Financial Exploitation

Abusive Behaviours:

• Criticizing an older adult’s spending choices
• Pressuring an older adult to offer financial assistance, repeated borrowing, or unpaid loans
• Using an older person’s money for unintended purposes, e.g. for the personal use of someone other than the older person
• Using an older person’s resources (e.g. food, car) without payment or permission
• Moving into or not moving out of an older person’s residence, against their wishes
• Over-bearing, aggressive, or underhanded control of an older person’s funds
• Gifting or excessive spending of an older person’s funds
• Restricting access to funds
• Withholding bank or credit card statements, bills, or other financial statements
• Misuse of personal checks, credit cards, or accounts, including online activity
• Theft of money and property
• Fraud or extortion
• Forging an older person’s signature, engaging in identity theft
• Pressuring or forcing an older person to change legal documents
• Compelling or coercing an older person to grant or change a Power of Attorney (POA)
• Intentional or unintentional misuse of a POA
• Forcing the sale of property or possessions against an older person’s wishes
• Overcharging for services

Possible Indicators:

• Unrealistic burden of care for housing/support of children/grandchildren/great-grandchildren
• Unwillingly used as a babysitter or housekeeper
• Unusual or frequent withdrawals of money or withdrawals inconsistent with the older person’s means or historical patterns of spending
• Financial activity the older adult is incapable of performing, such as ATM withdrawals when bedridden
• Older person’s lack of knowledge of his or her own financial situation
• Concern or confusion about money given or loaned
• Older adult seeking permission to spend own money
• Others insisting on handling or controlling finances
• Unable to use money for things the older person needs or wants
• Unpaid bills although the older adult can afford to pay them
• Level of care not commensurate with the older person’s income or assets
• Sudden or unexplained changes in an older person’s financial condition, e.g., diminished standard of living, inability to pay bills, insufficient money for food, clothes, required aids, or social activities
• Disappearance of cash or possessions
• Suspicious changes in wills, power of attorney, titles, and policies
• Addition of names to an older person’s bank accounts, investments, real estate etc.
• Unnecessary services, goods, or subscriptions
• Excessive charitable contributions
• Property sold without permission
• Other(s) believing that an older adult does not need all of his or her money

Emotional/Psychological

Any intentional/unintentional action, inaction, comment, or threat that causes emotional anguish, fear, or diminished self-esteem or dignity

Abusive Behaviours:

• Using condescending language
• Treating an older adult like a child – e.g., using baby talk
• Talking about an older person or the person’s affairs in his or her presence as if the older adult is not there or cannot hear, not including the older adult in conversations
• Expecting an older person to look after grandchildren when beyond his or her wishes or ability
• Denying access to grandchildren
• Alienating family and friends
• Denying or refusing to allow access to community groups or programs
• Isolating an older person from friends, activities, family gatherings, social events
• Habitual verbal aggression, name calling
• Intimidation through yelling, threatening, bullying, ridiculing, insulting, mocking, scolding
• Withholding affection, shunning, ignoring as punishment
• Humiliating an older person in public or private, including online through social media
• Blaming or scapegoating
• Falsely accusing
• Threatening violence or retaliation, terrorizing, or menacing
• Questioning competency
• Excluding an older adult from decision-making
• Threatening to put an older person in a ‘home’
• Misuse of Power of Attorney for Personal Care
• Making harassing phone calls
• Mocking or challenging an older person’s mental or cognitive capacity
• Mocking or challenging an older person’s ability to communicate
• Refusing to facilitate access to English as a Second Language classes
• Threatening to send an older adult back to his or her country of birth

Possible Indicators:

• Sudden changes in behaviour
• Few or no visitors or outings
• Withdrawn, depressed, extremely passive
• Low self-esteem
• Resignation, helplessness, hopelessness
• Tearful, emotional
• Inappropriate guilt
• Anxiety, agitation
• Older adult is overly apologetic and frequently puts himself or herself down
• Older adult apologizes frequently for poor English, calls himself or herself stupid
• Sleep disturbance, sleeping too little or too much
• Change in eating patterns
• Change in weight
• Fearful, cowering
• Reluctance to talk openly
• Confusion, forgetfulness
• Contradictory statements, or other ambivalence, not resulting from mental confusion
• Older person appears nervous when a specific individual/s is present
• Avoidance of physical, eye, or verbal contact with specific individual/s
• Excessive deference to specific individual/s
• An individual with an older adult shows an unusual amount of concern (too little or too much); speaks on behalf of the older person; makes decisions for the older person with little or no consultation; is reluctant to leave the older person alone with professional or others

Physical

Any act of violence or rough treatment causing injury or physical discomfort

Abusive Behaviours:

