Abuse Of Older Adults: - Alberta Council of Women's Shelters

Alberta Council of Women’s Shelters2Table of ContentsIntroduction------------------------------------------------------------- 3Overview----------------------------------------------------------------- 4-Scope Of The Problem----------------------------------------------------- 6The Challenge -------------------------------------------------------------- 8Plan Of Action: Community Development Model-----------------10Community Development Model --------------------------------- 12-Assessment--------------------------------------------------------- 14Stakeholder and Community Meetings-------------------------------14Identify and Assess Resources---------------------------------------- 15Build Upon Existing Resources---------------------------------------- 15Ongoing Public and Professional Awareness------------------------- 16Building Awareness & Education---------------------------------- 17Identify Allies----------------------------------------------------------- 17Define and Identify the Abuse---------------------------------------- 17Agency Interaction----------------------------------------------------- 17Community Interaction------------------------------------------------ 17Public Awareness and Education-------------------------------------- 17Planning: Objectives, Strategies & Resources- ------------------- 18Involve Stakeholders--------------------------------------------------- 18Form a Multidisciplinary Team---------------------------------------- 18Identify Committee Leaders------------------------------------------- 19Train Service Providers------------------------------------------------- 19Build or Strengthen Networks---------------------------------------- 20Action--------------------------------------------------------------- 21Developing Preventative Strategies----------------------------------- 21Develop Intervention Strategies---------------------------------------22Evaluation is Vital---------------------------------------------------27Encourage Ongoing Participation-------------------------------- 28Appendix A - Definitions & Context of Abuse--------------------- 30Appendix B - What Needs To Be In Place?--------------------------38Appendix C - Existing Programs------------------------------------ 46Appendix D - Selected Resources-----------------------------------58Appendix E - What Is Evaluation?---------------------------------- 68Appendix F - References----------------------------------------------76

5 Abuse Of Older Adults: A Guide for Co-ordinated Community Response

Alberta Council of Women’s Shelters8The ChallengeAs the abuse of older adults is a verycomplex issue, no one organization hasthe scope and capacity to fully addressthe problem. An effective community responsewill involve many stakeholders working incollaboration, with each group contributingand building on its own strengths.Abuse of older adults often occurs withinthe broader context of family violence andbullying. Community-based programs andservices need to continually evolve to ensurethey are meeting the needs of individuals andfamilies, including an aging and increasinglydiverse population. Improving the coordinationof existing programs and services, fromprevention to intervention and follow-up, makethe system more accessible to a wide rangeof Albertans, regardless of their age, culturalbackground, or sexual orientation.Alberta communities range from remoteand secluded to cosmopolitan metropolises.Therefore, community response to the abuseand neglect of seniors, should be equally asdiverse. Programs, services, and supportshave to be adapted to meet the needs of eachdistinctive community. Different approachesin rural, Aboriginal, and immigrantcommunities are required. Accessibility is akey factor, as those who need services themost may be the least able to find or use them.An atmosphere where seniors are comfortablein speaking about their situation, with servicesdesigned or adapted to meet their expressneeds, is critical for success.When addressing the abuse of older adults,it is recognized that certain supports andservices need to be in place within or nearAlberta communites. A check list has beendeveloped to assist communities in identifyingpossible service enhancements to better meetthe needs of abused seniors. This Checklistcan be found in Appendix B.In addition, existing programs and initiativesrange from specific services for abused seniorsto community groups that are working towardincreasing education and awareness. AppendixC, Existing Programs and Initiatives Addressingthe Abuse of Older Adults, provides you with awealth of examples and contacts. 1515This list was compiled during the early part of 2010 and every effort was made to ensure its comprehensiveness and accuracy; however,the availability of programs, services, and contact information, etc. may vary over time, or perhaps change altogether. The services listed arethose specifically addressing the abuse of older adults rather than general services that may or may not be available for seniors.

Alberta Council of Women’s Shelters10A Plan Of Action:CommunityDevelopment ModelNow that you know about the problem, some of itscauses, and the requirements that need to be in placeto support the success of a senior-specific program,what follows is the Community Development Modelwe’ve created that can be applied in your community.

13 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponseSince communities vary, each community’s entry point will vary, as will the level and degree ofadaptation. Communities can adapt the model in whole or in part, depending on the particularneeds of a community and availability of resources. Since smaller communities generallyhave fewer resources than larger communities, some parts of the model may be unattainablelocally – you may need to tap into a larger network. Larger communities with certain services inplace may find themselves picking and choosing certain elements or ideas for implementation.Therefore, the model can be visualised as a Ferris wheel – always revolving and evolving, wherepeople can get on and off whenever they need to.Building Awareness& EducationAssessmentPlanningEvaluationAction

Alberta Council of Women’s Shelters14AssessmentStakeholder and Community MeetingsCall stakeholder meetings. Invite communitygroups and local businesses, includingrepresentatives from faith, aboriginal andimmigrant serving organizations. A communitycan be proactive (to explore the issue of theabuse of older adults) or reactive (to a knownabusive event that has already occurredin the community).Although not an inclusive list, and appearingin no particular order, the following aresome potential stakeholders you may wishto contact:• Seniors• Police• Victim Services• Family and Community Support Services• Women’s Shelters• Alberta Children and Youth Services(Prevention of Family Violence and Bullying)• Alberta Health Services• Community Health Services• Aboriginal Services• Immigration Services• Legal Services• Financial Services• Income Support Services• Home Care• Sexual Assault Centres• Alberta Seniors and Community Supports• Alberta Council on Aging• Alberta Alcohol and DrugAbuse Commission• Crisis Line Workers• Senior Citizens Groups• Seniors’ Recreation Centres• Victorian Order of Nurses• Office of the Public Guardian• Veteran Affairs• Community Housing Services• Seniors’ Outreach• Mental Health Association• Faith Communities• University Affiliates• Policy Makers

15 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponseHold a series of community meetingsor workshops to discuss and define themagnitude of the problem. Look at howto develop a comprehensive, coordinated,community-specific response. Identifystrengths, limitations, how each participantcan contribute and gaps.Identify and Assess -Community ResourcesBe realistic about what can be accomplishedin your particular community and thenbuild on your successes. How does yourcommunity respond when a senior comes toyou saying they have experienced abuse orknow someone who has? What processesare currently in place? Every case is different.The victim could be a man or a woman fromany socio-economic or cultural background.They may have a disability or special healthcare needs. One agency might not be able torespond to all their needs. Mapping out howyour community might respond to specificissues around the abuse of older adults canhelp your community plan comprehensive andintegrated responses for different scenariosand identify potential gaps and how to fillthem. You may wish to refer to the checklist inAppendix B as you work to identify potentialgaps or needs for enhanced services. Assessyour community’s resources and begin workingwith whatever is available.Build Upon Existing -Community ResourcesA community’s response to the abuse ofolder adults can be enhanced by better useof existing services. Begin by evaluating eachservice to see what changes or additions mightbe required to increase effectiveness. Kinnonsuggests, “[t]o build on existing services,examine how individual servicesmay be adapted to respond to the needs ofolder people. Although many services donot have a specific mandate to respond tothe abuse and neglect of older people, theymay be able to offer what is required bymodifying what they currently do. For example,transition houses could make at least oneground floor bedroom available for olderwomen and adapt bathrooms and other dailyliving facilities for people with disabilities.” 18The Alberta Council on Aging’s Senior FriendlyProgram and the Canadian StandardsAssociation, Design for Aging (B659-01) offeruseful information in designing services forolder adults.Another approach to enhancing currentapproaches might include training a localpolice officer about the abuse of older adults,how to recognize signs of abuse, and how torespond. If possible, assign a social worker torespond with a police officer to specific cases.If your community has a women’s shelter,perhaps an outreach group could be formed,such as Older Women Living Safely (OWLS)in Calgary (see Appendix C).Anne McGregor (in the Abuse and Neglectof Older Adults) “proposes the followingroles for community nurses, which could beapplied to other service providers such associal workers."a) Support and counselling to encouragedisclosure and the expression of emotions,to provide emotional support and‘respectful confrontation’ if the older adultis self-blaming, and to aid in the decisionmakingprocess.b) Education to dispel mistaken beliefs andprovide accurate information about human/civil rights and available options.c) Assessment of both the physical abilityto cope with the situation and the mentalcapacity to cope and make decisions.18Kinnon, Dianne. 2002. Abuse and Neglect of Older Adults: Community Awareness and Response. Public Health Agency of Canada, FamilyViolence Prevention Unit (P.59)

Alberta Council of Women’s Shelters16d) Medical intervention to assess, treatand follow up on physical injuries andpsychological trauma.e) Resource linkage to provide home-basedservices, protective services if available,and alternative housing if desired.f) Development of a plan of care with theolder adult that addresses the abuse orneglect, improves the quality of life withoutany increased risk, and involves thehealth care team.A community should try to ensure thatculturally appropriate services and models ofservice delivery are integrated in all communityagencies. Each community has to adaptexisting resources to reflect its unique culturalcharacter. Service needs in a large multiculturalcommunity are different from those in a smallvillage where people may be quite similar inbackground (pp. 59-60).” 19Anyone experiencing abuse is unlikely todisclose their abuse in front of their abuser.Protocols are needed to ensure that serviceproviders provide the opportunity forprivate interviews.Ongoing Public and -Professional AwarenessKeeping current, continuing education andskill development are integral to professionaldevelopment. It is also important to sustainand update your public awareness campaignand training programs to ensure theireffectiveness. Increase community, agency,and professional awareness of services,resources, supports, or programs availablein or near the community. There are severaltraining toolkits available on the internet(see Appendix D).The Alberta Government’s CulturalCompetency: A Self-Assessment Guide for HumanServices Organizations provides a guide to planand implement culturally competent practices(see Appendix C).19Ibid. Pages 59-60

17 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponseBuilding Awareness & EducationIdentify AlliesBegin by initiating discussion among agenciesand service providers within the communityand among community members. Findindividuals or groups in your community whohave an interest in the issue and have themhelp identify and approach others who maywant to become involved. Develop criteria andprocedures for involvement. You may be ableto draw upon existing networks, either formalor informal, like social workers, police officers,seniors’ organizations, women’s shelters orhealth professionals who are dealing withthe abuse of older adults. You can then worktogether to address the issue, as well asdrawing in other concerned individuals.Define and Identify the Abuse of Older Adultsin Your CommunityProfile your community by contacting involvedmembers of the public and professionalsalready working on the abuse of older adults.Define the problem. Get the facts. Verify theneed. Set priorities. Encourage everyone in thecommunity to become involved.Profile your community• Invite community members to participate• Define the problem• Agree upon common values and goals• Identify resources and barriers indeveloping a response to abuseof older adults• Strategize on how to optimally usecurrent resources• Identify limitations and gaps in resources• Evaluate your progressAgency InteractionHold a general discussion with agenciesin order to create awareness and network.Continue to define and identify what theabuse of older adults is and how you canwork together to prevent and address it.Sharing common goals and values is critical toongoing collaboration. Invite participation fromAboriginal and immigrant serving agencies.Discuss who is going to take the lead. Defineguiding principles. Set goals.Community InteractionHold a community meeting to increaseawareness of the abuse of older adults.Broadcast the message that the abuse of olderadults exists in the community, and it is allright to talk about it. Defining and identifyingthe abuse of older adults; raising publicawareness and education; and identifyinghow you might work together to prevent it areamong the first steps to building an effectivecommunity response. Get seniors involved.Establish goals.Public Awareness and EducationEducating and motivating the public are keyfactors in enacting social change. Arrangea public education event among agencies.Bring in another community that has alreadyaddressed this issue to learn from theirexperiences. See Appendix C for potentialcontacts and Appendix D for possibleresources (e.g., the step-by-step guide, Abuseand Neglect of Older Adults, AwarenessInformation for People in the Workplace).

Alberta Council of Women’s Shelters18Planning: Objectives, Strategies, & ResourcesIdentify and Involve StakeholdersOnce you have discussed and defined themagnitude of the problem in your community,you will want to continue to involvestakeholders in your planning activities and,indeed, through all stages of this model.Stakeholder involvement is fundamental to aneffective approach and may vary dependingupon the issue at hand. As you begin to plan,establish a working committee. Motivatedstakeholders will also come forward ontheir own accord. Find out who is involvedin existing initiatives; then determine whoyou want to work with. As you identifystakeholders you will also learn what is alreadybeing done in the community and what needsstill exist. This helps inform the planningprocess. While not all stakeholders will havethe same level of passion and interest at eachstage, it is important to ensure communitystakeholders are regularly invited toparticipate. Refer to the listing on Page 14 as apossible checklist and add to it as you identifyother stakeholders on an ongoing basis.For examples of comprehensive participationmodels please refer to the following:• Alberta Culture and Community Spirit:“Working in Partnership – Recipes forSuccess” at http://culture.alberta.ca/voluntarysector/partnershipkit/default.aspx• Service Canada: The CommunityDevelopment Handbook,www.servicecanada.gc.ca/eng/epb/sid/cia/comm_deve/handbook.shtmlForm a Multidisciplinary TeamYour group will need to establish objectives,decide who will lead the process, and forma multidisciplinary team. The specific needsof diverse and unique communities shouldbe reflected on the team and culturallyappropriate services and service deliverymethods developed accordingly. Goals for amultidisciplinary team include:1. "Provide a forum for detailed casepresentations and the formulation of plansfor intervention;2. Ensure that intervention protocolsare followed;3. Assign responsibility for specific tasks tocertain team members, and provide supportand advice to them;4. Refer cases to other appropriateintervention teams if necessary; and5. Evaluate the effectiveness of particularinterventions and jointly decide on differentcourses of action." 20Clearly articulate your group’s goals andobjectives. This is a critical step as you willwant to be able to effectively evaluate thegroup’s progress. Goals are general statementsof what a project is trying to do and objectivesare specific, measurable statements of thedesired change(s) that your community wantsto accomplish within a certain timeframe (seeEvaluation Section, Appendix C).20Ibid. Page 58.

