2021 Inservice Education
Abuse

These definitions of abuse and neglect apply to both Long Term Care and the Retirement Residence.

Abuse and Neglect:

• “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” (WHO, 2002, p.126).

• “Mistreatment of older adults refers to actions and/or behaviours, or lack of actions and/or behaviours that cause harm or risk of harm within a trusting relationship. Mistreatment includes abuse and neglect of older adults” (NICE, 2012, p.99).

 

Emotional/Psychological Abuse:

“Severe or persistent verbal or non-verbal behaviour that results in emotional or psychological harm” (NICE, 2012, p.99).

Psychological, emotional, and verbal abuse is also defined as, “any action, verbal or nonverbal, that lessens a person’s sense of identity, dignity and self-worth” (ESDC, 2011).

Psychological, emotional and verbal abuse may include one or more of the following:

 • words or actions that belittle an older adult, are hurtful, make the person feel unworthy;

 • not considering an older adult’s wishes;

• not respecting an older adult’s belongings or pets;

• inappropriate control of activities for example, denying access to grandchildren or friends;

• threatening an older adult with for example putting them in a “home”;

• treating an older adult like a child;

• removal of decision-making power while the older adult is still competent;

 • withholding affection;

• verbal aggression, humiliation, isolation, intimidation; and • name-calling”(ESDC, 2011). pg. 6 RNAO LTC Video Discussion Guide April 2015

Financial/Material Abuse

“An action or lack of action with respect to material possessions, funds, assets, property, or legal documents, that is unauthorized, or coerced, or a misuse of legal authority” (NICE, 2012, p.99). “Any improper conduct, done with or without the informed consent of the older adult, which results in a monetary or personal gain for the abuser and/or a monetary or personal loss for the older adult. The misuse of another individual’s funds or property through fraud, trickery or force is financial abuse” (ESDC, 2011).

Sexual Abuse

“Direct or indirect involvement in sexual activity without consent” (NICE, 2012, p.99). Sexual abuse “includes coercing an older person through force, trickery, threats or other means into unwanted sexual activity. Sexual abuse also encompasses sexual contact with older adults who are unable to grant consent. This includes inappropriate sexual contact between service providers and their older adult clients” (ESDC, 2011).

Physical Abuse

“Actions or behaviours that result in bodily injury, pain, impairment or psychological distress” (NICE, 2012, p.99). “Physical abuse may include one or more of the following, but is not limited to:

• pushing, shoving;

• hitting, slapping, poking;

• pulling hair, biting, pinching;

• spitting at someone; and

• confining or restraining a person inappropriately” (ESDC, 2011).

Neglect:

“Repeated deprivation of assistance needed by the older person for activities of daily living” (NICE, 2012, p.99). Neglect is also defined as the “intentional or unintentional failure to provide for the needs of the older adult” (ESDC, 2011). Neglect can be divided into two categories: 1) Active neglect is “the deliberate or intentional withholding of care or the basic necessities of life”; and 2) Passive neglect is “the failure to provide proper care due to lack of knowledge, information, experience or ability” (ESDC, 2011). Pg. 7 RNAO LTC Video Discussion Guide April 2015 Systemic abuse.

 

Systemic Abuse has multiple meanings. These may include:

• rules in a facility or at the government level that inadvertently cause harms;

• repeated patterns of substandard care;

• situations where employees are unaware that their behavior is wrong and therefore there is no corrective action;

• failure of administration to effectively address incidents of abusive conduct; or

• system wide problems, such as inadequate resources or an institutional culture where staff fear consequences for reporting abuse (Spencer et al., 2008).

Violation of Rights:

“A violation of rights is defined primarily as the denial of a person’s fundamental rights according to the Canadian Charter of Rights and Freedoms or the United Nations’ Universal Declaration of Human Rights. Conduct that denies an older adult’s rights may include one or more of the following:

 • censoring or interfering with a person’s mail;

 • withholding information to which the person is entitled;

• restricting liberties, not allowing the senior go out and/or socialize; and

• denying privacy, visitors, phone calls or religious worship/spiritual practice” (ESDC, 2011).

