5. Findings

This section presents the results of the case study. The first subsection examines the ways abuse is reported and at what points police intervention may occur. The following subsections provide a snapshot of victim, alleged abuser and incident characteristics, and report outcomes. The final subsection gives an overview of promising practices identified by interviewees. Qualitative information from the interviews are included, where appropriate, throughout the analysis.

5.1 Reporting abuse and police points of entry

Reports of senior abuse come to the Senior Protection Unit’s attention directly from victims, families or witnesses via the police line or filtered through the Elder Abuse Intake line, a public hotline managed by Catholic Social Services where cases are triaged according to their risk level:

• low-to medium-risk cases are referred to EARS; and
• high-risk cases are referred to the SPP.^{Footnote 33}

The Senior Protection Unit might also receive reports of senior abuse through referrals from community organizations and agencies, as well as service providers.^{Footnote 34} According to the unit, complex and serious senior abuse reports primarily come to their attention through the Elder Abuse Intake line, often from someone other than the senior victim themselves such as a family member of the senior; a healthcare or social service provider (e.g., a doctor, nurse, physiotherapist, social worker); or others (e.g., a bank teller, neighbour). Interviewees noted that the most common barrier to reporting senior abuse was the victim’s desire to protect the relationship with their abuser—who may be a spouse, a family member such as a child or grandchild, or a friend—from any legal consequences. Other reasons why the victim, or others, may not report a situation of abuse or seek help include.

• fear and distrust of the police;
• fear of retaliation and consequences (e.g., fear that the situation will get worse, fear of conflict);
• feelings of shame, embarrassment and guilt;
• abuse is unknown—this was identified by interviewees as particularly common in financial abuse cases, where the abuse can go undetected for years; and
• lack of awareness and knowledge of the signs of senior abuse and the available community supports and services.^{Footnote 35}

From 2015 to 2021, the Senior Protection Unit responded to 691 reports of senior abuse. The number of reports decreased 42% over the study period, from 108 reports of senior abuse in 2015 to 63 in 2021 (Figure 1).

The number of reports peaked in 2018 (124 reports of senior abuse), then began decreasing. Several factors may have contributed to decreasing reports of senior abuse. One possibility is that incidents of senior abuse that came to the attention of police decreased because a greater number of incidents were dealt with outside of the criminal justice system. This explanation is supported by a general increase in the number of clients served by the SPP, from 2015 onward (Figure 2). According to interviewees, the COVID-19 pandemic, starting in March 2020 and continuing throughout 2021, also affected the prevalence, severity, identification and reporting of senior abuse as public health restrictions left some seniors without the kinds of social interactions where abuse is sometimes identified and reported (e.g., by a family member, a healthcare or social service professional, or others).

5.1.1 Abuse in long-term care homes

Long-term care homes with similar characteristics have different names across the country (e.g., nursing homes, continuing care facilities, residential care homes) and are typically categorized into the following.

• ownership of publicly funded long-term care homes offering 24-hour care, which can be public or private; and
• privately owned long-term care homes, which can be subdivided into for-profit and not-for-profit organizations.

Of Alberta’s 176 long-term care homes, 57% are publicly owned; 30% are owned by private not-for-profit organizations; and 13% are owned by private for-profit organizations.

In Alberta, the Protection for Persons in Care Act (PPCA) provides a safeguard for adults receiving government-funded care or support services, such as in long-term care homes. This law requires that any incident or suspicion of abuse or neglect occurring in a long-term care home be reported either to: 1) the Protection for Persons in Care Information and Reporting Line (non-emergency); 2) the police (if criminal in nature); 3) a professional regulatory college or body (if the abuse involves a health professional); or 4) the Mental Health Patient Advocate (if the client is detained under the Mental Health Act, or if the client is or was subject to a Community Treatment Order at the time of the abuse). The PPCA states that it is optional for victims to report experiences of abuse; however, should they choose to report, the victim must do so no later than two years following the date of the abuse.

According to interviewees, cases involving abuse in long-term care homes are rarely brought to the attention of police as they tend to be reported and investigated by the PPCA. Though the PPCA may collaborate with police on a case, the Senior Protection Unit noted that the PPCA has the legislative framework to access information in long-term care homes quicker and more efficiently than the police.

Because of underreporting to police and the various methods to report and seeking help, police data do not appropriately capture the extent and nature of abuse in institutional settings such as long-term care homes.^{Footnote 36}

5.2 Victim characteristics

Of the 691 reports of senior abuse from 2015 to 2021, the average age of victims was 77 years, regardless of gender, with the most common age range being 70 to 79 (39%). Only one female victim was under the age of 50, while 10% and 8% of female and male victims were 90 years or older, respectively (Figure 3).

