The following 12 guiding principles are meant to help people working with older adults to respond to the rights of older adults who are abused, neglected, or at risk in a manner that is effective and reflects best practices.
1. Listen to the older adult
Elder abuse response should be grounded in the older person’s understanding of a situation or relationship—not other people’s views. Similarly, your response should focus on actions the older person identifies as being helpful, not invasive. This approach entails getting to know the older person, asking respectful questions, and doing a lot of listening.
Conversations will build rapport and trust, and help you and the older person to identify appropriate resources. Listening shows value for the older person’s experiences and ideas, and can help you develop a more healing power dynamic with the older person than the dynamics of control characterizing abusive relationships.
It is usually a good idea to speak privately with the adult at some point to make sure they are not being pressured by others, a dynamic known as undue influence. It is also important to respect the older person’s desire for support from people they trust.
2. Respect personal values
It is important to respect the personal values, priorities, goals, and lifestyle choices of an older person, and identify solutions and support networks that suit the older adult’s individuality. The same responses and resources will not work for everyone. Elder abuse is often rooted in a lack of respect for the older person, their values, and their choices, and so we must support the older person’s freedom of expression and identity.
3. Respect and support decision-making autonomy
All adults with decision-making capacity have the right to make decisions for themselves, regardless of age or disability, including decisions that other people might consider risky or unwise. While legal standards vary, decision-making capacity (or mental capability) refers to a person’s ability to understand relevant information and make a reasoned decision. Adults are presumed capable unless there is a court order or expert finding that the person is not capable of making a specific decision or type of decisions, for example, a guardian has been appointed.
Keep in mind that someone may be incapable of making one kind of decision yet capable of making others. Capacity can fluctuate, change from day to day, and can be influenced by many circumstances, such as stress. Some people cannot make decisions independently, but can make decisions with support or assistance from someone they trust. Always consider whether the older person needs support with decision-making, and explore whether their supportive decision-maker should be included in discussions.
4. Seek consent or permission
In most circumstances, you should get consent from the older adult before you take any action, including phone calls. Consent is an ongoing process. Check regularly to make sure that the older person is comfortable with how events are unfolding, and understands that they can change their minds. Abuse takes away a person’s sense of power and control, and can negatively impact self-esteem. Be conscious that your actions support the older person’s autonomy rather than taking more power away.
In some emergency situations, such as where a person has been assaulted and is unconscious, it will be appropriate to call 911 without consent.
5. Respect confidentiality and privacy rights
Know laws, policies, and codes of ethics that apply to privacy and personal information. In most instances, it is against the law to disclose personal or health information without prior consent. Sharing confidential information can harm an older adult’s sense of dignity, stop an older adult from trusting you, and damage other efforts to get help for the older adult. Where disclosure is required, you can explain the situation to the older person so they understand who is being informed of their situation.
6. Avoid ageism and ableist thinking
Be alert for ageist and ableist attitudes, and discrimination in access to services. Avoid stereotypes about older people, including about mental capacity, physical ability, and judgement. You should assume all older people are capable and treat them with the dignity and respect you would accord any adult.
7. Recognize the value of independence and autonomy
Honour and protect the adult’s independence as much as possible while at the same time helping the person to get the assistance they want. Abuse can rob a person of freedom and independence. Be conscious that your response does not further undermine personal freedom. This approach means asking the older person what they need, and learning about what kinds of supports they will welcome. Some older people will not reach out for help because they fear being forced to live in long-term care, or losing the right to make choices about their future.
8. Develop trauma-informed practice
Older people who have experienced abuse may have survived different kinds of trauma throughout their lives, including intergenerational trauma. These traumatic experiences will impact their brain development, their understanding of the world, and their needs for safety and healing. An awareness of the dynamics and impacts of trauma will assist you to provide meaningful support without causing further harm. Training in trauma-informed practice will also help you to be aware of, and respond appropriately to, your own experiences of vicarious trauma, which can arise out of hearing about older people’s experiences of abuse. Surviving trauma can also demonstrate resilience, and provide a lens of hope and recovery to bring to experiences of elder abuse or neglect.
9. Apply a holistic lens
Consider older people in a holistic manner in order to identify meaningful and welcome assistance and support. Be willing to look beyond the issue that brought the older adult to you, or that alerted you to abuse or neglect.
For example, consider whether the older person needs more appropriate housing or requires financial assistance, including help accessing pensions. If the person is providing care for another person, including an abuser, explore how the older person can be better supported as a caregiver. Consider whether the older person is an immigrant or refugee, a survivor of spousal violence, an Indigenous person, a trans person, or a person living with a disability, and how their identify and experiences might impact their needs. Consider dynamics of power that impact their safety and autonomy.
This approach will likely identify needs that are outside your scope of practice or expertise. As a result, it is very important to have up to date information about local agencies to which you can refer the older person for other kinds of assistance. Notice when collaboration with other service providers might help you to provide more comprehensive assistance.
10. Respect cultural values
Acknowledging, respecting, and integrating the cultural backgrounds, needs, and preferences of older people is part of applying a person-centered approach. Be curious about how a person mentions culture within their story of abuse, including identifying barriers and possible solutions. Recognize your own biases linked to culture.
Some people make sense of elder abuse as a continuation of domestic violence, rooted on patriarchal family relations. For some immigrants, a sense of family obligation or shame impacts the options available to them. Relationships linked to culture and family can also be a source of strength and support. Learning about an older person’s cultural identity and community can help you provide better services.
11. Respect relationships that matter
Be aware of the relationships that are important to the older person. Help preserve these relationships while offering safety planning strategies, if appropriate. Family and other caregiving relationships are extremely important to many older people. They may be concerned about the safety and well-being of a spouse, children, or grand-children, including their abuser, or may not want their abuser to get in trouble with the law. Addressing the needs of family and other dependents can be critical to helping an older person to feel comfortable accessing assistance and care for themselves.
12. Consider Indigenous experiences
Racism and colonization, including through residential schools, foster care, health care facilities, and the criminal justice system, have significantly impacted the lives of most Indigenous people. When assisting Indigenous older people, it is important to consider past physical, mental, emotional, or spiritual harm as well as their safety concerns related to health care providers, police, and other institutions. Indigenous community and culture can be a tremendous source of strength, resilience, and healing. Learn about the Indigenous communities where you work or volunteer, and consider Indigenous cultural humility and safety training for yourself and others within your organization.