In late August, MCIS collaborated with Senior Helpers Toronto (SHT), and held the second session of our webinars complementing our online training initiative: Supporting Senior Victims of Crime. The webinars are designed to raise awareness about senior abuse, provide an in-depth look at various aspects of the training program, and offer opportunities for participants to engage live with experts.
SHT is a private in-home care provider that specializes in Alzheimer’s and dementia care and Parkinson’s care. With the promise of helping older adults to “age in place,” the company provides services through three platforms that cover the three different levels of help that are often needed: companion care, personal support and care management. Being a professional care provider and with their clients’ conditions in mind, one of the issues that SHT hopes to raise awareness of is an issue that is often neglected: the unintentional abuse that seniors with memory loss sometimes suffer at the hands of their family caregivers.
Through the webinar, Dale Cadeau, SHT’s Director of Care, discussed unintentional senior abuse by caregivers from three aspects: numbers, types of abuse, and things to look out for. In the Q & A session, she also gave examples of challenges that caregivers might face when handling care recipients’ daily routines, along with proper solutions.
Data suggests that senior abuse to those who experience memory loss is no rare incident. In the slides that Cadeau showed during the webinar, 5.4% to 11.9% of older adults with dementia were exposed to various types of abuse, 34% to 62% among them were abused by their caregivers, and only one in five of these incidents were brought to the attention of those who were able to help. In fact, elder abuse is a worldwide issue that has gained WHO’s attention and is addressed in Canada on a provincial level. In Ontario, there are resources and information provided on the government’s website, and in British Columbia, the information for caregivers on unintentional abuse of older adults has its own dedicated page on HealthLinkBC.
There are many factors that might trigger unintentional abuse. In the studies that Cadeau listed, the unique challenges, demands, stresses and burdens that caregivers of those with dementia face could contribute to frustration and overwhelmingness, leading to abuse occurring. The lack of knowledge on the care recipients’ conditions, alternative strategies, psychological rewards, appropriate counselling and support, and the overburdened hours can all also increase the risk of abuse.
Unintentional abuse comes in many different forms. The most common ones are verbal abuse, psychological abuse, physical abuse, financial abuse and neglect. What’s worth noticing though, is that a lot of these unintentional abuse cases not only happen unexpectedly, but also are hard to recognize afterwards as acts of abuse. Cadeau gave some examples: when two siblings who both love their mother fight over her guardianship and argue beside their mother’s bed, they actually are unintentionally abusing her psychologically. When a daughter gets extremely frustrated by her mother’s child-like behaviours caused by her health condition and say, “if you keep behaving like this, I’ll have to send you to a nursing home,” the threat she poses is also unintentional abuse. Knowing that unintentional abuse exists, and being able to tell when it happens, is often the first step to prevention.
In the last part of the webinar, Cadeau gave suggestions and solutions to some of the situations caregivers might encounter. One of the very useful tactics is to address the issue rather than defer elsewhere. When one suffers from memory loss, the same area in our brain that controls the “filters” in our language is also affected, causing people with dementia to speak exactly their mind and talk inappropriately in public sometimes. In this situation, what caregivers can do is to correct them in a gentle way: “That’s not a pleasant way to say things, and you are such a pleasant person, so I don’t think you meant it that way.” The key to solving these situations is to know the proper method to guide and direct care recipients’ behaviours, rather than to simply leave it and accept that that’s what’s expected of patients with dementia.
Caring for older adults can be a challenging task. It’s a work of love, but handling it properly requires more than love and a good heart. When exhausted and overwhelmed, unintentional abuse can happen. This type of abuse is subtle and hard to recognize, though with adequate support, training and supervision, it can be prevented.