Executive Summary
Prepared for:
Department of Justice Canada
March 30, 2009
Prepared by:
The Strategic Counsel
21 St. Clair Ave E., Ste. 1100
Toronto, Ontario M4T 1L9
Tel: (416) 975-4465 Fax: (416) 975-1883
Email: info@thestrategiccounsel.com
Website: www.thestrategiccounsel.com
POR-048-08
Contract # 19040-080210/001/CY
Contract award date: 2009-01-08
The Strategic Counsel is pleased to present the Department of Justice Canada with this research report on qualitative research among Canadians regarding awareness and perceptions of elder abuse.
In May 2007, the Government of Canada created a National Seniors Council to give advice to the Government on matters of national importance to seniors. One of the first areas identified by this group was combating elder abuse. In the Speech from the Throne that was delivered that fall, the Government announced its intention to address elder abuse. Budget 2008 committed $13 million over three years to help seniors and others to recognize the signs and symptoms of elder abuse and to provide information on what support is available.
As part of the Justice Canada contribution to addressing elder abuse, a decision was made to undertake research on the awareness of elder abuse among Canadians. To better understand public opinion on elder abuse, two phases of research were to be undertaken. The first of two phases is comprised of a quantitative survey to determine existing levels of awareness of elder abuse among the Canadian public. The second phase of research, which includes the current study, is qualitative in nature and is comprised of two separate elements. The first step was to conduct a series of focus groups among various segments of the Canadian population to complement and specify the findings of the survey. This report summarises the findings from this research phase. The second step, to be conducted at a later stage, will test communication materials developed on elder abuse with a specific emphasis on financial abuse.
This report summarises the findings from a series of focus groups aimed at gauging general awareness levels among the Canadian public and providing guidance for future communication strategies.
The broad objectives of the research program for the 2008-2009 fiscal year are as follows:
The Strategic Counsel conducted a series of 15 focus groups to provide insight into the stated research objectives and follow up on the main findings of the quantitative phase of research. The focus groups were held in the evening in all locations in order to facilitate attendance for people (e.g. workers, students, retired). Each group lasted approximately 90 minutes and comprised a maximum of 10 participants. Formal recruitment screeners, included in the appendix, were developed prior to the start of recruiting. Recruiting grids for all locations can also be found in the appendix.
The focus groups were held in six locations, chosen so as to capture the views of a reasonable cross-section of Canadians from all parts of the country. Groups were thus held in Yellowknife, Vancouver (1 group composed of immigrants), Winnipeg (3 groups of Aboriginal participants), Toronto (1 group of immigrants), Montreal (in French, 1 group of immigrants) and Moncton (one French group and one English group) between February 17th and March 2nd, 2009. In order to explore potentially different views and understandings, participants were divided into three different age groups: 20 to 30 years old, 35 to 50 years old and finally, 65 years and older (56 years and older in the older immigrant group). The study’s results confirmed the importance of this approach since participants felt at ease in discussing age-related themes such as generation gaps and ageism.
Another important requirement of this research was to capture views from members of both Aboriginal communities and more recent immigrants to Canada. In order to allow for more in-depth discussion of issues that might be specific to Aboriginal communities, The Strategic Counsel held a series of three focus groups in Winnipeg comprised of only members of Aboriginal communities. Aboriginal individuals were also included in groups in Yellowknife, Vancouver and Toronto. A series of three groups, one in each of Vancouver, Toronto and Montreal, were held again with individuals born outside of Canada only. Some individuals born outside of Canada were also included in other focus groups. We also examined any differences in the perspectives of francophone and anglophone communities in Canada by conducting four of the groups (three in Montreal and one in Moncton) in French and the remainder in English. Finally, although it was not possible to also isolate groups on the basis of gender, moderators looked for any differences in perspective that appeared to be associated more with women or with men.
Important note on methodology and interpretation of findings:
The findings from qualitative research cannot be extrapolated to the broader target population with any degree of statistical validity. As such, this research does not present percentages or proportions, but rather seeks deeper understanding of participants’ opinions and attitudes on the topic of elder abuse. This research is meant to provide guidance and suggest directions for the Government of Canada and should not be read as a “representative survey” of Canadians.
