Risk factors and vulnerability factors

This section presents the risk and vulnerability factors, both for the elderly person and the abuser that predispose a situation to abuse. Current knowledge does not show, however, that there is a typical profile for an abused senior or an abuser.

Vulnerability factors

Characteristics specific to the senior that can make them more likely to experience abuse.

Risk factors

Related to the person’s environment.

In the elderly person

No one is safe from abuse: women and men of all ages, from disadvantaged or underprivileged backgrounds, diverse ethnocultural backgrounds, living at home or in residential care can pay the price. However, many vulnerability factors and risk factors predispose some seniors to be targets of abuse. The presence of these various factors does not systematically lead to situations of abuse.

  • Cohabitation with one or more relatives;
  • Conflicts with family members or friends;
  • Inaccessibility of resources;
  • Social isolation and underdeveloped social network;
  • Third-party financial dependency status related to sponsorship status and immigration ;
  • The senior and the abuser sharing the same home
  • Tension in the relationship between the senior and the person providing help.
  • Advanced age ;
  • Illiteracy;
  • Personal characteristics that may predispose to prejudices (eg, odours, appearance, etc.);
  • Disruptive or violent behavior toward caregivers (eg, aggression, reluctance to care, wandering, etc.);
  • Substance dependence (eg alcoholism, drug addiction, medication, etc.);
  • Dependence on others for the management of affairs (eg budget, bill payment, finances, etc.);
  • Dependence for basic care (eg, nutrition, hygiene, medication, etc.);
  • Difficulty in or inability to express oneself, submissive attitude, excessive trust in others;
  • Behavioral or emotional difficulties (eg mental health, depression, etc.);
  • Financial difficulties ;
  • Social and geographical isolation;
  • Lack of knowledge of both official languages ​​(French and English);
  • Lack of awareness of the rights and resources available to them;
  • Mistrust of public services (eg, health and social services, police, etc.);
  • Presence of physical health problems, cognitive loss or mental health problems;
  • Reluctance or resistance to receiving care;
  • Female gender.

In the abusive person

The abuser may be a son or a daughter, a spouse, but also a provider of care or services, a friend or a neighbor, etc. Like abused seniors, these individuals have their own risk and vulnerability factors.

  • History of family violence;
  • Addiction issues (eg, drugs, alcohol, gambling problem, etc.);
  • Mental and physical health problems;
  • Personal problems related to work, finances, family;
  • Financial dependence on the senior;
  • Social isolation ;
  • Lack of support;
  • Closest caregiver
  • Aid relationship imposed;
  • Lack of knowledge about diagnoses and the care to be provided;
  • Stress and exhaustion regarding the help needed, feeling burdened.

Protective factors

Protective factors are characteristics specific to the person (intrinsic) or to their environment (extrinsic) that tend to reduce the incidence of a problem, such as mistreatment.

The presence of protective factors does not necessarily mean the absence of vulnerability factors or risk factors. Protective factors are also not the opposite of risk or vulnerability factors. That said, when the following conditions are present, the older person will still be better protected …

Good self-esteem

  • Self-awareness, allowing them to recognize when to seek help, recognize achievements, accept failures and benefit from them;
  • Confidence: having a high level of trust in others;
  • Sense of responsibility;
  • Resourcefulness.

Ability to ask for help

  • Emotional support: being able to confide, be understood, receive advice, etc.;
  • Cooperation, mutual assistance;
  • Concrete support: being able to rely on someone when needed;
  • Safety net.

Understanding emotions

  • Understanding, recognition and appropriation of emotions;
  • Ability to express emotions and feelings;
  • Ability to cope with events and make sense of them;
  • Strategies for coping with stress.

Social participation

  • Sense of belonging (eg social belonging, social inclusion, social support);
  • Ability to put one’s skills into practice: willingness to mobilize knowledge and deploy various strategies in a particular context;
  • Sense of social competence.

Ability to learn about oneself and the community

  • Personal development: engaging in a hobby, self-learning, exercising, setting personal goals, continuing to learn throughout life.

