The Parliamentary Committee on Palliative and Compassionate Care highlighted the problem of elder abuse in its landmark report released on November 17, 2011. The report, Not to be Forgotten, a result of the committee’s consultations with stakeholders across the country, makes policy recommendations in the areas of disability issues, elder abuse, suicide prevention, and palliative care.

The report identifies elder abuse as an extensive societal problem. It is estimated that 4 to 10 per cent of seniors are victims of elder abuse and that there has been a 14 per cent rise in family violence against the elderly since 2004. However, almost half of violent incidents against the elderly are not reported. According to the last detailed survey in Canada on elder abuse in 1989, it mostly takes the form of financial abuse, affecting at least 60,000 seniors. Chronic verbal aggression and physical abuse by the spouse were also common forms of mistreatment. The victim, though, often does not take action against these incidents because of “fear, love for the abuser, lack of understanding or impairment, lack of awareness of resource options, or acceptance of abuse or neglect as normal.”

The authors of the report use several examples to illustrate the abuse some seniors face. For instance, in late February 2011, a 68-year-old Toronto woman suffering from dementia was discovered to have been made to live in a cold garage by her son and daughter-in-law even though there was still room in the house for her.

Famous film legend and entertainer Mickey Rooney testified to the US Senate about how a relative took his money and psychologically marginalized him, treating him as a child. “In my case I was eventually and completely stripped of the ability to make even the most basic decisions in my own life… I felt helpless… I couldn’t muster the courage to seek the help I knew I needed. Even when I tried to speak up, I was told to be quiet,” he said.

The World Health Organization defines elder abuse in its Missing Voices report as “a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person.” It categorizes abuse as being physical, psychological or emotional, financial or material, sexual, or simply neglect.

Not to be Forgotten adds that abuse may be perpetrated by government or bureaucratic systems and by institutions where seniors are housed. It also lists medical abuse, meaning “elders having their medical care wishes ignored, facing systemic cutbacks in medical support i.e. homecare, being faced with unilateral treatment withdrawal and other forms of medical rationing, inadequate pain control, etc.”

The report identifies risk factors that make elder abuse more likely to occur. Abusers possibly have mental health or drug problems, histories of physical aggression, or are facing financial difficulty, stress, and depression. Victims may be mentally or physically impaired, aggressive, or socially isolated. Abuse will happen more often in environments that are overcrowded and have a lack of privacy. This particular environment may also depict the elderly as “frail, weak, and dependent,” making them seem “less worthy of government investment or even of family care” and thus “ready targets for exploitation.”

One major recommendation the authors of the report make to deal with elder abuse is to set up an Elder Abuse and Prevention Office under the Minister of State for Seniors to help coordinate different government agencies and community stakeholders in addressing the problem. The office would establish a National Elder Abuse Prevention Strategy, fund research, give out information, and create a national public awareness program. It would also work with other levels of government to form a National Forensic Centre on Elder Abuse, change the criminal code, and facilitate better collection of statistics. The second recommendation the committee makes is to fund two organizations dedicated to helping seniors in trouble, the Canadian Network for the Prevention of Elder Abuse (CNPEA) and the National Initiative for the Care of the Elderly (NICE).

Another solution the report suggests is developing programs that integrate seniors into the community. It cites the example of the federal government’s New Horizon for Seniors Program which funded over 5,000 local projects. The program aims to involve seniors and other generations in volunteering, allow seniors to become mentors, encourage social participation among the elderly, and increase awareness of elder abuse. Another program, the Wilmot Seniors Woodworking Club and Craft Shop based near Kitchener, Ont., allows seniors to build products that are later sold to finance the club.

Owing to an increase in awareness and thus pressure on the country’s existing resources to cater to elders in need of help, the report advocates an expansion in services, including a national elder support help line, an agency for seniors similar to adult protective services, and emergency short or long term shelters or housing catering specifically to seniors.

To prevent cases of financial abuse, the report recommends that financial institutions such as banks provide information to clients about fraud and abuse, screen clients to detect whether abuse is taking place, and monitor transactions on joint accounts.

Furthermore, there are issues with the justice system, as “elder abuse cases often find abusers receiving at best token punishments, with the message being sent to the community that abuse of the elderly doesn’t really matter, or doesn’t matter as much as abuse of younger people.” In addition to tougher treatment of abuse cases, the authors note that there is a need for police staff trained in handling cases of elder abuse and medical staff comfortable in forensic medicine or testifying in court. They also call for a court process that facilitates senior participation and the expansion of legal advocacy groups geared towards the elder victims of abuse. Currently, only two – the Advocacy Centre for the Elderly (in Toronto) and the BC Centre for Elderly Advocacy and Support (in Vancouver) exist. In cases where the victim does not want criminal charges against the abuser, where there is no serious physical harm, and where there is “a pre-existing familial or communal bond, and a desire for change,” restorative justice is recommended as a way to restore the family and foster forgiveness.