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Published: 14 September 2014

Thanks to Sandra Hurst and Susan McNeil for an excellent presentation at last week’s AGM on the newly published Registered Nurses Association of Ontario (RNAO) best practice resource for nurses on abuse and neglect of older adults. Download their presentation, Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches: CNPEA Presentation Sept 11, 2014 RNAO.

Download the RNAO toolkit.

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Published: 28 May 2014

Interview with Sharon Mackenzie, Founder/Executive Director of i2i

“That was one of the richest mornings of my life. You have charged the seniors’ lives with more energy and openness, and charged the students’ lives with more compassion. Wow! It is indeed a model for Canada.” Shelagh Rogers (CBC Sounds Like Canada), commenting on her visit to an i2i classroom

Sharon: The i2i Intergenerational Society grew out of a decade of intensive research that involved over 400 British Columbian children and older adults in the unique Intergenerational Immersion Model, The Meadows School Project. For two months thirty intermediate students moved into a makeshift classroom at a retirement home. The two generations dovetailed their calendars, combining curriculum, public service and one-on-one buddy meetings. Residents, students, staff, parents, children of the residents and school administration applauded the life-changing outcomes of the initiative. After seven years our society was established to:

• Inform others of the health, social and educational benefits of intergenerational involvement
• Assist in envisioning, implementing and sustaining respectful and purposeful intergenerational relationships.

We stage three levels of intergenerational bridge building:

1. Baby steps- one time, brief interaction. For example, pre-school visits to a care home to perform a song for senior audience
2. Mama steps- organized ongoing involvement, up to 90 m/wk, or monthly. For example, teens visiting to play board games
3. Full immersion- Meadows School Project

Sharon: This work is important because:

1. It dramatically improves mental, physical, emotional and social health at a remarkably low cost by:
   • Connecting individuals from generations that are both confronted by ageism, ie children and seniors;
   • Providing opportunities and time for friendship, trust, empathy and understanding to develop on a one-to-one basis; and
   • Reducing isolation and loneliness
2. It strengthens links between generations, building a more resilient community network.
3. It reduces mistreatment in the future of all ages by instilling empathy and understanding across generations.

Intergenerational learning is proactive and counteracts ageism. If we invest in proactive, intergenerational learning opportunities now, then by the time today’s young reach adulthood, they will have an enlightened attitude towards ageing. Last year (2013) we entered Meadows School Project into the IFA International Innovative Intergenerational Solidarity Competition. Our project was short listed with five in the world. The judges, chaired by Dr. Beard, UN WHO, stated, “this project demonstrates forward-thinking advancements… and should be adopted worldwide.”

Sharon: In the immersion project, there are three components: the government mandated curriculum, public service and 1-on-1 relationships. The students continue to follow their government-mandated curriculum with the teacher selecting appropriate topics for the intergenerational setting (e.g. history, geography, development and aging of the body, healthy lifestyles, story writing, reading, art, music, etc.). The second component is service, teaching students about work ethic and giving back within community (e.g. table setting, raking, etc). The third is a 1-on-1 component to build relationships (e.g. playing cards or visiting together).

Sharon: It is possible! It works! We can do this, collaboratively, and it is fun and simple. It does not require that you spend money. Instead it only needs you to do things differently: ‘put on intergenerational glasses’ and see how you can do what you have always done, but do it with an intergenerational perspective. We can help build real understanding between real people of different generations by merely giving them opportunities to become friends. Older adults and children are more the same than different and their joy in discovering this is what makes this approach irresistible. Respectful intergenerational relations are the building blocks to our future as a society.

Sharon: We address communication: face-to-face, eye-to-eye, minimize distractions and background noise, rephrase to assist understanding, say what you mean, mean what you say, be polite, smile. We create opportunities for children and older adults to meet as one person to another. In building their relationships, they eventually find they share many things in common all the way from loneliness, to the same birth month or perhaps a hearing disability. They inadvertently work through the issues of ageism together while becoming respectful and empathetic friends. In every one of our immersion projects, the children, when asked by parents how their visits with the seniors are going, have responded: “they’re not seniors, they are my friends.”

