An Overview of Justice Canada Research on Senior Abuse^Footnote31

By Natacha Bourgon

Seniors’ safety and healthy aging is an important global priority.^Footnote32 Ensuring their safety involves eliminating all forms of neglect, abuse, and violence against older persons (hereafter referred to as “senior abuse”). Though Canada uses several definitions to identify senior abuse, the definition of the 2002 Toronto Declaration on the Global Prevention of Elder Abuse remains key (Beaulieu and St-Martin 2022). It defines the issue as:

A single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person. (World Health Organization [WHO] 2002)

Senior abuse can include

• physical abuse, such as assault,
• financial abuse/misuse of property, such as fraud,
• psychological/emotional abuse, such as threats and harassment, and
• sexual assault.

It can also include

• mental cruelty,
• irresponsible medication practices (overmedication, withholding medication),
• humiliation,
• intimidation,
• censoring,
• invasion of privacy,
• denial of access to visitors,
• violation of human/civil rights,
• self-neglect,^Footnote33 and
• spiritual, religious, or cultural forms of abuse. (Beaulieu and St-Martin 2022)

Seniors represent an increasing proportion of the population in Canada. In 1996, 12 percent of the Canadian population was aged 65 and older^Footnote34 compared with approximately 19 percent in 2021. This proportion is predicted to further increase to 25 percent by 2060 (Statistics Canada 2019). The growth of the senior population is not unique to Canada. Many countries report rapidly aging populations.^Footnote35 Alongside this growth, senior abuse is also predicted to increase substantially.^Footnote36

Although senior abuse is a significant public health and justice issue, it is hard to know how widespread it is because of gaps in data. There are three reasons for this:

• Terms and definitions for senior abuse are not consistent. This limits researchers’ ability to compare findings from different areas and understand the problem.
• Data is not collected from some of the most vulnerable people and certain living environments, such as those living in long-term care homes. This leads to underestimating the kind of abuse and how often it happens.
• There are not enough tracking and reporting processes, or guidelines for gathering data in care homes for older adults. This also contributes to underestimating the problem.

Furthermore, Canada’s constitution states that the provinces, territories, and federal governments share responsibility for the issue of senior abuse. This makes it harder to agree on a single definition or a national approach to preventing or responding to the issue, a challenge that has also been identified by experts and stakeholders around the world.^Footnote37 Canada aligns itself well with global priorities in this area. For example, the 2021 mandate letters commit the Minister of Justice and Minister of Seniors to invest in collecting better data on senior abuse.

Producing quality data is not easy, particularly when there are so many barriers to identifying and reporting the issue. To inform and guide work in this area, Justice Canada did two research studies: Enhancement of Canadian Data on the Abuse of Older Persons: An exploratory study and A Case Study of Edmonton Police Service’s Response to Senior Abuse. This article presents an overview of these two research projects to further knowledge, understanding, and responses to senior abuse.

Enhancement of Canadian data on the abuse of older persons: An exploratory study by Beaulieu and St-Martin (2022)

In 2021, Justice Canada contracted with subject matter expert Marie Beaulieu, Research Chair on Mistreatment of Older Adults from 2010 to 2022, via the University of Sherbrooke, to explore and further document the challenges of producing national data on senior abuse and how to address these challenges.

Methods

Beaulieu and her colleague Kevin St-Martin thoroughly reviewed the literature, giving special attention to Canadian work over the last 10 to 15 years. They also interviewed 42 key national and international experts and provincial and territorial government representatives working in this area.

Findings

The results of this study highlighted two types of key challenges to generating national-level data on senior abuse:

