Crime and Abuse Against Seniors:
A Review of the Research Literature With Special Reference to the Canadian Situation
6. GAPS IN RESEARCH ON SENIORS AS VICTIMS OF CRIME AND ABUSE
6.1 The World Health Organization's Definition of Elder Abuse
The World Health Organization (WHO) defines elder abuse as "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."
WHO's definition of elder abuse appears to be excessively broad and narrow at the same time. It is broad in the sense that both single and repeated acts may qualify as abusive. It is also broad in that the term "any relationship" involving an expectation of trust can qualify as abusive. This notion is highly ambiguous. Would an assault by any staff member of an institution, contractor, or visitor to an institution qualify as a breach of trust, even if the institution has done a laudable job in protecting residents?
The subjectivity of the term "expectation of trust" is also a concern, as people may not have a sound basis to trust one who becomes a perpetrator. A senior may believe that a relationship based on trust exists with a caregiver, whereas a stranger may quickly manipulate his or her way into the life of the senior for the purpose of fleecing the senior. The WHO definition fails to provide objective indicators of what constitutes a relationship based on trust. The definition can include people a senior has known for a very short period of time. Similarly, terms like "harm" and "distress" are also broad, subjective, and ambiguous.
At the same time, WHO's definition may be viewed as narrow in some respects. While much victimization involves relatives and professional caregivers, many forms of victimization of seniors, from violent acts to financial exploitation, are committed by total strangers or acquaintances. WHO's definition excludes many forms of financial victimization. It also excludes from consideration particularly traumatic violent crimes by strangers that often occur in the senior's residence.
Fraud and identity theft are becoming more prevalent and sophisticated. As the population of seniors grows and as seniors become more internet savvy, the number of financial crimes against them will also grow. The internet is a vehicle that facilitates the identification and grooming of victims by fostering communication and providing access to both public records and personal information. For example, with the stroke of a few keys, an individual can identify those seniors who have just lost a spouse and who may be vulnerable to an approach by a "friendly and caring" stranger.
The WHO definition fails to distinguish between illegal acts and those that are harmful but not illegal—e.g., making an elderly person feel unwanted or like a nuisance (psychological harm). Also, it is important to distinguish between subjective concepts (harm and expectations) and acts that are objectively injurious (assaults and neglect of medical needs or basic hygiene).
There are a large number of issues to consider in formulating and refining a definition of elder abuse. These issues include some of the following:
- Should the concept apply only to those elderly persons who have specific vulnerabilities, impairments, or dependencies (i.e., who rely on others for their care)? In cases not involving such vulnerabilities, our traditional legal system and social services may be able to deal with harm incurred by the elderly.
- Should the concept of elder abuse be confined to those in some form of relationship—family, caregiver, or fiduciary—with their abusers?
- Should abuse refer to repetitive acts only or can it also relate to a single act against an elderly person?
- In order to qualify as abuse, does the behaviour need to be willful, or can the harm result from recklessness or "benign" neglect?
- When considering whether elder abuse has occurred, should we focus on the behaviour or its consequences (i.e., whether harm occurred)?
- Is the presence of abuse culturally relative? Thus, as there are different norms internationally with regard to the treatment of the elderly, should abusive behaviour be viewed differently around the world and in different segments of our society? Such relativity would impede the establishment of national and international standards in the treatment of the elderly and in the development of a consensus definition.
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