Participants in most groups identified “isolation” of seniors from the wider society as a major social concern contributing to the conditions underlying elder abuse. The “isolation” was described as metaphoric and real, social and physical, and was equally raised by participants in all age groups. Lack of mobility due to physical frailty and cognitive dysfunction and lack of social supports, such as family, social network and transportation services to address the need for assistance, were seen as leading to loss of autonomy resulting in a major limitation on an individual’s quality of life by cutting them off from others. For many, Canadian society, as well as other Western societies (some resisted the idea that Europe was part of this problem, blaming North America instead) has collectively marginalized seniors. Social change, connected to exponential technological change, including the faster pace of life, greater mobility due to jobs, the focus on individual success and financial strain, was seen to have contributed to the isolation of those who require extra time, patience and care.
Older participants on the whole identified a feeling that seniors were no longer useful, or that they were devalued in the broader society. Older participants also talked of the negative effects of marginalization, in that their ability to contribute was discounted because of stereotypes based on their age. They tended to describe the emotional impact in terms of a lack of respect and a general loss of dignity and frustration at being treated as children or like they had “one foot in the grave”, often before they even had a chance to open their mouths. Isolation and loneliness was seen as making seniors more vulnerable to abuse, both because they would tend to overlook abuse from family in order to maintain contacts, and because the family support necessary to fend off potential abusers was lacking. Younger participants identified differences in values because seniors had grown up in a different time, and differences in technological savvy, as reasons why the input of seniors was sometimes of less use to them. The continuing decrease in the level of contact between the generations was seen as a key factor contributing to elder abuse. Adult children may have moved far from home for work, or may have to balance the demands of employment and their own children, and older people are “parked” or “discarded” to retirement homes or hospitals and left there to fend for themselves. Institutions dedicated to caring for the elderly are perceived to be under-funded and under-staffed, further isolating seniors.
Interestingly, this marginalization was seen as affecting mainly those whose families have been part of this western culture for many generations. Immigrants in all locations talked of a much higher level of respect for older people in their cultures compared to what they see here in Canada. This distinction between the level of respect for older people in the dominant culture of North America and that of other countries was also identified by numerous participants whose families have been Canadians for many generations, who lamented this state of affairs. Aboriginal participants also stated that their cultures had a higher degree of respect for older people, although many said that the erosion of traditional beliefs created by the residential schools system and other intrusions of modern culture were to blame for a declining level of respect for elderly members in their communities.
While the issue of elder abuse was seldom identified as a key concern for seniors on an unprompted basis, participants demonstrated a fairly good understanding of the types and causes of elder abuse once they were directly prompted to talk about this issue. How can we reconcile participants’ apparent lack of unprompted awareness of elder abuse with their apparently high degree of understanding of the issue? The answer to this question seemed to lie in the fact that people rarely, if ever, talk about elder abuse. Indeed, many participants described it as a private issue that was to be kept in the family, a sentiment that seemed to particularly resonate in the immigrant groups. This applied both to persons within the family who might be unwilling to “wash their dirty linen in public”, and to witnesses who might be hesitant to get involved in matters affecting the family, because it was not their business. Some participants said that the only time they hear about and thus think about, elder abuse is when it is reported by the media. It was most participants’ view that the main reason they do not talk about elder abuse is because of the lack of visibility of the issue: they don’t see it or hear about it. A few participants also felt that this topic was a taboo subject for most Canadians, and one indicated that “if we don’t talk about it, it doesn’t exist”. Other participants indicated that it just doesn’t come to mind unless some type of abuse-related event happens in one’s immediate social circle. Because the topic is not openly talked about, some participants believed that many victims, witnesses and even perpetrators may simply be unaware of abusive or potentially abusive situations, which also serves to explain, to some extent, the apparent lack of top-of-mind awareness of the issue.
