Elder Abuse

An information manual when working with seniors

who are blind or partially sighted
Elder Abuse Manual
Elder Abuse
An information manual when working with seniors
who are blind or partially sighted
This project is funded in part by the Government of
Canadas Social Development Partnerships Program.
The opinions and interpretations in this publication
are those of the author and do not necessarily refect
those of the Government of Canada.
Elder Abuse Manual
Table of Contents
Introduction ....................................................................... 2
Defning Elder Abuse ........................................................ 4
Types of Elder Abuse that Blind and
Partially Sighted Individuals Might Experience ............................. 4
Understanding Elder Abuse ............................................. 7
How to Recognize Elder Abuse ....................................... 9
Responding to Elder Abuse .............................................. 11
Witnessing Elder Abuse ........................................................... 11
Disclosure of Elder Abuse ........................................................ 11
Legal Options ..................................................................... 13
Conclusion .......................................................................... 14
Case Studies for Discussion ............................................ 15
Discussion Guiding Answers for Each Case Study ........................ 21
Bibliography ....................................................................... 26
Notes ................................................................................... 28
3 2
INTRODUCTION INTRODUCTION
Introduction
Unfortunately, elder abuse is not a new issue.
Despite its prevalence, elder abuse is often diffcult to detect and
prevent because it is not usually reported. Because elders who are blind
or partially sighted are more dependent on others for support, they are
more vulnerable to abuse.
But if we become more aware of elder abuse, we will be more attentive to
the signs of abuse and more able to intervene. This is why this manual is
so important in raising awareness and ending this type of violence.
Elder abuse is often carried out in private by a relative or a trusted
caregiver. Victims are often afraid, ashamed and unwilling to report
the abuser, despite being hurt by them. Victims might also encounter
language and cultural barriers, or cognitive decline and ill health. All
of these factors can prevent them from reporting their abuser. An
additional challenge is that service providers, such as social workers
and law enforcement offcers, often lack proper training and knowledge
about elder abuse.
Elder abuse is particularly relevant today because Canadians are living
longer (Carp, 2000, p. 15) and seniors have become the fastest-growing
age group. In 2011, about one in seven Canadians was over the age of
65. By 2051, it is estimated that about one in four Canadians will be 65
or older (Canadians in Context, 2014, para. 1).
There is a strong relationship between aging and vision loss. The
presence of visual impairment for those aged 65+ is at 8% and rises to
25% for those 85+ (CNIB, 2014, para. 8).
In comparison to the general population, people with vision loss
experience:
Up to fve times more diffculty with daily living.
Three times higher risk of clinical depression.
Twice as much dependence on others.
A greater number of medication errors.
Twice the risk of falls and premature deaths.
Four times the risk of serious hip fractures.
Premature admissions to nursing homes (on average three years
earlier) (Summary Report, June 2009).
Increased fear of victimization (Rounds, 1996, p. 39 and Brennan,
2008 p. 58).
Unlike younger people who lose their sight, elders are more
likely to lack the physical ability and confdence to access
support services. In addition, elders from immigrant
communities have a more diffcult time reaching out to
vision support agencies such as CNIB. Failure to access
support services, vision aids, and devices can increase
social isolation and vulnerability and reduce elders overall
quality of life.
Elders who are blind or partially sighted are more at risk of abuse
than elders who are sighted because they are:
More dependent on caregivers, which increases their risk of
becoming victims of abuse.
More fearful, which abusers can exploit to prevent elders from
acting to end their abuse (Hanrahan and Gibbs, 2004, p. 93).
Unable to effciently read documents and are more likely to have
their signatures forged (Rounds, 1996, p. 34).
More likely to make medication errors which caregivers can exploit
by under medicating required drugs or over medicating elders
with sedatives (Summary Report, June 2009).
More prone to falls and fractures because they are less able to see
obstacles ahead (More et al, 2000, p. 573) which abusers can exploit
by not warning them of impeding dangers.
Less able to identify their abusers.
More likely to be marginalized from the familys routine and be left
out of the decision making process, even when their own lives are
concerned.
More likely to experience excessive dependence, which is often
followed by regression and depression (De Leo et al., 1999, p. 340).
With this information manual, CNIB aims to help end elder abuse and
alleviate the negative effects it can have on seniors with vision loss.