19 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponseIdentify a Committee LeaderAppoint someone to take the lead. This isa very important step and, therefore, mustbe done carefully. Experience, commitment,leadership abilities, and time are all importantconsiderations. Some communities may beable to have an agency social worker take thelead, or, a community development workermay be able to assist. Approaches will varyfrom community to community.The Community Development area withAlberta Culture and Community Spiritprovides customized services to enhance thecapacity of community leaders, organizations,communities and networks. For moreinformation go to http://culture.alberta.ca/communitydevelopment.Family and Community Support Services(FCSS) may be able to help either withleadership resources or through fundingservices that “enhance the quality of lifeof the retired and semi-retired” (seewww.child.alberta.ca/home/818.cfm forsome examples of programs and servicesoffered through FCSS).A local agency may have the resources to takethe lead, or you may need to identify potentialfunding resources (government, servicegroups, foundations, etc.) and request fundingto hire someone to lead your communitybased initiative.Train Service ProvidersOngoing, current training for frontline workersand anyone involved with older adults is key toan effective response. When service providersbecome educated and sensitized to the abuseand neglect of older adults, identification ofabuse will increase and cases will be handledmore effectively. In addition to training socialworkers, physicians, seniors’ recreation staff,and caregivers, Kinnon (2002, p. 52) suggeststraining home care workers, community careworkers, Meals on Wheels volunteers, housingmanagers, postal carriers, grocery store staff,home maintenance workers, and others whocould play a role in responding to the abuseof older adults. These individuals can identifythe abuse of older adults and alert their ownagencies or other community organizations.According to Kinnon, objectives of the trainingmight include:• "Becoming sensitive to the aging process;• Understanding the social context of abuseand neglect in order to identify high-riskfactors and avoid blaming the victim;• Ensuring a culturally appropriate responseby being sensitive to ethnocultural minority,racial and religious communities, andworking in collaboration with them;• Learning about appropriate interventionsand available community resources; and• Developing the ability to assess familydynamics and stay involved with abused orneglected adults.Training activities can include:• Identifying groups requiring training anddevising strategies to reach these groups;• Making trainers available tocommunity groups;• Preparing older adults to work as advocateswithin their local communities;• Developing manuals for serviceproviders; and• Changing curricula in professionalschools to include courses in gerontology,family violence, and abuse and neglectof older adults.

Alberta Council of Women’s Shelters20Tips for successful training:• Begin by assessing what trainees know andwant to learn about abuse and neglect ofolder adults.• Consider the level of education and thelearning experiences of participants.• Use adult learning principles to designtraining sessions (e.g., involve the adultlearner in setting goals and viewing thetrainer as a resource).• Be flexible and prepared to interact withparticipants who present their ownexperiences for discussion.• Make sure to include discussion of actualabuse situations in order to make thematerial “real.”• Try to create a balance between providinginformation and exploring attitudes.• Draw on both professional resources andknowledgeable community members.” 21There are several training toolkits available onthe internet, as indicated in Appendix D.As well, many professionals have the optionfor continuing education credits. Encouragethem to include modules on the abuseof older adults.Build or Strengthen Networks AmongAgencies and Service ProvidersStrengthen your network by training andmeeting with other related agencies. Whenagencies are working together and buildingon each other’s strengths, it supports theachievement of common goals and avoidsduplicating services. Cross-sectoral trainingsuch as training social workers and policeofficers together about responses to the abuseof older adults can be very effective. Createscenarios: take a case involving the abuseof older adults and brainstorm about how tosolve it. Attempt to establish an interventionteam and/or consultation team, using theEdmonton models as potential guides (seeAppendix C).21Ibid. Page 51 – 53.

21 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponseActionDevelop Preventative StrategiesPreventative strategies involve empoweringolder adults. This includes educating seniorsabout abuse and what to do if it occurs.When you empower older adults you assistthem in taking control of their lives andmaking decisions that reflect their ownpersonal interests. Education, support andabuse-prevention strategies contribute tothe autonomy of older adults and enhancetheir quality of life. Encourage their personaldevelopment through discussions aboutcommunicating, boundary-setting, and theirhuman rights. Knowing their rights can helpimmigrant, Aboriginal, and indeed all seniors. 22Empowering older adults “is more abouthow help is offered rather than what is done.Empowerment can be fostered by:a) Providing support and information in arespectful, non-controlling way.b) Encouraging feelings of power and ability toaffect one’s situation.c) Teaching skills related to self-protectionand assertiveness.d) Sharing knowledge about rights andproblem-solving strategies.Service providers play an essential role inabuse prevention. Professionals can helpby paying attention to dysfunctional familyrelationships and assisting families to improvecommunication patterns, maintain affectionand develop problem-solving skills. One ofthe most effective ways to prevent abuseand neglect is to decrease social isolationthrough a variety of home-based servicessuch as friendly visitors, Meals on Wheels,home support, professional services andhomemakers. Another strategy is to increasethe number of activities older adults canattend outside the home, such as adult daycentres or special events at public librariesand community centres. Access totransportation services (public transit passes,special transport services and volunteerdrivers) is critical.” 2322Elizabeth Podnieks (1998) developed a model for education on the prevention of elder abuse.23Kinnon, Dianne, 2002. Abuse and Neglect of Older Adults: Community Awareness and Response. Public Health Agency of Canada, FamilyViolence Prevention Unit (Page 59-60).

Alberta Council of Women’s Shelters22Develop Intervention StrategiesBasic intervention may include training,education, crisis lines, an information referralnumber, protocols, screening tools, casemanagement, providing shelters or a safeplace, developing a multidisciplinary team,public awareness programs, and group workwith seniors. Other intervention strategiesinclude risk assessment, safety planning anddecreasing seniors’ isolation. If interventionstrategies are ineffective, then engage inharm reduction.The following provides greater detail withrespect to various intervention strategies:a) Crisis LineCollaborate with local services to ensurethat seniors have access to a telephoneline when they are in need of immediatehelp, or in a crisis situation. This might beaccomplished with police services, victimservices, a local women’s shelter and soon. Some communities have establishedspecific crisis lines for seniors, where askilled professional can provide support andcounsel to someone who is experiencing, orat risk for abuse while other communitieshave lines that serve the population moregenerally. These crisis lines help individualsdevelop a safety plan and may also offera follow up call. It is critical that thoseresponding to these calls have specializedtraining both in working with seniors and onthe abuse of older adults.b) Safe Shelter and HousingVictims of abuse must have a safe place togo. A shelter specifically for abused seniorsis, ideally, the best option, but not possiblefor every community. Options includeworking with local women’s shelters, longtermcare facilities, seniors’ residences,or hotels to establish safe housing options.For example, in Cochrane two local hotelsprovide rooms for seniors fleeing an abusivesituation. The Kerby Centre then providestransportation to Calgary. Be aware thatthere are safety issues for anyone providingshelter that must be continually assessed.Another option for abused seniors is toaccess a nearby women’s shelter. 24 Abusedmen typically cannot stay at a women’sshelters, but they can phone the shelterfor help.c) Community Co-ordinated Responseand ResourcesBuilding strong alliances among agencies isnecessary to build an effective, communitycoordinated response to the abuse ofolder adults. Some of the services youwant to connect with when developing acoordinated community response include:• legal services and systems• social service agencies• seniors’ organizations, service providers,and groups• health services (i.e., physicians,community nurses, home care)• counselling services• police• Aboriginal organizations• immigrant serving organizations• mental health services• seniors’ housing services• government services• women’s shelters and domestic violenceservice providers• victim servicesCommunities, agencies, and organizationscan work together to develop an abuse ofolder adults community response protocolto help ensure that adequate intervention,referral, follow-up, and after care is24Research indicates that abused older women are a largely invisible group who fall into the gap between two forms of family violence: domesticviolence and elder abuse. These older women remain invisible because society assumes that domestic violence is not a significant problem for oldercouples, and that domestic violence is primarily a problem of women in their teens to 30s. Women’s shelters remain the primary location in whichwomen receive help when fleeing domestic violence and the shelter network holds great potential for adapting to meet the needs of abused olderwomen, given the appropriate resources (Straka and Montminy, 2006).

23 Abuse Of Older Adults: A Guide for Co-ordinated Community Responseprovided. It is also important to establishcriteria for assessing resources that workeffectively in the community. For instance,agencies might want to work together todevelop standardized risk assessments,processes, and intake forms, etc.d) Develop and Use ProtocolsProtocols provide a framework of serviceaccountability between agencies by:• Setting out guidelines to promote servicequality and local innovations to addressspecific local needs.• Assisting workers to identify and refercases of suspected abuse.• Outlining procedures to follow when theysuspect abuse.• Promoting cooperation amongpartnering agencies.• Educating all partners about theirrespective roles and responsibilities.• Identifying areas of collaboration.Community protocols in health centres,hospitals, police services, home care,mental health facilities, seniors’ centres,government agencies, women’s sheltersand in the public at large increase theeffectiveness of the response to the abuseof older adults. Protocol developmentbegins with a community needs assessmentto demonstrate the complexity of theissue. This is usually performed byrepresentatives from interested agencieswho determine what is required in a specificprotocol. For examples, see Appendix D.Kinnon (2002) outlines possible questions toaddress when developing a protocol:a) “What principles will guide interventions?Shared values and principles are critical tothe success of any collaborative effort.b) What are the policies of the organizationor inter-agency group related to clientservices, inter-agency collaboration,reporting and documenting situations,family violence, abuse and neglect, andhow will these affect action on abuse andneglect of older adults?c) What definitions will the protocol include?d) What reporting structure will beused (inside and outside the agency,including any mandatory requirementsfor reporting)?e) What roles will different staff assume, andhow will they work with each other?f) How will emergency and/or criminalsituations be handled?g) Who has the authority to investigatealleged abuse and what steps will betaken to ensure a thorough but sensitiveassessment/investigation?h) What intake/documentation proceduresare needed?i) What interventions will be made indifferent situations?j) What referrals will be made to otherorganizations and services?k) How will situations be followed up?l) What case review process will be used?m) What appeal process will be usedif needed?” 25 An appeal process willhelp identify how concerns identified bya senior, family member(s) or anotheragency are addressed.e) TransportationSeniors fleeing abusive situations must haveaccess to transportation. This maybe especially difficult in rural and remotecommunities. The following list gives you25Ibid. Page 55, 56.

Alberta Council of Women’s Shelters24some strategies to consider when youaddress a lack of transportation:• Identify who in your networkof community services providestransportation and for what purposes.They may be able to assist with someof the transportation gaps identified inyour community.• Use local Community CoordinatingCommittees to identify ways towork together and make servicesmore accessible.• Strategize with service clubs andcommunity organizations to findtransportation options, such as car poolsand volunteer driver programs.• Coordinate services and improvecommunications between serviceproviders to minimize transportationchallenges (e.g., reduce the tripsrural victims need to take by schedulingappointments on the same day).• Create partnerships to establish accesspoints for video conferencing in differentcommunities, instead of having victimstravel for meetings and appointments.• Instead of seniors having to travelto search out information, provideinformation about the abuse of olderadults and relevant services to thoseservice providers who go into ruralhomes (for example, public healthnurses and home care workers).• Share office space with other serviceproviders in the outlying communities.In this way, you may be able to lessentravel distances for seniors and theirfamilies to access services. 26f) Police ResponseOfficers who have received specializedtraining on the abuse of older adults canplay a pivotal role in responding to victimsand dealing with the perpetrator. Aneffective response to any call regardingabuse of older adults involves dispatchinga specially trained police officer – and ifpossible, a social worker. 27 When distanceand staffing levels are a challenge,specialized training for police and VictimServices as well as informational resourceson community supports is critical. TheScreening and Assessment tools outlinedbelow can also provide guidance. See inparticular, the Elder Abuse Assessmentand Intervention Reference Guide(www.nicenet.ca/files/U_of_T_Nice_Police_Tool_W.PDF) .g) Medical ResponseEducate medical staff in detecting theabuse of older adults. See Appendix B forresources. Encourage the use of screeningtools as outlined in the following section.h) Screening and Assessment ToolsThe following evidence–based tools forsocial workers, health care providers,caregivers and the police can assist in thedetection, intervention and prevention ofelder abuse.• Elder Abuse Suspicion Index (EASI). 28The EASI was developed to raise amedical doctor’s suspicion about theabuse of older adults to a level where areferral for further evaluation isproposed. It was developed out ofconcern that family physicians are ideallypositioned within the community todetect and report elder abuse, yet rankedtenth among professionals who do so.(See www.mcgill.ca/files/familymed/EASI_Web.pdf).26Serving Victims of Violence in Rural Communities: Challenges and Best Practices Deborah Kasdorff Barbara Erb, 201027Not all cases of elder abuse are illegal, of course, however, officers respond when called and decide whether or not to intervene/apprehend,etc. at the scene.28Yaffe, Lithwich and Wolfson, 2004, cited in E. Podnieks, 2008: 137

25 Abuse Of Older Adults: A Guide for Co-ordinated Community Response• Brief Abuse Screen for the Elderly(BASE). 29 The BASE screens througha consensus of intervener opinions;and consists of a series of 5 questionsto assist practitioners in assessing thelikelihood of abuse; (Seewww.uihealthcare.com/depts/med/familymedicine/research/eldermistreatment/screeninginstruments/brief.pdf).• Caregiver Abuse Screen (CASE). 30The CASE screens through thecaregivers’ responses to a set ofquestions; and was designed forcommunity use to screen for abuseand neglect by primary or other unpaidcaregivers. (See www.uihealthcare.com/depts/med/familymedicine/research/eldermistreatment/screeninginstruments/caregiver.pdf).• Indicators of Abuse (IOA). 31 The IOAchecklist alerts interveners to importantrisk factors of abusers and victims,as well as screening for abuse.(See www.uihealthcare.com/depts/med/familymedicine/research/eldermistreatment/screeninginstruments/indicators.pdf).• Abuse Intervention Description (AID). 32The AID form establishes a writtenintervention plan that clearly statesand prioritizes problem, and is usefulin documenting and evaluating abuseintervention strategies, while helping totrack and evaluate.(See www.bccrns.ca/resources/cacc/englishCD/membersonly/abuseofseniors/trainingmanuals/interventionmodels.html).• Elder Assessment Instrument(EAI). 33 The EAI has been used sincethe early 1980s and is a 41-itemLikert scale assessment appropriatein all clinical settings for the screening ofelder abuse. (See www.medscape.com/viewarticle/493951).See also the document, DiscussingScreening for Elder Abuse at PrimaryHealth Care Level by Silvia Perel-Levin(www.who.int/ageing/publications/Discussing_Elder_Abuseweb.pdf) and theElder Abuse Assessment and InterventionReference Guide (www.nicenet.ca/files/U_of_T_Nice_Police_Tool_W.PDF).i) Safety PlanningIf risk and abuse are identified, steps canbe taken to enhance safety. The safety planoutlines what can be done to increase thevictim’s safety from the different typesof abuse they are experiencing. Whilethose experiencing abuse will often havehelp from service providers to develop andimplement a safety plan, that plan belongsto the senior experiencing abuse. It mightinclude such things as keeping copiesof key documents at someone else’s house.Safety support factors identify thesupports needed to implement the plan.For an example of a safety plan, seewww.albertaelderabuse.ca/page.cfm?pgID=28. Each safety plan needs to betailored to the person’s particular situation.j) Senior-Specific ServicesImplement and maintain servicesspecifically to address the unique needsof seniors. This can be done through standalone services, adapting existing servicesand by training staff specifically on seniors’needs. If your community does not havesupports specific to the abuse of olderadults, assess what you can do with whatis available. Consider whether you have theability to apply for grant money, additionalstaffing, funds to improve physical access,29, 30, 31, 32, 33Reis and Nahmiash, 1995

