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Published: 23 November 2014

• Canada
• Ontario

Interview with Janet Wilson, Violence Against Women and Healthy Family Programs, Family Services Toronto

CNPEA: How does the Healthy Families, Safer Families Project peer support model work?

Janet: I’m a big believer in the peer support model because it’s not only about getting support to seniors, but also empowering seniors to give support. Peer seniors who provide support feel as though they have something offer which increases agency, self-efficacy and resilience. Seniors appreciate receiving support from someone who has had a similar lived experience, is from the same culture and who speaks their preferred language. Peer leaders were trained to provide peer support and were given information and resources that would be helpful to a senior experiencing abuse. In addition to peer support, seniors, their families and the community members at large were offered educational workshops on the issue of elder abuse. Each community used peer support in a way that suited their community.

CNPEA: Can you tell us about how you used different strategies to work with different ethno-cultural communities?

Janet: The Spanish speaking community, in Toronto, is very volunteer based, so in this community we trained 40 volunteers who wanted to be peer leaders, and offered honoraria for each day of training in which they participated. 10 of these trainers worked on advocacy issues related to elder abuse and presented at seniors groups in the community. Other peer leaders, who were already involved in volunteering with our partner organization on a seniors support line, were given more education and knowledge about elder abuse, so that when a senior calls they know how to guide them to appropriate services. We also continue to host a movie morning series, where we show a movie that has something to do with seniors and elder abuse. The movies are quite varied and can be romances, comedies or other dramas, as long as they have a scene related to an elder abuse situation. Our peer leaders then use the movie to lead the group of seniors into conversations about elder abuse.

In the Somali community volunteerism is not as prevalent. These seniors come from a war torn country and their priority is often settling and adjusting to life in Canada. As a result, we decided to hire 5-6 peer leaders who were also trained to provide peer support, information and referrals to other seniors. As seniors from ethno-cultural communities are often looking after their grandchildren, many are isolated. Because the Somali community in Toronto is in a specific geographic location, peer leaders were able to identify apartment buildings with a high density of Somali seniors living there. This facilitated connecting with seniors through door to door outreach. The seniors were offered accompaniment to appointments, doctor visits and so on. Through outreach we were able to recruit over 40 Somali senior volunteers. Peer leaders have also facilitated small groups, and have provided one to one support through drop-ins at seniors centres.

CNPEA: In what ways do you connect with isolated seniors? What strategies were most successful?

Janet: Both communities were connected with media, particularly the radio. So, even if a senior is isolated this was one way to connect them with the outside world and us to them. Through a Spanish-speaking radio station, we established a weekly show focusing on seniors’ issues, including the topic of elder abuse. We also managed to speak about the issue on three Somali radio shows.

The Spanish-speaking group created calendars, with elder abuse information and resources on each page. These calendars are in high demand and this year we are sending out 3000 copies. In addition to reaching out via radio and a calendar, we recognized that a lot of seniors would make more of an effort to attend programming that was fun and enjoyable rather than something on elder abuse directly. That’s why we started the movie mornings. They are more appealing for seniors

Outreach with the Somali was largely achieved by going door to door and by creating easily accessed space to hold drop-in programming. Instead of creating a calendar, the Somali community, having a strong oral tradition, decided to write a book of seniors’ stories and poems illustrating their resiliency, which will be shared with the whole community.

CNPEA: Working with two culturally and linguistically unique communities, Somali and Spanish-speaking, have you noticed any similarities in challenges or strengths?

Janet: In addition to what I mentioned earlier with regard to different engagement strategies, the Somali community, like other communities that have experienced war in their homeland their primary focus was on surviving the greater violence of war, rather than what’s happening in their own home. In fact, in the Somali language there is no word for ‘abuse’. Both immigrant communities had similar cultural values, where the family expects them to hand over their income and put it towards a family shared income. The potential for financial abuse is present in both communities. Because the peer support model is a very grassroots model, it appeals to and can be easily applied in most communities—so this approach proved to be extremely effective.

CNPEA: What advice would you give to a project hoping to explore ethno-cultural community engagement?

Janet: Ethno-cultural community work needs to be very flexible. The intrinsic aspects of community engagement are applicable, but have to be adapted to suit each community. Build on the strengths and go with outreach methods that work for them. We worked with these two communities in particular because we had a pre-existing relationship with them and were able to hire people in the community who know the people and the issues well. It is important to be continually thinking of how to develop community capacity by strengthening the capacity of both individuals and organizations within the community.

Over the course of our project, we had three knowledge exchange meetings, bringing together the two distinct communities to share their learnings, challenges and strategies. This was of great interest to both communities, as it supported them to identify their similarities and their differences.

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Published: 13 November 2014

• Northwest Territories

Interview with Barb Hood, Executive Director and Carly Aasen, Director

NWT Seniors Society

CNPEA: How does your project prevent abuse of older adults?

The emphasis of this project is including the whole community in preventing abuse of older adults. We have led 14 Creating Safe Community workshops with elders, service providers, youth, RCMP and others to build action plans that are community specific. During the first day of the two-day workshops we first identify what abuse looks like in their communities—this is important because it can look really different in each community. On day two of the workshop we develop action plans to address these issues. We believe this process is helpful because while people often are aware of abuse, they may not know how to address it.

12 Intergenerational Connections projects were supported through Leading the Way. Initiatives ranged from Grandmother Walks in Fort Good Hope to elders visiting the preschool in Tulita—but all involved interactions between older adults and youth. For example, during the grandmother walks older women would walk with grandchildren and teach them about the plants and how to harvest them to use for traditional purposes. Summaries of each initiative are being compiled into an Intergenerational Handbook for distribution around the territory.

The NWT Seniors’ Society has also made an effort to support research related to older adults’, including a comparative research study on older adult abuse. This is huge for the North—the first comparative research study of this nature to have ever happened.

CNPEA: How does your project engage rural and remote practitioners? Do you have any promising tips you could share?

Often resources developed in the south are not transferable to a northern context. The Neighbours, Friends and Families project created specific videos relevant to the north, helping to provide engaging materials for service providers here. Overall, we have found that service providers are really interested in training as long as it is relevant and considerate of the language and culture of their community.

We have teamed up with other not-for-profit organizations and the Health and Social Services Department to help fund and deliver workshops to ensure older adults’ issues are represented and discussed. We have also done some training with nurses and social work students at the local college. In terms of engaging and maintain relationships, we find is it is best to work with the service providers that are already advocates in their community and provide them with any information or resources they require and we have available. Regular follow-up and consistent contact is important, because the rate of practitioner-turnover is relatively high in smaller northern communities.

CNPEA: What part of this project are you most proud of?

The relationships that have been created and the creditability this project has brought to the NWT Seniors’ Society. People are becoming more aware of us and trust our work. As more people learn about us, our Seniors’ Information Line is accessed and promoted in 33 distinct communities. The project itself is driven and guided by older adults. We are also proud of our research projects which have engaged over 500 adults and 100 service providers.

CNPEA: How do you plan to sustain this project?

We have a conference scheduled in the new year with the goal of discussing sustainability. We plan to bring together people who have been engaged in the project and other key players who care about the health and well-being of older adults to have a conversation about how we can move forward with limited funding. The results of our comparative research project will be presented during this conference. It is predicted that this study will give us a good idea of the current realities regarding elder abuse and potential next steps in moving forward. We hope our Strategy to Address Abuse of Older Adults in the NWT is adopted by legislature.

More information on the Leading the Way—Networking to Prevent Abuse of Older Adults project can be found on the NWT Seniors Society website or the website of the NWT Network to Prevent Abuse of Older Adults.

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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.