Keys to stopping elder abuse
 
Facts about elder abuse

1. perpetrators are commonly family members or someone the elder knows and trusts 
2. elders often feel shame and guilt and are frightened to speak-up  
3. elders can be frightened to speak-up in fear of retribution & punishment 
4. up to 14% of older Australians experience abuse with thousands of others not reporting their abuse, neglect and exploitation
5. people from marginalised groups can be at greater risk of elder abuse
6. the Coronavirus pandemic is causing greater fear and suffering of older people

 
Types of elder abuse
There remains no one single definition of elder abuse in Australia. The WHO has adopted the definition that elder abuse is "a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person."  

​Financial abuse - the illegal or improper use of an older person’s finance or property by another person with whom they have a relationship implying trust such as stopping access to their personal funds; forging signatures, misusing enduring power of attorney or not returning change after shopping for them.

Psychological abuse - the infliction of mental anguish, often involving actions that cause fear of violence, isolation or deprivation, and feelings of shame, indignity or powerlessness such as verbal threats, degrading behaviours including name callings and threats of institutionalisation, that is “Do what I’ll say or I’ll put you in a home.”

Physical abuse – causing physical pain or injury or physical coercion such as hitting, slapping, pushing, scratching or shaking an older person. It also includes the use physical restraints such as tying elders to a chair or putting them in a chair they cannot get out of.

Sexual abuse - using force or taking advantage of another person by sexual or exploitive behaviour such as indecent assault, sexual harassment, inappropriate touching or making an older person feel uncomfortable about their body or gender.

Social abuse - preventing an older person from having social contact with friends or family or access to social activities such as moving them away from their community; isolating them from others; and not allowing use of or monitoring the telephone.

Neglect - the failure of a carer, whether intentional or not, to provide the necessities of life to another person for whom they are caring such as lack of food and drink, stimuli or (when relevant) supervision; poor hygiene, clothing and inappropriate use of medicine.

Signs of elder abuse
Changes in behaviour, mood or physical appearance may be the first indicators that an older person is being abused. Sometimes it may be no one factor and the elder may be reluctant to disclose so being aware and being willing to dig below the surface is important.

​What can I do?
Every person has a role to play in addressing elder abuse. First and foremost it is important to value our elders and reflect on personally held beliefs and attitudes towards older people as ageism is an accepted part of society.  Though caring is a rewarding role it can also cause additional stress and pressure for the carer. Check in with carers you know, see if they need help and if so connect them to relevant support networks. Finally, educate yourself, share your knowledge and ensure if you recognise the signs of or know about elder abuse that you record and report it while supporting and reassuring the elder being abused. 
 
World Elder Abuse Awareness Day 2020
The United Nations has designated 15 June as World Elder Abuse Awareness Day to focus global attention on the problems of abuse of elders. Use this day as a time of reflection and an opportunity to raise awareness and make positive changes to stop elder abuse.
 
How can Consultivation help?
We we work with communities, organisations and individuals to help people identify and address ageism, stigma and stereotypes including identifying and responding to signs of elder abuse. We believe that together we can create safe, inclusive and viable communities for all. Act to today.
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We believe by helping organisations and people flourish
​we contribute to safe, inclusive and viable communities.

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​References:
ABS, 2020, 3101.0 Australian Demographic Statistics, Canberra ACT
Dow, B; Brijnath, B; 2019, Elder Abuse: Context, Concepts and Challenges, National Ageing Research Institute, Parkville VIC
Kaspiew, R; Carson, R; Rhoades, H; 2016, Elder Abuse: Understanding issues, frameworks and responses, AIFS, Melbourne VIC
Tibbits, J , 2019, Elder Abuse: To Think It Doesn’t Happen is Ludicrous, Perth WA
UN, 2020, World Elder Abuse Awareness Day, New York, USA
WHO, 2020, Ageing and Life-course: Elder Abuse, Geneva SWITZERLAND

Image of woman wearing hat: Flickr

The Coronavirus outbreak has helped raise awareness of loneliness and social isolation within our communities with a focus on those who are vulnerable including older people. The presence of the virus coupled with instructions to stay at home is seeing an increase in community connections and innovation including on-line community groups, adopt a neighbour schemes, and for people to connect or reconnect. One such initiative is the use of red and green cards for vulnerable people to use however I believe there is some caution to be taken.