• Rough handling, pinching, squeezing, pushing, shoving, poking, jerking
• Hitting, kicking, punching, slapping, choking, biting
• Burning, shaking, twisting, pulling hair
• Force feeding
• Restraining
• Forced confinement in a room, bed, chair, home, etc., locking in a car
• Throwing objects, use of weapons
• Improper use of medication, including overmedicating or withholding medication
• Attempting to apply force or threatening (by act or gesture) to apply force to an individual in such a way that the individual can reasonably expect the threat or action to be carried out

Possible Indicators:

• Unexplained physical injuries such as cuts, abrasions, bumps, burns, bruises, finger/grip marks, welts, scars, lacerations, punctures, fractures, sprains, dislocations, rope marks, swelling, symmetrical grip marks, internal injuries
• Unexplained falls
• Explanation for an injury does not fit the evidence
• Delay in seeking treatment
• Injury to scalp, evidence of hair pulling
• Pain or discomfort or signs of under-medicating
• Appears ‘drugged’ or unusually lethargic, or shows other signs of over-medication such as tremors
• Drug or alcohol abuse
• Confusion, disorientation
• History of accidents, claims of being ‘accident prone’
• Broken eyeglasses or frames
• Excessive repeat prescriptions or failure to take medication regularly (prescription not finished when it should be)
• Seeking medical attention from a variety of doctors or medical centres

Sexual

Any sexual behaviour directed towards an older adult without that person’s full knowledge and consent

Abusive Behaviours:

• Rape – forcing intercourse with self or others
• Sexual assault, sexual harassment
• Any unwanted form of sexual activity, e.g., touching, fondling, kissing
• Inappropriate sexual comments or jokes
• Forcing person to commit degrading acts
• Showing pornographic material
• Forcing an older adult to watch sex acts
• Forcing an older person to undress
• Over-involvement with dressing and personal hygiene
• Withholding sex or affection

Possible Indicators:

• Pain or bruises in genital area
• Unexplained vaginal or anal bleeding
• Torn, stained, or bloody underclothing
• Bruises around breasts
• Unexplained venereal disease or genital pain, itching, or infections
• Difficulty walking or sitting
• Frequent complaints of abdominal pain
• Rope marks or other signs of physical restraints
• Unexplained changes in behaviour such as aggression, withdrawal, or self-mutilation
• Sexual behaviour that is out of keeping with usual relationships and personality

Neglect/Abandonment

• Intentional or *unintentional failure to provide the basic necessities of care by an individual/organization in a position of trust
• * Possibly due to lack of experience, information, or ability
  Self-neglect is not considered to be abuse.Abusive Behaviours
• Failure to provide adequate food, water, clothing, shelter, health care, hygiene, exercise, social stimulation
• Failure to provide a safe environment
• Failure to provide adequate supervision
• Withholding services

Possible Indicators:

• Unusual weight loss, malnutrition, emaciation, dehydration, mouth sores, delirium
• Missing dentures, glasses, hearings aids/batteries, assistive devices
• Missed or cancelled appointments, withholding of medical or other services
• Left alone at home or in public when supervision or assistance is required
• Lack of required safety features in home
• Unsafe living conditions (no heat or running water, faulty electrical wiring, other fire hazards, lack of ventilation in hot weather)
• No phone access
• Confined to bed, chair, room, or house
• Home in disrepair
• Fridge and cupboards contain little or no food
• Untreated medical or physical problems, such as bed sores
• Unsanitary living conditions: dirt, bugs, soiled bedding and clothes
• Unkempt appearance – clothing soiled or ill-kept
• Poor hygiene, unpleasant odour, open skin sores
• Unsuitable clothing or covering for the weather
• Frail or cognitively impaired and presents alone or without regular caregiver
• Lack of access to other care providers, e.g., doctor, dentist, therapist
• Lack of social contact

Violation/Denial of Human/Civil Rights

Any action or inaction that takes away the basic rights and freedoms to which all Canadians/residents are entitled

Abusive Behaviours:

• Withholding or restricting access to information
• Restricting right to privacy
• Denying access to religious worship
• Denying opportunity for informed consent
• Interference with or censoring mail
• Accessing personal information (e.g., email, online bank account) without permission
• Unwanted confinement
• Restricting social contact
• Restricting access to community supports
• Denial of independent legal advice
• Restriction of liberty
• Threatening deportation

Possible Indicators:

• Rarely seen outside
• Not making or receiving calls
• Not seeing family or friends, or not attending faith or social gatherings
• Restricted access – difficulty visiting, calling, or otherwise contacting an older adult
• An older adult makes excuses for social isolation
• Not receiving information to enable an informed choice
• Not given opportunity to understand documents being signed
• Not allowed to express opinions or to vote
• Isolation