It was interesting to note throughout the discussions that participants in all groups spoke interchangeably of “elders” and “seniors” in English and “aînés” or “personnes âgées” in French as being frail (physically and cognitively) and dependant. Although participants tended to speak in general terms and rarely identified a specific age range, all groups including the older participants (aged 65 years and above) in all locations did not include themselves as “old” or vulnerable to abuse, but most often referred to “old people” or “les vieux” as individuals who were much older than themselves.
Despite low top-of-mind awareness, participants were well-versed on a number of factors that can make seniors more vulnerable to abuse and obviously spend more time discussing these factors than the issue itself. Apart from sexual abuse, which evidently made participants very uncomfortable, it was also noticeable that individuals were relatively at ease with talking about the topics at hand. Participants also had a difficult time trying to estimate the extent of abuse in Canadian society because they felt they only heard about the most extreme cases and many could not give any estimate as to extent of other forms of abuse, while others gave very tentative answers. Participants indicated that there is a large grey area in where the lines are between what constitutes abuse and what does not, particularly with regard to family interactions, and so people might not be certain that a behaviour they see or experience would constitute elder abuse. Participants thought that additional information on what constitutes elder abuse would likely help people change their own behaviours as well as encourage victims to speak out. Participants in one group indicated that mistreatment was a better way to explain the behaviours than abuse, as it was broader and might help individuals consider the impact of their actions. Two of the younger francophone groups indicated that there was a different between “mauvais traitements” and “violence” with the latter being more aggressive and intense.
While physical abuse was the most common first example given by participants when asked to name types of elder abuse, participants were able to identify a very wide array of types of abuse (including emotional/psychological and financial abuse) and to provide examples from the most visible, and sometimes violent, forms to more subtle cases. It was notable that participants in all groups moved rapidly from the example of physical abuse to discussions of situations of neglect, which occupied more of the discussion. Neglect seems to be connected in most participants’ minds with the fact that seniors were not valued and respected in the broader society, although the neglect was also discussed in terms of family. One participant said in a very poignant manner that the most important problem facing seniors was a chronic lack of love and a fear of losing the love of their families.
It was also noticeable during the groups that participants possessed a good understanding of the main concerns facing seniors in Canadian society beyond the issue of abuse. Health and healthcare clearly dominated the list of concerns, as well as many other issues that were also identified as the major factors leading to greater vulnerability to abuse. These included physical frailty and cognitive dysfunction, which lead to lack of mobility and autonomy, and consequently dependence on others, resulting in isolation and reduced personal safety, exacerbated by poverty and lack of adequate housing.
Immigrant participants also more readily identified language barriers as a key issue facing seniors in Canadian society. Aboriginal participants also discussed language barriers, as well as the harmful impact of historic discrimination and the resulting higher levels of substance abuse, as major problems facing seniors in their communities.
Participants in most groups identified physical frailty and cognitive dysfunction as two of the most important factors making seniors vulnerable to elder abuse. Interestingly, many of the male participants began with a discussion of institutional abuse, whereas the female participants often began with family violence. On the whole, the groups were more comfortable discussing the behaviour of abusers in institutional care, where they tended to discuss individuals who had criminal tendencies. When participants turned to discussions of family, they tended to begin listing extenuating circumstances that could to some extent justify the behaviours, such as a prior history of family violence, financial strain or drug or alcohol abuse. Most participants were of the opinion that the situation mostly triggers the abuse, and not the personality type. Participants indicated that anyone could be the abuser, including abuse between older people and abuse of older people by adolescents.
There was a general consensus that elder abuse transcends culture – “when you’re old, you’re old”. At the same time, many participants from the immigrant groups commented that in Canada, seniors seem to be seen as a burden and so institutionalized, rather than as a moral obligation, and so cared for at home. Aboriginal participants discussed a decline in traditional values associated with the care of seniors. Factors that were seen to magnify the vulnerability of seniors were: physical frailty and cognitive dysfunction; dependency (both dependency on others for simple tasks and for necessities, such as food and shelter, transportation and dispensing medication); lack of respect and stereotyping; isolation; technological change; continuing to hold more traditional values; language barriers; and institutional shortfalls (lack of resources and trained staff in retirement homes and hospitals).