1. Conceptual: All the terms and definitions being used to identify and define senior abuse frame the problem differently. There are also differences in the types and forms of abuse that are recognized. To make the research even more challenging, the terms and definitions also vary considerably in French and English.
   • How is the problem of senior abuse framed? Hall and colleagues (2016) note differences in one or more of the following components of abuse:
     • intentionality (did the abuser intend to act or to not act?);
     • single or repeated actions (how many incidents must take place for it to be considered abuse?);
     • trust relationship (was the action or inaction committed by someone in a presumed relationship of trust with the victim?);
     • consequences (did the action or inaction result in, or was it at a high risk of, affecting the victim’s overall well-being in the short and long term?); and,
     • vulnerability.^Footnote38
   • What types and forms of abuse are recognized? This typically includes physical abuse, as well as psychological or emotional abuse.^Footnote39 Most regions in Canada also include financial or material abuse, sexual abuse, and neglect. Other types and forms are self-neglect, organizational abuse, abuse of power by agents (e.g., power of attorney)those wit), spiritual or religious or cultural abuse, and others.
2. Methodological and operational: There are two types of data collection methods: population surveys and administrative or operational data. Each presents its own unique gaps and challenges:
   • Population surveys, such as the General Social Survey on Victimization, are based on self-reports from individuals. Gaps and challenges include, for example,
     • a lack of validated measurement scales and tools; and,
     • certain people or living environments are excluded, such as First Nations people living on reserves, older persons living in long-term care homes, in one of Canada’s territories, in prisons, or speaking neither English nor French.
   • Administrative or operational data is collected from agencies or organizations such as police services, courts, or shelters. Gaps and challenges include, for example,
     • different laws and policies for adult protection services across regions;
     • the lack of guidelines both for gathering data and for tracking and reporting processes; and,
     • the lack of a centralized data repository, which ultimately affects the compatibility and accessibility of data.

The study also included a series of proposals to help address these gaps in the data on national senior abuse. They state that any future work in this area must align with the five priority areas the World Health Organization (WHO) identified in June 2022 as part of the work for the Decade of Healthy Ageing. These are to:

• combat ageism;
• generate more and better data on prevalence, risk, and protective factors;
• develop and scale up solutions that are cost-effective;
• invest in generating data on the costs of abuse and on the cost-effectiveness of solutions;
• raise funds for both research and for interventions. (World Health Organization [WHO] 2022)

For more information, please refer to the full report: Enhancement of Canadian data on the abuse of older persons : an exploratory study : final report (lac-bac.gc.ca)

A case study of Edmonton Police Service’s response to senior abuse by Natacha Bourgon (forthcoming)

Starting in 2021, Justice Canada worked with the Edmonton Police Service (EPS) to examine and better understand police data the EPS had collected on reported incidents of senior abuse, as well as how the police responded to such incidents. This case study was intended to recreate an earlier study called An Empirical Examination of Elder Abuse: A review of files from the Elder Abuse Section of the Ottawa Police Service (Ha and Code 2013).

Methods ^Footnote40

The study examined incidents of senior abuse that came to the attention of the EPS from 2015 to 2021. It used two sources: the Seniors Protection Partnership’s (SPP)^Footnote41 database^Footnote42 and the Edmonton Police Reporting and Occurrence System (EPROS), a record management system. The case study also used two group interviews with a total of 10 key informants. These included officers from the Edmonton Police Service, as well as other partners and community service providers who are members of the Elder Abuse Consultation Team.^Footnote43

Findings

The findings showed that incidents or suspicions of abuse come to the attention of the EPS in one of two ways:

• directly from victims, families, or witnesses via either the police line or filtered through the Elder Abuse Intake line,^Footnote44 or
• referrals from community organizations and agencies, as well as service providers.

The EPS find out about incidents or suspicions of senior abuse primarily from someone other than the senior victim themselves:

• direct reports by a family member of the senior;
• a healthcare or social service provider (for example, a doctor, nurse, physiotherapist, or social worker); or
• others (for example, a bank teller or neighbour).

The study identified various barriers to reporting. The most common one was the victim’s desire to protect their relationships. For example, many seniors want to protect the alleged abuser – who may be a family member (a child or grandchild) or a friend – from any legal consequences. Other reasons why the victim, or others, may not report an abusive situation or seek help include:

• fear and distrust of the police;
• fear that their abuser will retaliate, fear that the situation will get worse, fear of what will happen to the abuser, fear of conflict;
• feelings of shame, embarrassment, and guilt;
• not knowing abuse is occurring; this was identified by interviewees as particularly common in financial abuse cases, where the abuse can go undetected for years; and,
• not being aware of or know the signs and results of senior abuse and the community supports and services that are available.^Footnote45

