NICE Tools: Archive

Responding to Elder Abuse and Neglect: Factsheet for Administrators

What is elder abuse and neglect?

Elder abuse refers to any actions that cause physical, psychological, financial or sexual harm to an older adult. Neglect includes situations where a person or organization fails to provide services or necessary care to an older adult.

Examples of elder abuse and neglect include:

  • withholding medication
  • overmedicating an older adult
  • invading privacy
  • misusing funds
  • physical assault
  • non-consensual sexual contact
  • neglecting an older adult’s basic needs
  • threats of harm
  • causing or supporting social isolation
  • inappropriately gaining access to an older adult’s money
  • not getting appropriate consent
  • harassment
  • forced confinement

Sometimes, elder abuse and neglect results in a criminal offence.

How does elder abuse and neglect happen?

Elder abuse and neglect may occur at home, in the community or in institutions (e.g. hospitals, health care facilities and long-term care homes). A person might intentionally or unintentionally harm an older adult in any of these settings.

Ageism can lead to elder abuse. Ageism is an attitude towards older adults based on negative beliefs about aging and assumptions that older adults are weak, frail or incapable. Ageism can result in demeaning, discriminatory or dismissive behaviour.

How should staff respond to elder abuse and neglect? 

The appropriate response to concerns regarding abuse and neglect is to offer the most effective, but least restrictive and intrusive support, assistance or protection. Health care and social service workers should always try to speak directly with the older adult in order to: 

  • verify whether any suspicions of abuse or neglect are accurate 
  • refer the older adult to available resources and support networks 
  • obtain consent from the older adult to disclose information if necessary
  • allow the older adult to accept or refuse help 
  • involve the older adult in decision making and care planning as much as possible, depending on the adult’s mental capacity

Is there a legal obligation to notify someone else? 

The laws are different in each province and territory. The legal obligation to respond to elder abuse or neglect will depend on: 

  • which province or territory the older adult lives in 
  • employment role or professional responsibility 
  • whether the older adult is living in the community or in care 
  • whether the older adult is in need of support or assistance, or is unable to care for himself or herself 

In some provinces, staff must notify a delegated person or government authority about incidents of abuse or neglect when an older adult is receiving assistance from a health care facility or living in a long-term care home. In other provinces, the person who operates the care facility is legally obligated to notify the patient’s representative, medical employees, funding program or health authority 

In some provinces and territories, health care and social service workers must notify an appointed person or organization when an older adult is being abused or neglected and is in need of assistance or support, or is unable to care for himself or herself, regardless of whether or not the adult resides in a care facility. 

Refer to Summary of the Law in Each Province and Territory: Responding to Elder Abuse and Neglect for details about when to notify the appropriate person, organization or government body. 

How should staff respond when an older adult is at risk? 

“At risk” means that an abusive incident has not happened, but circumstances indicate that an older adult is likely to be abused or neglected. In some provinces, health care and social service workers have a legal obligation to notify a designated person or government authority when an older adult is at risk of abuse or neglect and living in a health care facility or long-term care home.

How can personal support workers identify elder abuse and neglect?

Some hospitals and health authorities have developed diagnostic tools to help health care professionals identify elder abuse.

The National Initiative for the Care of the Elderly (NICE) has published user-friendly versions of the following tools:

IOA: Indicators of Abuse

CASE: Caregiver Abuse Screen

EASI: Elder Abuse Suspicion Index

IN HAND: An Ethical Decision-Making Framework

What about elder abuse and neglect in the workplace? 

Employers, managers and supervisors should ensure that the work environment complies with legal obligations and encourages transparency, honesty and responsibility. 

Workplace policies need to provide guidance about when and how to respond to elder abuse and neglect. Employees who are legally obligated to notify a designated person,  organization or government authority about elder abuse, neglect or risk cannot be disciplined or fired for disclosing the incident or concerns. 

Health care and social service workers will also need to respect the older adult’s right to privacy and right to make decisions. Refer to the brochures Confidential Patient and Client Information: Responding to Elder Abuse and Neglect and Mental Capacity and Consent: Responding to Elder Abuse and Neglect for more information. 

This project has been supported by the Public Health Agency of Canada through the Federal Elder Abuse Initiative. The views expressed herein do not necessarily reflect the official views of the Public Health Agency of Canada.

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You should not rely on information tools for medical, financial or legal advice. It provides general information only. NICE is not responsible for any use of the information other than for general educational/informational purposes and no claim can be made against NICE or any of its personnel for any such use.

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