Elder Abuse (M. Phair)

Recommendation:
That this report be received for information.

Report Summary

This report provides a response to Councillor Noce’s request for an update on the Elder Abuse Intervention Team pilot project.

Previous Council/Committee Action

At the December 15/17, 1997 Community Services Committee Meeting, the following motion was passed:

  1. “That the November 12, 1997 Community Services Department report be received for information.
  2. That the Administration report back in September with an update on its project.”

Report

The purpose of this report is:

  • to describe the activities of the pilot Elder Abuse Intervention Team since its April, 1998 inception; and
  • to describe results of the pilot project deriving from the first five months of operation.

The information provided here is summarized from a report (Attachment 1) based on information system data, discussions with Team members and interviews with key community and agency stakeholders.

  1. Establishment of the Team
    In early March representatives from Community Services, Edmonton Police Service, Capital Health Authority and Catholic Social Services decided that the core pilot project team should include a social worker from Community Services, a detective from Edmonton Police Service and a seniors resource coordinator from Catholic Social Services.
    The Team formed in April and is known as the Elder Abuse Intervention Team. Administrative arrangements are in place and building of the critical interdisciplinary, interpersonal working relationships among Team members is well underway. The Team has developed fundamental working relationships with key providers of services for older adults.
  2. Response to Elder Abuse Referrals
    A detailed analysis of referrals received during the first five months is provided in Attachment 1.

Team members, in particular the police detective and the seniors coordinator, have provided elderly adults and agencies with:

  • advice and information on legal matters, court processes and available community resources;
  • assistance with the development of safety plans;
  • connections to service providers (health, financial, housing);
  • service coordination;
  • supportive counselling; and
  • follow-up.

Referrals have been steadily increasing as the Team’s existence becomes known in the community. Some older adults have chosen to refuse services offered by the Team. Team members have noted that elderly victims of abuse must reach a stage of readiness before involving helping professionals. Where the Team has become involved, they have succeeded in providing appropriate and timely support.
Team members have identified several factors that affect the level of support and intervention they can offer to abused older adults:

  • the victim’s fear of the perpetrator;
  • guilt and shame associated with accusing a family member;
  • timing/confidence to act;
  • cognitive impairment;
  • isolation/lack of support from family or friends;
  • fear of loneliness if perpetrator is removed; and
  • concern for what would happen to the perpetrator.

These factors contribute to Team members spending considerable time tracking and verifying information, calling in other service providers where specific assessments appear to be required and counselling the abused persons on realistic courses of action.

Service providers in the community have confirmed the importance of police participation on the Team. It results in consistent access to Edmonton Police Service resources, particularly helpful when the personal safety of clients is an issue. One provider has stated, “they are more ‘part of the system’ now as opposed to previous ‘hit and miss’ involvements”. Another provider feels that police involvement in the Team “adds legitimacy to elder abuse as a societal problem that is unacceptable.”

  1. Providing Public Education
    At least ten formal presentations have been made to groups including a number of seniors’ residences, Minerva Seniors Studies at Grant MacEwan Community College, police recruits, medical students and service agencies. Television and newspaper media gave the Team coverage at the project’s launch June 8, 1998. Team members have also participated in a radio talk show and an educational television series that included a module on elder abuse. The Team’s social worker participated on a panel at a provincial seniors’ conference sponsored by the Seniors Advisory Council.
    Feedback provided at presentations indicates participants intend to use the information in their ongoing work with the elderly or to inform other professionals about elder abuse and Team services.
  1. Facilitating Community Development
    Three major community development initiatives have been undertaken since the Elder Abuse Intervention Team was established in April.
    The first is the creation of a Community Consultation Team comprised of providers of services for older adults. The second involves the creation of an Elder Abuse Steering Committee comprised of seniors. The third involves collaboration with community stakeholders in a survey of seniors living in the Oliver community, which has a large seniors population.
    All three initiatives, which are designed to actively involve community members and professionals in understanding and seeking solutions to elder abuse, are progressing well (see Attachment 1).

Edmonton Police Service has provided assistance in compiling this report.

Background Information Attached

  1. Update on Elder Abuse Intervention Team Pilot Project

(Page 1 of 3)

Attachment 1

UPDATE ON ELDER ABUSE INTERVENTION TEAM PILOT PROJECT

INTRODUCTION

In December 1997, Community Services Department and Edmonton Police Service appeared before Community Services Committee of Edmonton City Council to respond to questions concerning elder abuse and a proposed elder abuse intervention team. The Committee requested that the Administration report back in September (subsequently changed to November) with an update on the pilot project.