5 4
DEFINING ELDER ABUSE DEFINING ELDER ABUSE
Defning Elder Abuse
The terms elder abuse or senior abuse describe the experience of
an older adult who is being abused by someone in a position of trust
and/or authority. Either action (doing something) or inaction (not doing
what is needed) can put the well-being of the elder at risk. Victims of
elder abuse can belong to diverse cultural, ethnic, and socio-economic
groups. They have varying physical and mental health levels. Potential
consequences to a victim of elder abuse include a decline in general
health, depression, and in some cases suicide. It is important to
remember that usually the abuser is someone the elder knows - a family
member, friend, caregiver, landlord, or care provider.
Types of Elder Abuse that Blind and Partially Sighted
Individuals Might Experience
Elder abuse can take on many forms. Frequently, cases of abuse involve
a combination of forms rather than just one. The following descriptions
will help you identify signs of abuse and focus on types of elder abuse
that blind or partially sighted elders are more likely to encounter.
1. Financial or Economic Abuse involves the taking away of an
elders funds or property through fraud, theft, force or deception
without regard or consideration to the elders wishes (Setterlund
et al., 2007, p. 599). Those who are blind or partially sighted are
particularly vulnerable to this form of abuse because they can be
more easily deceived into signing a document. They are also more
prone to purse snatching and more likely to be taken advantage
of due to their inability to determine the value of paper currency
(Rounds, 1996, p. 34).
Signs that might be helpful to identify if someone is being
fnancially abused include a more disheveled appearance than
usual, confusion about banking or sudden changes to his or
her banking arrangements.
2. Medication Abuse includes withholding medication
or prescriptions resulting in pain and/or hardship. It
also includes overmedicating an elder with unnecessary
sedatives. Elders who are blind or partially sighted are also
more likely to make medication errors (Summary Report, June
2009).
Signs of medication abuse can include prescriptions not being
followed properly (e.g. too often or not often enough) or an elder
experiencing drowsiness or excessive pain that goes untreated and
unaddressed by a medical professional.
3. Physical Abuse is the result of aggressive behavior directed
towards another person with the intent to hurt or scare. This abuse
can consist of pushing, hitting, slapping, poking, and pulling hair. It
can result in broken bones, cuts, bumps, and bruises. Elders who
are blind or partially sighted are also more prone to being victims of
this abuse because they may not be aware of impending danger and
are less likely to be able to protect themselves. Elders with partial
vision and blindness also tend to have more frequent falls, which
can result in fractures, dislocation, and lacerations (Moore et al.,
2000, p. 573).
Since physical abuse can occur in various forms, the signs of
abuse can also vary. Some of the more common signs include
inappropriate dress for the season (e.g. long sleeves on a hot
day), bruises around the wrists and chest or in unusual places,
lacerations, burns, multiple fractures, or a history of accidents.
4. Sexual Abuse is any sexual behavior directed toward an older adult
without that persons full knowledge and consent. This includes
coercing an older person through force, deceit, or threats into
unwanted sexual activity (ONPEA, 2008, p. 30). As elders who are
blind or partially sighted are more dependent on their caregivers,
they are more vulnerable to this abuse and less capable of avoiding
these situations. They also have more diffculty identifying their
abuser and therefore are less likely to report the abuse.
Signs of sexual abuse include unexplained venereal diseases or
genital infections and pain or blood in the genital area. A person
who is sexually abused will also show behavioral changes such as
withdrawal, fear, depression, insomnia, or increased interest in sex
and aggressive behaviors.
5. Neglect is failing to meet the basic needs of an elder. It can be
either an active withholding of care or a passive omission to provide
proper care (ONPEA, 2008, p. 23). Even overprotection can be a
form of neglect because it can reinforce the elders physical and
fnancial dependence on others. This excessive dependence is often
followed by regression and eventual depression amongst elders who
are blind or partially sighted (De Leo et al., 1999, p. 340).
Signs of neglect include poor nutrition, excessive weight loss,
disheveled appearance or a change in living arrangements (e.g. the
elder lives mostly in one room). Elders who are neglected often
become depressed and lose interest in activities in which they used
to participate.
7 6
UNDERSTANDING ELDER ABUSE DEFINING ELDER ABUSE
6. Violation of Human Rights consists of the denial of a persons
rights as they are outlined in the Charter of Rights and Freedoms. It
can consist of restricting a persons mobility, either through active
restraints or medication, denying a persons privacy, withholding
information to which the person is entitled, or denying a person
visitors or phone calls (ONPEA, 2008, p. 27).