Of the reports that did come to EPS’s attention, they found that senior-abuse victims were often females with low incomes and with some level of diminished cognitive capacity as a result of dementia for example. Abusers were predominately men. They were often the victim’s adult children or grandchildren who were struggling with a variety of personal issues, such as mental health and addiction. Though data gaps exist with respect to the ethno-cultural identity of the victims and the accused, interviewees noted serving victims they’ve identified as White, Indigenous and Asian.^Footnote46

Senior abuse cases often involved multiple types of abuse. As a result of the complexities in senior abuse cases as well as the unique needs and vulnerabilities of the victims, most incidents of senior abuse are resolved outside the justice system, such as through other services provided via the SPP (e.g., health services or services relating to housing or financial issues). Only one-fifth of all EPS senior abuse cases from 2015 to 2021 resulted in charges being laid (most of these involved at least some type of physical abuse related charge), and only a little over one-third of those resulted in a finding of guilt. Of these, the majority received a custodial sentence as the most serious sentence in the case. Most of the sentences were under one year.

The findings highlighted two things:

1. that senior abuse responses are multifaceted; and
2. that the criminal justice system is only one way of dealing with them. Though many challenges still exist, interviewees identified many promising ways of responding to senior-abuse incidents. These include applying a people-centred approach, having dedicated senior-abuse professionals, training, and peer-support groups for seniors. Furthermore, according to EPS, the findings from this study also indicated the importance of revising data collection processes and practices.

For more information, please refer to the full report, which is planned for a Summer 2023 release.

Conclusion

The results from these two research projects highlight the need for agencies to work together to prevent and respond to senior abuse, including investing in data. Future work in this area should be framed as both a public health issue and a legal issue, and it should be informed by the latest up-to-date evidence, such as the findings in the two research studies summarized above.

References

Beaulieu, Marie, and Kevin St-Martin. 2022. “Enhancement of Canadian Data on the Abuse of Older Persons: An exploratory study.” Prepared for the Department of Justice Canada.

Bourgon, Natacha. Forthcoming. “A Case Study of Edmonton Police Service’s Response to Senior Abuse.” Justice Canada in collaboration with the Edmonton Police Service.

Catholic Social Services, an Edmonton based non-profit. “Elder / Senior Citizen Abuse Support.” Accessed January 16, 2023 at: https://www.cssalberta.ca/Our-Services/Elder-Senior-Citizen-Abuse-Support

Conroy, Shana, and Danielle Sutton. 2022. “Violence against seniors and their perceptions of safety in Canada”. Statistics Canada, Catalogue no. 85-002-X. Accessed at: https://www150.statcan.gc.ca/n1/pub/85-002-x/2022001/article/00011-eng.htm

Ha, Lisa, and Ruth Code. 2013. “An Empirical Examination of Elder Abuse: A Review of files from the Elder Abuse Section of the Ottawa Police Service”. Department of Justice Canada. Accessed January 16, 2023 at: https://www.justice.gc.ca/eng/rp-pr/cj-jp/fv-vf/rr13_1/index.html

Statistics Canada. 2019. “Table 17-10-0057-01 – Projected population, by projection scenario, age and sex, as of July 1 (X 1,000).” Accessed January 16, 2023 at: https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1710005701.

St-Martin, Kevin. 2019. “Synthèse de la terminologie sur la violence. ” Document produced for the Terminology Committee, 31 p. (unpublished).

World Health Organization [WHO].”Abuse of Older People.” Accessed January 16, 2023 at: https://www.who.int/news-room/fact-sheets/detail/abuse-of-older-people

World Health Organization [WHO]. 2020. “Decade of Healthy Ageing – 2021-2030.” Consulted on April 5, 2022. https://cdn.who.int/media/docs/default-source/decade-of-healthy-ageing/final-decade-proposal/decade-of-healthy-ageing-proposal---fr.pdf?sfvrsn=b4b75ebc_25

World Health Organization. 2002. “The Toronto Declaration on the Global Prevention of Elder Abuse.” Geneva: World Health Organization. Accessed at: TorontoDeclarationV-eng (eapon.ca)