1. Violence Prevention Initiative
Respect Aging: Preventing Violence against Older Persons
Section 1: RECOGNITION Module 3: Violence against older persons in Residential Care Facilities
Violence Prevention Initiative

2. Agenda Welcome Brainstorming Learning together:
Violence against older persons in residential care facilities
Small group activity
Reporting back to whole group
Wrap-up / Evaluation

3.  “residential care facilities”
What is an institution?
A set of organized beliefs and rules that establish how a society will try to meet its basic social needs…
 “residential care facilities”
An institution is a set of organized beliefs and rules that establish how a society will try to meet its basic social needs.
Major social institutions include family, school ,peer groups, mass media and government.
Residential care facilities are also examples of an institution and for the purpose of this training we will be focusing on residential care facilities, where care is provided in a residence or institution that is not the client’s original primary residence/home.

4. Residential care facilities in NL
Personal care homes
Long-term care homes
Long-term beds in hospitals
Seniors’ residences / Retirement homes
Community care homes
Cooperative apartments
Alternate family care homes
Assisted living residences
Congregate housing
In this session, we mostly look at the first two models of residential care facilities.

5. Personal care homes Private For-profit Licensed Minimal care
No on-site health services
95 homes
4000 beds
Private; for-profit
Licensed, regulated and monitored by Regional Health Authorities
Provide minimal levels of care
For people who do not need on-site health services
There are 95 personal care homes across the province with more than 4000 beds

6. Long-term care homes Public Accredited Regional Health Authorities
Long-term nursing
Higher-level care needs
2800 beds
Public
Accredited facilities
Operated by Regional Health Authorities
Provide long-term nursing care for residents with higher-level care needs
2800 beds available provincially.

7. Who is most affected by violence in residential care facilities?
1. Women
There are two groups who are most affected by violence in residential care facilities.
The first group is women.
Ask participants: “Why do you think that is so?”
Women live longer, so there are more older women than older men in residential care
Women = approximately 63% of individuals aged 80+ in NL*
Source
* Statistics Canada. (2013, July). Population by Broad Age Groups and Sex, 2011 Counts for Females, for Canada, Provinces and Territories. Retrieved from:

8. Who is most affected by violence in residential care facilities?
2. Residents in long-term care
The second group that is most affected by violence in residential care is residents in long-term care.
Ask participants: “Why do you think that is so?”
Often depend on others for care and support
Least able to protect themselves
They are the most elderly seniors
More frail, have more complex needs

9. Types of violence in residential care facilities
Physical violence
Psychological violence
Emotional violence
Verbal abuse
Sexual violence
Financial abuse
Neglect
Spiritual violence
Cultural violence
The nine types of violence that were described in Modules 1 and 2 are also found in residential care facilities.

10. Other forms of violence in residential care facilities
Failure to respect basic rights
Psychological neglect
Excessive use of restraints
Imposing care when unwarranted
Taking belongings without permission
Not respecting dietary preferences
Besides the nine types, there are two other forms of violence that occur in residential care facilities.
The first is “failure to respect basic rights”.
Ask the group for some examples of these forms of violence.

11. Other forms of violence in residential care facilities
Systemic violence
Rules and policies which have a negative impact on residents
Practices that have become “the norm”
Inadequate training, insensitivity, lack of awareness
Systemic violence is the second type of violence that can occur in residential care facilities.
Ask participants for examples of each of these kinds of systemic violence.

12. Why does violence occur in residential care facilities?
Isolation
Ageism
Systemic problems
There are three primary reasons why violence occurs in residential care facilities.
Isolation. Isolation may occur because of:
Physical distance from family/friends
Children moving away
Location of facility
Ageism:
Involves stereotypes or prejudices against older persons because they are old
These stereotypes can lead to discrimination: treating older persons as “lesser” persons or inconveniences
Systemic problems include:
Failure to deal with violence
Fear of reporting incidents
Lack of clarity about reporting incidents
Lack of education & training
Poor wages, working conditions
Ask participants if they have any examples or stories about isolation, ageism, or systemic problems in residential care facilities.

13. Rights of older persons
Same rights as all adults
Operational Standards
Residential care should…
be violence-free
provide dignity and respect
Residents of residential care facilities have all the same rights as other adults.
Operational Standards are provincial guidelines for residential care facilities that are violence-free and that provide residents with dignity and respect
There are two kinds of Operational Standards in this province:
Operational Standards for Personal Care Homes
Operational Standards for Long-term Care Homes
Point out the websites where the Operational Standards can be found (see page 50 in the Manual or handouts). (

14. Promising practices
Residential care facilities can act on those things that prevent people from speaking out, such as:
Not knowing how to report an incident
Fear of retaliation for reporting
Fear of getting evicted for doing something against the rules
Worry about getting someone fired

15. More promising practices
Increase awareness about ageism and violence against residents
Train staff
Encourage a culture of respect and compassion
Avoid labels
Provide advocates for residents
Ask participants what else institutions or residential care facilities can do to promote a safe, violence-free environment.

16. ALERT!!! If you witness or suspect violence
Staff or volunteers: tell your supervisor
Residents, family or friends: contact your Regional Health Authority
Immediate danger: call local police or 911 where available
Point out the phone numbers of the Regional Health Authorities (Manual, page 52)
Eastern Regional Health Authority (Rural Avalon)
Eastern Regional Health Authority (St. John’s Region)
Eastern Regional Health Authority (Bonavista, Clarenville, Burin Peninsula)
Central Regional Health Authority
Western Regional Health Authority
, ext. 226
Labrador-Grenfell Regional Health Authority

17. BE PREPARED! Take reports of violence seriously
Learn about reporting procedures in residential care homes in your region
Know your legal obligations to report violence
Show participants the “Contact Information for Reporting” Tool on page 53 of the Manual or handout.