By Krista James
On December 8, the B.C. Seniors Advocate released a systemic review of elder abuse and neglect in British Columbia. The report, Hidden and Invisible, indicates elder abuse is on the rise.
It draws a parallel with child abuse, finding B.C.’s policy regime deficient partly due to the lack of a centralized elder-abuse reporting line. Media coverage has emphasized this clarion call to develop a single point of contact for reporting elder abuse and neglect in B.C.
The problem with this messaging is that older people are not children. Consequently, they are entitled to both privacy and respect for their decision-making autonomy.
Sometimes, for example, when we witness violence and an older person is at risk of immediate physical harm, we should call 911. If an older person living with advanced dementia is being neglected and they cannot reach out for help, we should contact the relevant provincial health authority so they can assess the situation.
Other times, such as when we can see an older woman’s health is declining, and she is afraid of a family member who yells at her frequently, the better approach might be to ask how she is doing, keep in regular touch, let her know about helpful agencies, and help her call them when she is ready.
B.C.’s regime for elder-abuse response is multifaceted because abuse requires different kinds of responses, depending on the older person’s unique circumstances, who is hurting them, and, perhaps most importantly, what the older person wants.
B.C.’s Adult Guardianship Act applies to abuse, neglect, and self-neglect of adults who are unable to seek support and assistance themselves due to restraint, disability, illness, or disease. The law allows anyone to report concerns to health authorities and requires a response to every call.
The law permits both voluntary and coercive action by the health authorities ranging from offering a tailored support and assistance plan to entering the premises to forcibly remove the vulnerable person, bring them to a safe place, and provide emergency care.
The Adult Guardianship Act applies only to adults who cannot understand their situation or access help on their own because as a society we recognize that competent adults have a right to make their own choices, including living in risky situations.
Decades of research on violence against women has taught us a lot about responding appropriately to relationship violence. Abuse robs a person of freedom. Best practices emphasize responses that do not further undermine autonomy.
The Office of the Seniors Advocate notes that, based on responses to their survey, a very small number of British Columbians who witness elder abuse and neglect report the abuse. This data does not trouble me. Only a small number of instances of elder abuse and neglect call for a report to police or health authorities.
Elder abuse always requires a response; however, it does not always require a report. The notion of a 1-800 reporting number is compelling because we want someone to come in and fix the problem, rescue this older person. The method is anonymous; it allows us to pass the problem-solving onto someone else.
In reality, supporting an older person who has experienced abuse is usually more complicated.
This province should prioritize funding to enhance the capacity of communities and agencies to support older people who experience abuse or neglect. B.C. should increase funding to nonprofit community agencies to make robust victim assistance available to older people who need help, including to develop accessible transition housing that addresses their complex needs.
As citizens, we all need to find ways to respectfully offer support to older people who are being abused. Check out the It’s Not Right! Program offered by the B.C. Association of Community Response Networks to learn how you can help.
The report of the seniors advocate contains important findings. It rightly calls for a review of the Adult Guardianship Act and an examination of how it has been implemented. It highlights the need for better elder-abuse data collection and enhanced training for people who respond to elder abuse in their work.
But a 1-800 line is not a panacea for this complex problem. The emphasis on an integrated point of contact is misguided both because coercive though well-meaning third-party action is rarely appropriate and different situations point to different kinds of support. In many situations, calling a 1-800 reporting line would be paternalistic, ageist, and harmful.