Alberta Council of Women’s Shelters26etc. As noted in earlier sections, there area number of tools and resources availableto assist businesses and organizationsto better meet the needs of seniors.Work closely with your local seniorsorganizations to assesscurrent services.k) Abuse of Older Adults Intervention TeamImplementing and maintaining anintervention team is an effective responseto cases involving the abuse of older adults.The Edmonton Elder Abuse InterventionTeam, for example, is a partnershipbetween the City of Edmonton, EdmontonPolice Service, Catholic Social Services,and the Victorian Order of Nurses. Thisteam provides intervention, support,education, and referral services for seniorsin Edmonton who are experiencing abuse(see Appendix C).l) Elder Abuse Consultation TeamAn Elder Abuse Consultation Team isa community initiative comprised ofprofessionals representing communityand government agencies. Regular teammeetings provide a forum for those whowork directly or indirectly with issuesregarding elder abuse enabling themto consult with each other on difficult,multi-faceted cases of abuse, and identifyoptions and resolutions. Team membersnetwork, share experiences, analyzecases, problem solve, expedite the referralprocess, identify gaps in services, anddevelop strategies for making the abuseof older adults a public issue rather than aprivate family matter (See Appendix C).m) AdvocacyAdvocating on behalf of abused seniorsinvolves providing information anddirection to appropriate services, followup,and support in court. Advocacy alsoinvolves working toward identifying andaddressing gaps in services and calling formore effective service coordination andcommunity response.n) Peer AdvocacyIndividuals who have been in abusiverelationships and who have gone througha healing process may want to advocatefor other abused seniors. This may takeplace in a variety of ways, one of whichis outreach groups. One example is theKerby Centre’s program, Money Matters,where a woman travels around Alberta toeducate other seniors regarding financesand financial abuse. The feedback from thisis excellent. She is highly valued becauseshe is a senior herself and is therefore seenas a peer. It is important that only seniorswith proper support and training to reduceor prevent re-victimization should engagein peer advocacy.o) Initiate or Strengthen InformalSocial NetworksSupport networks can be recognizedand strengthened by family, friends,neighbours, and anyone who comes intoregular contact with abused seniors. Theseindividuals may have the opportunity tooffer assistance, support, information,and referral. Support networks can bestrengthened both informally in thecommunity and in organized peer-supportgroups. Individuals in the community needto know where they can call to report theabuse and what resources are available.SeniorConnect in Calgary for instanceworks with the police, fire department,meter readers, letter carriers, taxi driversto recognize the signs and symptoms thatmight indicate a senior is at risk(see Appendix C).

27 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponseEvaluation is VitalWhat is Evaluation?Evaluation is a systematic and ongoing processthat objectively assesses the impact, efficiency,and sustainability of your initiative, strategyor program in meeting established goals andobjectives. More specifically, evaluation canhelp you answer vital questions such as:• What is the intent of the program? Whatare the program’s goals and objectives?• Are the outcomes, goals and objectivesbeing met?• Are the goals and objectives being met in anefficient and effective manner?• Are the needs of clients being met and arethere any gaps between these needs andthe services or supports being provided?Why Evaluate?Evaluation benefits agencies, service providers,decision-makers, and most importantly,clients. It helps:• ensure that your program provides the bestpossible services to the clients; determineswhen a program is on track or wherechanges are required; and tests emergingand promising practices;• identify the most valuable and efficient useof resources and provides the necessarydata to effectively allocate or re-allocateresources where needed;• your organization be accountable to fundersand the community by showing a wellthought out program that is committed toongoing improvement and demonstratesprogram benefits; and,

Alberta Council of Women’s Shelters28• advocate on behalf of the clients you servewith current and potential funders as wellas the broader community by explainingand clarifying the situation and needs of theclients in your program.MilestonesEvaluate the progress that you have made.Document your events and note howmany people participated and what wasaccomplished to address the abuse ofolder adults in your community. Surveys,questionnaires, interviews, focus groups,observations and file reviews can all help youto measure the progress you have made inmeeting your goals and objectives.Celebrate!All successes should be celebrated,from major to minor.EvolveBuild on your successes! Look at newsituations, if necessary. 34For a selected list of community toolkits,screening tools, assessment tools, protocols,informative websites, and research, (seeAppendix D, Selected Resources). Beginwith these approaches and hold an exerciseto put these into the proper order for yourcommunity. Take a scenario, a test case, earlyon in the process of community collaborationand then look at it later on in the process tosee where you are at now, and where you wantto go in the future. You can also refer to theCommunity Checklist (Appendix B) to identifyfuture projects.Refer to Appendix E beginning on page 68 for adetailed description of the evaluation processincluding how, who and when to conduct anevaluation of your program.Encourage Ongoing ParticipationKeep people involved through regular contact. Continually invite people to participate eventhough they may not have been part of your original initiative. Modify plans as necessary basedon community feedback and evaluation results.34Adapted in part from Kinnon, 2002.

29 Abuse Of Older Adults: A Guide for Co-ordinated Community Response

Alberta Council of Women’s Shelters30Appendix A:Definitions & Context of Abuse

31 Abuse Of Older Adults: A Guide for Co-ordinated Community Response

Alberta Council of Women’s Shelters32Appendix A: Definitions & Context of AbuseDefining Abuse of Older AdultsAbuse of older adults, commonly knownas ‘elder abuse’, is defined as any action orinaction by self or others that jeopardizes thehealth or well-being of an older person. Anact of harm or the neglect resulting from afailure to act is especially detrimental wheninflicted by those in a position of trust, poweror responsibility. 35 A specific definition of theabuse of older adults is sometimes difficultas a result of varying situational and culturalcontexts; however, this is the definition usedthroughout this guide. 36Elder Abuse is a violation of Human Rightsand a significant cause of injuries, illness,lost productivity, isolation and despair. 37Types of AbuseAbuse of older adults can take several forms,often with more than one type of abuseoccurring at the same time. National andprovincial statistics indicate that the two mostidentified and reported types of abuse arefinancial and psychological. 38Note that while abuse is always wrong and canhave serious consequences, not all forms of abuseare criminal.The Alberta Elder Abuse Network hasidentified the various forms of abuse asfollows:Financial/Material Abuse: This is the misuseof an older person's funds or property throughfraud, trickery, theft or force.It can include:• frauds• scams• the misuse of money or property• convincing an older person to buy aproduct or give away money• stealing money or possessions• misusing bank or credit cards• misusing joint banking accounts35From the Alberta Elder Abuse Awareness Network, www. albertaelderabuse.ca36Cultural contexts and other diverse situational factors must be recognized and understood in the wider context of abuse of older adults (WHO, 2002: 3).37World Health Organization, Active Ageing Policy Framework, 2002, Page 29 http://whqlibdoc.who.int/hq/2002/WHO_NMH_NPH_02.8.pdf38Ibid

33 Abuse Of Older Adults: A Guide for Co-ordinated Community Response• forging a signature on pension cheques orlegal documents• misusing a power of attorneyAlso be watchful for trickery, interferencewith a senior’s financial decisions, persistentrequests for money, pressuring or forcinga senior to sign documents, abuse ofGuardianship responsibilities, and all otherdishonest actions involving taking an olderperson’s money or property;Psychological/Emotional Abuse: Thismay take the form of verbal aggression,humiliation, isolation, intimidation, threats andinappropriate control of activities. In all cases,it diminishes the identity and self-worth ofolder people. It can also provoke intense fear,anxiety or debilitating stress.It can include:• removal of decision-making power whilethe person is competent• withholding affection for manipulativepurposes• refusing access to grandchildren• denying privacy in institutions• forcing older people to do degrading things• controlling activities• treating them like children• attacking their self-esteem• intentionally frightening themAny actions or words that cause emotionalpain, fear, decreased self-esteem or dignity,such as verbal threats, yelling, insults,humiliation, degradation, blackmail, confiningthe older person to a chair, bed, room, orresidence, disrespect for privacy, belongings,or pets are some further examples ofpsychological and emotional abuse;Physical Abuse: Physical abuse is the use ofphysical force causing discomfort which mayor may not result in bodily injury, physicalpain, or impairment. Older persons who aresubjected to rough handling or mistreatmentare the victims of physical abuse.It can include:• slapping• shaking• pushing• kicking• punching• striking with an object or weapon• deliberate exposure to severe weather• unnecessary physical restraint• forced confinement• failure to provide adequate health careThe use of physical force, which also includeshitting, grabbing, strangulation 39 , coercion, andpersonal attacks, may cause broken bones,fractures, dislocations, bruising, abrasions,burns, or even death;Sexual Abuse: All unwanted forms of sexualactivity, behaviour, assault or harassment toolder persons is elder sexual abuse.It can include:• verbal or suggestive behavior• fondling• sexual intercourse• lack of personal privacy• being forced to commit degrading acts• unnecessary help with dressing/hygieneIt may also include exploitive use ofpornography, and any indecent exposure oracts by the abuser;Medical Abuse: Withholding or withdrawingfood, water, medicine, or prescriptions,over-administering prescribed medicationcausing bodily harm, sedation, or othernegative effects, improper refilling ofprescriptions, theft of medications for thepurpose of resale, refusing to act upon possibleside effects of medications, failure to seekmedical assistance;39The VON has developed an excellent Strangulation Protocol. See Appendix B, Selected Resources.

Alberta Council of Women’s Shelters34Legal Abuse: Any violation of human rightsand/or freedoms, being forced or tricked intochanging a will, denying or restricting accessto public services such as nursing, therapeutic,and home care;Spiritual Abuse: Any act of denying orridiculing religious or spiritual beliefs orparticipation in religious services;Cultural Abuse: Any act of denying theability or opportunity to participate incultural practices;Systemic Abuse: Abuse suffered by the victim,often causing feelings of re-victimization,stemming from within the health care system,legal system, and so on. Examples includeover-prescribing or unnecessary prescribingof medication by a medical doctor, anddiscrimination of Aboriginal peoples by thecriminal justice system;Neglect: This is the intentional or unintentionalfailure to provide for the needs of someone.It can include:• failure to provide a safe, warm andcomfortable place to live• denial of social contacts• failure to provide personal hygiene• failure to provide proper water, food orclean clothing• failure to provide aids for daily living,(hearing aids, walkers, canes,wheelchairs, etc.)• failure to prevent physical harm• abandonment or desertion• Active Neglect: Intentional failure of thecaregiver to fulfill caregiving duties;• Passive Neglect: Unintentional failure of acaregiver to fulfill caregiving responsibilitiesdue to lack of knowledge, skill, illness,infirmity, or lack of awareness of communitysupports and resources;• Self-Neglect: It involves cases whereby,older adults, by choice or ignorance, live inways that disregard their health or safetyneeds and can in some cases pose a hazardto others. An individual’s inability to providefor his or her own needs;Self-Abuse: An individual causing harm tohis or her self, such as through the overuseof alcohol or other drugs/prescriptionmedications;Abandonment: Desertion by an individual whoheld physical and/or legal custody, and/or helda moral responsibility to provide care for anelderly person; andMurder and Manslaughter. 40Failure to attend to personal needs such asexercise, attention, supervision if necessary,and health care are a few other examples.Neglect can be active (intentional) or passive(unintentional) and has the effect of failingto provide older persons with basic necessitiesor care.40The above definitions were largely drawn from the Alberta Elder Abuse Network and can be found at www.albertaelderabuse.ca/page.cfm?pgID=6;with their source identified as Health Canada, Abuse and Neglect of Older Adults: Resource and Training Kit for Service Providers, 1994.