Interestingly, many were of the view that seniors living in large urban centres were more at risk of being abused than those living in rural areas. Cities were seen as having more services but less chance of individual attention than smaller centres where seniors are known to more people. Larger cities were seen as more anonymous, making it more likely that older people may be isolated and forgotten. Some participants spoke of having to rely on others when help is farther away geographically, such as power-outs in the winter in the North. On the other hand, some participants thought that small town seniors may not be able to get away from abuse as much as they might in a larger centre, and might have less access to public transportation and social activities.
Participants saw health concerns as the primary factor directly affecting a person’s ability to defend themselves and to be heard, leaving them vulnerable to abuse. Diminishing health results in diminishing quality of life , described by some as being treated like children, impatience with slower (often elderly) people on foot or in cars, in lines or at bank machines, as well as a certain disinterest in elderly people in general – being listened to less and shrugged off more. Widespread technological change has contributed to a loss of access to information and reduced family interaction, again leading to isolation. Physical abuse was often seen to be taking place in institutional settings, while financial abuse was seen to be more common where seniors remained in the broader community.
Many participants described an uncertainty as to what behaviour constituted abuse, along with a lack of public awareness, as a key reason why many cases were left unreported. Their reasoning was that the less people were aware of the issue, the less likely they would notice it. As mentioned above, there was also some discussion about a general lack of understanding of what was and what was not abuse, particularly in family interactions. Lack of top-of-mind awareness was also seen to make it easier for individuals to pretend the issue was not happening or that it was not their business. Most participants felt that it would be very difficult for a victim to report a case of abuse involving their own family, and in particular an adult child because it risks disastrous consequences on the family. Participants felt there was additional hesitation where the caregiver was involved, as the senior would be concerned about the consequences for that family member on whom they were dependent or losing their care. Finally, participants felt that they would not know who to call or where to turn for help if they wanted to report an abusive situation and thought victims might be in the same situation.
Witnesses of abuse were believed to be put in a difficult situation as well in that they did not know about the legal consequences of their actions/inactions and that more information was needed about the consequences of becoming involved. In family situations, the witness might end up not only destroying the family but also inheriting the care for the elderly person. Participants also spoke about fear of reprisals and risking escalation of the behaviour if the abuser was not punished as a result of the complaint. Participants wanted to know if it was possible to ask questions about a case without having to formally identify themselves. They also wanted to know of someway of resolving the situation without having to press charges. The difficulty in proving many forms of abuse was also perceived to be a key barrier to reporting because a witness who was willing to help could unwittingly themselves become entangled in the legal process.
Many participants identified pride and shame as the main barriers for why victims did not report the abuse. Many felt that it was difficult for a senior to admit that they had been victimized, particularly where they were defrauded or taken advantage of by a stranger. Where the abuse involved a family member, many participants also stated that they would not report because it would be embarrassing or reflect badly on the family or even their own parenting of their now adult child. This sentiment came out across all groups, but was somewhat stronger in the immigrant and Aboriginal groups. Older immigrant participants believed there would be additional hesitancy to report abuse where in the home country, if you spoke out there would have been serious consequences.
Others pointed to the general isolation of older persons as a key problem. Isolated victims meant that few witnesses would be aware of the situation and that the victim would likely have no one to turn to who would believe them. Lonely individuals were also seen to be more likely to tolerate abuse in exchange for human contacts and some form of assistance.
In light of the barriers identified, most respondents were of the view that public education was crucial in breaking the silence by both victims and witnesses. Clear information was needed on: the parameters of elder abuse; informing seniors of their rights; telling people where to go for help and to report abuse; and what would happen once a complaint was filed. Education was deemed to favour increased vigilance as well as understanding one’s rights and responsibilities and knowing the consequences of taking action.
Overall, many participants felt that a general attitude change was needed in society that would address the silencing effects of ageism; a change that would see all treated with respect. Raising awareness might help, stressing that age happens to everyone and so everyone will at some point face the same issues and the same stereotypes, discrimination and ageism. More contact between the generations and more positive images of seniors in society was also seen as important to changing social perceptions and making this issue of more of a concern to all Canadians.