Over two-thirds (68%) of victims were women, while the remaining third (32%) were men; this distribution was relatively stable during the study period. However, according to interviewees, the SPP recorded a recent shift in the gender of clients served. In 2021, the SPP served more men than women for the first time.^{Footnote 37} Interviewees also mentioned senior victims often have low income and diminished cognitive capacity as a result of a stroke or dementia, for example.^{Footnote 38}

Though data on ethno-cultural identity of victims or accused persons were not available, interviewees were able to provide anecdotal information based on their professional experiences responding to senior abuse reports. Interviewees noted that victims were most often White, Indigenous or Asian, a finding consistent with the population distribution in Edmonton.^{Footnote 39} They further noted that Indigenous seniors and seniors from racialized communities experience unique circumstances and cultural contexts that may affect their likelihood of reporting abuse or asking for help. For example, an immigrant senior sponsored by their abusive family member may be scared to report the abuse for fear of being deported back to their country of origin.^{Footnote 40} An interviewee noted an increase over the years in the number of Indigenous seniors in shelters as a result of abuse.

5.3 Alleged abuser characteristics

While victims of senior abuse were most often women, alleged abusers were most often men (68%). One-third (34%) of alleged abusers were between the ages of 46 and 60, close to one-quarter (23%) were aged 61 and over, followed closely by those aged 36 to 45 (21%); these findings were consistent regardless of gender of the abuser. There were few alleged abusers 20 years old or younger (1%).

Over two-thirds (69%) of alleged abusers were identified as the victim’s adult child or grandchild,^{Footnote 41} while the rest were identified as either an intimate partner (13%),^{Footnote 42} other (8%),^{Footnote 43} other family member (6%),^{Footnote 44} or caregiver (4%).^{Footnote 45 Footnote 46} According to interviewees, alleged abusers often struggle with mental health or addiction issues, and have a history of financial difficulties (e.g., debt, gambling) or other challenging personal circumstances (e.g., divorce, living at home, criminal history, controlling and aggressive behaviours, past trauma).

5.4 Outcome of police involvement

Of the 691 reports of senior abuse from 2015 to 2021, most (80%) were resolved or addressed outside the justice system, such as through the supports and services provided via the SPP including health, housing, and financial supports. Interviewees explained that reported incidents tend to be resolved this way due to the complexities in senior abuse cases, as well as the unique needs and vulnerabilities of the victim. In reports resolved without criminal charges, police involvement typically includes conducting a risk assessment, safety planning, and connecting those involved in the incident with the appropriate supports and services. Police take a supportive and precautionary approach with the objective of mitigating the risk. According to interviewees, victims of senior abuse are often looking for help, not just for themselves, but also for the alleged abuser, noting that “victims just want the abuse to stop and for the alleged abuser to get some help” rather than seeking a legal outcome. The remaining one-fifth (20%) of reports resulted in a police charge being laid.^{Footnote 47} These trends were consistent throughout the study period, with the exception of in 2017 when there was a slight decrease in the proportion of reports where police charges were laid, and in 2021 when there was an increase (Figure 4).

5.5 Type of abuse

Data on the type of abuse was only available for 20% (n = 141) of all 691 reports included in the study, as these are the reports that resulted in police charges which was used as a proxy for abuse type. The types of charges laid were organized into the following three categories of abuse:^{Footnote 48} physical abuse,^{Footnote 49} financial abuse,^{Footnote 50} and psychological or emotional abuse.^{Footnote 51} Overall, about two-thirds (67%) of charges involved physical abuse, over one-quarter (28%) involved financial abuse, and over one-tenth (15%) involved psychological or emotional abuse.^{Footnote 52} Among victims of senior abuse, men were more likely than women to have experienced physical abuse (76% v. 62%, respectively) and psychological and emotional abuse (24% v. 11%, respectively), whereas men and women were equally likely to have experienced financial abuse (28%, each).

Interviewees noted that financial abuse often goes unnoticed by the victim, and typically comes to their attention when the victim seeks help to manage their finances. Interviewees also noted that the severity of financial abuse has worsened over the years. They explained a lack of technological skills can make seniors more vulnerable to financial abuse, particularly with respect to online fraud. Some examples shared involved cases of severe financial abuse of up to $750,000, leaving seniors in danger of losing their home. Less severe theft (e.g., theft of a senior’s monthly pension cheque), would be captured under a less serious offence of theft under $5,000; this type of abuse, also occurs frequently and can be financially devastating to the senior.

