Abuse, the silent problem.

01 March 2017

Caring for the elderly is complex. Though your organization carefully selects employees and volunteers, it might one day be faced with allegations of abuse. By recognizing potential exposure and understanding the need for a prevention program and training, your organization will be ready to respond should an incident occur. By choosing to include abuse coverage into your commercial insurance package, you can take a step further to help protect your organization.

Abuse is usually excluded from Commercial General Liability (CGL) policies. By adding abuse coverage to your insurance package, your organization will be financially protected in the event of allegations of abuse against your employees, volunteers and/or organization. How does it protect you? It includes:

  • Lawyer's fees, experts' fees and expenses such as disbursements, expenses incurred in the counseling, negotiation, arbitration or appeal
  • Internal investigation expenses
  • Additional expenses, such as rehabilitation, mental health services, medication and medical expenses in the event of an insured claim, your organization will be covered for up to $10M per occurrence, up to $20M in aggregate for one year, and your Commercial General Liability (CGL) limits will not be impacted.

Elder abuse has become increasingly common across Canada. In 2015, more than three-quarters of a million Canadian seniors suffered some form of abuse, including physical, sexual, psychological, financial abuse and neglect. In Ontario alone, there may be as many as 200,000 seniors being abused – often in silence. 1 Although a universal definition of the term ‘elder abuse’ does not exist, Health Canada has defined it as “the physical, psychosocial or financial mistreatment of a senior” – through deliberate action or inaction – by someone they should be able to reply upon. Power and control underlie all abuse situations.

There are five main categories of elder abuse:

  1. Emotional or psychological abuse is the infliction of mental anguish or suffering. It is the highest form of elder abuse 
  2. Financial abuse is the second most common form of abuse and includes theft, fraud or any improper use of a senior’s assets or funds. A report shows that adult children or grandchildren are responsible for 37% of financial abuse (while 10% is being committed by strangers)1 
  3. Physical abuse is the use of unnecessary force, causing pain, injury or harm to a senior. Any act of violence or rough treatment causing injury or physical discomfort qualifies as physical abuse 
  4. Neglecal is the refusal or failure to provide services or necessary care to a senior 
  5. Sexual abuse is characterized as non-consensual sexual activity or inappropriate comments of a sexual nature directed at a senior 

Other types of elder abuse include medication abuse (this could be withholding medication or overmedicating), medical abuse (any treatment done without the informed consent of the senior) or the violation of civil/human rights (for example: denial of privacy, denial of visitors or mail censorship).

Many of the above, such as physical assault, sexual assault, uttering threats, unlawful confinement, failing to provide the necessaries of life, theft and fraud are considered crimes under the Criminal Code of Canada. Other types of abuse, like harassing telephone calls, stopping mail with intent, forcible confinement or intimidation also fall into this category. Contrary to common belief, most victims are mentally competent and do not require constant care. They are often victims of ageism, or, in other words, have been removed from the decision-making process due to the belief that they are frail and incapable of making their own decisions.

Elder abuse can be perpetrated by family, friends, paid care providers, landlords, staff or any person in a position of trust or authority. According to a study by the Government of Ontario, the single largest factor that contributes to the development and/or maintenance of an abusive relationship is isolation.2

How can you identify the signs of abuse? Unexplained injuries, depression, fear, anxiety, detachment, withdrawal, changes in hygiene, signs of malnutrition and unusual bank withdrawal are all signs that a senior might be the victim of abuse.

Unfortunately, elder abuse is rarely reported, due to:

  • Fear. The victim is afraid of reprisal or of not being believed 
  • Control. The victim is completely under the control of the abuser or depends on them for food, medication or other essentials 
  • Misinformation. The victim believes they will be put in an institution if they report the abuse, or does not realize that they are being abused 
  • Shame. The victim feels too embarrassed or guilty to report the abuse because someone close them is harming them 

Sometimes, service providers fail to report elder abuse. They might be reluctant to raise the issue because they are not sure the victim will accept help, or they believe the information should be kept confidential. In some cases, abuse remains unreported due to a failure to recognize it is a crime, or due to a lack of understanding. As such, training and education play an essential role in preparing caregivers and mitigating abuse. By hiring certified and fully trained staff, you can help prevent abuse, provide the highest standard of care, and ensure the right steps are being taken should you suspect someone is the victim of abuse.

There are plenty of issues to consider when it comes to running your organization. In today’s technology driven environment, cyber attacks and data breaches are not uncommon. To find out about more coverages to discuss with your broker that will help protect your organization, keep your eyes peeled for our next blog on Cyber Insurance!

1 www.citynews.ca/2016/05/26/new-study-gives-shocking-snapshot-of-elder-abuse-in-canada/

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contact Suzanne Liberman
Managing Director - Healthcare