new dialogue across sectors to respond to the abuse of older people; and reflect on ideas and practice in the complex issues of the abuse of older people.

Click here for more information on the Ageing Safely Forum.

October 22 to 24, 2009 - "Where the Rivers Meet: Merging Perspectives on Aging" 38th Canadian Association on Gerontology Conference, Winnipeg, Manitoba

The Canadian Association on Gerontology (CAG) is holding its 38th Annual Scientific & Educational meeting October 22-24, 2009, at the Fairmont Hotel in Winnipeg, Manitoba. This year's program includes a pre-conference workshop on elder abuse, entitled Elder Abuse: Rippling Effects of Multi-Disciplinary Approaches. The workshop will highlight promising approaches in elder abuse prevention and intervention from across Canada including: innovative programs, intergenerational initiatives, multi-disciplinary approaches. Christina Wolf, Detective Constable with the Elder Abuse Section at the Ottawa Police Service, will be delivering an in-depth workshop reviewing privacy legislation and learning practical ways to share information to assist older adults who are experiencing abuse.

For more information, visit the CAG website: http://www.cagacg.ca/

November 3 to 4, 2009 – Ontario Network for the Prevention of Elder Abuse Conference, Toronto, Ontario

The Ontario Network for the Prevention of Elder Abuse (ONPEA) annual conference will be held on November 3rd – 4th, 2009 in Toronto, Ontario. This national conference welcomes participants from across Canada to participate and present. The theme of this year’s conference is “National Perspectives on Elder Abuse: Join the Conversation.” The objective of the conference is to facilitate knowledge exchange among stakeholders across Canada about promising approaches in elder abuse prevention and intervention. The conference themes will include legislation, justice system responses, legal and law practices, intervention practices, research, community and health programs, education and awareness initiatives and governmental strategies.

Additional information about the conference can be found at: http://www.onpea.org

Justice Partnership and Innovation Fund

Funding may be available to organizations that want to conduct short-term and innovative pilot projects to develop, test and assess models, strategies and tools to improve the criminal justice system's response to family violence, including elder abuse. Funding may also be provided to support Public Legal Education and Information (PLEI) projects to promote public access to elder abuse information, promote public awareness of the factors contributing to elder abuse, and advance public involvement in the responses to elder abuse.

Visit the Justice Canada website for more information.

Researcher Profile

Dr. Mark Yaffe is a tenured Associate Professor of Family Medicine in the Department of Family Medicine of McGill University and St. Mary’s Hospital Center in Montreal. In active clinical practice for over 30 years, Dr. Yaffe engages in research derived from issues and questions that arose from daily practice. This work has resulted in authorship of four book chapters and over 50 journal articles and 160 scientific and academic presentations on topics such as the delivery of primary health care services, determinants of detection of colo-rectal cancer at the primary care level, mental health of seniors, chronic disease management, and family caregiving.

An off-shoot of Dr. Yaffe's research into the aspects of family caregiving has been a seven year commitment, to date, to improving detection of elder abuse by family physicians. He served as principle investigator on a Canadian Institutes of Health Research (CIHR) funded project that permitted an interdisciplinary team in Montreal to develop and validate, in English and French, a six item questionnaire for administration by family physicians to cognitively administer intact seniors in office settings. Known as the Elder Abuse Suspicion Index (EASI), this copyrighted tool is the shortest of only two tools validated for direct questioning of potential victims of mistreatment and has been shown to have content validity in a number of cultural settings. Researchers in Israel, Germany, Spain, and the U.K. are exploring the potential of the EASI in those settings and here, in Canada. Dr. Yaffe and colleagues have recently completed a feasibility study that successfully demonstrated the potential of a slightly modified version of the EASI as a self-administered tool (EASI-sa).

To follow-up on this work, Dr. Yaffe and colleagues are doing a secondary analysis of data to explore the prevailing perception that women are the predominant victims of elder abuse.

Selected Publications:

Yaffe MJ, Wolfson C, Weiss D, Lithwick M. Development and validation of a tool to assist physicians’ identification of elder abuse: The Elder Abuse Suspicion Index (EASI ©). Journal of Elder Abuse and Neglect. 20 (3): 276-300, 2008.