​The green and red cards are dual faced. They can either be one side green and one side red; or one side green with a happy face and the other side red with a sad face. The idea is, that vulnerable people place the card in their window to let others know how they are faring. The green side means all is ok and the red side means something is wrong, I need some help. Though these cards are a quick and perhaps an efficient way of communicating with others while maintaining social distancing guidelines there are also issues with them including an increasing risk of being a victim of crime and creating a false sense of security.
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The first issue with using the cards is identifying that a vulnerable person lives in that residence. Crime can often be about convenience more than planning. The use of the red and green card may increase the risk of unpremeditated crimes. This is when a criminal seizes an opportunity with little or no planning such as burglary, assault or theft. Other offenders may notice the card and make a note of the address to return to at a later time.

​Secondly, offenders often pursue reward with little effort or risk. We know there are incidences when people fraudently claim to represent a community service or charitable organisation approaching elders and people with disability at the shops, in their gardens, on the telephone or even knocking on their doors. Use of the green and red cards could increase opportunities for offenders of such heinous acts.
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Thirdly, use of the cards can create a false sense of security. What happens if the green card is in the window, but something has happened to the resident? Perhaps they have had a fall, are unconscious, need assistance or even died. The green window card continues to communicate to the passers by or the support person that everything is ok when it may not be. It is important to not underestimate risk. ​

It is true that these cards may do more good than harm, and some people may even ponder that the likelihood of something awful occurring may be unlikely however is that a risk you are willing to take? Will you be responsible for this or if you represent an organisation where does the organisation’s responsibility and duty of care lie? Some people already have in place signals for when things are o’kay and things are not which they share with families, neighbours, support networks and even community-based support organisations such as aged care and disability support providers. For example, people I know have:

• curtains opened means all is o’kay, curtains closed something is wrong
• teddy bear in the window all is o’kay, no teddy bear something is wrong
• a particular roller shutter is up all is o’kay, that roller shutter is down something is wrong
• a blanket resting over an outdoor chair means all is o’kay, no blanket something is wrong

When trusted relationships with families, neighbours and support workers exist it mitigates the risk in creating a false sense of security and possible criminal activity. I remember one occasion, when an elderly client left her curtains open overnight. That evening a support worker noticed the curtains open on their way home so deliberately drove by the client's home early the next morning to check ‘the signal’. The curtains were still open so the support worker reported their concerns. On follow up, the client had experienced a fall and suitable help was organised. It makes me wonder, if the outcome for this client would have been different if a green card was being used?

​Being a good neighbour is important and it is great to hear of people supporting one another through this pandemic. Please continue to look after and support each other reporting anything suspicious to the police. Our message for neighbours, friends and family is not to encourage people to put green or red cards in their windows instead find another way to communicate which isn’t as obvious to others. For organisations, we encourage not using the cards and in lieu work with the client to find another way to communicate and support them. Taking a risk management approach to cultivating innovative service delivery is best practice to ensure safe and quality support while maintaining duty of care. A risk management approach assists with identifying and analysing hazards and control measures to mitigate negative risk. Most of all, I encourage all people harnessing new-found community connections to maintain these long after Coronavirus has gone to build safe, inclusive and livable communities. For organisations considering using these cards or for other risk management practices please do not hesitate in contacting Consultivation for assistance.

At Consultivation we believe by helping organisations and people flourish we contribute to safe, inclusive and viable communities.

​Elder Abuse: to think it doesn’t happen is ludicrous. Sad but true. Painful, yes. Frightening, absolutely.

Yesterday, I read a dreadful article from the ABC News. It made me feel sick to my core. A young Mum with early onset dementia enters residential aged care for appropriate and quality care and support. Her husband is unable to care for her at home for he is living with motor neurone disease (MND) - already a devastating situation for this family. We know that in most cases accessing residential care for a loved one isn’t an easy thing to do. This decision is often full of anguish, guilt and pure raw emotions.

The heading ‘Just so vulnerable’ was heavy with sadness, ladened with despair. I could feel their pain. ‘Just so vulnerable,’ is a quote from their daughter.  Jeanette Post, the woman living with early onset dementia, was sexually assaulted while living in an aged care home by a worker. I cannot image what Jeanette or her family must have thought, felt or lived through since that time. Following the assault, Jeanette’s health actually declined and she died 3 months later. The article shared her husband has been in utter despair, devastated and left feeling helpless.

This is only one story about elder abuse.     
                  
Elder abuse is more common than what most people realise with up to 14% (AIFS, 2015) of older Australians experiencing abuse. In June 2015, this would have been approximately 500,000 older Australians! In 2018, with an assumption the 14% abuse rate remained static; this would be approximately 562,000 older Australians being abused.
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This is not good enough.

We all have a role to play in addressing and stopping elder abuse. The most important thing we can all do is learn what elder abuse is, what the signs are and how to respond. 

Types of elder abuse
​There remains no one single definition of elder abuse in Australia. The WHO has adopted the definition that elder abuse is "a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person."  
 