Maintaining good lifestyle habits

  • Ability to project into the future, to detach, to relax, to recognize, etc.;
  • Encouragement of autonomy;
  • Establishment of positive and beneficial relationships with family members and one’s network of friends.

Network

  • Quality network or social support composed of suitable, available and equipped people;
  • Ability of the network to adapt to the needs of the senior and to use community services.

Environment

  • Healthy physical and psychosocial environment in which the senior feels safe;
  • Presence of local services (medical, community, etc.);
  • Living environments free from ageism and social exclusion.

Financial capacity

  • Availability of sufficient income;
  • Implementation of various means to secure assets.

Proper treatment

Being treated properly is about well-being, respect for dignity, fulfillment, self-esteem, inclusion and the person’s safety.

It is expressed through concerns, attitudes, actions and practices respectful of the values, culture, beliefs, life course, singularity and rights and freedoms of the senior person.

Proper treatment is seen as a positive approach and complementary leverage in the fight against abuse. It can prevent the onset of abuse by promoting positive attitudes and behaviours that respect the senior’s wishes and preferences. It is neither the opposite nor the absence of abuse.

Conditions that favour proper treatment

The six elements of this section are considered conditions favouring proper treatment. In short, well-being means to:

1. Place the person in the center of the action. The elderly person judges whether the action being performed or suggested is appropriate for them; if it is good for them.

  • Always consult the senior regarding any questions or choice concerning them; do not assume what they want or prefer.
  • Arrange work schedules, meal management, bedtime and waking routine, taking into account the senior’s preferences, as much as possible.
  • Discuss the senior’s life path with them, to get to know them better.
  • Consider the senior in their entirety; don’t define them by their age or health condition.

2. Promote the senior’s self-determination and empowerment to enable them to take charge of their life, to make choices in harmony with their values, lifestyle, culture, etc.

  • Allow the person to make their own decisions and respect them, even if they conflict with your values ​​or are not the best choice for ourselves.
  • Consult and involve the senior in all decisions concerning them.
  • Include the senior in discussions about choosing a new living environment that is better adapted to their physical condition.
  • Inform the person about their choices, rights, recourses and various legal concepts, in addition to offering them support.
  • Establish various committees so that seniors can play an active role in the governance of different organizations.

3. Respect the person and their dignity so that they feel considered and develop their self-esteem.

  • Knock on the door before entering, announce your arrival before going to the person’s home.
  • Arrange living spaces to respect their privacy as much as possible.
  • Stay at an “acceptable” distance for the senior; this distance may vary from one person to another.
  • Respect the confidentiality of conversations with the senior.
  • Adapt funeral services according to the rituals of the various ethno-cultural minorities as requested when a loved one dies.

4. Promote social inclusion and participation to promote wellness to seniors who wish to break out of their isolation and contribute to society.

  • Organize a neighbourhood party or other activities where neighbours of all ages and backgrounds can become connected.
  • Create a variety of social spaces in seniors’ living environments, for example, in common rooms.
  • Establish mentorship programs that allow experienced workers in a company to share their expertise with the youngest ones.
  • Ensure the safety of buildings and public places in the municipality (eg adequate lighting, clean and accessible spaces).
  • Encourage seniors’ volunteerism in community organizations.

5. Deploy actions and interventions combining skills (know-how) and judgment (soft skills).

  • Look at the senior when talking to them, use a respectful tone, encourage them to express themselves, be patient.
  • Develop a professional and personalized relationship with the senior.
  • Announce what you are about to do and explain what you are doing.
  • Ask the person how they want to be addressed, by name or surname
  • Know the techniques needed to move the senior safely during care.
  • Ensure that seniors’ caregivers know and understand their illness and the impact the illness may have on the senior’s behaviour.

6. Offer concerted support to take the most appropriate action for each aspect of the senior’s life (eg, housing, health, nutrition, love and family life, etc.), always respecting their choices.

  • Ensure that the relevant information is communicated between those who have to interact with the elder, for example, during shift changes in CHSLDs.
  • Support those who interact with the senior, especially caregivers (recognition, training, etc.).
  • Conduct a census of people in vulnerable situations in municipalities.