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Guest Blogger: Deborah Marshall

          Quite often you turn on the news and you hear that the world is getting older and our population is aging. The media portrays the aging population as a negative thing, when in reality, older adults are often involved contributors, helping other older adults, working, volunteering and generally infusing money back into the economy. Getting older has many positives associated with it: having more time to volunteer, to travel, learn, visit and help family members.  Getting older does not necessarily mean becoming unwell, and, for many Canadians, their best years will be in the ‘golden age’.  Unfortunately, some seniors may not be as healthy in later years.  Frailties can and do develop with the aging process, and these frailties, combined with putting too much trust in the wrong person, may lead to elders becoming vulnerable to abuse.

          Elder abuse awareness is important but we also need healthcare professionals  who can deal with elder abuse in an appropriate manner.  In my experience, there are seminars and informative learning opportunities to raise awareness of elder abuse but there are few, if any, dedicated higher education courses or programs for nurses.  An online search of courses offered by Universities in Canada produced one course, through the University of Toronto, called Special Topics in Social Work in Gerontology: Elder Abuse that specifically examines violence and abuse against older adults.  Beyond this, it was difficult to assess the offerings by the various Canadian Medical Schools, as there are many streams of study and elder abuse may be included as part of another course.  There is a need for such programs.  Various associations and businesses often offer informative seminars on how to detect and address elder abuse.  While these seminars are helpful, they are subject to funding availability and typically only address one type of abuse at a time.  By focusing on only one area of elder abuse, other forms of abuse, such as neglect, might be missed.   

          Overall, despite the fact that 18 universities in Canada offer graduate and postgraduate degrees in Gerontology, few deal with abuse in old age.  Some might add elder abuse to the “family” or “domestic” violence profile, but to not approach elder abuse as a course of its own is too narrow.  Elder abuse does not only occur within the framework of spousal/family/domestic abuse; it can occur in old age or as the progression of violence experienced across the Lifecourse.

          Even my own Masters program did not deal with elder abuse directly.  If we, as learners, wished to examine it, we could bring it up for discussion or create a presentation.  Due to the many areas for research under gerontology, elder abuse may not be as sought-after as more traditional areas of research such as falls, dementia and delirium.  This is a tragic oversight, for, while a difficult topic to consider, elder abuse is a critically important one.  Older adults who have had a fall or are living with dementia might be more vulnerable to abuse.  How will we recognize elder abuse if we haven’t been taught to suspect it; no one wants to consider a family, friend, or neighbour could be harming anyone.  

          Discussing elder abuse at a higher education level helps learners understand the complex nature of abuse, the silence, the shame, lack of reporting and the discussion surrounding it.  A gap in knowledge may add to the feelings of inadequacy to initiate conversation about such a topic. Engaging in conversation in a relatively safe environment is critical in assisting and supporting the older adult experiencing abuse.  Knowing what is available to assist in the prevention of elder abuse is necessary, as is having the right tools to address the issue immediately.  Asking the question is often the largest hurdle.  Having the tools and the knowledge to locate assistance can make an attempt to prevent elder abuse falter or succeed.  Knowledge gained in an educational setting can help empower healthcare professionals to feel confident to seek out the right people and the right supports.

          So why have elder abuse training at the undergraduate or graduate level in the Health Sciences field?  Well, if the training is not mandated as a learning goal, not many of us will go looking for a specific educational support until we really need it.  Elder abuse is real and it is uncomfortable for most people to think about but there is an urgent need to talk about it.  Not talking about abuse is destructive, it hurts the senior experiencing the abuse, can tear families apart, and can make a person feel guilty if they did not notice or did not intervene.  This often causes pain, just as abuse causes pain.  Learning how to spot and recognize the signs and symptoms of abuse as a student in a safe learning environment is critical and should not be underestimated.  It may allow those involved with older adults to feel more confident and competent to open up a discussion when it really counts.



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