A personal story

A personal story: Starting a journey
Sandra P. Hirst RN, PhD, GNC(C)
Director, Brenda Strafford Centre for Excellence in Gerontological Nursing
University of Calgary
It would be well over twenty years now that I recognized that an older client was
physically abused by a professional care provider, a nurse, working in a long term
mental health facility. I had just completed a full day workshop with a colleague and we
were having a tour of the facility from one of the nursing administrators. I saw a nurse
literally shove an older lady into a chair. I saw too the “rope burn” that was given to the
arm of this same client. I caught my breath and did nothing. I look back and know that
the experience at that time was simply one that I did not understand. I knew what I saw
but I really could not fully comprehend it. I just did not believe what I saw.
Looking back to this experience, I know now it was aged abuse. I know that I did
nothing at the time. However, I also know that it changed both my professional and
personal lives in so many ways. My colleague and I talked about what we had seen on
our drive back to Calgary and we both acknowledged that we should have done
something. We wondered if the administrator had seen it to but simply said nothing. We
recognized that we had been shocked, but that we should have done or at least said
something. We introduced the word “violence” into our conversation.
I made a very real and conscious decision to be an advocate and not to stand quiet
again. I have spent a large part of my professional nursing career since this episode
addressing the very really challenge of aged abuse within society in general and within
long-term care facilities in particular. I am proud of how I have moved forward to speak
out publically and at professional conferences about this serious issue. I have talked
about how we need to promote awareness of aged abuse. I have raised the need for
professional associations to provide guidelines to their members so that accurate
assessment and appropriate interventions can be initiated.
One avenue that has opened up to me to facilitate my role in addressing aged abuse is
NICE – the National Initiative for the Care of the Elderly. Their web site is
http://www.nicenet.ca/ . I would strongly encourage you to visit the tools that are listed
on its pages, they include:
Caregiver Abuse Screen (CASE)
Questionnaire de dépistage de l’abus chez les aidants naturels (DACAN)
Elder Abuse: Assessment and Intervention Reference Guide
La Maltraitance des Personnes Aînées
Elder Abuse Risk Assessment
Évaluation des Risques de Maltra Itance chez les Aînés
Elder Abuse Suspicion Index (EASI)
Indicators of Abuse (IOA)
Liste des indices de situations abusives (LISA)
In Hand - click on this link to view the instructional videos, before using the Tool
En Mains - S'il vous plaît cliquer sur ce lien pour voir la vidéo d'instruction avant
d'utiliser l'outil
Coordinated Community Response to Abuse – CCR – English
Intervention communautaire coordonnée contre la maltraitance des aines - ICC –
French
Theft by Person(s) Holding Power of Attorney
Vol par une Personne Détenant une Procuration
Being Least Intrusive - BLI
Approche Misant sur l’écoute : Un Guide vers la Pratique pour les Intervenants
de Première Ligne en Cas de Maltraitance des Aînés Autochtones (AME)French
Resources for Older Women - ROW - BC
Resources for Older Women - ROW - NL
Resources for Older Women - ROW - SK
Resources for Older Women - ROW - Greater Toronto Area
Train the Trainer in Elder Mistreatment – TTT-EM
This is an impressive list. It includes English and French resources, in both print and
video format. They address Canadian content. They can be down loaded free of charge.
However, what stands out for me is the fact that each tool is evidence based. In our
nursing practice, we are encouraged to be evidence based or evidence informed. These
resources provide us with the tools to be so. They have certainly been of use to me in
my own work with older adults.
The list is a credit to how knowledge of aged abuse has grown over the past number of
years. It is also sad to realize that we know that such a serious social problem exists
within Canadian society. I find these tools user friendly. I would encourage you to have
a review of them – if the list seems too long then just pick one or two.
As I said, I am proud of where I stand today – but I learned a hard lesson those twenty
years ago. I learned that aged abuse existed. I am still on my journey of understanding
as to why this health challenge exists and how to enhance the effectiveness of my
response.