7. Psychological or Emotional Abuse and Stalking is any verbal or
non-verbal action that lessens a persons sense of identity, dignity,
or self-worth. Stalking is a form of harassment that causes a person
to fear for their safety. Fear of being a victim is also higher amongst
people who are blind or partially sighted and can be exploited by
their caregivers (Hanrahan and Gibbs, 2004, p. 93; Brennan, 2008,
p. 58; and Sussman-Skalka, 2008, p. 98). The fear of being a victim
can lead some elders who are partially sighted to lie about their
vision. This makes them more vulnerable to abuse (Weber and
Wong, 2010, p. 107) and more susceptible to criminal victimization
because they are less able to protect themselves
(Rounds, 1996, p. 31).

Understanding Elder Abuse
There are many possible reasons why elder abuse occurs. As each
case is different, they are best examined individually. Use the following
examples as guidelines to help identify situations in which elder abuse is
more likely to occur.
1. Isolation and Loneliness of the Elder makes the elder more
prone to abuse from the caregiver (Evans and Jaureguy, 1982,
p. 34). An elder can become isolated due to reduced mobility,
age-related health issues, loss of sight and language barriers.
Isolation can have a profoundly negative impact on an elder and
can lead to depression and even suicide. Loneliness can create high
psychological stress for elders at the onset of their visual loss.
2. Situational Stress on the Caregiver is placed on an elders
caregiver, especially when the caregiver is a family member. Adult
children who are the caretakers of both their own children and their
aging parents (the sandwich generation) can be overburdened by
their multiple responsibilities. However, this only represents a small
percentage of elder abuse cases (Blowers, 2004, p. 78-79).
3. History of Abuse in the Family can contribute to the occurrence
of elder abuse. Domestic violence can include all members of
the family. It is primarily directed towards women, with the male
spouse typically being the primary abuser (ONPEA, 2008, p. 32).
Complicating matters, as women age and adult children become
caregivers, the children can also become abusive.
4. Increased Vulnerability and Diminished Capacity to Make
Decisions also contributes to elder abuse. Increased physical frailty
or reduced vision and blindness can increase a persons dependency
on their caregiver. This dependability can make the abused elder
more reluctant to report the abuse.
In addition to physical vulnerability, some elders have a diminished
capacity to make decisions because of memory lapses or dementia.
In such cases, the elder might have a more diffcult time convincing
others that they are being abused.
5. Psychopathological Problems of Abusers can have an impact on
the way they treat elders in their care. Research shows that adult
children who are dependent on their elderly parents for fnancial
assistance are more likely to be abusive (Blowers, 2004, p. 79). The
abusers often suffer from a variety of issues including substance
abuse, arrest records, poor employment histories, mental illness,
and inadequate social skills.
9 8
HOW TO RECOGNIZE ELDER ABUSE UNDERSTANDING ELDER ABUSE
6. Rationalization by Abusers occurs when abusers justify the
abuse they commit. They might deny that someone was hurt,
believe the abuse was necessary, blame the victim, or make the
victim feel guilty or ashamed. In cases of fnancial abuse, abusers
justify their abusive actions with false claims of borrowing sums
of money that are never paid back (Payne, 2011, p. 213-214). This
form of rationalization can be particularly damaging because the
elder who is abused might actually believe the abuser or might not
say anything to avoid further confrontation.
How to Recognize Elder Abuse
Elder abuse does not go away on its own. The longer it persists, the
more signifcantly it impacts the elders quality of life. Abused elders are
more likely to suffer injuries, to have a lower quality of life and are three
times more likely to die than those who did not experience abuse. In
order to prevent these consequences, early recognition is critical.
Some helpful ways to recognize elder abuse include:
Remain attentive and alert about possible cases of elder abuse in
the community.
Build trust with the elder who might be in an abusive situation and
discuss personal issues when appropriate.
Ask questions that allow the elder to provide you with detailed
responses (ONPEA, 2008, p. 54).
Trust your instincts. If something does not feel right then consult
with a co-worker or a supervisor.
Be observant to red fags and be prepared to ask questions to both the
elder suspected of being abused and his or her caregiver. For example,
an elder can be asked:
When fnancial abuse is suspected: Is someone helping you with
your fnances? Are you comfortable with that?