Interviewees also noted an increasing number of financial abuse cases that resulted from ageism^{Footnote 53} imbedded in the laws, regulations and policies of financial institutions.^{Footnote 54} According to one interviewee, “ageism is the manure that allows senior abuse to flourish in our communities.” Interviewees highlighted that one of the biggest challenges they face is when financial institutions reject legally drafted documents such as a power of attorney^{Footnote 55} and personal directives,^{Footnote 56} even when the senior is of sound mind. Challenges are further exacerbated in situations where the senior does not have anybody willing to take on the trustee and guardianship role, including the Office of the Public Trustee and Guardianship as a result of their strict mandate.^{Footnote 57} Interviewees noted that a review of Alberta’s Powers of Attorney Act to better address and respond to the needs of the public, including seniors at risk of abuse, standardized processes, and reoccurring awareness or educational strategies for financial institutions would be helpful in building proper understanding and handling of cases with seniors, and ultimately improve outcomes.

Interviewees also discussed the issue of neglect at the hands of the senior’s caregiver. Neglect refers to the non-willful failure to fulfill caregiver responsibilities such as providing food, housing or medical care. Interviewees noted that neglect often results from inadequate caregiver knowledge, training and resources, as well as from caregiver burnout due to difficult working conditions, high patient-to-worker ratio, and high staff turnover at care facilities.

5.6 Outcome and disposition of police charges

Of the 141 reports that led to police charges, half (50%) resulted in a stay of proceedings or the charges being withdrawn,^{Footnote 58} while less than half (42%) resulted in a finding of guilt.^{Footnote 59} The majority (80%) of cases with a guilty finding received a custodial sentence as the most serious sentence in the case, of which most (83%) were a sentence of less than one year. The rest led to a probation order (17%) or fine (3%).

Although too few police reports contained information on the length of time to close a case to allow for a statistical analysis, interviewees noted that while many reports can take under three months to close, some may take much longer, even years, due to the complexities of the investigation.

5.7 Best practices

Interviewees shared practices, programs and services that have been helpful in responding to senior abuse. These include applying a people-centred approach, having dedicated senior abuse professionals and training, and providing peer-support groups for seniors.

5.7.1 Applying a people-centred approach

Interviewees emphasized the need to apply a people-centred approach in responding to senior abuse. For the Senior Protection Unit, this includes ensuring an inclusive and diverse workforce, and building client rapport by being flexible, patient and adaptive to the needs of victims. For example, the Senior Protection Unit noted many seniors feel more comfortable engaging with police officers that are wearing plain clothing as opposed to those wearing their official police uniforms. This was noted to be particularly true for Indigenous seniors as a result of laws, policies and practices that have led to profoundly traumatizing experiences in their interactions with police.

Another example is with respect to interviewing practices. While police interviews can last hours, the Senior Protection Unit highlighted that multiple short interviews, of no more than 40 minutes each, are more productive with senior victims to account for their diminished cognitive capacity. Further, conducting interviews during a time of day when the senior is most lucid and relaxed is also beneficial.

5.7.2 Dedicated senior abuse professionals and training

In addition to the Edmonton Police Service’s Senior Protection Unit, the Crown Prosecution Office in Edmonton has dedicated prosecutors assigned to focus and consult on senior abuse cases. These professionals are trained to recognize the complex dynamics and risk factors of senior abuse. They collaborate with justice system stakeholders and community partners to promote the referral network and use of alternative approaches to the traditional criminal justice system response, in an effort to obtain the best possible outcome for the victim.

Training was also identified as a best practice to increase professionals’ knowledge and understanding of senior abuse. For example, the Edmonton Police Service includes a senior abuse module in their police recruit onboarding training program to help professionals recognize the signs, symptoms and risks of abuse. The Elder Abuse Police Guidelines, developed by the provincial government for all police services in Alberta (including the Royal Canadian Mounted Police and Municipal and First Nations police services), is also a helpful tool in sharing and promoting best practices for senior abuse police intervention and investigation.

5.7.3 Peer-support groups

Interviewees noted the value-add of providing peer-support groups for senior victims of abuse. Catholic Social Services runs an eight-week educational support group called Relationship with your Adult Children for women and men over the age of 60 experiencing challenges with their adult children. This group aims to teach seniors communication skills and how to establish appropriate boundaries and maintain overall personal wellness. According to interviewees, the Relationship with your Adult Children groups have led many seniors to build long-lasting relationships with other group members.