The purpose of this update is twofold:

  1. To describe the activities of the Elder Abuse Intervention Team since its inception April 13, 1998.
  1. To describe results or short-term outcomes of Elder Abuse Intervention Team activities during its first five months of operation.

ACTIVITIES and RESULTS/OUTCOMES

1. Establishing the Team

At a meeting in early March representatives from Edmonton Community Services, Edmonton Police Service, Capital Health Authority and Catholic Social Services decided that the core organizations to be involved in the elder abuse collaboration at this time would be Edmonton Community Services, Edmonton Police Service and Catholic Social Services. The core team would consist of a social worker, whose primary responsibilities would be community development to address elder abuse issues with seniors and community organizations; a detective, whose primary responsibilities would involve advice, information and support on cases that have criminal or legal aspects; and a seniors resource worker, whose primary responsibilities would be responding to the immediate needs of older abused citizens through providing advice, information, short-term supportive counselling, and connections to other community-based service providers.

The start date for the Elder Abuse Intervention Team was April 13, 1998. In coming together as a team the members had several immediate tasks. These included determining a name for the team, deciding if and where the team would co-house; learning about one anothers’ backgrounds, training and skills; developing communication and problem-solving tools and processes, and contacting community organizations and agencies to introduce members and the new elder abuse service.

Outcomes

The team has made progress in the establishment of a functioning elder abuse team. Team identity has been established in the community as the Elder Abuse Intervention Team. A team building workshop produced a team mission and served to better acquaint members with each other and their respective agencies. Currently, the social worker and detective are co-housed at the south-central Community Services office. A proposal has been developed for co-housing at the Edmonton General site, an area that has the highest number of seniors in Edmonton. Contacts have been made with key service providers to older adults. A community health service provider made the following comment about the Team.

“Having a team of people experienced with this issue adds to the efficiency of a response to elder abuse. With their experience and their assessment skills they are quickly able to discern the need for their involvement or referral to a more appropriate resource.”

2. Responding to Elder Abuse Referrals

A data collection system has been evolving with the Team as their experience in responding to referrals has helped to determine what information would be useful to collect. An analysis of information that has been recorded on referrals received over the first five months of the Team’s existence provides the following picture:

  • a total of 67 referrals have been received by Team members from April 13, 1998 to September 30, 1998;
  • approximately 50% of referrals came from agencies, 20% from family or friends, and 30% from seniors themselves;
  • 50% of the elderly were between 60 and 75 years of age, 35% were between 76 and 85 years, and 15% were between 86 and 95 years;
  • 59% of alleged victims were female, 41% were male;
  • a majority of victims lived in the same household as the alleged abusers;
  • alleged abusers included spouses, sons, daughters, grandsons, sons-in-law, friends and unrelated caregivers; and
  • 60% reported financial and emotional abuse, 35% physical abuse, 5% other (medication/neglect).

This data is quite consistent with data on 623 clients, collected between January 1989 and September 30, 1997 by the Elderly Adult Resource Service (E.A.R.S.) of Catholic Social Services. Major deviations are noticeable only in the gender category. Where the E.A.R.S. Program had 84% referrals of females and 16% of males, E.A.I.T. referrals reflected a breakdown of 59% female, 41% male. These statistics may reflect that elderly men and women are equally frail and susceptible to the various forms of abuse, and that elderly men are increasingly reaching out for help. However, because of the relatively small number of cases that E.A.I.T. statistics are based upon, caution should be exercised in their interpretation.

E.A.I.T. members have provided elderly adults and agencies with:

  • advice and information on legal matters, court processes, and available community resources;
  • assistance with the development of safety plans;
  • connections to service providers (health, financial, housing);
  • service coordination;
  • supportive counselling; and
  • follow-up.

A case which illustrates the work of the team with abuse victims is that of an elderly couple whose grandson had become increasingly violent over the three years that he had lived with his grandparents. The police had sent out patrols on a number of occasions in response to calls from the couple. After the referral was made to the Team, they went out to visit the couple. An assessment of the couple’s story, along with the history of property damage and personal injury obtained from police records, indicated the couple’s personal safety was at considerable risk. Incorporating photos the couple had taken of previous abuse, the two responding Team members first helped the couple understand the seriousness of the situation by discussing with them the now well-documented Cycle of Violence. Options for dealing with their situation were then presented. The couple were supported in obtaining a Peace Bond, which was the course of action that they chose to take. Workers helped the couple develop a safety plan and were in frequent contact with them once the Peace Bond had been executed.