When physical abuse is suspected: Do you have someone close to
you who has diffculty controlling their emotions? Is this affecting you?
When emotional abuse is suspected: Does anyone threaten you?
Do you feel safe?
When medication abuse is suspected: Do you need any
prescriptions reflled? Who usually reflls them? Do you have the
vision aids you need? (This list of questions was adapted from
ONPEA, 2008, p. 59-62).

11 10
RESPONDING TO ELDER ABUSE HOW TO RECOGNIZE ELDER ABUSE
Asking questions of caregivers suspected of committing abuse can
be diffcult. However, it is important to remember that as long as
these questions are not phrased in an accusatory way, they can be
instrumental in clarifying the situation further.
For example, a caregiver can be asked:
Are you aware of the supports available in your community?
Did you have to make many changes to accommodate for (elders
name) loss of vision? Do you have other cases of blindness in the
family?
Is caring for (elders name) different than you expected? How so?
Do you have any support when you need a break?
Most caregivers fnd their role to be stressful. I sense caring
for (elders name) is stressful for you (This list of questions was
adapted from ONPEA, 2008, p. 63).


Responding to Elder Abuse
Elder abuse can be diffcult to assess as situations can be very sensitive.
The elder who is being abused might feel afraid and ashamed to disclose
information while at the same time, want to end the abuse.
The caregiver involved might be under a lot of stress at home and
alternate between feelings of guilt for offering poor care and anger for
having to be the one providing it. If possible, get to know the person
you suspect might be a victim of abuse. The relationship you build with
the elder might be the key to fnding out if abuse did occur. It will also
be helpful in fguring out the most appropriate and effective avenues to
heal the abused elder.
Witnessing Elder Abuse
If you witness a physical and/or verbal assault, or if you have immediate
concerns about an elders safety, call 9-1-1.
Keep a clear and detailed record of all observations that lead you to
suspect that this might be a case of elder abuse. For example, what
bruises, body language, or changes did you notice?
If you are suspicious of elder abuse, discuss the situation with a
manager as soon as possible and keep him/her updated. Together, a
decision should then be made regarding the best course of action and
whether further reporting is required.
Disclosure of Elder Abuse
If there is an immediate threat to the elders life, call 9-1-1.
Be aware of your own feelings and remain calm. Speak to the person
privately. Ensure that the conversation is carried out in a relaxed fashion
and in a stress-free environment. Be attentive if the person is blind or
partially sighted. If other issues make communication diffcult, such as
hearing problems, try to provide appropriate assistance for them.
Keep the following tips in mind when reporting an incident of elder abuse.
Believe the disclosure.
Be respectful and listen to the victim without judgment.
Tell the victim that they did the right thing in telling you.
Ask the victim if there is a trusted friend, neighbour or relative who
could offer additional support.
13 12
LEGAL OPTIONS RESPONDING TO ELDER ABUSE
Learn what services the elder might need and try to connect them
with support groups who offer those. For example, trusted banking
services, community support groups, or visual aids.
Respect the victims choices and facilitate decisions without taking
control. If the elder has the capacity to decide, be prepared to
accept the elders decision not to make the abuse public. Do let the
elder know that they can change their mind in the future.
Exceptions:
If the elder does not have the capacity to communicate on their
own, report the case to the police.
If the abuse occurs within a public care facility such as a lodge,
hospital, long-term care facility - you are required to report it.
Check provincial legislation as it may differ from province to
province.
Legal Options
Elders who have been victims of abuse can pursue a variety of legal
options to help them end their abuse. This manual is not intended to
provide legal advice, but to give a general perspective of available
options.
It is important to remember that some abused elders might choose not
to follow legal channels against their abusers. If an elder is in imminent
danger, the police must be contacted. This reporting does not have to
be done by the elder. Anyone who suspects abuse can report it to the
police and can remain anonymous (Kinnon, 2002, p. 66).
Some additional options include civil sanctions (actions) or lawsuits and
class action lawsuits. In these cases it is advised that the abused elder
seeks legal counsel.
Legal options do not constitute an end to elder abuse by themselves.
Abuse is made possible by a multitude of other factors such as social
discrimination against the elderly, lack of general education about elder
abuse, and poor cooperation between social services.