Types of elder abuse include:
Financial abuse is the illegal or improper use of an older person’s finance or property by another person. For example mum or dad helps to pay for house extensions or a granny flat then to be kicked out of the house. Other examples include stopping access to their personal funds; forging signatures, misusing enduring power of attorney or not returning change after shopping for them.

Psychological abuse is the infliction of mental anguish, often involving actions that cause fear of violence, isolation or deprivation, and feelings of shame, indignity or powerlessness. For example, verbal threats, degrading behaviours including name callings and threats of institutionalisation, “Do what I’ll say or I’ll put you in a home.”

Physical abuse is the infliction of physical pain or injury or physical coercion. For example, hitting, slapping, pushing, scratching or shaking an older person. It also includes the use physical restraints such as tying them to a chair or putting an older person in a chair they cannot get out of.

Sexual abuse is sexually abusive or exploitive behaviour. For example, rape, indecent assault, sexual harassment or making an older person feel uncomfortable about their body or gender.

Social involves preventing an older person from having social contact with friends or family or access to social activities. For example, moving them away from their community; isolating them from their friends, family members and neighbours; and not allowing use of or monitoring the telephone.
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Neglect is the intentional or unintentional failure of a carer to provide the necessities of life to another person for whom they are caring. For example, inadequate food and drink, lack of stimuli, lack of supervision (when relevant, for example the person has advanced dementia), poor hygiene and clothing; and inappropriate use of medicine.

Signs of elder abuse 
Signs an older person is abused may include but is not limited to:

• reluctance to make a will; loss of jewellery and personal property
• unprecedented transfer of funds; loss of financial materials such as credit cards, cheque books etc
• loss of interest in self and their environment
• ambivalence towards family member, carer, nurse or support worker
• apathy and lack of eye contact
• withdrawal and reluctance to talk openly
• discrepancies between injury and history
• swelling, burns, abrasions or bruising
• unexplained accidents or injuries
• difficulties walking or sitting
• bruising on inner thighs, breasts or near genital area
• unexplained genital infections, bloody underclothing
• malnutrition, weight loss, wasting and dehydration
• lack of mental, social or physical contact or stimulation
• consistent poor health, pressure sores, over or under sedated
• abandoned or unattended for long periods

What you can do
Understand you have a role to play in valuing our elders and stopping abuse. Learn about elder abuse and what you can do to stop it. Share your knowledge and experience with others. If you work in a job which interacts with older Australians, identify what systems are in place to recognise, record and report elder abuse; and what support is available to help the older person at this time. If none exist, develop and embed safe systems to support older Australians experiencing abuse. Most of all, 

“Speak up, no matter how much your voice shakes.” 

What we need to address elder abuse
A broad range of initiatives we can do as a nation, community, family and as individuals to address and stop elder abuse include:

1. agreeing to a national definition of what elder abuse is
2. undertaking health campaigns and community education
3. providing education and empowerment to older Australians to feel less vulnerable, to notice the signs of elder abuse and to act 
4. carer support and coping mechanisms including crisis-help lines
5. upskilling people in support positions including care workers, nurses, neighbours, bank staff and police in identifying, responding to and providing appropriate support 
6. creating partnerships between health, aged care and justice 
7. improving reporting and actioning of elder abuse 
8. building social and community connections for older people
9. breaking down stigma and stereotypes of older people
10. stopping elder abuse 

World Elder Abuse Awareness Day 2019
The United Nations has designated 15 June as World Elder Abuse Awareness Day to focus global attention on the problems of abuse of elders. 
 
Consultivation can help  
At Consultivation we can work with communities and organisations to help people understand the signs of elder abuse and how to respond to them. We currently work with people and organisations to address ageism, stigma and stereotypes of older people to create safe, inclusive and viable communities.

ACT TO TODAY.

​As the end of 1999 neared there was growing concern for computer formatting, storage and programmes. Risk managers, IT consultants, business executives and everyday people were gripped with Y2K or millennium bug issues. There were thoughts online calendars wouldn’t work, archives would be lost and computers would fail. I remember those days and the growing hysteria, the streaming of news articles and chatter and gossip through offices, shops and social gatherings. We held our breath as the new century dawned and the hype and hysteria of Y2K deflated like a balloon during a good party.
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As the 1 July 2019 nears and the new streamlined Aged Care Quality Standards take effect I find myself thinking back to 1999, the Y2K scare and their similarities. Both changes have lead in times, opportunities to identify difficulties, manage risk, and plan for possible consequences while dread and fear slowly creeps in and takes hold.