35 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponseBarriers to Disclosing AbuseThe abuse of older adults is often hidden, asseniors are reluctant to speak out. They maybe protective of the abusive individual, fearfulof not being believed, afraid of revenge, fearfulof being left alone or put in an institution, orbelieve that they cannot do anything abouttheir situation. Older adults often experiencenegative psychological effects such as a deepsense of loss of power and rejection, loss ofdignity and self-esteem, or depression. 41The Alberta Elder Abuse Network identifiesthe following barriers for seniors toreport abuse:1. Fear of being punished, ofinstitutionalization, of rejection orabandonment by family members, of losingtheir caregiver and of losing access to familymembers, including grandchildren.2. Love for the abuser.3. Lack of understanding or impairment.4. Shame and/or guilt. Victims of abuse mayblame themselves for the violence and feelashamed of what has happened to them.5. Unaware of resources and options.6. Acceptance of abuse or neglect as normal. 42Theories Regarding the Abuse -of Older Adults(Alberta Elder Abuse Awareness Network).Research in the area of abuse of olderadults is relatively new, but a few theorieshave emerged that address the cause.These include:• Learning Theory: Learning theory, ortransgenerational violence theory, is basedon the belief that violence is a learnedbehaviour. Based on this theory, a childobserves violence and learns that violenceis an acceptable reaction to stress, andinternalizes this as an acceptable behaviour.The abused child becomes the adult abuserof the parent.• Physical/Mental Dependence: This theoryis based on the belief that older personswho have a severe mental or physicalimpairment are most vulnerable to beingabused. In relationships where oneindividual is dependent on another for care,there is a potential for misuse of power bythe caregiver.• Pathologic Abuser: This theory suggeststhat abusers have personality flaws thatcause the abuse. Caregivers with substanceabuse issues, or mental illness or inabilities,are more likely to be abusive.• Stressed Caregiver: This theory proposesthat the stress associated with caring forolder persons can result in violence.• Societal Attitudes: Negative societalattitudes toward older persons maymake it easier for abuse to occur withoutremorse on the part of the caregiver.Societal attitudes can result in devaluationand lack of respect for seniors, as they areoften stereotyped as frail, incompetentand powerless.Risk FactorsThere are a number of risk factorsthat contribute to the abuse of olderadults, including:• A history of spousal abuse: In somesituations there has been long-term abusepresent in the relationship, and it continuesas the couple ages.• Family dynamics: The family’s methodof dealing with issues perhaps always41Let’s Talk About It: Tool Kit to Hosting an Awareness Café, 200742The Alberta Elder Abuse Network, www.albertaelderabuse.ca/page.cfm?pgID=10

Alberta Council of Women’s Shelters36included forms of abusive behaviour.The family values and ways of managingstress and differences may result in adultchildren acting abusively towards theiraging parents.• Social isolation: If an older person or coupletend to be isolated and have few supports,the risk of abuse is greater.• Caregiver stress: Troubled caregivers maynot have the resources and capability toproperly care for an older person.• Ageism and lack of knowledge aboutthe aging process: A caregiver may lackknowledge about the aging process and beintolerant of the behaviours and attitudesof an aging person in their care.Some Points to ConsiderOlder adults may have been in long-termpartner relationships and strugglewith issues of separation and being ontheir own.When interviewing an older person, beaware that s/he may have challenges withhearing or vision impairment that need tobe accommodated. Ensure that you checkfor any immediate physical needs such as aneed to obtain medications or eye glasses.Be aware that an older person mayrequire more of your time when completingan intake/and or during a counsellingsession. 44• Societal acceptance of violence. 4343Health Canada, Abuse and Neglect of Older Adults: Resource and Training Kit for Service Providers, 1994.44Plesuk, Susan, LeBlanc, Sandra, ACWS Shelter Practice Orientation Manual, Alberta Council of Women’s Shelters, 2010, Module 12, page 4.http://www.acws.ca/documents/Module12Eolderadults.pdf

37 Abuse Of Older Adults: A Guide for Co-ordinated Community Response

Alberta Council of Women’s Shelters38Appendix B:What Needs to be in Place?A Community Checklist

39 Abuse Of Older Adults: A Guide for Co-ordinated Community Response

Alberta Council of Women’s Shelters40Appendix B: What Needs To Be In Place?The project team, consulting with variousstakeholders throughout the province,set out to determine the services,supports, resources, and responses neededwithin or near each Alberta community toaddress the abuse of older adults. This doesnot imply that each community must offerall services. Through collaboration amongstagencies and communities, programs andservices can either be adapted or specificallydesigned to meet the needs of seniors.As you move forward to address the abuseof older adults in your community, use thefollowing checklist of services, supports,resources, and responses to assist inidentifying community needs and gaps.Individual communities are in the bestposition to identify their own priorities. Someorganizations, particularly those in ruralareas, can benefit from connecting throughregional networks in order to offer a widerarray of programs and services. While differentcommunities have different requirements andresponses, the following checklist provides thecommon elements that comprise a responseto the abuse of older adults:☑ Public Awareness It is important to conveythe message that the abuse of seniorsoccurs more than is expected and that itis okay to talk about it. Informing seniorsabout what constitutes abuse and whatthey can do about it is critical. Seniorsneed clear, concise, realistic and practicalinformation on what to do and who to call.A greater understanding of the dynamicsof intergenerational family relationshipsis needed. Many different services andsystems come into contact with olderadults; they need to be aware of the issueso they can help to make a difference.This includes those providing housing,transportation, health care, and financialservices. Given that there is a significantneed for public awareness, your communitywill be able to identify an extensive list andwill therefore need to priorize areas forattention. Victims, service providers, andthe community at large all need to be aware

41 Abuse Of Older Adults: A Guide for Co-ordinated Community Responseof available resources and supports inorder to respond effectively to the abuseof older adults.☑ Skilled Service Providers As peoplebecome more aware of the issue, they willwant to know what they can do. Throughpublic education, community membersmust become more educated on the abuseof older adults and appropriate preventionand intervention strategies. Since a largepercentage of abused seniors first go tomedical staff for information and help, 45it is important to train physicians, nursesand other health care providers to identifypossible abuse and ask the right questions.In addition to medical staff, educatingpolice, government authorities, socialworkers, mental health workers, addictioncounsellors, and financial personnel suchas bank employees is necessary, as wellas educating those involved in seniors’centers and community agencies. Buildingpositive relationships between seniors andservice providers, health care professionals,clergy, and the community in general willhelp decrease negative attitudes towardsseniors, rectify misconceptions, therebyincreasing disclosures and appropriateresponses.☑ Community Coordinated ResponseBuilding strong connections amongagencies is necessary for an effectivecommunity coordinated response to theabuse of older adults. Communities candevelop a community response protocol,working collaboratively with otheragencies, organizations, and neighbouringcommunities to ensure there is adequatereferral, follow-up, and after care.☑ AdvocacyIndividuals and community groupscan work together to advocate on behalfof individual seniors at risk by connectingabused seniors and their families withexisting resources and services. They mayalso wish to advocate on a broader scaleby promoting more easily accessibleresources and services when servicedelivery gaps are identified.☑ Resources Establish criteria forassessing resources that are at workin the community. This can range fromagencies working together on collaborativeresponses, to intake forms, riskassessments, safety planning, crisis linesand so on. Identify gaps and work towardsecuring adequate community resources toaddress them.☑ Services Designed Specifically For SeniorsService providers and seniors across theprovince have identified senior-specificservices for both women and men as anurgent need. This does not necessarilymean stand alone services, but ratherthat services are accessible to seniorsand that service providers have a strongunderstanding of seniors’ issues or needs. 46As an example, older abused women do notaccess women’s shelters in large numbersbecause they have different needs thanyounger women fleeing abuse. Deterringfactors for older women include high noiselevels exacerbated by the challenges ofcommunal living, accessibility and specialneeds. However, older abused women (andmen) regularly arrive at the Edmonton’sSAGE Seniors’ Safe House and KerbyCentre in Calgary, shelters that arespecifically for seniors.Seniors report that they feel mostcomfortable reaching out to servicesthat are designed specifically for them,and speaking with people from their owngeneration, peers and service providers.45Human Resources and Social Development Canada, Awareness and Perceptions of Canadians Toward Elder Abuse, August 2008; (Page 5) website .http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/human_resources_social_development_canada/2008/001-08-e/report.pdf46The Alberta Council on Aging’s Senior FriendlyTM Program provides tools to assist organizations to gear their services to seniors’ needs.

Alberta Council of Women’s Shelters42These services must also be adequatelystaffed in order to remain effective.Beginning with the need to access safespaces for seniors, the committee identifiedthe following needed services:• Safe Spaces and Access to SafetyWhen older adults are at risk of abuse,they need a safe place to go, such as thedesignated seniors’ shelters offered bySAGE and Kerby. Increasing the numberof safe spaces designed specifically forseniors is necessary. There are a varietyof ways that a community may worktogether to meet this need.In smaller communities, it may bepossible to work with a local women’sshelter to create and maintainspecialized shelter and outreachprograms. The majority of Albertacommunities have facilities such asseniors’ complexes or apartmentbuildings, lodges, care facilities,hospitals, hotels, and so on, whereone or two rooms could be modifiedin order to become safe and secure forabused seniors to access. Appropriatecommunity supports and outreachprograms must also be implemented asan imperative part of follow-up to thesafe housing process.While the majority of abuse is sufferedby women at the hands of both men andwomen, men are also victims of elderabuse. Consistently, 30% of the abusevictims who come to the SAGE Seniors’Safe House are men. This statistic issignificant when addressing the abuseof older adults and requires specialattention in the design of services.• Abuse of Older Adults -Intervention TeamsBy working in partnership, police, socialworkers and other service providerscan effectively prevent and respondto the abuse of older adults. Goodcommunication and informationsharing supported by protocols acrossdisciplines and agencies are essential.Locating services together may assist inbuilding information sharing practicesfor the benefit of the abused senior andtheir family. The Edmonton Elder AbuseIntervention Team (EEAIT) is based ona proven model that has been adaptedin other communities in Canada, suchas in Waterloo, Ontario. For moreinformation on EEAIT (see AppendixC, Existing Programs and InitiativesAddressing the Abuse of Older Adults).Other communities across Alberta havestarted intervention teams by assigninga social worker to accompany the policewhen responding to a call concerningthe abuse of older adults. Communitiessuch as Hobbema are in the processof applying for the funding for a socialworker to work in this capacity. Morework could be done to establish elderabuse intervention teams across theprovince. See Form a MultidisciplinaryTeam (page 17) for a few pointers.• Crisis LinesIn addition to 911 for emergencies, crisislines provide a skilled person who cansupport and counsel an abused seniorthrough a difficult situation; help themdevelop a safety plan, and offer a followup call. There is a need for both crisisand non-emergency information lines,such as the Seniors Abuse Helplinein Edmonton and the Alberta FamilyViolence Information line. Communitiesmay wish to augment an existing crisis

43 Abuse Of Older Adults: A Guide for Co-ordinated Community Responseline by providing specialized trainingfor staff or volunteers on responding tothe abuse of older adults and possiblyadding a dedicated number.• Sexual Assault CentresIt must be recognized that sexual abuseoccurs among seniors. Strengtheningthe capacity of sexual assault centresto respond to sexual assault involvingseniors must be part of the response.• Police ResponseOfficers trained in the area of seniors’abuse are able to respond effectivelyto assist the victim and deal with theperpetrator. A police officer and a socialworker responding together to a callconcerning the abuse of older adults isan effective minimum response. It mustbe noted that responding to a crisis/high-risk situation is different fromresponding to someone who is seekinginformation. The Alberta Elder AbuseNetwork developed an informationpackage and training video for policeofficers that is available on their website.• Health CareThe World Health Organizationrecommends training primary careworkers on what to watch for and howto play an active role in the preventionof abuse and neglect, given that asystematic review revealed that mostprofessionals underestimate theprevalence of some abuse and neglectof seniors. 47 All health care providerscan benefit from training opportunitiesthat cover a broad range of abuseissues (such as financial, physical andemotional abuse) 48 and inform them ofresources that are currently available inthe broader community.• TransportationAbused seniors need transportation toaccess safety, services and supports.This can be especially challenging inrural and remote areas of the provinceand remains a key area to address.• ProtocolsCommunity protocols provide guidelinesto assist in understanding and guidingcollaborative response to the abuse ofolder adults. They can be particularlyeffective in areas such as hospitals,health centers, police authorities,home care, mental health facilities,addiction facilities, seniors’ centers,government agencies, women’s shelters,and the general public. Protocolsare developed based on local needs,systems and resources. When rolesare clearly identified and responsesplanned in advance of a crisis, you canhave the best possible response. Forexamples, see Edmonton’s NortheastHealth Center protocol (www.edmonton.ca/city_government/news/healthcareprofessionals-taugh.aspx forcontact information) and the healthyaging model in the Yukon Territories(www.hss.gov.yk.ca/seniorservices_aging.php). Calgary’s Action GroupAgainst Elder Abuse created a resourcemanual which provides a usefullisting of various protocols (see www.albertaelderabuse.ca/resourceDocs/Resource Manual - Final.pdf).☑ Legislative and Policy FrameworksIn developing any strategy relating to theabuse of older adults, it is important tounderstand the requirements and remediesoutlined in legislation. The governmentsof Alberta and Canada have enactedlegislation to help prevent and address47World Health Organization. (n.d.). Elder Abuse. Retrieved on March 16, 2010, from www.who.int/ageing/projects/elder_abuse/en/47Cooper, C., Selwood, A., & Livingston, G. (2009). Knowledge, Detection, and Reporting of Abuse by Health and Social Care Professionals:A Systematic Review. American Journal of Geriatric Psychiatry, 17(10), 826-838.48The National Seniors Council. (2007). Report of the National Seniors Council on Elder Abuse.

Alberta Council of Women’s Shelters44elder abuse. This includes legislationrelating to personal and financial decisionmaking,such as the Adult Guardianshipand Trusteeship Act, the Personal DirectivesAct and the Powers of Attorney Act andlegislation designed to protect andsafeguard persons under the care of others,such as the Mental Health Act and theProtection for Persons in Care Act. In addition,the Protection Against Family Violence Actprovides for the protection and supportof victims of family violence, includingthe abuse of older adults. The federalgovernment’s Criminal Code of Canadaaddresses criminal aspects of elder abuse. 49Community stakeholders see, at thegrassroots level, how legislation and policiesare implemented and their result. Theyare therefore in a good position to review,discuss, and make recommendations onlegislative and policy frameworks.Data collection and program evaluationpertaining specifically to the abuse of olderadults is imperative in order to facilitateunderstanding of key policy issues (seeAppendix E, the Evaluation Process).In some cases, policy change may bemore appropriate than a legislativechange. Individual organizations shouldalso review their policy and operationalframeworks as they relate to the abuseof older adults to ensure that they are inkeeping with good practice.49Addressing Elder Abuse in Alberta: A Strategy for Collective Action www.seniors.alberta.ca/services_resources/elderabuse/AddressingElderAbuse.pdf

45 Abuse Of Older Adults: A Guide for Co-ordinated Community Response

Alberta Council of Women’s Shelters46Appendix C:Existing Programs andInitiatives Addressing theAbuse of Older Adults

