From The Shadows
FSA Toronto shines much-needed light on elder abuse
Lina Turco* made her first call to Family Service Association's (FSA Toronto) Seniors and Caregivers Support Service (SCSS) unit because she was feeling sad and lonely. The counsellor arrived at her home to find the woman alone in her kitchen, sitting on its only piece of furniture – a hard-backed chair. The floors were ripped up and the walls were pocked with gaps where cupboards had once been. Although she was ailing, Lina didn't have a family doctor. Her adult son, on whom she was dependent for financial support, had no funds to help her. Even her pension income, he'd told her, was tied up in other matters.
Signs and Symptoms
Victims of elder abuse may show signs of:
• Depression, fear, anxiety, passivity
• Social withdrawal
• Unexplained physical injury
• Lack of food, clothing or other
necessities
•Changes in hygiene and nutrition
(e.g. signs of malnutrition)
• Failure to meet financial
obligations
• Unusual banking withdrawals
What To Do If You Suspect
You may worry about getting involved, not saying the right thing or wrongly identifying the situation if you think a friend, family member, neighbour or acquaintance is being mistreated or abused. But there is one simple thing you can do – make the effort to reach out and talk to the person. Ask non-judgmental questions, such as:
• How are you doing?
• Are you having any trouble at
home? Can I help you?
• Is there someone I can put you in
touch with who may be able to
help you?
• How would you like to be
assisted?
From the FSA Toronto website, on an Information Sheet developed by the Government of Ontario as part of Ontario's Strategy to Combat Elder Abuse
Evelyn Darlen* reached out to SCSS for homemaking and community support. When the unit counsellor went to visit, she found a metal bar on the front door that could lock Evelyn in. The elderly woman bore old and new bruises from her husband's beatings, and was sitting on a soiled couch, wrapped in a bed sheet. No one had troubled to take her to a doctor, optometrist or store to purchase the eyeglasses and walker she clearly needed.
Still another individual, Adele Mwaanda,* found the SCSS unit a few years after she had cashed in all her worldly possessions in her home country and come to Toronto to take care of her grandchildren. When her charges grew up, Adele was relegated to the basement of her adult children's home. During the day, when no one was home, she was expected to wander the streets. Fortunately she befriended a young woman of her culture in a local park. That young woman welcomed Adele into her home and family, and eventually connected her with the SCSS unit for assistance.
At 80, 76 and 83 years old, respectively, Lina, Evelyn and Adele were all victims of elder abuse – a crime that is only now emerging from the shadows, in large part due to the work of the Seniors and Caregivers Support Service unit of FSA Toronto.
Dr. Lisa Manuel, manager of the SCSS unit, has passionately led the charge to cast a light on this largely taboo issue. "All of us have older people in our lives," says Manuel, "so it's hard for people to imagine that someone would abuse Granny. But abuse of older people is happening, and with shocking consequences. Findings from two large U.S. research projects have found that victims of elder mistreatment had a much poorer survival rate than people who were not abused (9 per cent vs. 40 per cent)."
The five-person SCSS team therefore devotes its work to education, prevention and intervention. The team provides counselling, home visits, group work and advocacy for 150-200 seniors annually. They also conduct training and education sessions for crown attorneys, police staff, young people and public servants.
"The fact is, abuse of our elders is about the misuse of power and control in a relationship, just like abuse is with younger women or children. Our elders are entitled to an environment in which abuse is unacceptable and where they can live with dignity in a manner of their own choosing," says Dr. Manuel.
To this end, FSA Toronto also created the Elder Abuse Consultation Team (EACT) in 2001—a well-received and positively-evaluated collaboration of 16 members that deal with older people, representing 13 organizations from different sectors. EACT meets at least once a month to give advice to service providers who are dealing with complex elder abuse cases.
Dr. Manuel has also presented at and/or provided telephone consultation with community organizations throughout Ontario about EACT. She has responded to requests for information from agencies in Scotland, Hong Kong, New Zealand and Australia.
In 2004, EACT published Breaking the Silence, a comprehensive compendium for service providers that provides advice on responding to individuals experiencing violence in later life. The culmination of almost three years of work by the EACT, Breaking the Silence is the first best practice manual of its kind.
Work on this groundbreaking publication began with a request from the community to provide information about what the SCSS did when it encountered cases of elder abuse. Unfortunately, the unit had considerable experience to draw from.
Its work on elder abuse goes back to 1981, when FSA Toronto, acting on its commitment to serve seniors and develop leading-edge solutions to issues that marginalize or affect vulnerable people, began to focus on providing practical support to seniors around housing issues.
"Within
a few years," recalls Dr. Manuel, "we began to realize
more and more of our clients in their 70s and 80s were telling
us, 'I have to move because I can't afford to live here,' when
their pension income or savings could clearly have covered their
housing costs. Or we'd hear, 'I can't get in touch with anyone
because there's no telephone in the house,' or 'my children don't
have the time to come around unless they need something – and they can be
mean sometimes.'"
Then and now, people seldom called because they were concerned
about elder abuse. They were getting in touch because someone was
concerned about the caregiver. Or they called because an older
person was isolated – isolation is the single most important indicator
of abuse. Or they reached out because they knew someone who was
anxious, depressed, having difficulty coping with bereavement or
having difficulty communicating.
"You knew you'd get a much bigger story when you got there," understates SCSS counsellor Brenda Anderson. "People tend to be very honest about their situations when they talk to you face to face."
Soon it became clear that the concern that had no name was abuse, defined by the World Health Organization as "a single or repeated act, or lack of appropriate action, occurring in any relationship where there is an expectation of trust that causes harm or distress."
Today we know that an estimated 4 to 10% of seniors experience emotional, physical and financial abuse or neglect. They remain silent due to shame, barriers to assistance, fear of continued abuse or cultural taboos. Furthermore, some three-quarters of these seniors are abused by their adult children, who themselves may be marginalized due to mental illness, substance abuse, unemployment, financial woes or other issues.
inform them of the legalities and obstacles to geSCSS counsellors ask their clients what they want, and tting there. They may call the police, find housing, make an appointment with a medical professional, access financial supports, or – possibly the most important service of all – just listen.
"I think of myself as a counsellor-advocate," says SCSS counsellor Marilyn Rivers. "My most important job is to listen. Sometimes, letting a 74-year-old client give voice, for the first time, to how her husband first hit her when she was 16 years old, two weeks after they met, can help her see the effects, on her and her children, of years of disrespect."
As the ranks of the baby boomers reach their senior years, there may be more Linas, Evelyns and Adeles in our society. To reduce this possibility, FSA Toronto's SCSS unit will continue its important work.
"Our aim is to increase awareness
of issues surrounding elder abuse, to educate seniors, their caregivers
and others working with seniors about abuse, to advocate for policies
that have a positive effect on seniors and, most important, to
reduce incidents of elder abuse," says Dr. Manuel. "As people who work in the seniors
sector, we have a real opportunity to have a positive impact on this trend."
*all names have been changed
Want to comment on this article or this issue? Fill out the form below or e-mail catalyst@familyservicetoronto.org
Note: After submitting the form you'll be redirected to the main page of the Catalyst website. You'll also receive a copy of your submission at the e-mail address provided.
355
Church St., Toronto ON M6C 1L9