Supporting someone who has experienced abuse

supporting someone who has experienced abuseSupporting someone who has experienced abuse

As a worker, your response to a situation of suspected or known abuse of an older person is really important. You need to manage any suspicion sensitively, making sure that your actions do not cause further harm. Supporting someone who has experienced abuse is a very sensitive and important process and it is best to seek support if you are unsure. Speak to Seniors Rights Victoria

 

Photographer: Bev Pascoe for West Gippsland Community Radio

What should I do if I think someone may be being abused?

As a worker, your response to a situation of suspected or known abuse of an older person will depend on the position you hold and the requirements of the organisation you work for. It’s important to manage any suspicion sensitively, making sure that your actions do not cause further harm. This means working respectfully and respecting the rights of the older person and their carer/s.

Organisations funded to provide health or community care services should have clear, established frameworks including policies and procedures covering how workers are expected to respond to clients’ needs. These should include frameworks for responding to emergency care needs such as those arising from situations of elder abuse. Your organisation should ensure you and all staff are aware of these requirements. Further information is available in With Respect to Age 2009. See Yarra Interagency Elder Abuse Protocol for an example of a useful protocol between agencies in a local government area.

The basic responsibilities of all workers if they suspect elder abuse are:

  • Don’t ignore it
  • Ensure that your actions are respectful of the older person’s rights and wishes
  • Contact emergency services if there is an immediate risk of harm (see Safety in emergencies)
  • Gather information by asking questions sensitively (see What questions should I ask?)
  • Record the details – eg. what you saw and/or heard and when; this record should be in writing and must be kept confidential
  • Notify your manager or supervisor.

Safety is the most important concern – safety for the older person, their carer/s and for yourself and any other workers involved (see Safety in emergencies).

More information

See What are my responsibilities as a worker if I suspect elder abuse below.

For information about the responsibilities of organisations in responding to elder abuse, including information to assist organisations to develop intervention and referral frameworks, see With Respect to Age 2009.

Regional elder abuse tool kits also offer guidance and locally relevant information. They were developed by Primary Care Partnerships across Victoria during 2012. See the full list of regional elder abuse Tool Kits in the Resource Library.

What are my responsibilities, as a worker, if I suspect elder abuse?

In many instances a direct care worker will be the first person to recognise or suspect the abuse of an older person. Direct care workers may suspect that something is wrong by witnessing the abuse first hand, or by noticing several risk factors affecting an older person.

In the first instance, direct care workers should report suspicion of abuse or risk of abuse to their supervisor. It is important to gather as much relevant evidence as possible and to document this by making clear notes. Your service may have service coordination tools you should use.

Vital considerations when addressing abuse include:

  • How suspicion is managed
  • Who is spoken to and when

Ensure that actions do not cause more harm, and do not undermine the rights of an older person or their carer/s.

A worker is expected to:

  • Follow their agency’s policies and procedures
  • Contact Victoria Police or an ambulance, if the matter is urgent
  • Refer suspected, disclosed, witnessed or alleged abuse to their supervisor
  • Make a detailed, confidential record of what happened.

A worker is not expected to:

  • Solve the problem
  • Medically assess an older person and their living situation in any way
  • Decide whether the incident meets the threshold for laying criminal charges.

A worker’s safety is the subject of their organisation’s occupational health and safety policies and procedures, which should be complied with at all times. Whether abuse is suspected or confirmed, worker safety is of utmost importance. Workers should be supported by their employers to develop appropriate self-care strategies.

The Responding to Elder Abuse sample flow chart  is a clear example of a flow chart developed to assist workers in a given local government area to exercise their responsibilities. The Yarra Elder Abuse Prevention Tool Kit also contains a useful section on ‘Procedure if you suspect potential abuse’, see Section 7.

Workers from outside the aged and disability sector may not have internal frameworks specifically for elder abuse, but are likely to have duty of care, safety or security policies that may apply. Often these will require a formal risk assessment process. It is likely that any tools available for workers outside the aged and disability sectors provide limited information about working with older people. See ‘Working With Older People’ or contact Seniors Rights Victoria for advice.

What is ‘duty of care’?

Duty of care is a legal term to describe the obligation workers have to avoid causing harm to another person. The extent of your duty of care will depend on your work role, but you should be aware of your obligations. Health and aged care workers have a duty of care to the older people they are assisting. If a worker breaches their duty of care, they have failed to meet the expected standards of care.