It is often through cooperation between community support groups and
additional education amongst the general population that elders are able
to end their abuse and begin the healing process (Payne, 2011, p. 189).

15 14
CASE STUDIES CONCLUSION
1
3
5
2
4
6
Conclusion
As the Canadian population continues to age, elder abuse is a growing
concern. Professionals and volunteers working with seniors need to be
able to identify the risks and signs of elder abuse in order to prevent
and stop this violence from continuing. They must also remember that
elders who are blind or partially sighted are more dependent on others
for support and more vulnerable to becoming victims of abuse.
Elder abuse cases might differ from one another, but the consequences
of this crime are far reaching. Aside from the reduced quality of life for
those who are abused and the increased health care costs, elder abuse
has larger ethical implications for our society. It is important that we
treat our elders with respect so that as our society ages, it does so with
grace and dignity.

Case Studies for Discussion
We have included fve case studies to help simulate elder abuse
situations that you might be confronted with. Keep these following
questions in mind while reading through each case study. An answer key
is provided at the end of the manual.
1. What types of abuse do these cases illustrate?
2. What reasons might best explain (not excuse) some of these cases?
3. What should be the next course of action in each case and why?
4. What other types of community services could become involved?
5. What are some options the abused elder can pursue?
6. What might an elder do to prevent similar situations from occurring
in the future?

17 16
CASE STUDIES CASE STUDIES
A B
Case A:
Mrs. Adams is a 75 year old widow who lives alone. She has very few
friends, a niece who lives out of town and a son living in the same
city. Her last medical visit confrmed that she has Age-related Macular
Degeneration (AMD). She could no longer drive her car. She felt
overwhelmed and afraid.
She called her son, who was unemployed and had a history of substance
abuse. She gave him her car to help him drive her around when she
needed. He began to ask for money for gas and car expenses over the
next few months and over that span of time, she paid him a total of
$5,000.
One day, the son came over to her house with some papers for her
to sign. He said they were for car insurance purposes. Mrs. Adams
vision was too poor to read and she felt uneasy and hesitated to sign.
He became angry. As she tried to get up from the table, he forcefully
pushed her back onto her chair and insisted it was for her own good.
Then the doorbell rang.
Her niece had arrived unexpectedly from out of town and wanted to
surprise her. Mrs. Adams son opened the door and was uncomfortable
seeing her and left. Fortunately, Mrs. Adams asked her niece to look
over the documents and clarify for her why the car insurance needed
her signature. Her niece looked over the documents and quickly realized
that he was trying to gain power of attorney. She informed Mrs. Adams
of the documents content.
* Recall that if the document is to be legally binding, both parties and
a legal professional must be present when the documents are signed.
However, there have been cases where lawyers have recognized a signed
document without actually seeing the elder.
Case B:
Mr. Brown is a 67 year old who is blind and lives alone in his house with
his guide dog. His wife passed away two years ago and they had no
children. His only other relatives live out of the province. He has been
healthy, but since his wife passed away he has been more reserved and
stopped visiting his friends. He takes fairly good care of himself and his
guide dog but shows no interest in other things.
One day he received a phone call from a distant cousin from another
province. She was single, in her 40s, and told him that she has some job
interviews and would like to stay with him for a few days. Mr. Brown felt
uneasy about her staying with him as he barely knew her. She reassured
him and it was only for three days and that she would be job-hunting for
most of the time. She also reminded him that her own mother was blind
and that she will be very mindful.
She arrived late on Sunday evening and sounded very unhappy. She
told him she had nowhere else to go and no money but that the two
interviews sounded promising. He tried to console her and gave her $40
cash to help her out.
On the third day, the niece told Mr. Brown that the interviews had not
gone very well. She also said that she has no savings, no home, and
nowhere to go. She began crying and asked him if she could live with
him for a few months. She said she is certain that she could get a job if
she had a more stable residence. He did not know what the best course
of action should be and asked her to give him some time to think it over.
She became agitated and asked how long he would need and reminded
him that he had an extra bedroom that nobody was using. Mr. Brown felt
overwhelmed.
19 18
CASE STUDIES CASE STUDIES
C
D
Case C:
Mrs. Carson is a 75 year old widow who lives in her own home with
her daughter and her daughters family, her husband and one child.
Mrs. Carson has glaucoma and is partially sighted. Her daughter and
her family moved in after she suffered a stroke two years ago. For the
frst year, this worked well for everybody. Her daughters family paid a
modest sum for rent and in return they did most of the housework and
took care of the cooking.