Resources
Developed by the Aged Care Quality and Safety Commission:​

Consultivation is an independent consultancy service driven by an ethical values base 
supporting businesses, people and communities to flourish. 

The aim of this forum was to generate practical solutions to suicide prevention that members can take away and implement. I was honoured to be invited to help plan and cofacilitate the event with Aunty Liz Hayden, the WASSPN's Governance Group and  Lifeline WA.

Held on 12 March 2019 in the Djeran season of adulthood, the Forum was attended by approximately 80 people from around Western Australia inlcuding Aboriginal and non-Aboriginal people; community  members, Aboriginal-lead organisations and other service providers. Bevan Winmar, Bevan Jnr and Nevaeh opened the forum during Welcome to Country which was conducted by Aunty Liz, which I responded to and acknowledged in Noongar and English. 

We came believing that every person in the room and around the state has a role to play and that each of us can make a positive difference reducing deaths by suicide; and supporting health, healing and wellbeing of self and others. We came together with respect and compassion for ourselves and each other lead by our Kaat Koort Weirrn, that is, our Head, our Heart and our Spirit. The forum focused on the voice of the community and their needs, ideas and initiatives to help individuals and organisations make a difference.

Presentations were made by Wayne Ryder and Aunty Josie Ford on their Aboriginal Health and Wellbeing Festival; and Hayley Thompson of the Aboriginal Health Council of WA.

​We empowered attendees through exploring three main discussion areas of:
1. needs of the community
2. voices of the community (what do you see needs to happen) and
3. how do providers hold the community

At the end of the day, the final discussion was a call to action having participants answer a question 'I will make a change by doing.....' where attendees indicated what they would do as a result of attending the forum.

Six main areas I identified from listening to people in attendance were the need and desire of Aboriginal people for:
* unity
* healing
* leadership
* capacity building
* empowerment
* collaboration

There was a great energy and urgency in the room. I hope the momentum which continues to build sees action  to help with the health, healing and wellbeing of Aboriginal and Indigenous Australians.

A copy of  the forum's report is available below.

I would like to thank the WASSPN, James D'Alesio, Aunty Liz Hayden, Jenny Bedford, Deb Costello, Bevan Jnr and Nevaeh for their help and support in my co-facilitating of this important discussion. I would like to thank attendees who spoke with me after the forum for their positive feedback and feelings of 'having a voice' and 'being heard'. Thankyou, too, for those attendees who gaves thanks through their feedback forms.

I look forward to seeing change, and plan to play my small part in making a difference, after all, we are stronger together.

 If you would like to join the network contact James D'Alesio at jamesdalesio@lifelinewa.org.au ​

On International Women’s Day 2019 we give thanks for the amazing, strong, supportive and intelligent women we work and connect with.

Within the global theme of ‘Think equal, build smart, innovate for change’ we would like to share that we support this by fostering:

​Our work in raising awareness of this change element during sessions is regularly received with caution, followed by thought, self-reflection and inquisitive inquiry through to acceptance of the concept, appreciation that is being discussed and adoption by managers and leaders working within change. We have recently been working with board members, executives and middle-managers to identify strategies for middle-managers to feel supported and competent in their role during change. Strategies regularly identified by participants include clear and transparent communication between parties, consultation with opportunities to influence change, to ask questions and provide feedback as well as access to training for developing new knowledge and skills; and general support.
 
Participants have also identified the importance of individual and team contributions and remaining positive during change; and that they would like to be appreciated and praised receiving positive feedback when it is appropriate to do so. Research by Huy (2001) highlighted middle-managers play an important role in maintaining change momentum by staying attuned to the emotional needs of others and addressing tension often without reward or recognition by senior positions so it is interesting this is precisely what people in middle-management positions are asking for during our Working within Change sessions.
 
Appropriately supporting middle-managers during change is essential to help your organisation flourish. We understand change can be daunting for some and full of opportunities for others but challenging for most. At Consultivation we are here to help by supporting you on your journey. We can assist with change and project management, professional development and capacity building of all staff and volunteers, mentoring and resource development. 

​Consultivation is an independent consultancy service driven by an ethical values base 
supporting businesses and people to flourish. 

Middle management positions for this article include but are not limited to managers, supervisors, coordinators and team leaders. It can also lend itself to executive positions of not-for-profit organisations.

Sources
Barnard, C (1958.) Elementary Conditions of Business Morals, California Management Review, Vol 1, 1-13.

Consultivation (2018). Professional Development Session: Working within Change for Managers and Supervisors.

Huy, Q. (2002). Emotional Balancing of Organizational Continuity and Radical Change: The Contribution of Middle Managers. Administrative Science Quarterly, Vol 47, 31-69.

