Terminology

Poor treatment of an older adult, or making the older adult act against his or her will, through the use of force and/or bullying*.

* “Bullying of older adults is an act, or the absence of action, of a single or repetitive nature that is generally deliberate and is committed directly or indirectly within a relationship of force, power or control between individuals, which is motivated by the intent to cause harm to one, or more, older adults.” (See Beaulieu, M., Bédard, M.-È. & Leboeuf, R. (2016). L’intimidation envers les personnes aînées : un problème social connexe à la maltraitance? Revue Service social. 62(1), 38-56.)

Failure to show concern for the older adult, particularly by not taking appropriate action to meet his or her needs.

Discrimination based on age, through hostile or negative attitudes, harmful actions or social exclusion.

Violence : Imposition of restrictions or social standards based on age, limited access to certain resources, prejudice, infantilization, scorn, etc.

Neglect : Failure to recognize or respond to ageist practices or comments, etc.

Signs: Failure to recognize a person’s rights, skills or knowledge, use of condescending language, etc.

NB: We are all influenced, to varying degrees, by negative stereotypes and discourses about older adults. These misguided assumptions lead us to misinterpret various situations, which can ultimately lead to mistreatment.

Any discriminating situation created or tolerated by organizational procedure (private, public or community institutions providing all types of care and services) responsible for providing care or service of all types to older adults.

Violence : Organizational conditions or practices that exclude older adults from decision-making which concerns them, causing the failure to respect older adults’ choice or limits in unjustified way the availability of help programs, etc.

Neglect :Services not adapted to older adults’ needs, absence of or poorly understood instructions on the part of personnel, lack of resources, complex administrative procedures, inadequate training of staff, unmobilized staff, etc.

Signs : Treating the person as a number, provision of care or services according to more or less rigid schedules, undue delays in service delivery, deterioration of the person’s physical – psychological – social health, complaints or reports to diverse instances, etc.

NB: Organizational mistreatment is not limited to the healthcare or social service network. It is important to remain aware of organizational shortcomings that could violate the individual or collective rights of older adults to receive care and services, or that could lead to conditions that negatively affect the work of staff in charge of providing care or services.

Any infringement of individual and social rights and freedoms.

Violence : Forced medical treatment, denial of the right to: choose, vote, enjoy one’s privacy, to be informed, take decisions or risks, receive phone calls or visitors, express one’s sexual or romantic orientation or one’s gender identity, practice one’s religion or spirituality, etc.

Neglect : Lack of information or misinformation regarding the older adult’s rights, failure to assist the person in exercising his or her rights, failure to recognize the person’s capacities, denial to offer care or services, when justified, etc.

Signs : Preventing or blocking the participation of the older adult in the choices and decisions that concern them, a family member answering on behalf of the older adult, restriction of visits or access to information, isolation, complaints or reporting to various authorities, etc.

NB: Violation of rights occurs in all types of mistreatment. Everyone fully retains their rights, whatever their age. Only a judge can declare a person incapable and can appoint a legal representative. Persons declared incapable still preserve their rights and can exercise them, within the limits of their capacities.

Illegal, unauthorized or dishonest acquisition or use of the older adult’s property or legal documents; lack of information or misinformation regarding financial or legal matters.

Violence : Pressure to change a will, banking transactions without the person’s consent (use of a debit card, online banking, etc.), misappropriation of money or assets, excessive price charged for services provided, forced or concealed contractual or insurance transaction, identity theft, signature of a lease under pressure, etc.

Neglect : Failure to manage the person’s assets in his or her best interest or to provide the necessary goods and/or services as required, failure to assess the person’s abilities, understanding and financial literacy, etc.

Signs : Unusual banking transactions, disappearance of valuable items, lack of money for regular expenses, limited access to information regarding the management of the person’s assets, etc.

NB : Older adults who are in a relationship of dependency (e.g., physical, emotional, social or business-related) are at a greater risk of being mistreated in this way. In addition to the financial and material implications, this type of mistreatment can affect older adults’ physical or psychological health by limiting their ability to fulfill their duties or meet their own needs.

Attitudes, words, gestures or absence of appropriate actions with a non consensual sexual connotation which are harmful to the person’s well-being, sexual integrity.

Violence : Suggestive comments or attitudes, jokes or insults with a sexual connotation, promiscuity, exhibitionist behaviours, assault (unwanted touching, non-consensual sex), etc.

Neglect : Failure to provide privacy, treating older adults as asexual beings and/or preventing them from expressing their sexuality, etc.

Signs : Infections, genital wounds, anxiety when being examined or receiving care, mistrust, withdrawal, depression, sexual disinhibition, sudden use of highly sexualized language, denial of older adults’ sexuality, etc.

NB : Sexual assault is above all an act of domination. Cognitive impairment may lead to disinhibition, which can result in inappropriate sexual behaviour. Not recognizing older adults’ sexuality is a form of mistreatment, and it also makes it more difficult to identify and report sexual mistreatment. It is also important to keep an eye out for pathological sexual attraction toward older adults (gerontophilia).

Attitudes, words, gestures or absence of appropriate actions, which harm the physical well-being or integrity

Violence : Shoving, brutalizing, hitting, burning, force-feeding, inadequate medication administration, inappropriate use of restraints (physical or pharmacological), etc.

Neglect : Failure to provide a reasonable level of comfort and safety; failure to provide assistance with eating, grooming, hygiene or taking medication when the older adult is in a situation of dependency, etc.

Signs : Bruises, injuries, weight loss, deteriorating health, poor hygiene, undue delay in changing of incontinence briefs, skin conditions, unsanitary living environment, atrophy, use of constraints, premature or suspicious death, etc.

NB : Some signs of physical mistreatment may be mistaken for symptoms associated with certain health conditions. It is therefore preferable to request a medical and/or psychosocial assessment.

Attitudes, words, gestures or absence of appropriate actions that negatively affect an individual’s psychological well-being or integrity

Violence : Emotional blackmail, manipulation, humiliation, insults, infantilization, belittlement, verbal and non-verbal threats, disempowerment, excessive monitoring of activities, comments that are xenophobic, ableist, sexist, homophobic, biphobic or transphobic, etc.

Neglect : Rejection, indifference, social isolation, disinterest, insensitivity, etc.

Signs : Fear, anxiety, depression, withdrawal, reluctance to speak openly, mistrust, fearful interaction with one or several people, rapid decline of cognitive abilities, suicidal ideation, attempted suicide, suicide, etc.

NB : Psychological mistreatment is the most common and least apparent type of mistreatment :

• It often accompanies other types of mistreatment.
• Its effects can be just as detrimental as those of other types of mistreatment.