The Counterpoint Project

Responding to Elder Abuse and Neglect:
Challenges for Health Care and Social Service Workers

The purpose of the Counterpoint Project is to help health care and social service providers negotiate the various legal and ethical challenges in elder abuse prevention and response.  The resources produced as part of the Counterpoint Project includes a plain language discussion paper, guidelines for a continuum of health care providers, print tools and videos.

The Discussion Paper

The Counterpoint Discussion Paper, Moving From Scrutiny to Strategy: An Analysis of Key Canadian Elder Abuse and Neglect Cases, reviews a number of recent elder abuse and neglect cases that have been recorded in Canadian court decisions – largely criminal cases.  The cases serve as a backdrop for highlighting social dynamics at play in elder abuse cases, comparing relevant legislation across the country, clarifying legal obligations to respond to elder abuse under legislation and professional codes of ethics, and making recommendations for protocol and policy development, and professional development and training to support the practice of health care and social service workers in the area of elder abuse and neglect.

The Counterpoint Tools: Resources to Enhance Practice

The CCEL has produced an assortment of tools to support practice of health care and community services professionals with respect to elder abuse and neglect prevention and response by clarifying obligations under the various laws that impact on this area.

The tools available as part of this series include:

Confidential Patient and Client Information (Brochure)
Mental Capacity and Consent: (Brochure)
Charting Sheet (Form)
Factsheet for Administrators
Factsheet for Doctors
Factsheet for Nurses
Factsheet for Personal Support Workers
Guidelines for Developing Improved Practices
Table of key legislation in each Province and Territory
Video series

Background

Like many professionals who work with an older adult clientele, health care and community service workers appreciate that elder abuse is a growing phenomenon, but encounter significant barriers in responding to concerns in the context of their practice.  People working in health care and community services are uniquely positioned to detect circumstances of abuse and neglect or identify older adults at risk by virtue of opportunities to interact with older adults in their homes, communicate with their other formal and informal caregivers, and make observations about their health and well-being.  By virtue of their mandate to deliver care and services, this community of professionals is also well situated to develop relationships of support that could mitigate against increased vulnerability and further abuse or neglect.

However, in practice, addressing elder abuse and neglect raises difficult questions and poses ethical dilemmas.  Here are but a few of the tricky questions health care and community service workers are confronted with on a regular basis:

• What is my obligation to respond to abuse and neglect?

• Does my duty apply to risk of abuse?

• How can I simultaneously adhere to professional practice guidelines, adult protection laws and other relevant legislation, and employer policies?

• What is my duty when these rules appear to conflict?

• What confidentiality rules apply to practice?

• How can I respond to concerns regarding risk in a manner that respects an older adult’s right to privacy and independence and decision to live at risk?

• How can I support the older adults I work with to live (and sometimes die) with dignity, and to age in place, without abandoning them to abusive relationships?

• How can I accomplish the above in a context of increasing deinstitutionalization of health care and greater emphasis on community care?

Elder abuse is a complex social problem and the network of rules and guidelines surrounding adult protection can present a maze of information.  None of the above questions lends itself to a simple answer.  Collectively these questions begin to illustrate the extent to which addressing elder abuse and neglect may present practitioners with additional daily stressors on top of a job description that is likely very demanding.  The Counterpoint tools are intended to support health care and social service providers to navigate the many challenges they encounter in addressing concerns in relation to elder abuse and neglect.

This project has been supported by the Division of Aging and Seniors, Public Health Agency of Canada, under the Federal Elder Abuse Initiative.

The opinions expressed in the materials developed for this project are those of the Canadian Centre for Elder Law and do not necessarily reflect the official views of the Public Health Agency of Canada.

Keywords: elder abuse, neglect, seniors, violence, older adults, health care, social services, Canada, legal obligations, confidential personal information, mental capacity, adult protection, disclosure, recommendations, educational tools, court cases,