47 Abuse Of Older Adults: A Guide for Co-ordinated Community Response

Alberta Council of Women’s Shelters48Appendix C: Existing Programs and InitiativesAddressing the Abuse of Older AdultsThis list was compiled during the early partof 2010. Every effort was made to ensure itscomprehensiveness and accuracy; however,the availability of programs, services, andcontact information, etc. may vary over time, orperhaps change altogether. The services, listedin alphabetical order by municipality, specificallyaddress the abuse of older adults and does notinclude services of a general nature that may ormay not be available for seniors.CALGARYCoordinated Community Response Model1. Action Group on Elder Abuse (AGEA)The Action Group on Elder Abuse (AGEA)was an initiative of Calgary’s Alliance to EndViolence, whose mission was to enhanceand coordinate the response to the abuseof older adults. The group began as a resultof informal conversations among a fewagencies concerned about the lack of acoordinated response.A community consultation in the fall of2003 recognized the necessity for a multiagencygroup. A part-time CommunityDevelopment coordinator was hired to focuson the mapping of resources, identifyinggaps, establishing protocols, training, andorganizational development. The AGEAbegan the Pulling Back the Curtain workshopseries in March, 2008. Communitystakeholders agreed to participate in futuresessions concerning the development of acomprehensive, coordinated communityresponse model. In 2009, a broad range ofstakeholders addressed how to implementthe model and needed resources.Since its inception in January 2004, theAction Group has accomplished a strategicplan, resource mapping, a tool kit on hostingan awareness café, identification of servicegaps, protocol and resource manuals,development and implementation of acomprehensive education strategy andpublic awareness campaign on the abuse ofolder adults.Website: www.endviolence.ca/resourcesolder-adultsVictim-Focused Services2. Calgary Police Service Senior -Liaison ProgramThe primary role of the Senior LiaisonOfficer is to assist seniors with issues thatfall between criminal matters and the civillaw, such as home renovation scams, doorto-doorsales, bogus lotteries, and othersattempting to gain access to or take controlof seniors’ financial affairs for their ownbenefit. The Officer works with communitiesand seniors’ organizations by responding toquestions and concerns pertaining to issuesof safety, security, and fraud prevention,and delivers informative and preventativeseminars at seniors’ centres, seniors’apartments, and community organizations.This Officer also serves as a resource forcommunity professionals such as nursesand social workers, acting as a publicguardian and public trustee.Senior Liasion Officer

49 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponseTelephone: 403-428-8311Website: www.calgarypolice.ca/sectionsandunits.html#seniors3. Calgary Seniors’ Resource SocietyThe Calgary Seniors’ Resource Societyoffers the SeniorConnect Program whichhelps seniors who might be at risk connectto community support services that assistthem in living safely and independently intheir homes. SeniorConnect is a three-partprogram consisting of;a) Education: citizens are offered a free halfhoursession on how to recognize the signsand symptoms that a senior might be atrisk. Letter carriers, taxi drivers, on callpharmacists, meter readers and membersof the City of Calgary Police, EmergencyMedical Services, Fire Department, Enmax,and various community associations havebeen trained in this program.b) A 24-Hour Seniors’ Help Line: answers callsfrom concerned citizens who have identifiedseniors that they believe to be at risk orcould use some help and then refers themto the SeniorConnect Social Worker. Thisline is operated by a partner organization,the Calgary Distress Centre.c) Access to Support: the SeniorConnectSocial Worker contacts seniors who havebeen identified as being at risk through theHelp Line and then connects them with thecommunity support services that they need.SeniorConnect Social WorkerTelephone: 403-266-6200Education Awareness: 403-264-7700Website: www.calgaryseniors.org4. Kerby CentreKerby Centre is a centre for people55 years of age and older, and offers anextensive list of activities, programs, andservices. Services include: Adult DaySupport Program, Centre of Excellence,Food Services, Fund Development, GroceryDelivery, Housing, Information/Advocacy,Kerby News, a Wellness Centre, and theKerby Rotary House Shelter for abusedseniors.Another important program at Kerby is theMoney Matters for Seniors Program, which isa program that Kerby delivers throughout theprovince of Alberta. This program is aimedat helping seniors become more aware offinancial abuse and how to prevent it.Telephone: 403-265-0661Fax: 403-705-3211Email: information@kerbycentre.comWebsite: www.kerbycentre.com/index.php5. Kerby Rotary House ShelterKerby Centre operates the first purposebuiltshelter in North America for abusedsenior men and women. This uniqueshelter offers safe, secure shelter to abusedseniors over the age of 55 in Calgary andarea. Kerby provides crisis intervention,a 24-hour crisis line, support, advocacy,referral, short-term housing, and thenecessities of daily life. Kerby also offerseducation, recreation, life skills and artsprograms, risk assessment, specializedprogramming for Aboriginal clients andother cultures, training opportunities forstaff, computer programs, clothing bank, acook on staff, supportive counselling andcase management, personal incidentals,legal services in partnership with lawyers, acollective kitchen, transport to emergencymedical/dental care, follow up services,housing support and advocacy, volunteerprograms, and support groups.

51 Abuse Of Older Adults: A Guide for Co-ordinated Community Responseaccompaniment, and provided informationand assistance in connecting with services.• In April, 2003 both the Seniors’ AbuseHelpline and the Older Adult KnowledgeNetwork (Oak-Net, www.oaknet.ca)were launched. Oak-Net, developedby the University of Alberta Faculty ofExtension, Legal Studies Program providesfictional stories about the types of abuse,accompanied by a guide to definitions,legal processes, legal action, preventionmeasures and a listing of resources.The Edmonton Community ResponseModel has evolved over the years and nowsupports abused seniors through the ElderAbuse Community Action Committee,the Elder Abuse Intervention Team, theSeniors’ Abuse Helpline, Police Services, theVictorian Order of Nurses, the Seniors’ SafeHouse, the Elder Abuse Consultation Team,and through various community agencies.Ongoing activities include building awarenessthrough education, serving culturally diversepopulations, addressing gaps in legislation,the strengthening of intervention strategies,documenting and sharing learnings andinformation, and promoting a province-wideresponse to the abuse of older adults. Acommunity development worker is involvedwith the Elder Abuse Intervention Team andworks with the community to identify gaps indealing with the abuse of older adults.Victim-Focused Services1. Elder Abuse Intervention Team (EAIT)The Elder Abuse Intervention Team is apartnership between the City of Edmonton,Catholic Social Services, Edmonton PoliceService, and the Victorian Order of Nurses.The team provides intervention, education,support, and referral services for seniorsover the age of 65 residing in Edmontonwho are at risk of or are experiencing abuse.Consultation is provided to others workingwith seniors experiencing abuse. The teamalso focuses on prevention by way of raisingawareness, community development, andeducation to professionals and studentbodies. The team has also compiled a listof other resources available in Edmonton.The Elderly Adult Resource Service worksclosely with EAIT and handles the phoneline. Calls regarding the abuse of olderadults may come in via the intake line orfrom the police. The EAIT was formed in1998 and all team members are co-housedin the same building, which is crucial to theirsuccess. The team assesses the situationthen intervenes with the greatest amount ofrespect and the least amount of intrusion,in the most effective way possible. Theteam responds to all abuse of older adultsconcerns. The majority of the calls (75%)are related to financial, psychological/emotional, or physical abuse of seniors, witha son, daughter, grandchild, other familymember, or unrelated caregiver identifiedas the abuser. The spouse is identifiedas the abuser less than 25% of the time.Mental health concerns, alcohol and drugabuse, low income, and housing needs areconsistent contributing factors to the abuseof older adults. In fact, each contributingfactor is cited in 20% to 30% of the cases,and sometimes higher. Caregiver stress isseen as a contributing factor anywhere from6% to 18% of the time.Intake Line: 780-477-2929Alberta Elder Abuse Network website:www.albertaelderabuse.ca/page.cfm?pgID=30City of Edmonton website: www.edmonton.ca/for_residents/resident_services_programs/stop-elder-abuse.aspx

Alberta Council of Women’s Shelters52Edmonton Police Service website: www.edmontonpolice.ca/communitypolicing/familyprotection/elderabuse.aspx2. Elderly Adult Resource Service (EARS)Catholic Social Services in collaborationwith Edmonton Police Services, the TodayCentre for Family Violence, Victorian Orderof Nurses and Edmonton CommunityServices offers the Elderly Adult ResourceService (EARS) and provides clientassessment, emotional support, andreferrals to community resources, as wellas providing information to the communityregarding seniors.Telephone: 780-455-6880 or780-477-29293. Seniors’ Abuse HelplineThe Seniors’ Abuse Helpline is a programoperated by the Support Network, inpartnership with the City of EdmontonCommunity Services, the Elder AbuseIntervention Team, and the SeniorsAssociation of the Greater Edmonton Area(SAGE). This help line is answered 24 hoursa day by Support Network volunteers whohave taken part in a comprehensive 64-hourtraining program that teaches them basiccommunication and crisis managementskills with special emphasis on assessingvarious risks, including seniors’ abuse.These volunteers also provide confidentialand anonymous support, referrals, andinformation regarding seniors’ abuse.Callers may be seniors who are experiencingabuse or those who are concerned about anolder person. The help line receives between1,000 and 1,200 calls each year, and thetop concern reported on the line is seniors’abuse. Recent statistics indicate that 31% ofcalls came directly from seniors concernedabout living in an abusive situation, and35% of calls came from concerned thirdparties. The other 34% of calls typicallyinvolve supportive listening around healthissues, legal issues, and seniors struggling tomeet their basic needs. Those tend to be themost common issues behind first and thirdparty senior’s abuse.Telephone: 780-454-8888Website: www.thesupportnetwork.com.ws026.alentus.com/crisispreventionprograms/seniorabuse.php4. SAGE (Seniors Association of -Greater Edmonton)SAGE is a full service, not-for-profit seniors’organization whose mandate is to buildand maintain a broad range of programsand services that enhance the quality of lifefor seniors and their families in the greaterEdmonton area. With over 37 years ofexperience, SAGE is regarded as a majorprovider of innovative seniors’ services inthe Edmonton region. With communitysupport, SAGE provides a wide variety ofprograms and services to seniors, includingguardianship services, health services, homeservices, income tax program, memberservices, multicultural seniors outreach,Seniors’ Safe House, social work services,This Full House for seniors who hoard, theSunshine Cafe, and SAGELink newsletter.Telephone: 780-423-5510Website: www.mysage.ca/safehousing.cfm?ts=145. SAGE Seniors’ Safe HouseThe SAGE Seniors’ Safe House providestemporary housing for men and womenwho are approximately 60 years of age andolder and need a safe haven from an abusiveenvironment. The Safe House offers a safeand secure furnished suite on a locked floor

53 Abuse Of Older Adults: A Guide for Co-ordinated Community Responsefor up to 60 days, sometimes longer, freeof charge. Services are provided as neededto the senior. All meals and snacks areprovided by the Sunshine Cafe, as well ascleaning service, emotional support fromstaff members, professional counsellingfrom a social worker, connections tocommunity resources, transportation,advocacy, hands-on assistance withfinances, locating secondary or permanenthousing, life skills, referrals to legal andother services, and so on.Health services are provided by theVictorian Order of Nurses. It is reportedthat abused seniors seeking shelter at theSafe House are approximately 30% maleand 70% female. About 50% of the seniorswho escape have experienced spousalabuse (97% of the time it is the malewho is the abuser), and 50% as a resultof victimization by a child, grandchild, orcaregiver. Men most often seek shelterfrom an abusive child or grandchild, butoccasionally because of spousal abuse.Women most often seek shelter becauseof spousal abuse. The lethality risk is alsohigher in cases of spousal abuse. There aretwo full-time staff members who care forthe abused seniors in the Safe House, andthere is a life line for after hours. Follow-upservices are provided once a senior leavesthe shelter.SAGE has guiding principles for workingwith abused seniors, a care plan, an ecomap,senior intake forms, an exit surveyform, and a seniors’ shelter logic model. TheSAGE Seniors’ Safe House was establishedout of a need identified by the EdmontonElder Abuse Intervention Team.Telephone: 780-702-1520Website: www.mysage.ca/safehousing.cfm?ts=146. Elder Abuse Consultation TeamThe Elder Abuse Consultation Teamis another result of the communitydevelopment efforts of the Elder AbuseIntervention Team. The consultation teamis a community initiative committee ofapproximately 31 professionals representing28 community and government agencies.The consultation team was formed in1999 and any organization/agency canapply to become a member of the team.The objective of the team is to providea forum for those who work directly orindirectly with the abuse of older adults. Ona monthly basis, the team members bringa specific case before the committee, andthe committee then engages in consultationwith one another to reach resolutions.Team members network, share experience,discuss cases, facilitate problem solving,expedite the referral process, identify gapsin service and develop strategies to movethe abuse of older adults from the realmof “private troubles” to the broader issueof creating social change. Membership iswide-ranging but includes representationfrom the Elder Abuse Interventionteam, SAGE, Capital Health, AlbertaHospice, Primary Care Network, CHOICE(Comprehensive Home Option of IntegratedCare for the Elderly), Public Trustees Office,Guardianship Office, Veteran Affairs, DayPrograms for Seniors, and others.Telephone: 780-392-32677. Relationship With Your Adult -Children GroupOffered by the City of EdmontonCommunity Services, this group meetstwice per month on a drop-in basis forsupport, education, and informationconcerning older adults’ relationshipswith their adult children.Telephone: 780-496-4777

Alberta Council of Women’s Shelters54LETHBRIDGECommunity Response Model1. Elder Abuse Awareness ProgramThe Elder Abuse Awareness Program (Let’sTalk About It) is a partnership between theLethbridge Senior Citizens Organizationand Lethbridge Regional Police Service. Thegoal of this program is to raise awarenessand knowledge about the abuse of olderadults in the community of Lethbridge andsurrounding areas. The Lethbridge SeniorCitizens Organization and its volunteers,in partnership with the LethbridgeRegional Police Services, is proactive in theprevention of the abuse of older adults. Theybring awareness to the community, provideopportunities for the participants to identifythe different types of abuse and provide aplan of action so that people will know whatto do if ever involved in a suspected caseof abuse of older adults. The program isdelivered to seniors’ facilities, communitygroups and service organizations, as wellas educational facilities at all levels, postsecondary, secondary, and elementaryschools, in an attempt to disrupt the cycleof family violence.Lethbridge Senior Citizens OrganizationTelephone: 403-320-2222Lethbridge Regional Police ServiceCommunity Diversity OfficerTelephone: 403-330-5133Website: www.albertaelderabuse.ca/page.cfm?pgID=39MEDICINE HATCoordinated Community Response ModelCommunity Response to Abuse and Neglectof Elders (CRANE)As part of the Alberta Elder Abuse AwarenessNetwork, this community response programstrives to prevent abuse of older adults,neglect, and self-neglect through EAR –Education, Advocacy, and Response. CRANE’sgoal is to reduce the abuse of older adultsand neglect by way of a coordinated,collaborative community response tosituations of financial, emotional, physicalor sexual abuse and neglect or self neglect ofseniors in the community.In order to address the alarming numberof local enquiries and disclosures aboutabuse, neglect, and self-neglect the SeniorCitizens Advisory Committee and SeniorServices at the Veiner Centre promotedthe concept of a coordinated communityresponse in conjunction with Alberta ElderAbuse Awareness Network’s public educationcampaign (November, 2003).More than 40 stakeholders representingthe well-being of seniors and their familiesmet on several occasions to develop aservice delivery model.The Edmonton Elder Abuse Intervention Teammembers shared their service delivery models,success stories, and best practices. CRANEwas officially launched in June 2004. TheCRANE logo is based on the origami craneas a symbol of honour, loyalty, and hope for ahappy ending.The Veiner Centre successfully employs acommunity-based wellness model to addressgaps and overlaps in local 54 healthy aginginitiatives. The EAR component was addedto the Veiner Centre’s multidisciplinary

