1 Developed by the Canadian Nurses Association and the Registered Nurses’ Association of Ontario Adapted for use by [name of PEACE site]

2 MODULE 2 RECOGNIZING ELDER ABUSE

3 Two-year national project between Canadian Nurses Association and the Registered Nurses’ Association of Ontario from April 2010 – March 2012 A series of education sessions implemented in 10 PEACE Sites across Canada Topics included are recognizing elder abuse; when and how to report elder abuse; how to intervene; and what you can do to prevent elder abuse Resources and materials on NurseONE Promoting Awareness of Elder Abuse in Long-Term Care Homes

Objectives By the end of this module, the learner will be able to: 1.Identify characteristics of the abuser 2.Identify characteristics of the abused 3.Identify signs and symptoms of different types of abuse 4

Understanding the Abused Factors that may leave some residents at risk for abuse and neglect: Cognitive impairment (confusion) Physical conditions and dependency on others for care Inability to express wishes Isolation Lack of choice Economic vulnerability 5

VIGNETTE: Mickey Rouney talks about his experience with emotional/financial abuse 6

Understanding the Abuser Anger, frustration, resentfulness Lack of self confidence Does not like job Stress Control, bullying Addictions: gambling, drugs, alcohol, other compulsive behaviours 7

Broader Issues Work environment with a lack of supervision and role modeling of good care and practices Work environment accepting of violence, aggressiveness or ignorance Task oriented care vs. resident centred care 8

Physical Abuse: Possible Indicators Depression Fear Discomfort or anxiety in the presence of particular people Visible scratches, bruises, cuts, swellings or burns Vague or illogical explanations for injuries 9

Indicators of Sexual Abuse Physical symptoms: pain, bruises, bleeding in the genital area Disclosure of sexual encounters with other residents or staff Strong reactions to changes or situations where the resident may have little or no control 10

Indicators of Emotional Abuse Low self-esteem Extreme tiredness Nervousness and being uncomfortable around a particular individual Depression Anxiety Increased isolation Fear Withdrawal 11

Examples of Financial Abuse Unpaid bills may be noticed by management team Resident confides in staff about family pressure to change will Resident unable to take part in activities that require money Lack of spending money ie. for haircuts Family member not willing to purchase needed items ie. Clothing, classes, walker etc 12

Indicators of Neglect Malnourishment, dehydration Dentures not put in the resident’s mouth Glasses not put on the resident’s face Hearing aids not put into the resident’s ear Resident left unattended for long periods of time Dirty or inappropriate clothing 13

Indicators of Violation of Rights Prevented from having visitors, phone calls or contact with others without reason Being placed away from others intentionally with wheelchair brakes on Being left in bed for staff convenience 14

Key Points There are many factors that may leave some residents at risk for abuse and neglect There are many factors involved in trying to understand the abuser There are many indicators of the different types of abuse 15

Resources 16

Questions?

What’s Next? Module 1: What is Elder Abuse Module 2: Recognizing Elder Abuse Module 3: Learning the Law 18