Another case illustrates the role Team workers fulfill in collaborating with other service providers. The situation involved the alleged abuse of two elderly men living in a private group home. Investigation by the Team revealed that the men were being adequately cared for, but that there were irregularities in the operation of the home that could put the residents at risk. After being in contact with several service providers, the E.AI.T. seniors resource worker coordinated a meeting of all six agencies involved with the two men, and facilitated the development of a plan that made everyone aware of what each agency would do.

Outcomes

Referrals have been steadily increasing as word of the Team’s existence becomes known in the community. Some older adults have chosen to refuse the services offered by the Team. As members on the Team with experience in spousal abuse have learned, people have to reach a stage of readiness to address their abuse by involving others. In other situations where the Team have become involved, they have succeeded in providing appropriate and timely support. The elderly couple mentioned in the above illustration had this to say:

“It’s hard for grandparents to do this. You need outside support. When we told him (Detective) that we wanted him (grandson) to leave, they helped us right away. Since our grandson moved out, they have phoned us two or three times. We’re doing fine.”

Another senior who was being physically abused by her grandson stated that she “felt that somebody cared” due to the concern shown by the Team for her safety. She said that going to court was frightening, but having the social worker and detective present was helpful.

Team members have found several factors that affect the support and effort that they can offer to abused older adults. These include:

  • fear by the victim of the perpetrator
  • guilt and shame associated with accusing a family member
  • timing/confidence to act
  • cognitive impairment
  • isolation/lack of support from family or friends
  • fear of loneliness if perpetrator is removed
  • concern for what would happen to the perpetrator.

These factors contribute to Team members spending considerable time tracking and verifying information, calling in other service providers where specific assessments appear to be required, and counselling abused elderly on realistic courses of action.

Agencies too feel that both they and the community as a whole have benefited from the presence of the Elder Abuse Intervention Team. One provider stated that the Team “has made a difference both in direct service delivery and public awareness of elder abuse”. In the area of direct service, service providers have stated that a major contribution of the Team is that of coordination of other service providers. As a result of the leadership and coordinating role taken by the Team in the group home case illustrated above, a manager with Alberta mental health claimed, “we were much less fragmented, we knew where each other stood.”

Also identified as helpful in facilitating action by other service providers was the knowledge base that Team members have of accessible services in the community, their being available for consultation on cases, and their ability to provide contacts or help “bridge” with various services.

The police component was felt to be important for several reasons. It gives ready and consistent access to Edmonton Police Service resources where safety may be an issue. One provider stated, “they are more ‘part of the system’ now as opposed to previous ‘hit and miss’ involvement.” Police training and ability to take a ‘hard line’, combined with their skills in investigation, were considered very useful and complimentary to the skills of traditional helping professions such as health and social work. Finally, one provider felt that the police component on the Team “adds legitimacy to elder abuse as a societal problem that is unacceptable.” Ironically, Team members have found in their contacts with abused elderly that the elderly are reluctant to involve police, and in situations where charges are laid against abusers, many request to have police drop the charges. In being responsive to this sensitivity on the part of older adults, the Team detective does not wear a police uniform, and Team members make a special effort to explain the necessity of involving the detective where safety or criminal elements may be a factor.

3. Providing Public Education

The Elder Abuse Intervention Team have engaged in a number of different activities and used various opportunities to inform community organizations, agencies, businesses and individuals about the societal issue of elder abuse and the Team’s mandate and services. At least ten formal presentations have been made to groups including a number of senior’s residences, Minerva Seniors Studies at Grant MacEwan Community College, police recruits, medical students and service agencies. Television and newspaper media gave the Team coverage at the E.A.I.T. launch on June 8, 1998. Team members have also participated in a radio talk show and an educational television series that included a module on elder abuse. The Team’s social worker participated on a panel at a provincial seniors conference sponsored by the Seniors Advisory Council.

Outcomes

Feedback provided at presentations indicate that the information will be used by people in their work or to inform others of elder abuse and Team services. A presentation at one seniors residence resulted in an offer for emergency accommodation for abused older adults. Immediately following the launch, there was a surge in the number of referrals to the Team. At the provincial seniors conference, the social worker was publically recognized for her demonstrated caring and hard work on behalf of abused seniors. A service provider made the following comment,