55 Abuse Of Older Adults: A Guide for Co-ordinated Community Responseservice delivery model for clarity, andwas complemented by the EdmontonEdder Abuse Intervention Team’s FlowChart and Intervention Indicator. CRANE’smultidisciplinary collaboration connects a widevariety of community resources and all levelsof government to enhance services to seniorsand families through:“Education” is designed to:• increase public awareness on the abuse ofolder adults, neglect, and self-neglect bydeveloping a “train the trainer” model ofseniors speaking to seniors,• developing training programs forprofessionals and caregivers• promoting the CRANE community response• promoting the safety and well-being ofseniors,• promoting public awareness regarding theavailability of resources to seniors• delivering public awareness presentationsto the community• delivering one-on-one interviews,assessments, and referrals;“Advocacy”:• by working with other community groups toadvocate on behalf of seniors at risk• by assessing and addressing servicedelivery gaps,• by promoting the need for sufficient, timely,and easily accessible resources and services• by connecting seniors and their familieswith resources to help them through difficulttimes"Response”:• by developing a community responseprotocol, and ensuring adequate referral,follow-up, and after care is conducted andaccomplished.The Veiner Centre in Medicine Hat is the maincontact point. CRANE Champions deliverpublic awareness sessions which include slideshow presentations, a table top display, alongwith posters, and origami cranes which providethe CRANE contact number.Telephone: 403-529-4798 Monday to Friday8:00 a.m. to 4:00 p.m. with voice mail for afterhours messages.Website: www.city.medicine-hat.ab.ca/veiner/crane.html1. Veiner Centre – Seniors’ Centre - SeniorsCommunity OutreachSeniors Outreach is a service offered atVeiner Centre to all citizens of MedicineHat. Working closely with the SeniorCitizens Advisory Committee they serve:• Older persons, families, and friends;• Formal and informal caregivers;• Representatives from: all orders ofgovernment, financial institutions; healthcare; home care; referral agents; lawfirms; social service agencies; advocacygroups; or, volunteer organizations; and• Anyone interested in the well-beingof older persons.Seniors Outreach helps families connectwith the community resources that bestsuit the situation. Their strong networkof community partners work together toproblem-solve and educate on issues about;Crime Prevention; Family Matters; Housingor Lodging; Income Support; Mental Health;Nutrition; Physical Well-being; Recreation;and, Transportation.Contact information:Senior’s Outreach Officer403-502-8718 or 403-529-8368

Alberta Council of Women’s Shelters562. Wise Owl ProgramThis program has been developed inpartnership with the Edmonton Wise OwlProgram, Medicine Hat Police Services andthe City of Medicine Hat Senior Services.This program provides awareness andeducation on telemarketing, phony bankinspectors and home renovations scams.The target population is seniors. Volunteertrained facilitators present workshops onwhat these scams are, how to identify them,what to do and not to do, and whoto telephone if this occurs to you. Thisprogram is free.Contact information:403-527-5173RED DEERVictim Focused Program1. S.O.A.R. (Seniors Outreach AbuseResources)SOAR is a new program established throughthe Golden Circle Senior Resource Centrein Red Deer. SOAR’s mission is to inform,refer, assist, and coordinate responses forvictims of abuse of older adults age 65 andover (although service is not refused topersons of any age from Central Albertaand beyond). At present, this program dealsspecifically with Red Deer; however, as theproject grows, the program will includemuch of Central Alberta.developed an initiative to provide 24-hourservices in the areas of outreach, emergencyhousing, education, and referrals throughthe 24-hour Seniors Abuse ResourceInformation Line.Telephone: 403-341-1641Toll Free: 1-877-544-1641Golden Circle Senior Resource Centre:403-343-6074Website: www.goldencircle.ca/soar.htmST. ALBERTSt. Albert is in the process of developinga program entitled “A Community for ALLAges”. It includes an integrated, communitybasedprotocol to address the abuse of olderadults. Key initiatives involve: an inventory ofcurrent services, developing community andinteragency abuse of older adults protocol,determining if funding is needed to supportsuccessful implementation, educatingprofessionals on the protocol, building onexisting community education programs andeducating the general public. Note that thisproject has not been formally evaluated todetermine effectiveness. To see what St. Alberthas been doing with regard to abuse of olderadults in the community and the developmentof a protocol, go to www.stalbert.ca/st-albertstrategy-and-mobilization-committee.Telephone: 780-459-1574SOAR’s goal is to advocate on behalf ofseniors who have experienced any formof abuse and reduce the number of abuseincidents in Red Deer by maintaining a24-hour Seniors Abuse Resource telephoneinformation line answered by speciallytrained advocates. The SOAR ManagementCommittee, which is a sub-committeeof the Golden Circle Board of Directors,

57 Abuse Of Older Adults: A Guide for Co-ordinated Community Response

Alberta Council of Women’s Shelters58Appendix D:Selected Resources

59 Abuse Of Older Adults: A Guide for Co-ordinated Community Response

Alberta Council of Women’s Shelters60Appendix D: Selected ResourcesAgencies: The following agencies haveinformation resources or provide specificassistance in response to the abuse of older adults.Alberta Health Services,www.albertahealthservices.caAlberta Health Services, Alberta HealthLink, www.healthlinkalberta.ca/default.htmor call Toll-Free 1-866-408-LINK (5465)or 780-408-LINK (Edmonton area) or403-943-LINK (Calgary area) where nursesare available 24-7 to provide health adviceand information.Alberta Association of Sexual Assault Centres.www.aasac.caAlberta Caregivers Association.www.albertacaregiversassociation.orgAlberta Council of Women’s Shelters.www.acws.caAlberta Culture and Community Spirit,Community Development http://culture.alberta.ca/communitydevelopmentAlberta Elder Abuse Awareness Network.www.albertaelderabuse.ca.Alberta Police Based Victim Services.www.apbvsa.comCalgary Chinese Elderly Citizens’ Association.www.cceca.ca/Calgary Immigrant Women’s Association.www.ciwa-online.comCalgary Police Service Senior Liaison Program.www.calgarypolice.ca/sectionsandunits.html#seniorsCalgary Seniors’ Resource Society.www.calgaryseniors.orgCanadian Network for the Prevention of ElderAbuse www.cnpea.caCommunity Response to Abuse and Neglectof Elders (CRANE). www.albertaelderabuse.capage.cfm?pgID=33Elder Abuse Intervention Team (Edmonton).www.police.edmonton.ab.ca/Pages/Elder/ElderAbuse.htmEdmonton Seniors’ Safe Housing.http://web3.userinstinct.com/48973912-edmonton-seniors-safe-housing.htmElder Advocates of Alberta.http://elderadvocates.caElder Abuse Awareness Program (Lethbridge).www.albertaelderabuse.ca/page.cfm?pgID=39Elder Care of Edmonton.www.eldercareedmonton.caFamily and Community Support ServicesAssociation of Alberta. www.fcssaa.ab.caFamily Service Toronto.www.familyservicetoronto.orgHealth Canada. www.hc-sc.gc.caInternational Network for the Prevention ofElder Abuse (INPEA).www.inpea.net/weaad.htmlKerby Centre. www.kerbycentre.comKerby Rotary House Shelter (Calgary).www.kerbycentre.com/shelter_abused_seniors.phpMeals On Wheels. www.mealcall.org/canada/alberta/index.htmNational Initiative for the Care of the Elderly(NICE). www.nicenet.ca

61 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponseOffice of the Public Guardian.www.seniors.gov.ab.ca/opgOffice of the Public Trustee. http://justice.alberta.ca/programs_services/public_trustee/Pages/default.aspxOlder Women’s Long-term Survival (OWLS).www.calgarywomensshelter.com/page/Programs/Community%20Based%20Programs/OWLSPolice Services. Royal Canadian MountedPolice. http:/www.rcmp-grc.gc.ca/ab/detach/index-eng.htmPrimary Care Networks. www.albertapci.ca/AboutPCNs/PCNsInAlberta/Pages?ProvincialPCNDetails.aspxPublic Health Agency of Canada.www.publichealth.gc.caSt. Albert Seniors’ Working Group.www.stalbert.ca/st-albert-strategy-andmobilization-committeeSeniors Association of Greater Edmonton(SAGE). www.mysage.ca/safehousing.cfm?ts=14Seniors’ Abuse Helpline. http:/www.thesupportnetwork.com.ws026.alentus.com/crisispreventionprograms/seniorabuse.phpSeniorConnect. www.calgaryseniors.orgSeniors Outreach Abuse Resources (S.O.A.R.).www.goldencircle.ca/soar.htmVeiner Centre. www.medicinehat.ca/veiner/crane.htmlVeteran Affairs Canada. VeteransIndependence Program (VIP). www.vac-acc.gc.ca/CLIENTS/sub.cfm?source=services/vipAlberta Legislation and Policy: The followinglists some key government of Alberta documentsfor your reference:Addressing Elder Abuse in Alberta: A Strategyfor Collective Action, November 2010,AlbertaCommunity Development www.seniors.alberta.ca/services_resources/elderabuse/AddressingElderAbuse.pdfAging Population Policy Framework,November, 2010, Alberta Seniors andCommunity Development, www.seniors.alberta.ca/Seniors/AgingPopulation/docs/AgingPopulationFramework.pdfA Profile of Alberta Seniors, 2010. AlbertaSeniors and Community Supports.www.seniors.alberta.ca/policy_planningAlberta Seniors and Community Supports.Adult Guardianship and Trusteeship.www.seniors.gov.ab.ca/opg/guardianship/Alberta Seniors and Community Supports.AGTA Frequently Asked Questions.www.seniors.gov.ab.ca/opg/guardianship/FAQ.asp#07Alberta Seniors and Community Supports.Personal Directives Registry.www.seniors.gov.ab.ca/opg/registryAlberta Seniors and Community Supports.Seniors Programs and Services Information Guide.Government of Alberta. Seniors Programs andServices Information Guide. Government ofAlberta. www.seniors.alberta.ca/services_resources/programs_services/booklet/ProgramsServices_InfoGuide.pdfGovernment of Alberta. Protection AgainstFamily Violence Act. www.child.alberta.ca/home/528.cfmMultiple Resources: The following contactsoffer a wide range of resources including readingmaterials, resource kits, brochures andPowerPoint presentations.Alberta Elder Abuse Awareness Network.Community Resource Kit. 2005.www.albertaelderabuse.ca

Alberta Council of Women’s Shelters62Alliance to End Violence has a number ofresources on abuse of older adults rangingfrom Help Cards to evaluationwww.endviolence.ca/resources-older-adults/British Columbia’s Community ResponseNetwork (CRN). www.bccrns.caElder Abuse: A listing of materials available atthe Justice Institute of BC Library. www.jibc.ca/library/Bibliographies/Elder_Abuse_-_JIBC_Library.pdfEdmonton Police Service. “Who is Involvedin Elder Abuse.” from www.edmontonpolice.ca/CommunityPolicing/FamilyProtection/ElderAbuse/WhoisinvolvedinElderAbuse.aspx(includes Adult Counselling , Elder AbuseBooklet, Elder Abuse Flowchart and ElderAbuse Resource List )Elder Abuse and Neglect. Information availablefrom the Information Resource Centre, NSDepartment of Seniors. September 2007.www.gov.ns.ca/seniors/senior_abuse_prevention.asp (television spots in Englishand French. and Financial Planning &Protection Fact Sheets)Elder Abuse: A listing of materials available atthe Justice Institute of BC Library. www.jibc.ca/library/Bibliographies/Elder_Abuse_-_JIBC_Library.pdfGovernment of Canada – Seniors.http:/sww.seniors.gc.ca for brochures, factsheets, publications and reportsInternational Network for the Prevention ofElder Abuse (INPEA). www.inpea.net/weaad.html (international resources and links)Ontario Network for the Prevention of ElderAbuse. www.onpea.orgSpecific ResourcesBooksBaskin, Cyndy. 2006. “Systemic Oppression,Violence, and Healing in Aboriginal Familiesand Communities,” in Cruel but not unusual:Violence in Canadian Families. Ramona Alaggiaand Cathy Vine (editors). Waterloo, Ontario,Canada: Wilfrid Laurier University Press,pp. 15-20.(book)Boyak, Virginia. 1997. Golden Years – HiddenFears: A Handbook for Front-line Helpers Workingwith Seniors. Calgary: Kerby Centre.Boyak, Virginia, L. M. McKenzie, and E. K.Hansell. 1995. Synergy II: A DemonstrationProject to Address the Issues of Violence in OlderFamilies. Calgary: Kerby Centre.Reis, Myrna and Daphne Nahmiash.1995. When Seniors Are Abused: A Guide toIntervention.” York University, Ontario:Captus Press Inc.Community DevelopmentCommunity Development Models andLanguage. 2007. Retrieved on April 21, 2010from www.mapl.com.au/ComDevModel.pdfGovernment of Canada. Treasury Boardof Canada Secretariat. CommunityDevelopment Model. www.tbs-sct.gc.ca/tbs-sct/index-eng.aspParticipation Model. Retrieved onApril 21, 2010 from www.wrha.mb.ca/community/commdev/files/CommDev_ParticipationModel.pdfService Canada. The Community DevelopmentHandbook, www.servicecanada.gc.ca/eng/epb/sid/cia/comm_deve/handbook.shtml