Over time, Mrs. Carson realized that she was more tired than usual.
Sometimes she would sleep through the day and night. Because she
slept for such long periods, she occasionally wet the bed. Her daughter
recommended she wore diapers when she went to sleep. Mrs. Carson
began to worry about her health. Her daughter reassured her that she
was fne and should not worry.
Because Mrs. Carson was relatively healthy, she knew that the only pills
she should be taking were her cholesterol pills. However, a few months
ago, her daughter advised her to take additional vitamins. That was
also when her sleepiness began. Mrs. Carson had an appointment with
her family doctor the next day and decided to mention her increased
fatigue.
The doctor tested her blood and urine. The tests confrmed that Mrs.
Carson has been exposed to high doses of sedatives. Mrs. Carson was
afraid to go home.
Case D:
Mr. Dawson has been living in a nursing home for the past three
years. He has glaucoma and is partially sighted and suffers from early
dementia. His daughter lives in the same city but she has just given
birth to twins.
Four months after her twins were born, Mr. Dawsons daughter was
fnally able to visit him. She found him withdrawn and uncommunicative.
She reached to touch his arm and he pulled it away quickly and looked
the other way. She became worried and thought he might be upset with
her for not visiting more often. She told him she was sorry for not being
able to visit as much recently. Her father murmured that it was ok and
he understood. After all, he was once a young parent himself. Aside
from that, he said nothing and refused to make conversation.
Finally, the daughter convinced him to go for a walk in the garden.
It was a warm sunny day and she asked him if he would like her to
help him take off his sweater. He became agitated and said no. She
remembered he always liked the sun as they would often spend holidays
at the beach when she was young. She reminded him of that and then
realized he was holding back his tears.
Mr. Dawson looked directly at her and slowly lifted his sleeve. His lower
arm was severely bruised showing signs of mistreatment. She helped
him take off his sweater. He had bruises all over his arms. Are my arms
bruised? He fnally asked. They feel bruised, but I cannot see well. His
daughter became very worried and wanted to fnd out more. Mr. Dawson
did not want to worry his daughter but he also wanted the caretakers to
stop leaving him alone for hours on end and rough handling him when
he asked for assistance. He felt trapped and did not know where to turn.
21 20
CASE STUDIES DISCUSSION GUIDES CASE STUDIES
A
E
Case E:
Mrs. Emani is an 85 year old widow who lives alone in her own
apartment. She suffers from chronic back pain and early phases of
glaucoma. Her daughter, who is her primary caregiver, lives in the
neighbourhood. Mrs. Emanis daughter convinced her to give her Power
of Attorney and made arrangements with a long-term care home to look
after Mrs. Emani while her family went away on holiday for three weeks.
Mrs. Emani does not meet the eligibility requirements to live in a nursing
home on a permanent basis and is capable of making her own decisions.
Since her arrival, Mrs. Emani helped out with various tasks around the
facility and did not need any assistance herself. On the day her daughter
was scheduled to return, Mrs. Emani packed her things and was ready
to go home. Her daughter did not arrive and did not contact the care
facility.
When the staff called her, Mrs. Emanis daughter informed them that
she had given up her mothers apartment and that Mrs. Emani could
not return home. Her daughter told them that she had done everything
she could, but caring for her mother had become too diffcult and her
mother needed to remain in long-term care. She told them she did her
best to ensure her mothers basic needs were met up to this point and
that from now on, it was the facilitys responsibility.
Discussion Guiding Answers
for Each Case Study
Case A
1. What types of abuse does Case A illustrate?
Financial abuse
Physical abuse
Psychological or emotional abuse
2. What reasons might best explain (not excuse) this case of abuse?
Psychopathological problems of abusers
Isolation and neglect
3. What should be the next course of action for Mrs. Adams? Why?
Mrs. Adams could alert the police and try to obtain a restraining
order.
4. What other community services could become involved?
Mrs. Adams could connect to other peer support groups.
She could also contact CNIB for help with vision support and
independent living skills training.
She could make alternative arrangements to provide for her
transportation (e.g. grocery delivery, handi-transit services)
5. What other avenues can she pursue to end the abusive situation?
Mrs. Adams must remain cautious about her son.
