Silver Linings

On one of last season�s episodes of "ER," a popular prime-time drama, an elderly man was brought to the hospital with obvious signs of neglect. The man, who had age-related disabilities, had not had a bath in days. His skin had broken down with pressure sores. He appeared thin and frail.

The emergency-room doctor took matters into his own hands. Suspecting the man�s adult son, who had been collecting the old-age pension cheques while "looking after" his father, of abuse, the doctor transferred responsibility for his patient�s care to a social agency. He then arranged for the man to be moved to a nursing home after he had recovered.

Later, when the patient recovered, the doctor gently but with some pride explained what he had done. Perhaps he expected his patient to be grateful for the rescue. Instead, to the doctor�s bafflement, the elderly man began to weep with despair.

He wanted to go home. Not to "a home," but to HIS home.

Many victims of abuse find it difficult to leave the abusive situation, for various reasons, and seniors are no exception. Often seniors feel dependent on the abusers for care, for financial assistance, or even for a sense of familiarity -- a family member or caregiver, no matter how poorly he or she treats you, is still someone you know. And that counts for a lot.

"The devil you know is so often better than the devil you don�t," says Ivan Hale, National Secretary of One Voice, The Canadian Seniors� Network.

"For many seniors, there�s nothing worse than being parted from a relative who�s been around for a long time. There�s nothing worse than the uncertainty of what that would mean in their lives." Hale, whose organization addresses national issues of concern to Canada�s aging population, points out that many abused seniors fear the loneliness and isolation of being separated from their family members. They may also be financially dependent on the abuser, or perhaps they lack the mental capacity or physical ability to leave the abusive situation.

Besides, in cases of spousal abuse, Hale says, "today�s generation of older adults were taught that marriage is for life. You go through good times and bad times, until death do you part."

This year 12 per cent of our population is over the age of 65. Over the next 30 years, that figure is expected to double -- practically one-quarter of us will be seniors. The rate of disability is much higher among older adults than the general population, and this can lead to increased vulnerability.

Elder abuse comes in many shapes and forms, such as psychosocial abuse (yelling at or demeaning the person, treating him or her without respect), neglect (failure, whether wilfully or not, to meet the person�s needs) and physical assault. While some forms of abuse, like sexual abuse, are less common in this population, financial abuse is the most frequent. This is when personal property is stolen, a signature is forged on a pension cheque, or a Power of Attorney is misused as in the episode of "ER" described above. "Sadly," says Hale, "it�s often done by the children of seniors, not strangers. Or friends, people in trusted positions."

Sometimes the onset of a disability transforms a loving spouse into an abuser. Alzheimer disease, which has devastating effects on many older people, can introduce a high level of stress into the household. Family members who feel the pressure may behave differently as a result.

"My family made such a fuss over me when I was big and great in business," says Ruth Gingell, 66, who was at the height of her career in real estate 10 years ago when she developed multiple sclerosis. "What a difference now."

She says it all happened so quickly that "I never had a chance to figure out where I was. One day I was a working mother, and the next day I didn�t know who I was. And neither did my family, so I couldn�t lean on them. They resented my disability."

Gingell, who has also had joints replaced all over her body because of haemochromatosis (an excessive level of iron in the body), uses a wheelchair or scooter to get around. When she was in hospital for a year, her family couldn�t offer her support. "They just gave up, because they didn�t think I would ever get out -- neither did the hospital. They were afraid they�d be stuck. They were going to put me in a home."

But Gingell, who values her independence, couldn�t believe she would be institutionalized. As she watched an apartment building being constructed outside her hospital window, she told the doctor: "I want that." Eventually Gingell left the hospital to move into her own apartment. She started using attendant services three years later.

Another senior, who did not want to be named, had similar problems. When her disability worsened, her family assumed she was having a stroke or a seizure and forced her to be admitted into hospital. Her family "meant well." But the woman endured four months of in-hospital tests that proved what she already knew. In the meantime, she lost what weight bearing she had, and lost the ability to go to the bathroom independently.

Mentally competent seniors should know, she says, that when you are being pushed into situations or treatments against your will, "you have the right to refuse." She wishes she had.

Being aware of your rights is an important step to protecting yourself from abuse. Traditionally, abuse wasn�t spoken about within the generation that is now aging. "It was a taboo subject," Ivan Hale says. There had never been support mechanisms in the community that might enable seniors to escape abusive situations. And he adds that, even now, most seniors view women�s shelters as resources for younger women.

For an older person in an abusive situation, "the first point is to recognize it. That�s not always easy," says Hale. If a criminal act has occurred, the victim should consider speaking with local police, and realize they have the right to press charges.

Seniors should find out what support groups exist in their community, and also seek professional help, whether from a social worker, a health care worker, or a spiritual advisor. "Whatever it takes to open the door and start discussion about these very personal things," says Hale. Sometimes assistance is available from a local hospital, distress centre or senior citizen home.

"When I know that I need help, I�ll be able to get some help, I�m sure," says Marty Shultz, 74, who has multiple sclerosis and finds that being involved with her community is a good way to keep in touch with the resources that exist. "This is my lucky point, that I�m aware that they�re there when I need them."

Shultz, an artist and grandmother of seven, has taught art to other people with disabilities, including children. "I enjoy that very much. I�ve had a lot of personal satisfaction," she says. She has been profiled in the media several times. Shultz is also a member of the Ontarians with Disabilities Committee, and she has assisted a local entrepreneur with clothing designs for people with disabilities.

