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Who are regulated professionals?

Regulated professionals are those who are required to be registered with regulatory bodies such as professional colleges that define specific standards for the profession. These professionals often work in positions that enable them to provide formal interventions to seniors at risk of abuse.  Their roles may include (but are not limited to) assessment of risk, safety planning, supportive counselling, education to client about their “rights,” and referral to other related services (community, legal, or otherwise).

Regulated professionals include:

Nurses (RN/PRN/BScN), Social Workers, Occupational Therapists, Physiotherapists, Pharmacists, Dental Hygienists, Dentists & Denturists, Massage Therapists, Dieticians, Optometrists and Opticians, Audiologists, Speech Language Pathologists, Naturopaths & Homeopaths, Kinesiologists, psychologists & Psychotherapists, Medical Laboratory Technologists, Medical radiation technologists, Physicians.

What resources do regulated professionals need?

  • Access to education about senior abuse, including ways to identify potentially abusive situations and prevent escalation of abuse by working to minimize client risk and increase supports.
  • Access to a supervisor or allied health team for support and guidance about suspected elder abuse.
  • Clear organizational policies and procedures about elder abuse including responses consistent with the organization’s mandate.
  • Clear occupational health and safety policies and procedures including workplace violence and harassment.

How does workplace safety and risk of violence in the workplace related to senior abuse?

Support provided by front line workers is typically carried out on a one to one basis, increasing personal safety risks. Employees have the right to refuse to work in environments if they believe that their personal safety is at risk. Your employer has a legislated responsibility to enact policies and procedures to ensure safety on the job.  Information on workplace safety/danger and violence/harassment.

https://www.ontario.ca/laws/statute/90o01#BK51

What are the different phases of Senior abuse response?

What is the process for responding to suspected cases of abuse?

Ask Yourself

  1. Why is this situation causing me concern? The concern could be a “gut” feeling, “red flag,” changes in the person’s “normal” behaviour, or an observation that something is different.
  2. What am I observing/experiencing? (What do you see/hear?)

Ask Yourself

  1. Is this considered abuse/neglect?

Steps of interventions required:

  1. Educate yourself elder about abuse reviewing both the warning signs of abuse and the indicators of abuse to help assess suspected abusive behaviour.
  2. Report/discuss your concerns with your supervisor.
  3. Document the indicators of abuse (be as objective as possible, important for possible police reporting). For help with documentation: http://www.bcli.org/sites/default/files/Counterpoint_Charting_Sheet_11-04-20.pdf

Ask Yourself

  1. Is the senior in immediate danger of physical harm? (If yes call 911)
  2. Are there concerns about the health or safety of the senior?
  3. Are there concerns about the capacity of the senior and/or caregiver (suspected abuser)?
  4. What are my professional duties according to my regulatory body? (Please refer to the regulatory body of your profession for clarification).
  5. What are the policies & procedures regarding abuse in my work place.
  6. What laws relates to this type of abuse? Do I have an obligation to report?

Steps of interventions required:

  1. If you are concerned about the health or safety of the senior, conduct a risk assessment in order to decide on an appropriate intervention process.
  2. Use the assessment tool approved for use at your workplace, to identify risk factors (for example the inter-rai-CHA, the OCAN, etc).
  3. If you are concerned about the capacity of the senior: ‘Best Practices’ http://www.bcli.org/sites/default/files/Counterpoint_Brochure_Mental_Capacity.pdf

Ask Yourself

  1. How can I help?
  2. What can I do?
  3. Is the senior open to receiving support about the suspect or witnessed abuse?
  4. Is the suspected ‘abuser’ open to change/interventions?
  5. Who can I collaborate with to support the senior and/or suspected ‘abuser’?

Steps of interventions required:

  1. Overcome your hesitation to help the senior.
  2. If the senior makes a disclosure of abuse, welcome the discussion by listening and being nonjudgmental (don’t feel like you have to solve the problem).
  3. Talk to the senior about your concerns. Ensure the suspected “abuser” is NOT Discuss the warning signs/indicators of abuse if the senior requires education about what constitutes “abuse.”
  4. Talk to the senior about the risks involved in an abusive relationship and educate the senior about the cycle of abuse (i.e that it often gets worse over time).
  5. Provide the senior with education regarding his/her rights – including the right to safety, security, independence, etc.
    1. Explain the importance of safety planning, and (with the senior’s consent) develop a safety plan to minimize risks.
    2. If the senior is capable include people from his/her support system (with consent).
    3. If the senior is incapable, involve the person holding the power of attorney (POA) or the substitute decision maker (SDM). If the abuser is the POA/SDM (and there are questions surrounding capacity) contact the public guardian and trustee for investigation.
    4. Collaborate and share the safety plan with other community partners involved care (with client’s consent)
  6. Engage in supportive counselling to empower the client regarding choices.
  7. Attempt to engage the caregiver/suspected “abuser” in changes/interventions.
  8. Identify and link to necessary supports and resources (with consent)
  9. Maintain documentations and contact with the senior

Ask Yourself

  1. As a result of the interventions has anything changed? (Improved? Stabilized? Or Deteriorated?)
  2. Is there anything else I can do at this point?
  3. Who else can help?
  4. Given the circumstances and the resources available, have I reached a point where I can do no more?

Steps of interventions required:

  1. Establish and clarify the roles and responsibilities of the various supporters involved.
  2. Develop a shared care plan among service providers (with consent). This will help to establish roles/responsibilities of those involved, and also identify limitations of organizational mandates.
  3. Revisit interventions/care plan and adapt as necessary. Is it working to keep the senior free from abuse? Are changes required? Is reassessment needed?
  4. Reinforce interventions as necessary while providing supportive counselling.
  5. Review the case with your supervisor or care team to receive feedback/support, and to acknowledge limitations of organizational mandate.
  6. If the case has progressed beyond the mandate of your organization, terminate services, with the invitation to reconnect at a later date.
Cases of senior abuse often requires working in collaboration of multi community partners. We all have a role to play in the prevention, intervention and response to Senior abuse and can help only within the boundaries of her practice.
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Need Help? Call the Seniors Safety line : 1-866-299-1011

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