6. What might she do to prevent similar situations in the future?
Mrs. Adams could be more cautious when she reaches out to
others for help.
23 22
CASE STUDIES DISCUSSION GUIDES CASE STUDIES DISCUSSION GUIDES
C
B
Case B
1. What types of abuse does Case B illustrate?
At this point, no abuse has been committed but early signs of
psychological, emotional and fnancial abuse are noticeable.
2. What reasons might best explain (not excuse) this case of abuse?
Rationalization by abusers
Isolation and neglect
3. What should the next course of action be? Why?
Mr. Brown could try to fnd out more about his distant cousin by
contacting other family members.
He could have a more direct discussion with his cousin and give
her a last and fnal date by which she must leave his house.
4. What other community services could become involved?
Both Mr. Brown and his cousin could call family support
organizations.
5. Could Mr. Brown involve the police?
If Mr. Browns cousin refuses to leave his house despite him
asking her clearly to do so, he should call the police.
6. What might Mr. Brown do to prevent similar situations from
occurring in the future?
Mr. Brown could ensure he fnds out more about the person he
allows in his house, and he can set a clearer and frmer limit as to
how long a houseguest could stay.
Mr. Browns emotional distress in this case is clear. Unfortunately,
many times it is very diffcult to reach elders in this early phase.
Case C
1. What types of abuse does Case C illustrate?
Medication abuse
Financial abuse
Psychological or emotional abuse
2. What reasons might best explain (not excuse) this case of abuse?
Isolation and neglect
3. What should the next course of action be? Why?
Mrs. Carson must work closely with her doctor.
She can also contact the police since she is not safe in her own
home.
4. What other community services could become involved?
The family doctor
Local family services
5. What are some avenues Mrs. Carson can pursue to end the abusive
situation?
Mrs. Carson should stay away from her daughter and her
daughters family.
She could reach out to other family or friends she trusts.
She could make an arrangement with her pharmacist to ensure
she takes the right medication and CNIB to obtain the appropriate
vision aids
6. What might an elder do to prevent similar situations from occurring
in the future?
Mr. Carson must not take medication that she is not absolutely
sure she needs.
She must only accept medication from someone she absolutely
trusts, if possible a pharmacist or her family doctor.
25 24
CASE STUDIES DISCUSSION GUIDES CASE STUDIES DISCUSSION GUIDES
E D
Case D
1. What types of abuse does Case D illustrate?
Neglect
Physical Abuse
Psychological or Emotional Abuse
2. What reasons might best explain (not excuse) this case of abuse?
Isolation and neglect
Increased vulnerability and diminished capacity to make decisions
3. What should the next course of action be? Why?
This case must be reported to the proper authorities. The
daughter can initiate the call and can do so anonymously.
4. What other community services could become involved?
Once a report is made, a private investigation will be conducted.
CNIB could provide a volunteer to check in on him regularly.
5. What are some avenues this elder can pursue to end the abusive
situation?
Mr. Dawson could stay with his daughter for a few days.
His daughter could also try to hire some extra help to visit her
fathers home until she is able to resume her visits.
6. What might Mr. Dawson do to prevent similar situations from
occurring in the future?
Mr. Dawson could make a call to the authorities himself.
If he is able, Mr. Dawson should keep a clear record of when the
abuse occurs and the caregiver who perpetrates it. This can be a
valuable resource if/when the investigation is conducted.

Case E
1. What types of abuse does Case E illustrate?
Financial abuse
Psychological or emotional abuse
Neglect
2. What reasons might best explain (not excuse) this case of abuse?
Isolation and neglect
Rationalization by abusers
Situational stress
3. What should the next course of action be? Why?
As Mrs. Emanis daughter is abusing her position of Power of
Attorney, the police should be contacted.
4. What other community services could become involved?
Family support services and victim services could be involved to
help Mrs. Emani navigate the legal process.
Perhaps an arrangement could be made with the care home to
allow Mrs. Emani to live there until her case is heard in court.
5. What are some avenues this elder can pursue to end the abusive
situation?
Mrs. Emani should take legal action to revoke her daughters
Power of Attorney.
She should also ask the authorities to investigate the activity of
her fnancial records.
6. What might Mrs. Emani do to prevent similar situations from
occurring in the future?
Mrs. Emani must ensure she only allows people she absolutely
trusts to make important decisions on her behalf.

27 26
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NOTES
Notes
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