Like a lot of other seniors, Shultz has also been the victim of a financial scam.

A couple of years ago a man approached her who had a picture and framing display set up in the local shopping mall. They got to chatting, and he offered to do some custom-framing for her. "I see you�re in a wheelchair," he said. "We could come over to your place, save you some trouble."

The man seemed sincere. So do most scam artists who prey on older people. Shultz lost a $500 advance payment as well as three original paintings she intended to frame as Christmas gifts. She never saw him again.

But Shultz has not allowed this unhappy incident to stop her from getting out and about. She is active and independent. "Basically, you have to keep interested in something," Shultz says. "Even though it may seem like too much trouble at the time, once you get there, you enjoy yourself."

Keeping busy seems to do the trick for Gingell as well. She volunteers at her local hospital, visiting the children�s ward and speaking with older patients who have had joint replacements. "I can relate to their problems and pick their spirits up," she says.

For emotional support, Gingell relies on a couple of close friends as well as her spirituality. "I go to bible study and it help a whole lot." She attends Multiple Sclerosis Society picnics, where "you meet others in the same shoes." She also got a kitten recently. She loves "Angel" dearly.

Gingell adds, "I try to help others. And that helps me."

"I�m pleased to see older victims coming out and talking about [the issues] publicly," Ivan Hale says. "That�s healthy."

The amount of resource material, too, has increased in recent years. One Voice published "A National Action Plan to Reduce the Abuse of Older Adults in Canada" in 1995 after the organization did cross-country consultations with older adults on the topic. Subsequently a national strategy for prevention was produced, involving seniors, caregivers, service providers, stakeholders and such groups as the Canadian Bankers Association (which has released a video, "Standing up for Yourself," on financial abuse).

But ultimately prevention needs to occur at the community level. One Voice has developed a Community Action Kit that contains international literature, comprehensive work sheets and videos. Although the kits have been piloted successfully in five cross-country communities, they are costly to assemble and One Voice is currently seeking funding to be able to distribute the product, and provide ongoing support to the communities.

Unfortunately, not every seniors� organization is equipped to provide support to abused seniors. Only a handful of national groups such as One Voice have led initiatives in this area, "but we would do our best to provide referrals," says Hale. Provincial seniors secretariats often have information, as do some schools of gerontology. In Ontario, InfoAbility is a non-profit organization set up to provide information and referral services to vulnerable adults, and that includes many seniors with disabilities. Self-advocacy skills and resources can also be obtained from local Independent Living Resource Centres.

Those who have access to the Internet can learn more from the Health Canada website (http://www.hc-sc.gc.ca), which houses both the National Clearinghouse on Family Violence and the Division of Aging and Seniors. They can also contact health professionals or local police for support, or a bank employee, if the case involves financial abuse.

Hale says that those who suspect that a senior is being abused should not delay in discussing the situation with them. "It may have been going on for longer than you realize. The pain and suffering may be far more serious than you realize too." However, be sure that you respect the senior�s wishes before taking any action.

Even seniors with disabilities who are celebrating life, like Ruth Gingell, may struggle every day with situations that threaten to take advantage of their vulnerability. In January, Gingell�s family did not "allow" her to attend her ex-husband�s funeral. It hurt her deeply. Gingell is also troubled that she is not close to her grandchildren, as they haven�t had much opportunity to visit and adjust to her disability. Now she prefers that her family just stay away. "I�m happier away from them, if they feel that I�m a disgrace," she says.

Gingell recently won a human rights case forcing the property manager of her building to improve access to the many tenants who have disabilities. But although it was a sweet victory, the fight lasted two and a half years, throughout which Gingell was unable to use the social rooms, exercise room, public washroom or even the front door without help.

Marty Shultz, too, battles "constant barriers." The sidewalks in her community are not accessible to her power wheelchair, and the adapted municipal bus system is also difficult to use. She is working to improve both. She also deals with constant negative attitudes from others. But on the bright side, Shultz says that many people are eager to "give you a helping hand." And she always accepts it.

"Share. Help. Be happy," Gingell adds. "You can do it!"

(Lisa Bendall is the Managing Editor of ABILITIES.)

This article was made possible by the National Clearinghouse on Family Violence, Health Canada.

RESOURCES

National Clearinghouse on Family Violence

Health Canada -- Health Promotion and Programs Branch

Ottawa, Ontario

(613) 957-2938

Toll-free: 1-800-267-1291

TTY: (613) 952-6396

Toll-free TTY: 1-800-561-5643

Website: http://www.hc-sc.gc.ca/nc-cn

One Voice, The Canadian Seniors� Network

Ottawa, Ontario

(613) 238-7624

Fax: (613) 235-4497

Canadian Association of Independent Living Centres (CAILC)

Ottawa, Ontario

(613) 563-2581 (voice/TTY)

Fax: (613) 235-4497

InfoAbility

Toronto, Ontario

(416) 482-4359

Toll-free in Ontario: 1-800-665-9092

Website: http://www.infoability.org

"Elder Abuse: A Portrait"

Video and discussion guide produced by the Township of Osgoode Home Support Program

Cost: $25 plus $5.95 shipping

(613) 821-1101

"Safeguarding Your Interests"

Published by the Canadian Bankers Association

(416) 362-6093

"Issues Affecting Aging and Elderly Individuals with Intellectual Impairment"

Literature review published by The Roeher Institute

Cost: $10

(416) 661-9611