Sharon: It’s about doing WITH as opposed to doing FOR. As health care workers of aging adults and educators of the young, we are great as socially responsible citizens. We are caretakers of others and watch out for their best interests. But where I see us really missing a tremendous opportunity is in the area of personal responsibility. As teachers and health care workers we often do FOR. In fact a much stronger approach is to do WITH—a true collaborative approach. That is a healthy empowering participatory mode for everyone. I did a presentation for the National Seniors Council and the banner they displayed said ‘Working FOR Seniors’. As I stood up to present I mentioned that I thought their banner should say ‘Working WITH Seniors’. Most seniors are perfectly capable of doing things FOR themselves with only some facilitating assistance. Why would we not consider their contribution as extremely valuable, cost effective and—as the senior demographic broadens—sustainable? The mistake we make, in good faith, both for senior adults and children, is taking away self-dependence and interdependence. What our real job should be is as facilitators to empower youth and older adults to work together on their own collaborative initiatives. We still need to be there, but as partners not leaders. At i2i we have had success with our projects because they are built with collaboration from the onset. Even our Board ranges from a 23 year old President to a 99 year-old Board member. We know that you have to be the change you want to see. Intergenerational Day is now recognized in many communities across Canada on June 2010. Learn more about the i2i Intergenerational Society.

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Published: 27 May 2014

• British Columbia
• Long Term Care

Interview with Martha Jane Lewis, BC Centre for Elder Advocacy and Support

CNPEA: Tell us a little bit about your project.

This project is funded by the Law Foundation of BC to produce an e-book describing the legal issues that affect people living in residential care in BC. Residential care is called different things in different provinces; in Ontario for example, it is called long-term care. What it refers to in BC is supportive housing provided to people who can no longer live in their own home who have been assessed and approved for residential care. We are creating the e-book to inform people of the legal issues: who has the right to make a decision, who can give consent and ways that problems can be resolved. The problem solving section is important because people do not often stay in residential care for long. This means solving an urgent, day-to-day problem through a formal legal means that could take up two years does not make sense. What this e-manual will provide are reasonable questions that residents and their family can ask to problem solve outside of the courthouse.

CNPEA: What else will the E-book cover?

The manual will contain units of information such as:

• Governing Regulations
• Legal Issues affecting entering a residential care facility
• Living in residential care: Residents’ rights, standard of care, professional care, informed consent, physical and chemical restraints, detention, informed consent
• Remedies for how to resolve common problems arising in residential care facilities
• Decision making: power of attorney, representation agreements
• Consent: treatment decisions
• CNPEA: How did you come up with the idea to develop this E-book?

The model is based on the Advocacy Centre for the Elderly (ACE) in Ontario Long Term Care Manual that has been widely used for many years by Ontario long-term care providers, legal professionals and advocates. ACE has as excellent elder law clinic and the manual itself is an amazing resource at over 900 pages. We knew what ACE had accomplished and we wanted to produce something similar in BC.

CNPEA: Who would use the E-book? Is there a particular audience?

The E-manual will be a valuable tool for our staff, the general public, care home staff and anyone else who wants to learn about legal issues related to residential care in BC.

CNPEA: What do you find most interesting about this project?

There is no similar resource in BC and it is really easy to get confused within the residential care system. We hear that residential care home management gets calls about residents after the resident has died. It seems that families are sometimes afraid to complain. You hear cases of family members being banned from facilities for complaining about the standard of care provided. Residential facilities need to be really open and invite feedback from families. This is a real challenge partially because staff may be defensive in receiving feedback and turnover of care-giving staff is high because it is exhausting work. Residential care homes can be very confusing for families. This project is about making information available and accessible. The guide can help both families and staff members learn their rights and responsibilities and clarify what level of care an older adult is entitled to.

CNPEA: How will this manual help prevent elder abuse?

