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Good practice approaches to identify and respond to the abuse of an older person

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There are five commonly recognised categories of abuse: physical abuse, sexual abuse, financial abuse, neglect and psychosocial/ emotional abuse.

Elder Abuse
  • Physical abuse
    Intentionally inflicting physical pain or injury or physical coercion.
  • Sexual abuse
    Unwanted sexual acts including sexual contact, rape, language or exploitative behaviours where the older person's consent has not been obtained, where consent has been obtained through coercion, or where the older person is unable to consent due to cognitive incapacity.
  • Financial abuse
    The illegal or improper use or management of an older person's money, property or other financial resources.
  • Neglect
    The failure of a responsible person to provide the necessities of life - such as adequate food, shelter, clothing medical or dental care - to an older person. Neglect can be intentional or passive.
  • Psychological/ Emotional abuse
    The infliction of mental stress involving actions and threats that cause isolation, fear of violence, restricting or preventing social contact with others, deprivation, and feelings of shame and powerlessness.

It is essential that those working closely with older people have sufficient clarity and resources to identify and respond to abuse. There are essentially five stages to identifying and responding to abuse, as follows;

  • Identify abuse
    Consider whether a risk assessment Is appropriate. Where you suspect, have witnessed or have had abuse disclosed, gather information. Always take an account directly from the victim rather than the ·carer' or family member.
  • Assess immediate safety
    Evaluate the urgency of safety concerns. Contact emergency services where appropriate. Protect evidence. Report via internal channels.
  • Provide support
    Listen, acknowledge and validate. Offer information to support fully informed decision-making. Refer to other services as appropriate.
  • Inform manager and document
    Report suspected, witnessed or disclosed abuse in accordance with agency procedures. Document the abuse and response according to your agency's policies and procedures. Document where the older person has made an informed decision not to accept intervention.
  • Respond and refer
    Discuss the available options with the older person (not an intermediary). If the person does not have decision-making capacity, discuss the available options With the older person and their lawful substitute decision-maker. Offer Information in an easily understood way. Seek consent from the older person or their substitute decision-maker for referral. then make the referrals. Where the older person makes an informed decision to not accept assistance. assess whether their safety is at risk or there is criminal activity. Be aware of the need for additional resources such as language or culture-specific supports. Understand when it is important to act without the consent of the older person. Understand when to refer to the NSW Police - staff should refer to internal policies clarifying situations when police must be called for reports of violence, abuse and neglect. Coordinate and monitor as appropriate.

In all cases, individuals should follow their agency’s policies and procedures.

All agencies with significant interface with older people through service delivery are required to have a policy and procedures on abuse of older people. At a minimum, the policy and procedures should address the following:

  • How to identify abuse
  • Assessing safety, including when to report to emergency services, and protecting evidence
  • Approaches to providing support, including a list of resources and how to identify where additional support (such as language or cultural support) is needed
  • Procedures for documenting and reporting suspected, witnessed or disclosed abuse
  • Procedures for responding and referral, which balance the need for empowering the older person to respond, respecting their decision, and responding appropriately to criminal or other serious matters. These should also address duty of care where appropriate
  • How to balance privacy concerns and dignity with the safety of the client
  • When to refer to specialist services
  • How to respond when the alleged abuser also needs support.

If a crime is suspected, there should be a coordinated approach to any investigation or intervention, involving NSW Police and any other relevant authorities.

Anyone who has reasonable grounds to believe that an adult with disability or older adult is subjected to, or at risk of, abuse, neglect or exploitation can the Ageing and Disability Abuse line.  Reporters can be anonymous, have protections under the law and can be made to the helpline by phone on 1800 628 221 (Mon to Fri 9 - 5) or email via www.ageingdisabilitycommission.nsw.gov.au 

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We acknowledge the Traditional owners of the land on which we meet, walk, work and live. We acknowledge the elders past and present and the care they have given this country.

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