Yaffe MJ, Weiss D, Wolfson C, Lithwick M. Detection and prevalence of abuse of older males: Perspectives from family practice. Journal of Elder Abuse and Neglect. 19 (1/2): 47-60, 2007. Conjointly published as book chapter in Abuse of Older Men. (ed Kosberg, JI), Howarth Press, Binghamton, New York, 2007, pp. 47-60.

Daichman LS, Yaffe MJ, Podnieks E. The recognition of distinct aspects of abuse and violence against older persons. Report solicited by the The Life Course and Ageing Division of WHO and the International Association of Gerontology and Geriatrics. December 2007.

Organizational Profile

The Canadian Centre for Elder Law (CCEL) is the national, non-profit body dedicated to exploring the particular legal issues which affect older Canadians. The mandate of the CCEL includes research, law reform and education relating to legal issues of significance for older adults. Uncovering “hidden issues” is an important part of the work of the CCEL. The work of the CCEL addresses a number of issues that are directly and indirectly related to elder abuse, and uses a number of lenses, including a gender lens.

Aging with Challenges

The CCEL’s Aging With Challenges project confronts the notion that people age in a homogeneous fashion and examines what it means to age differently. By seeking to identify some of the hidden issues faced by persons who are growing older and who have some other non-age-related barrier, the project attempts to draw attention to issues that affect vulnerable older adults.

The CCEL consulted extensively with the public with the aim of creating a working definition of “aging with challenges” and to identify specific legal issues that call for detailed legal analysis and research. A specific area of focus in the project is aging, gender and sexual orientation.

The project also examines the way Canada’s changing legal landscape affects gay, lesbian and bisexual older adults and considers areas where reforming existing laws may assist these populations to overcome some of the social barriers they face. Such barriers include homophobia, discrimination, increased vulnerability to abuse in care facilities and being forced “back into the closet”. Aging With Challenges also highlights the statistical invisibility of older gay, lesbian and bisexual adults in Canada.

Vanguard Project

In January 2009, the CCEL completed a two-year research project examining issues relating to the abuse and neglect of vulnerable adults, particularly vulnerable adults with capacity concerns. On behalf of and in cooperation with the Adult Abuse and Neglect Collaborative of B.C., the CCEL conducted an international review of both the laws governing capability for decision-making, which currently inform guardianship practice, and existing policies, protocols and guidelines that inform capability assessment. The Vanguard project identifies and critiques legislation governing capability and identifies best practices from existing policy and protocols.

BCCEAS Elder Law Clinic

The CCEL assisted in the creation of the British Columbia Centre for Elder Advocacy and Support’s (BCCEAS) Elder Law Clinic. The objective of the clinic is to provide access to justice for older adults in British Columbia who cannot otherwise obtain legal services, in particular seniors who have been abused or are vulnerable to abuse, or have had fundamental rights denied. The BCCEAS Elder Law Clinic opened in 2008 as the first legal aid clinic in Western Canada with a mandate to specifically serve older adults.

Ongoing and Upcoming Research Reports

A number of CCEL’s reports are looking at issues that specifically affect women. The CCEL has several upcoming research projects and reports that apply a gender lens and address issues related to elder abuse. These reports cover a range of topics including: Elder and Guardianship Mediation, Assisted Living reform, Family Caregiving, Unfair Contracts, Vulnerability and Capacity, Private Care Agreements, Privacy and Criminal Elder Abuse.

For more information, visit the Canadian Centre for Elder Law website: http://www.bcli.org/ccel

The next Elder Abuse E-bulletin in February 2010 will focus on Elder Abuse Screening and Assessment.

* * * * * * * * * * * * * * * * * * * * * * Content of the Elder Abuse E-Bulletin is provided as an information-sharing service; inclusion does not represent endorsement by PHAC or FEAI member departments. * * * * * * * * * * * * * * * * * * * * * *

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National Clearinghouse on Family Violence: Telephone 1-800-267-1291; TTY 1-800-465-7735; Fax (613) 941-8930; National Clearinghouse on Family Violence; e-mail ncfv-cnivf@phac-aspc.gc.ca