63 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponseCultural CompetencyCultural Competency: A Self-Assessment Guidefor Human Services Organizations http://culture.alberta.ca/humanrights/publications/competency/default.aspxEvaluationAlberta Seniors and Community Supports.The Seniors’ Policy Handbook: A Guide forDeveloping and Evaluating Policies and Programsfor Seniors. Retrieved on January 7, 2010 fromwww.seniors.gov.ab.ca/publications/.www.seniors.alberta.ca/services_resources/programs_services/booklet/ProgramsServices_InfoGuide.pdfBasic Guide to Program Evaluationhttp://managementhelp.org/evaluatn/fnl_eval.htm.Basic Guide to Out-Comes Based Evaluationfor Non-profit Organizationswww.managementhelp.org/evaluatn/outcomes.htm.Public Health Agency of Canada: ProgramEvaluation Toolkit www.phac-aspc.gc.ca/phppsp/toolkit-eng.phpEvaluation Management Resource, Version1.0 by Howard Research & ManagementConsulting Inc., prepared for Governmentof Alberta, February, 2008Monitoring and Evaluation of Initiatives onViolence Against Women and Girlswww.endvawnow.org/pampa/v0.1/library/filemanager/v1/files/ME_Asset_Feb2010_en.pdfPreventing intimate partner and sexualviolence against women: Taking actionand generating evidence. By World HealthOrganization, 2010 http://whqlibdoc.who.int/publications/2010/9789241564007_eng.pdfBoris Volkov on What (Internal) EvaluatorsCan do to Advance Evaluation CapacityBuilding, June 2010. http://aea365.org/blog/?p=967Manuals And Informational ResourcesAction Group on Elder Abuse. Elder AbuseResource Manual. Action Committee AgainstViolence. May 2006. www.albertaelderabuse.ca/resourceDocs/Resource%20Manual%20-%20Final.pdfAlberta Children’s Services. 2008. PreventingAbuse of Older Adults. www.child.alberta.ca/home/documents/familyviolence/doc_opfvb_booklet_older_adults_colour.pdfAlberta Council on Aging. Helping Hands:A Service Provider’s Resource Manual for ElderAbuse in Alberta. www.acaging.ca/“Are You Afraid in Your Own Home?”An Information Booklet for Older Women.BC/Yukon Society of Transition Houses.BC/Yukon Society of Transition Houses,2005, How to Establish Specialized Refugeand Support Services for Older Abused Womenand Developing Support Groups for Older AbusedWomen, A Resource ManualCanadian Association for Community Care.“Taking Action Against Abuse of Seniors.”www.coaottawa.ca/library/publications/fpr_aos.pdfCanadian Association for CommunityCare. Training Manuals. www.bccrns.ca/resources/cacc/englishCD/membersonly/abuseofseniors/caregiverinfo/staff.htmlDauvergne, Mia. 2003. “Family ViolenceAgainst Seniors,” in Canadian Social Trends.Spring 2003, 10-14. (Statistics Canada,Catalogue No. 11-008).

Alberta Council of Women’s Shelters64Dimah, Keren Patricia and Agber Dimah. 2003.“Abuse of older adults and Neglect AmongRural and Urban Women,” in Journal of Abuseof older adults & Neglect, Apr. 2003, Vol. 15,Issue 1, pp. 75-93.Domestic Violence Handbook for Police andCrown Prosecutors in Alberta. 2005. AlbertaJustice Department. Government of Alberta.ISBN 0-7785-4152-5. https://www.solgps.alberta.ca/safe_communities/community_awareness/family_violence/Publications/DomesticViolenceHandbook.pdfDumont-Smith, Claudette. 2002.“Aboriginal Abuse of older adults in Canada.”Retrieved on December 1, 2009 fromahfresearchelderabuse_eng-1.pdf locatedon www.uoguelph.ca/cfww/elderabuse/reports.cfm“Elder Abuse Education Project: When the Lineis Crossed, Elder Abuse – How Does it Start– What Can We Do To Stop It”? LethbridgeCommunity College.Elder Abuse E-Bulletin. www.phac-aspc.gc.ca/ea-ma/EB/eb-Feb-2010-eng.php#articleFort McMurray and the Regional Municipalityof Wood Buffalo. Elder Abuse: It’s Your Business.Fraud Cent$ Toolkit for Seniors.www.skseniorsmechanism.ca/html/fraud_cent__toolkit_.htmlHealth Canada. Mental Health Divisionand National Clearinghouse on FamilyViolence. 1994. Abuse and Neglect of OlderAdults: Awareness Information for People in theWorkplace. Ottawa: Minister of Supply andServices Canada. http://dsp-psd.pwgsc.gc.ca/Collection/H72-21-120-1994E.pdfHuman Resources and Skills DevelopmentCanada. Elder Abuse Awareness InformationMaterials. Abuse of older adults AwarenessResource Guide. www.hrsdc.gc.ca/eng/community_partnerships/seniors/nhsp/eaa/info_guide/guide.shtml#sKasdorff, Deborah and Erb, Barbara, 2010,“Serving Victims of Violence in RuralCommunities: Challenges and Best PracticesKinnon, Dianne. 2002. “Abuse and Neglectof Older Adults: Community Awareness andResponse.” Public Health Agency of Canada.Family Violence Prevention Unitwww.phac-aspc.gc.ca/ncfv-cnivf/publications/agecommuni-eng.phpLegal Resource Centre of Alberta. 2008.Abuse of Older Adults (3rd Edition): FrequentlyAsked Questions. www.law-faqs.org/docs/AbuseThirdEdAugFINAL.pdfLegal Resource Centre (Canadian Legal FAQs).www.law-faqs.org/wiki/index.php/Abuse_of_Older_AdultsLundy, Marta and Susan Grossman. 2004.“Abuse of older adults: Spouse/IntimatePartner Abuse and Family Violence AmongElders,” in Journal of Abuse of older adults &Neglect, Vol. 16(1), 2004, pp. 85-102.Older Adult Knowledge Network.www.oak-net.org/Outlook 2007: Promising Approaches in thePrevention of Abuse and Neglect of OlderAdults in Community Settings in Canada.November 2007. Project funded by the PublicHealth Agency of Canada and prepared by theCanadian Network for the Prevention of Abuseof older adults (CNPEA). www.cnpea.ca/PromisingApproachesFinal2007.pdf

65 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponsePlesuk, Susan, LeBlanc, Sandra, ACWS ShelterPractice Orientation Manual, Alberta Councilof Women’s Shelters, 2010, Module 12 andPowerPoint presentation www.acws.ca/documents/Module12Eolderadults.pdfwww.acws.ca/documents/Module12ShelterPracticeOrientationManualPresentation.pptxPodnieks, Elizabeth. 2008. “Elder Abuse: TheCanadian Experience,” in Journal of Abuse ofolder adults & Neglect, Vol. 20(2), 126-150.Population Health Improvement ResearchNetwork. “How Elder Care can Become ElderAbuse and Neglect.” Fireside Chat February 5,2010. www.chnet-works.caReis, Myrna and Daphne Nahmiash.1995. When Seniors Are Abused: A Guide toIntervention.” York University, Ontario: CaptusPress Inc. http://tiny.cc/lvpkkResearch Institute for Law and the Family.Retrieved on December 9, 2006 fromwww.ucalgary.ca/~crilf/publications/ElderAbuseFinalReport-June2006.pdf.The Response to Elder Abuse in Alberta:Legislation and Victim Focused ServicesFinal Report. May 2006. Prepared for theDepartment of Justice Canada FamilyViolence Initiative and the Alberta SolicitorGeneral Victims of Crime Fund by MonicaPauls and Leslie MacRae. Canadian ResearchInstitute for Law and the Family. Retrievedon December 9, 2006 from www.ucalgary.ca/~crilf/publications/ElderAbuseFinalReport-June2006.pdfSt. Albert Seniors’ Working Group. ACommunity for ALL Ages 2009-2011.www.stalbert.ca/st-albert-strategy-andmobilization-committeeThe Way Forward. November 17, 2009News Release. “New Programs SupportAlbertans Affected by Family Violence.”Government of Alberta. Retrieved onNovember 25, 2009 from http://alberta.ca/ACN/200911/27336FF1DBBBA-017A-CBEB-65765D3DAA6E7863.htmlThe Way Forward. October 30, 2009Information Bulletin. “Adult Guardianship andTrusteeship Act Proclaimed.” Government ofAlberta. Retrieved on February 16, 2010from http://alberta.caViolence Against Rural Women: What IsDifferent. Retrieved on May 19, 2009 fromwww.ruralwomen.net/rural_violence_difference.htmlWilliams, Cara. 2005. “The SandwichGeneration,” in Canadian Social Trends, Summer2005, 16-21 (Statistics Canada CatalogueNo. 11-0008).World Health Organization (WHO) and theInternational Network for the Preventionof ElderAbuse (INPEA). 2002. “MissingVoices: Views of Older Persons on ElderAbuse.” Geneva, Switzerland.World Health Organization (WHO). 2002.“The Toronto Declaration on the GlobalPrevention of Elder Abuse.www.who.int/ageing/projects/elder_abuse/alc_toronto_declaration_en.pdfWorld Elder Abuse Awareness Day.www.albertaelderabuse.ca/blogDetails.cfm?bID=216Yukon Health and Social Services, InformationSheets on the Abuse of Older Adultswww.hss.gov.yk.ca/seniorabuse.php

Alberta Council of Women’s Shelters66ProtocolsAction Group on Elder Abuse. Elder AbuseProtocol. Action Committee Against Violence.May 2007.Adult Victims of Abuse Protocols, Governmentof New Brunswick, 2005. www2.gnb.ca/content/dam/gnb/Departments/sd-ds/pdf/Protection/Adult/AdultProtocol-e.pdfInterdepartmental Working Group on ElderAbuse and Manitoba Seniors Directorate,Winnipeg. 1993. “Abuse of the Elderly: A Guidefor the Development of Protocols.”Screening ToolsBrief Abuse Screen for the Elderly (BASE).www.uihealthcare.com/depts/med/familymedicine/research/eldermistreatment/screeninginstruments/brief.pdfIndicators of Abuse (IOA). www.uihealthcare.com/depts/med/familymedicine/research/eldermistreatment/screeninginstruments/indicators.pdfVideos“What’s Age Got To Do With It? JudithBlackwell (2003) BC/Yukon Society ofTransitional Houses. A video about the abuseof older women.National Film Board of Canada. www.nfb.ca“Out From Abuse” (Video, 1999) 30 minutes.Calgary Women’s Emergency Shelter, OWLS.Alberta Elder Abuse Awareness Network.Training Video ( 2005)www.albertaelderabuse.caCaregiver Abuse Screen (CASE).www.uihealthcare.com/depts/med/familymedicine/research/eldermistreatment/screeninginstruments/caregiver.pdf“Elder Abuse Education Project: When the Lineis Crossed, Elder Abuse – How Does it Start– What Can We Do To Stop It”? LethbridgeCommunity College.Elder Abuse Screening, Assessment andIntervention Tools for Canadian Health CareProviders, National Clearinghouse on FamilyViolence. www.phac-aspc.gc.ca/ea-ma/EB/eb-Feb-2010-eng.php#orgElder Assessment Instrument (EAI).Terry Fulmer. “Elder Abuse and NeglectAssessment” in Dermatology Nursing, 2004,16(5). Retrieved on April 28, 2010 fromwww.medscape.com/viewarticle/493951

67 Abuse Of Older Adults: A Guide for Co-ordinated Community Response

Alberta Council of Women’s Shelters68Appendix E:What is Evaluation?

69 Abuse Of Older Adults: A Guide for Co-ordinated Community Response

Alberta Council of Women’s Shelters70Appendix E: What is Evaluation?When to Evaluate?Evaluation is an integral part of policy andprogram activities and should be conducted aspart of these processes. Ideally, an evaluationframework should be established as earlyas possible. Evaluation involves continuousmonitoring and collection of information togauge whether initiatives and strategies areseeing their desired results and if barriers orchallenges need to be addressed. Effectiveevaluation will also support responses to keyquestions related to performance and can becarried out to support staff or funder decisionmakingabout program improvements,which activities to continue/discontinue andprogram expansion.There are many types of evaluations whichcan be applied, depending on the focusand circumstances; these include needsassessments, cost/benefit analyses,effectiveness, efficiency, formative,summative, goal-based, process, outcome,etc. The type of evaluation used will largelydepend on the requirements and resourcesof the organization. (Please refer to thelist of supplementary resources for furtherinformation about evaluation).Who Should Carry Out the Evaluation?Evaluations can be carried out using internalor external resources depending on therequirements and resources of the program.Research has shown that internal evaluationcan be very useful when internal evaluators areable to systematically:• engage leadership in evaluation;• demonstrate value and use of evaluation;• seek to integrate evaluation intoorganizational culture;• develop organizational evaluation strategy;• expand the social network of evaluationchampions;• promote staff development in evaluation;• engage staff in evaluation activities(learning by doing);• share their experiences and resourceswith staff; and,• build a meaningful organizational database.Although many organizations would be ableto evaluate their services internally, externalresources can support the development ofmethodology, and may be particularly helpfulif a complex data analysis is required. Whenevaluations are used for reporting to funders ordonors, the use of external resources can helpto bring objectivity to the results.Developing Program Goals -and ObjectivesEvaluation begins with the developmentof goals and objectives, and continuesthroughout the life of the project. Goals andobjectives describe what the project intendsto accomplish and provides the overall contextfor the evaluation processes. Goals areusually broad statements which identify thekey intentions of a project and objectives arespecific, measurable statements of the desiredchange(s) that the initiative or project intendsto accomplish by a given time.Developing a Conceptual Framework

71 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponseProgram information is often summarizedin a conceptual framework that identifiesand illustrates the relationships betweenoutcomes/goals, activities, resources andexternal factors that may influence theprovision of services. There are differenttypes of frameworks that can be used (e.g.,change theory of change, results frameworks,logical frameworks, developmental evaluationframeworks and others) but there are usuallycommon elements which support evaluation.An example of a conceptual evaluationframework is included below.• Inputs refer to the financial, human andmaterial resources used for implementationof an initiative or program. These typicallyinclude funding sources and amounts, andphysical resources such as facilities, staffingand supplies.• Activities are the services and supportsthat the initiative or program provides andmay include: descriptions of how theseservices are provided (e.g., communityoutreach, counselling, telephone advocacy,etc.); models or approaches utilized (e.g.,harm reduction, psycho-educational); andfrequency of intervention (e.g., once a weekfor an hour, or as required by the client).• Outputs are “products” of the initiative/program’s activities or “goods and services”produced by the program. Outputsrepresent tangible “counts” of programactivities,such as number of counselling sessionsin time period; number of clients served;numberof reports produced; etc.• Outcomes are benefits to clients that resultfrom their participation in the program.They can be short-term, medium-term orlong-term depending on when the changeis expected to occur. Outcomes can beWho are the clients andwhat are their needs?InputsActivitiesOutputsOutcomesResourcesServicesProductsImpactHow does the external environmentimpact service delivery?