More information 

The following explanation of duty of care provides a more detailed example of how duty of care is determined.

 A duty of care encompasses a duty not to be careless or negligent, and arises from a relationship between people from which it is inferred that an obligation to take care exists in some form.

A duty of care involves a legal obligation to avoid causing harm to another person. This only arises when it is reasonably foreseeable in a particular situation that the other person would be harmed by an action or omission, without the exercise of reasonable care.

Duty of care refers not only to the actions of a worker but also to the advice the worker gives or fails to give.

The scope or extent of your duty of care will depend on a number of factors.

A duty of care is restricted to the role or duties for which the worker is employed. For example a community bus driver is not expected to take the same actions as a nurse.

Workers have a duty of care to older people they are assisting. A worker is not negligent in failing to take precautions against a risk of harm unless 

  • the risk was foreseeable (that is a risk of which the person knew or ought to have known) 
  • the risk was not insignificant (not far-fetched or fanciful)
  • in the circumstances, a reasonable person in the worker’s position would have taken precautions.

If a worker breaches their duty of care, they have failed to meet the expected standards of care. If harm occurs to the older person as result of this breach of duty of care, the worker may be legally liable for damages arising from this harm.

Whether a duty of care exists in a particular situation and whether it has been breached between the worker and the older person depends on the role of the worker. In particular a number of salient features will be taken into account, these include: 

  • the assumption of responsibility by the other party for the older person; 
  • the degree of reliance of the older person on the other party; 
  • the nature of the harm; 
  • the foreseeability of the harm; 
  • the degree and nature of control that can be exercised to avoid harm; 
  • the vulnerability of the person harmed; 
  • the proximity or nearness of the 2 parties. Proximity can be physical, temporal or relational.

What questions should I ask an older person about possible abuse?

The best questions to ask are those that can’t be easily given a ‘yes’ or ‘no’ answer. Your questions should be direct and non-judgemental. Questions that focus on family relationships, caring roles and dependencies may reveal tensions and difficulties. Information gathering may need to proceed slowly and carefully and may take time.

An effective way to begin the discussion may be to ask the older person to describe, in a general way, how things are at home and how they spend their day. For example:

  • How are things going at home?
  • How do you feel about the amount of help you get at home?
  • How do you feel your (husband/daughter/carer etc) is managing?
  • How are you managing financially?

Listen to the older person’s story. Acknowledge what they have said. Let them know they don’t have to put up with abuse, that help is available and that other people also experience abuse. Give them information about how to get further help and offer to assist them with this.

More information

A more comprehensive list of Questions to assist with identifying elder abuse can be found on page 17 of the Yarra Elder Abuse Prevention Toolkit 

What should I know about working with people with different values and cultural differences?

It is important to be sensitive to an older person’s values and cultural differences and to respect those differences. The meaning of certain verbal or non-verbal behavior should be understood in the context of their culture. For example, some cultures value eye contact in certain circumstances while others value avoidance of eye contact.

With the older person’s permission, contact other workers and organisations to assist with understanding different values and cultural differences as well as effective and acceptable methods and approaches for supporting someone. See this Tool Kit’s section on ‘Working with people from culturally diverse backgrounds’ for more information.

What should I know about working with somone who neglects their own needs?

Self-neglect is not considered a form of elder abuse, although it can be a sign that someone is experiencing abuse, for example the person may feel depressed and hopeless due to an abusive situation. Self neglect may include living in unhygienic or unsafe conditions, refusing to seek or comply with treatment for injury or illness or failing to eat or drink adequately.

Any support and assistance you offer should be respectful of the older person’s right to choose how they wish to live.

More Information:

Victorian Department of Health information on hoarding and squalor

With Respect to Age 2009: 1.3.4 Self-neglect or self-mistreatment (p. 6)

What elder abuse training is available for workers?

Elder abuse training for workers provided by Victoria University is currently being redeveloped.

A training manuals from earlier versions of the training are available on this site:

Elder Abuse Prevention Strategy Workshop 1 Manual

Elder Abuse Prevention Strategy Workshop 2 Manual

Acknowledgment

Some content on this page has been drawn from With Respect to Age 2009 and Elder Abuse Prevention Strategy Workshop Manual 1.

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