NATIONAL SURVEY ON THE MISTREATMENT OF OLDER CANADIANS 2015 INTO THE LIGHT: NATIONAL SURVEY ON THE MISTREATMENT OF OLDER CANADIANS 2015 EXECUTIVE SUMMARY his study is one of the largest studies of a single country and was funded by Employment and Social Development Canada (ESDC) and five provincial T governments that over sampled in the provinces of British Columbia, Alberta, Ontario, Quebec and New Brunswick. The study was based on a two-year pilot study, Defining and Measuring Elder Abuse and Neglect – Preparatory Work Required to Measure the Prevalence of Abuse and Neglect of Older Adults in Canada, (HRSDC, 2010). GOALS OF THE STUDY 1. To estimate the prevalence of five forms of mistreatment in a large, representative, nation-wide sample of community dwelling, older Canadians through direct respondent interviews; 2. To estimate the risk factors (correlates) of elder abuse and neglect; 3. To explore the relevance of life course conceptual framework to the study of elder mistreatment. METHODOLOGY A population-weighted sample of all Canadian residents 55 years of age and older was developed that yielded a representative sample of 8,163 Canadians. The sample was limited to community dwelling older adults who were interviewed by telephone in English and French by the Institute for Social Research (ISR) located at York University, Toronto Ontario. The survey instrument examined five subtypes of mistreatment: (1) neglect, (2) psychological abuse, (3) physical abuse, (4) sexual abuse and (5) financial abuse that had occurred in the last 12 months. Mistreatment usually refers to the four types of abuse plus i neglect (1 through 5) and elder abuse often refers to the four main types of abuse (2 through 5).1 RESULTS PREVALENCE • The aggregate prevalence for elder abuse in Canada for the last year was 7.5% (physical, sexual, psychological and financial abuse) representing 695,248 older Canadians; • The aggregate prevalence for mistreatment for the last year was 8.2% (physical, sexual, psychological, financial abuse and neglect) representing 766,247 older Canadians; • The prevalence of psychological abuse was 2.7% representing 251,157 Canadians; • The prevalence of physical abuse was 2.2% representing 207,889 Canadians; • The prevalence of sexual abuse was 1.6% representing 146,649 Canadians; • The prevalence of financial abuse was 2.6% representing 244,176 older Canadians; • The prevalence of neglect was 1.2% affecting 116,256 Canadians; 1 The concept of neglect is difficult to measure and has been the source of considerable controversy in the literature, particularly self-neglect. The research team decided that self-neglect would be omitted because it is difficult to be both a perpetrator and a victim. Two types of prevalence were therefore calculated for those who include neglect in their prevalence counts and those who do not include this concept. ii • There was a gap between what respondents reported on standardized scales of elder abuse and how they actually felt about the abuse, raising questions about the estimation of elder mistreatment and peoples’ understanding of elder abuse. PERPETRATORS • In situations of physiCal abuse the perpetrator was a spouse/ex-spouse (34.0% of physical incidents), followed by a child or grandchild (27.0%), a friend (12.0%), a service provider (7.0%), someone at work (7.0%), a sibling (4.0%), a neighbor or acquaintance (4.0%), and lastly, a stranger (3.0%); • In situations of sexual abuse the perpetrator was a friend (50% of incidents), followed by a spouse (19%), someone at work (11%), a service provider (9%), followed by a stranger (7%), and a neighbor or acquaintance (2%); • In situations of finanCial abuse, the perpetrator was an adult child or grandchild (37.0% of incidents), followed by a spouse/ex-spouse (22.0%), siblings (15.0%), stranger (10.0%), friends (8.0%), service provider (4.0%) and last, neighbours or acquaintances (3.0%); • In situations of psyChologiCal abuse, the perpetrator was a spouse/ex-spouse (41.0%), followed by an adult child (25.0%), a friend (12.0%), a sibling (9.0%), someone at work (6.0%) a service provider (4.0%) and lastly, a neighbor or acquaintance (1.0%); • Taking all situations of negleCt into account, the perpetrator was their spouse/ex- spouse (31% of incidents) followed by their adult child/grandchild (25%), a neighbor (14.0%) followed by their friend (11.0%), a caregiver (9.0%), a sibling (5.0%) and lastly a service provider (3.0%). iii RISK FACTORS Those risk factors for abuse that were the most consistent and in order of importance were: higher depression scores as measured on the C-DES, having been abused as an adult, a child, a youth, having higher unmet ADL/IAD needs, not feeling safe with those closest to respondent, living outside of Quebec, being single as compared to being married, and lastly being female. LIFE COURSE CONCEPTUAL FRAMEWORK The conceptual framework for the life course has led to new and significant predictors of elder mistreatment, with abuse at earlier stages in life (childhood, youth and middle age) significantly correlated with elder abuse in later life. iv RESEARCH TEAM PrinCiple InvestigatoR/ Institute for SoCial ReseaRCh AuthoR YoRk UniveRsity Dr. Lynn McDonald University of The telephone interviews were carried Toronto out by the Institute for Social Research (ISR) located at York University, located SpeCial AdvisoR, FrenCh at Toronto, Ontario. The ISR houses the largest university-based survey research Dr. Marie Beaulieu, University of centre in Canada and provides expert Sherbrooke consulting in social statistics, teaches statistics and social research, and ReseaRCh AdvisoRy Team operates the Research Data Centre. Dr. Thomas Göergen, German Police FundeR University Employment and Social Development Dr. Ariela Lowenstein, Haifa University Canada Dr. Cynthia Thomas, Westat Provinces ReseaRCh CooRdinatoR Five provinces also funded the project by over sampling their own jurisdiction: Dr. Anthony Lombardo, University of Quebec, New Brunswick, Ontario, Toronto Alberta and British Columbia. Each province paid to collect more data for SoCial Workers further assessment of their own provinces. The provincial data plus the Johannie Bergeron-Patenaude Canada data are included in this report. Teri Kay ProjeCt OfficeR Johanne Sabourin, Program Operation Branch, ESDC v TABLE OF CONTENTS EXECUTIVE SUMMARY .................................................................................................................................... i RESEARCH TEAM .............................................................................................................................................. v TABLE OF CONTENTS .................................................................................................................................... vi INTRODUCTION ................................................................................................................................................. 1 BACKGROUND .................................................................................................................................................... 2 The Problem Addressed ............................................................................................................................ 2 Defining Elder Mistreatment .............................................................................................................. 5 MISTREATMENT ................................................................................................................................. 6 PHYSICAL ABUSE ................................................................................................................................ 6 PSYCHOLOGICAL ABUSE ................................................................................................................. 6 SEXUAL ABUSE .................................................................................................................................... 6 NEGLECT ................................................................................................................................................ 6 FINANCIAL ABUSE ............................................................................................................................. 7 Defining Risk Factors .................................................................................................................................. 7 Conceptual Framework........................................................................................................................... 10 Previous Studies of Prevalence ............................................................................................................ 14 Significance of Study ................................................................................................................................ 15 METHODOLOGY.............................................................................................................................................. 16 Study Population ....................................................................................................................................... 16 Instruments ................................................................................................................................................. 18 Data Analytic Plan ..................................................................................................................................... 25 Ethics .............................................................................................................................................................