Alberta Council of Women’s Shelters72measured in terms of enhanced learning (e.g., knowledge, perceptions, attitudes or skills) orconditions (e.g., increased literacy, self-reliance, etc). Impacts are related to outcomes in thatthey also measure change, but this change is usually on a larger, societal scale.Developing a Measurement Framework and Collecting DataA measurement framework identifies the specific activities needed to implement yourconceptual evaluation plan. The chart below identifies key elements in developing ameasurement framework.An indicator is a specific, observable and measurable characteristic that is used to helpdetermine whether an initiative or program is on its way to achieving its outcomes. Ideally,there should be at least one indicator for each outcome. Indicators are measured using a specificmethods, such as surveys or questionnaires, interviews (or focus groups), observations and file/document reviews. Method(s) are typically selected based on the type of information needed,the resources available, and the number of clients involved. Please refer to the supplementaryresources for further information about data collection methods. The figure below illustratesan example of a measurement framework for a hypothetical Education Program on theAbuse of Older Adults. Note that the example shows only one indicator and how it wouldbe measured. In a real situation there would be several indicators each with a correspondingquestion on a survey.Analyzing the InformationDifferent types of approaches are utilized to analyze quantitative and qualitative information.Quantitative information is usually collected using surveys, questionnaires or program formsand is recorded in numbers. Such information is best analyzed using some kind of software (e.g.,IdentifyIndicatorsSelectMeasurementMethodsSpecify Timingof DataCollectionAssignResponsibilitiesExcel, SPSS or SAS). Qualitative information is typically obtained from interviews or focus groupsand can be analyzed by organizing comments in themes or similar categories of responses.

73 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponseObjectiveTo increase awareness about the abuse of older adults among caregiverswho work with seniors.IndicatorNumber and percent of caregivers who know how to identify the signs ofolder adult abuse as a result of training they recived.MeasurementMethodA pen and paper survey completed by the caregivers.MeasurementToolA survey with several questions reflecting the training topics. The questioncorresponding to this indicator may be phrased as follows: "As a resultof the training I received today, I know more about how to identify the signsof older adult abuse." The caregiver would then rate their answer on a scaleof 1 to 5, where 1 is "Strongly Disagree" and 5 is "Strongly Agree".Timing of DataCollectionSurvey would be completed by the caregivers immediately followingcompletion of the caregiver training session.Communicating the ResultsEvaluation results should be made availableto all key stakeholders and decision-makersand often community members. Results aretypically documented in a report. The scope,degree of detail and method of reportingevaluation results will vary depending on theinterest and needs of the various audiences.Ideally, evaluation results are communicatedas broadly as possible. This can facilitatewider support among decision-makers andthe community. The sharing of results canalso contribute to increased capacity amongstakeholder and partners, as wellas improvements in policy and practices.Supplementary Resources• Basic Guide to Program Evaluationhttp://managementhelp.org/evaluatn/fnl_eval.htm.• Basic Guide to Out-Comes Based Evaluationfor Non-profit Organizationswww.managementhelp.org/evaluatn/outcomes.htm.• Public Health Agency of Canada: ProgramEvaluation Toolkit www.phac-aspc.gc.ca/php-psp/toolkit-eng.php• Evaluation Management Resource, Version1.0 by Howard Research & ManagementConsulting Inc., prepared for Government ofAlberta, February, 2008

Alberta Council of Women’s Shelters74• Monitoring and Evaluation of Initiatives onViolence Against Women and Girlswww.endvawnow.org/pampa/v0.1/library/filemanager/v1/files/ME_Asset_Feb2010_en.pdf• Preventing intimate partner and sexualviolence against women: Taking actionand generating evidence. By World HealthOrganization, 2010 http://whqlibdoc.who.int/publications/2010/9789241564007_eng.pdf• Boris Volkov on What (Internal) EvaluatorsCan do to Advance Evaluation CapacityBuilding, June 2010. http://aea365.org/blog/?p=967

75 Abuse Of Older Adults: A Guide for Co-ordinated Community Response

Alberta Council of Women’s Shelters76Appendix F:References

77 Abuse Of Older Adults: A Guide for Co-ordinated Community Response

Alberta Council of Women’s Shelters78Appendix F: ReferencesAction Group on Elder Abuse, Let’s TalkAbout It: Tool Kit to Hosting an AwarenessCafé, April 2007; www.albertaelderabuse.ca/resourceDocs/Awareness_Cafes.pdf.Alberta Elder Abuse Network and can befound at www.albertaelderabuse.ca/page.cfm?pgID=6; with their source identified asHealth Canada, Abuse and Neglect of OlderAdults: Resource and Training Kit for ServiceProviders, 1994.Alberta Elder Abuse Awareness Network.Developing a Community Response. Retrievedon September 10, 2010 fromwww.albertaelderabuse.ca.Alberta Seniors and Community Supports.“The Seniors’ Policy Handbook: A Guidefor Developing and Evaluating Policies andPrograms for Seniors.” Retrieved on January7, 2010 from www.seniors.gov.ab.ca/publications/.Anetzberger, Georgia J., Barbara R. Palmisano,Margaret Sanders, David Bass, Carol Dayton,Sharen Eckert, and Maria R. Schimer. 2000."A Model Intervention for Elder Abuse andDementia,” in The Gerontologist, Vol. 40, No. 4,492-497.Brief Abuse Screen for the Elderly (BASE).www.uihealthcare.com/depts/med/familymedicine/research/eldermistreatment/screeninginstruments/brief.pdf.Boyak, Virginia (1997) Golden Years HiddenFears, Elder Abuse, A Handbook for Front-LineHelpers Working With Seniors, Kerby Centre,Calgary, Alberta.Caregiver Abuse Screen (CASE).www.uihealthcare.com/depts/med/familymedicine/research/eldermistreatment/screeninginstruments/caregiver.pdf.Community Development Models andLanguage. 2007. Retrieved on April 21, 2010from www.mapl.com.au/ComDevModel.pdf.Community-University Research Alliances(CURA) Program. “Women, Violence andVulnerability Contexts.” www.criviff.qc.ca/upload/equipe_recherche/Women,%20violence%20and%20vulnerability.pdf.Cooper, C., Selwood, A., & Livingston,G. (2009). Knowledge, Detection, andReporting of Abuse by Health and Social CareProfessionals: A Systematic Review. AmericanJournal of Geriatric Psychiatry, 17(10), 826-838.Domestic Violence Against Older Women.Stories of Survival from the World’s TribalPeople. www.slideshare.net/Madrisa/Congugal-Violencecag.Dumont-Smith, Claudette. 2002.“Aboriginal Elder Abuse in Canada.”Retrieved on December 1, 2009 fromahfresearchelderabuse_eng-1.pdf locatedon www.uguelph.ca/cfww/elderabuse/reports.cfm.“Elder Abuse Intervention Team andEdmonton’s Coordinated CommunityResponse to Elder Abuse: Building on Whathas been Learned through Documentation andEvaluation.” October 2005. Prepared by KarenKerr and Katherine Kilgour.Elder Abuse Suspicion Index (EASI). www.mcgill.ca/files/familymed/EASI_Web.pdf.Elder Assessment Instrument (EAI).Terry Fulmer. “Elder Abuse and NeglectAssessment” in Dermatology Nursing, 2004,16(5). Retrieved on April 28, 2010 fromwww.medscape.com/viewarticle/493951.Family Service Toronto.www.familyservicetoronto.org.

79 Abuse Of Older Adults: A Guide for Co-ordinated Community ResponseGordon, Robert M. 2001. “Adult ProtectionLegislation in Canada: Models, Issues, andProblems,” in International Journal of Law andPsychiatry, 24 (2001), 117-134.Government of Alberta, A Profile of AlbertaSeniors, 2010, www.seniors.alberta.ca/policy_planningGovernment of Canada, Abuse & Neglectof Older Adults: Awareness Information forPeople in the Workplace http://dsp-psd.pwgsc.gc.ca/Collection/H72-21-120-1994E.pdf.Government of Canada, Awareness andPerceptions of Canadians Toward Elder Abuse,August 2008; Seniors Canada website.http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/human_resources_social_development_canada/2008/001-08-e/report.pdf.Government of Canada reference, HumanResources and Social Development,Awareness and Perceptions of CanadiansToward Elder Abuse, August, 2008, website.http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/human_resources_social_development_canada/2008/001-08-e/report.pdfGovernment of Canada. Treasury Board ofCanada Secretariat. Community DevelopmentModel. Retrieved on April 21, 2010 fromwww.tbs-sct.gc.ca/oro-bgc/cdm-mdc/cdmmdc-eng.asp.Hawkins, David J. and Joseph G. Weis.1985. “The Social Development Model:An Integrated Approach to DelinquencyPrevention,” in The Journal of Primary Prevention,Vol. 6, No. 2, December 1985, 73-97.Health Canada. Mental Health Divisionand National Clearinghouse on FamilyViolence. 1994. Abuse and Neglect of OlderAdults: Awareness Information for People in theWorkplace. Ottawa: Minister of Supply andServices Canada. Retrieved on April 29, 2010from http://dsp-psd.pwgsc.gc.ca/Collection/H72-21-120-1994E.pdf.Indicators of Abuse (IOA).www.uihealthcare.com/depts/med/familymedicine/research/eldermistreatment/screeninginstruments/indicators.pdf.Kasdorff, Deborah and Erb, Barbara (Jan,2010) Serving Victims of Violence in RuralCommunities: Challenges and Best Practices;Victim/Witness Assistance Program, EastRegion.Kinnon, Dianne. 2002. “Abuse and Neglectof Older Adults: Community Awareness andResponse.” Public Health Agency of Canada.Family Violence Prevention Unit. www.phacaspc.gc.ca/ncfv-cnivf/.../agecommuni-eng.php.Media Monitor. Alliance to End Violence –Media Clips. “Research Combats Abuse ofolder adults.” February 12, 2010.Murphy, N (1994). Abuse and Neglect of OlderAdults: Resource and Training Kit for ServiceProviders, National Clearinghouse on FamilyViolence, 1994).Participation Model. Retrieved onApril 21, 2010 from www.wrha.mb.ca/community/commdev/files/CommDev_ParticipationModel.pdf.Pillemar, K. and J. J. Suitor. 1988. “Elder Abuse,”in V. B. Van Hasselt, R. L. Morrison, A. S.Bellack, and M. Herson (Eds.), Handbook ofFamily Violence, 247-270.New York: Plenum Press.Plamondon, Louis. University of MontrealNews Digest. www.umontreal.ca/english/news_digest/2004-2005/20050314.html.Plesuk and LeBlanc, ACWS Shelter PracticeOrientation Manual , 2010, Alberta Council ofWomen’s SheltersPlesuk, Susan, LeBlanc, Sandra, ACWS ShelterPractice Orientation Manual, Alberta Councilof Women’s Shelters, 2010, Module 12 andPowerPoint presentation www.acws.ca/

Alberta Council of Women’s Shelters80documents/Module12Eolderadults.pdfwww.acws.ca/documents/Module12ShelterPracticeOrientationManualPresentation.pptxPodnieks, Elizabeth and E. Dow. 1998.“Creating a Canadian Network for thePrevention of Elder Abuse.” Report of theRound Table Discussion held at CAG AnnualScientific and Educational Meeting, Halifax,NS, October 18, 1998.Podnieks, Elizabeth. 2008. “Elder Abuse: TheCanadian Experience,” in Journal of Elder Abuse& Neglect, Vol. 20(2), 126-150.Reis, Myrna and Daphne Nahmiash.1995. When Seniors Are Abused: A Guide toIntervention.” York University, Ontario:Captus Press Inc.Reis, Myrna and Daphne Nahmiash. 1998.“Validation of the Indicators of Abuse (IOA)Screen,” in The Gerontologist, Vol. 38(4),471-480.Robinson, Robert G. 2005. “CommunityDevelopment Model for Public HealthApplications: Overview of a Model to EliminatePopulation Disparities,” in Health PromotionPractice, Vol. 6, No. 3, July 2005, 338-346.St. Albert Elder Abuse Protocol Committee:Elder Abuse Guidelines for Action. St. AlbertSeniors’ Working Group.Statistics Canada, 2010, Projectedpopulation by age group and sexaccording to three projection scenarios for2010,2011,2016,2021,2026,2031 and 2036, atJuly 1 www.40.statcan.ca/l01/cst01/demo23aeng.htmStatistics Canada, Family Violence in Canada:A Statistical Profile, Catalogue no. 85-224.Released June 26, 2002. p. 27Straka, Silvia and Lyse Montminy. 2006.“Responding to the Needs of Older WomenExperiencing Domestic Violence,” in ViolenceAgainst Women, 12(3), 251-267.Turcotte, Martin & Schellenberg, Grant (2006)A Portrait of Seniors in Canada: A Closer Lookat the Lives of Canadian Seniors; releasedon February 27, 2007. Statistics CanadaCatalogue number 89-519XWE, page 12World Health Organization, Active AgeingPolicy Framework, 2002, Page 29 http://whqlibdoc.who.int/hq/2002/WHO_NMH_NPH_02.8.pdfWorld Health Organization (WHO) andthe International Network for the Preventionof Elder Abuse (INPEA). 2002. “MissingVoices: Views of Older Persons on Abuse ofolder adults.” Geneva, Switzerland.World Health Organization (WHO). 2002.“The Toronto Declaration on the GlobalPrevention of Elder Abuse. www.who.int/ageing/projects/elder_abuse/alc_toronto_declaration_en.pdfYaffe, M. J., M. Lithwich, and C. Wolfson.2004. “Development and Validation of aSuspicion Index for Elder Abuse For PhysicianUse.” Paper presented at the ONPEAConference, Toronto, ON, March 2004,cited in E. Podnieks, 2008: 137).