Huy, Q. (2001). In praise of middle managers. Harvard Business Review, 72-79.

Koene, B (2017) Why Middle Managers, Rather than Senior Leaders, Should Initiate Organizational Change. Forbes, https://www.forbes.com/sites/rsmdiscovery/2017/11/27/why-middle-managers-rather-than-senior-leaders-should-initiate-organisational-change/#73f1c0712188

Pictures courtesy of Pixabay.

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​On the 1 July 2018 the National Disability Insurance Agency (NDIA) assumed responsibility for the delivery of the National Disability Insurance Scheme (NDIS) in Western Australia.

​Covering all government-funded disability services in the state it is anticipated the NDIS will be rolled out by 30 June 2020 through a staged implementation. 

The NDIS was designed to support the independence and social and economic participation of people with disability by providing reasonable and necessary supports including early intervention supports.
 
Objectives of the NDIS include:

• complying with the Convention of the Rights of Persons with Disabilities in addition to other applicable covenants and conventions
• enabling people with disability to exercise choice and control in the pursuit of their goals and the planning and delivery of their supports
• facilitating a nationally consistent approach
• promoting the provision of high quality and innovative supports that enable  people with disability to maximise independent lifestyles and full inclusion in the community
• raising community awareness of the issues that affect the social and economic participation of people with disability
• facilitating greater community inclusion of people with disability

                                                                                                  (Australian Government, NDIS Act 2013)
 
It is anticipated these objectives will be achieved by governments working together to adopt an insurance-based approach to the provision and funding of supports for people with disability.
 
NDIS documentation clearly iterates that funding for supports is determined by consideration of the person’s individual needs, goals and aspirations; and that the NDIS is not welfare but a scheme investing in participants to improve long-term outcomes.
 
Reflecting the NDIS being a person-centred, consumer driven market the WA Government (2018) reports the number of service providers registered to deliver services has expanded from ninety-five (95) in 2013 to approximately two hundred and seventy (270) as of July 2018. The changing marketplace has invited new service providers into the disability sector including those without a disability-experienced background, therapists and those specialising in supporting people with psychosocial disabilities.
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Moving to a consumer-driven market is encouraging new providers to offer disability services promoting increased choice for people with disability and driving sector efficiency. New providers navigating the registration system can feel overwhelmed with the oversupply of information and minimal person-to-person guidance on how to understand this information.
 
To help with this, new providers wanting to deliver NDIS services in Western Australia are to:

1. Register with NDIS by registering for PRODA, creating a myplace account and submitting a Declaration of Suitability with supporting evidence
2. Complete Part D DSPP Registration Application Form to determine next steps taking particular note of Quality Standards
3. Follow Quality Standard requirements determined by category of services to be delivered
4. Test eligibility with the Disability Services Provider Panel through submission of Part D and other required evidence.​
   

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​Consultivation is an independent consultancy service driven by an ethical values base 
supporting businesses and people to flourish in the community, and aged care and disability sectors. 

References:
Australian Government, National Disability Insurance Scheme Act 2013, No 20, (2013) Canberra
WA Government, Request for EOI for WA Disability Sector Transition Funds, (2018) Perth
​Picture source: Flickr

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​For me, I haven’t set any new years’ resolutions for years. What was the purpose particularly after realising I often didn’t see them through and therefore setting them was purely setting myself up to fail. 2016 research by Finder.com.au identified 15% of Australians broke their resolutions in the first 3 months of 2015 while 40% broke theirs in the first 8 months. This was definitely me!
 
This year, however, I have applied a different approach. Rather than resolutions I have set goals for the year.
 
Resolution by its very definition is an official decision that is made after a group or organisation has voted – well no one is voting on my life or decisions; or a resolution is a promise to yourself to do or to not do something – well not achieving that is a blog for another day!
 
A goal, however, is an aim or purpose. It already sounds more uplifting and positive. With our years of goal setting in business, sport, studies and home each of us is developing our own way to successfully achieve goals we just don’t often acknowledge it. It can be actions like setting a sleep schedule, finishing assignments on time, spending less on clothes or making training sessions at the gym.  All of these take some order of goal setting.

​Making a goal is not only different to achieving it but easier to do too. Classic hurdles to overcome include setting of motherhood goals, waning of the new year excitement, our focus shifts, losing sight of the required steps or increasing self-criticism.
 
In light of this, here are some of my top tips to help you achieve your goals. These are not SMART or SMARTER goals – you already know that though some of these concepts overlap.

10 tips for achieving goals

​Consultivation is an independent consultancy service driven by an ethical values base 
supporting businesses and people to flourish in the community, health and aged care sectors.