These short vignettes have been created by Long Term Care staff to help other Long Term Care staff in their ability to address situations of abuse and neglect.

From what you have seen, would you perceive any behaviours

shown in this scenario as abuse or neglect?

What are two behaviours by the staff in this video that you thought were not acceptable or should be changed?

Duty to Report

A person who has reasonable grounds to suspect that any pf the following has occurred or may occur shall immediately report the suspicion and information on which it is based to the Director:

 

  1. Improper or incompetent treatment or care of a resident that resulted in harm or a risk of harm to the resident.

  2. Abuse of a resident by anyone or neglect of a resident by the licensee or staff that resulted in harm or a risk of harm to the resident.

  3. Unlawful conduct that resulted in harm or a risk of harm to a resident.

  4. Misuse or misappropriation of a resident’s money.

  5. Misuse or misappropriation of funding provided to a licensee

(See Long Term Care Home Act, 2007 section 24)

Mandatory Reporting (Section 75) of the Retirement Homes Act, 2010 (Act) is legislation for the retirement home sector in Ontario.

The Act sets out the care and safety standards that all licensed retirement homes must meet. The Act requires operators and licensees to immediately report to the RHRA:

  • harm, or risk of harm, to a resident resulting from:

  • improper or incompetent treatment or care • abuse by anyone

  • neglect by the licensee or staff of the retirement home

  • unlawful conduct

  • misuse or misappropriation of a resident's money

Whistleblower Protection legally protects staff who report abuse and neglect. The Whistleblower Protection Act contained in the Long Term Care regulations states “no person shall retaliate against another person, whether by action or omission, or threaten to do so because….” they have reported abuse or neglect of a resident or suspicion of to the appropriate authority.

(See Long Term Care Home Act, 2007 section 26)

Zero Tolerance Policy

The Leamington Mennonite Home maintains a Zero Tolerance Policy with regard to any form of abuse as defined in the Abuse Policy and Procedure.  The Zero Tolerance Policy ensures that:

  • Prevention, education and awareness of abuse remain the foundation of the Abuse Policy.

  • No exceptions occur.

  • No abuse, assault, neglect or any threat or intimidation as defined in the Policy is tolerated.

  • The Abuse Policy is always enforced and is applied to all individuals present at the Leamington Mennonite Home.

Zero Tolerance further means that the Leamington Mennonite Home shall:

  • Build awareness of, and educate, to achieve the goal of elimination of abuse.

  • Allow no exceptions.

  • Tolerate no abusive behaviour, and

  • Require strict compliance and enforcement.

Zero Tolerance means, within this policy, that the Leamington Mennonite Home shall:

  • Uphold the right of the residents of our Home to be treated with dignity and respect within the Home, and to live free from any abuse, neglect, and/or threat, intimidation and assault.

  • Not tolerate any form of abuse by anyone working, residing, visiting or volunteering at the Leamington Mennonite Home.

  • Provide information and education regarding abuse and the prevention of abuse.

  • Treat every allegation of abuse as a serious matter.

  • Investigate every allegation of abuse.

  • Take corrective action, including sanctions or penalties, against those who have committed abuse against a resident.

  • Report to the Ministry of Health and Long-Term Care every incident of abuse, improper or incompetent treatment and unlawful conduct that resulted in harm or a risk of harm to a resident.  Any misuse or misappropriation of the resident’s money or the misuse or misappropriation of funding to the Home shall be reported immediately upon becoming aware of the incident.

  • Make every effort to eliminate abuse through the Quality Improvement Program(s) of the Leamington Mennonite Home.

It is the duty of staff in both the Long Term Care Home and Retirement Residence to report cases of abuse and/or neglect.