The manual provides information that is helpful in describing what the vulnerable people who live in res care homes are entitled to. It helps families or others who care about a resident strategize about how to effectively approach the right person to discuss concerns. Abuse happens when an older person’s rights are ignored: the manual supports people to take action when they are concerned about a resident senior. It also helps ensure the senior is getting the right care, which helps prevent abuse and neglect. The manual is also useful to people managing or working in res care homes, as it explains what is reasonable, and why families may be hesitant to raise their concerns. All this contributes to a problem-solving environment that is more informed, compassionate and responsive. This helps keeps seniors safe, because when communication breaks down because family members are upset about the treatment of a loved one, the senior can get alienated from those very people who care about her the most and want to make sure she or he remains safe in a long term care setting.

CNPEA: Where can people go for more information?

The E-manual will be released this summer. For more information about BC Centre for Elder Advocacy and Support project and resources visit http://bcceas.ca.

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Published: 16 April 2014

• British Columbia

Jemma: On May 4, 2012, YWCA Metro-Vancouver was chosen to undertake a new project called Community Action on Elder Abuse (CAEA), funded by The New Horizons for Seniors Program. This is a 3-year initiative that runs from 2012-2015. The goal of CAEA is to develop culturally-appropriate training and resource materials for front-line/volunteer service providers whose clients include seniors.The project has created a train-the-trainer awareness course on taking action against abuse of older adults that supports front-line staff and volunteers to identify potential abuse and/or neglect of seniors. The project aims to enable front-line staff and volunteers to response appropriately to concerns about abuse and neglect by supporting them to communicate effectively and direct seniors to culturally appropriate resources.

Jemma: As an organization reaching so many individuals in the community, we felt compelled to utilize our position to address the critical issue of elder abuse, and explore relevant strategies we can utilize through our networks. A Seniors Advisory Committee guides the project. The development of materials has been based on data from three senior led focus groups with First Nations seniors, seniors who work with seniors and a cross-cultural seniors group. The program itself is very unique and based on adult education methodology. It features interactive case studies, role-play, small group work and individual work. The selected train-the-trainer course candidates have the opportunity to enhance their facilitation skills, as the training program requires each facilitator to deliver an elder abuse awareness presentation to the training group, using the slides that are a part of the CAEA Power Point presentation. So by the time they have completed the course, in essence, they are taking ownership of the workshop that they will deliver to their front-line staff/volunteers when their certified train-the-trainer course is completed.

Jemma: Being a national project, the Project Coordinator and I have had the opportunity to travel across Canada to deliver the train-the-trainer course. It is a privilege to meet the wonderful staff supporting and advocating for the needs of older adults. It is exciting to provide a new training opportunity that is reaching communities that are diverse, multicultural, rural and remote! In last year’s program, we had participants travel all the way from Haida Gwaii to Prince George, Dawson Creek to Burnaby to receive training that they delivered to front-line staff/volunteers in Bella Coola. We have had an abundance of positive support for our train-the-trainer course throughout Canada.

Jemma: It is essential to go out and meet in person the staff and volunteers who support older adults, and to connect with the seniors who access those essential services. For me, this meant researching events, getting out from behind the desk and spending time in the community. This makes such a big difference: when you are actually in the community you are able to find out who’s doing what, brainstorm solutions together and create informed, good quality projects.

Jemma: CAEA is in its final year and I strongly encourage all service providers (managers, supervisors, coordinators) to take advantage of this free training opportunity while it is still available. This project will strengthen the capacity of front-line staff/volunteers at community organizations in Metro Vancouver, key regions of British Columbia and in selected communities across Canada to detect and address elder abuse and/or neglect. Our website also features a resources section with our project materials that are available to access for educations purposes: YWCA Community Action on Elder Abuse Facilitators Guidebook; a brochure in 7 languages; and a standard policy and procedures template on responding to abuse of older adults—free to download. To register for a training event or get more information on the CAEA project go to: http://www.ywcavan.org/content/Community_Action_on_Elder_Abuse_Project/1640