Defining and measuring elder abuse and neglect – preparatory work required to measure the prevalence of abuse and neglect of older adults in Canada

The Research Chair on Mistreatment of Older Adults was implicated in this research project. The following is the description of the project:

Principal researchers

Lynn McDonald, University of Toronto, head researcher

Marie Beaulieu, co-researcher and responsible for the French section

Cynthia Thomas, Westat (USA), co-researcher and responsible for the collection of English data

Research teams

Simon Biggs; Thomas Göergen; Barry Goldlist; Sandi Hirst; Anthony Lombardo; Ariela Lowenstein; Shelley Raffin Bouchal; Judith A. Wahl; Christine Walsh; Laura Watts; Kevin D. Willison.

Chair staff involved in the project

Cynthia Brunet

Marie Crevier

Funding Agency

Human Resources and Skills Development Canada

Completion dates for the project

January 2010 to October 2011

Goals and objectives

This pan-Canadian research project is intended as a prelude to a possible study that will research and determine the scope of the phenomenon of mistreatment of older adults. It is the result, among others, of a collaboration between the National Initiative for the Care of the Elderly (NICE), Westat and the Research Chair on Mistreatment of Older Adults. This project has developed a questionnaire which enables to determine the scope of the phenomenon of mistreatment of older adults, both in the home and in accommodation. Several phases have been covered:

Phase 1: To develop a conceptual definition of mistreatment and negligence of older adults.

Objectives:

• Using a standardised grid, to carry out a systematic review of definitions of mistreatment and negligence and an inventory of risk factors.
• To assess the methods used and the issues encountered in assessing the scope of mistreatment.
• To study the inclusion criteria to be used to determine the target public.
• To examine in what consist the theories of mistreatment and how they influence the definitions.
• To hold a seminar of experts to determine the criteria for choosing definitions and to reach a consensus on the chosen definitions.

Phase 2: To develop measuring instruments (one questionnaire for people living at home and another for those living in institutions)

Objectives:

• To develop functional definitions that can be converted into questions to gauge the forms of mistreatment (physical, psychological, financial, and sexual and negligence), risk factors, characteristics of abusers and the effects of mistreatment.

Phase 3: Validation of measuring instruments

Objectives:

• To test the questionnaire in the home by means of face to face interviews with older adults.
• To test the modified questionnaire by telephone interviews with older adults living at home.
• To test the questionnaire by face to face interviews with older adults living in institutions.

Phase 4: Identification of ethical issues

Objectives:

• To develop a manual for the interviewer.
• To select an instrument to assess cognitive functions.
• To train the interviewers.
• To develop a questionnaire for by proxy respondents (on behalf of an older adult who is unable to respond).
• To hire a social worker/psychologist to provide support to respondents, should the need be.

Phase 5: Consensus

Chronology of actions

This is a multicentric and multilingual project which required several consecutive procedures.

• Review of the definitions of mistreatment and of negligence and the risk factors associated with this phenomenon, by using a standardised evaluation grid.
• Inventory of methods used to measure mistreatment in previous studies.
• Team meeting to determine the theoretical framework of the study.
• Seminar of experts to reach a consensus on the definition of mistreatment.
• Development of measuring instruments of mistreatment in the home and in institutions.
• A first validation of tools in focus group with older adults and in individual interviews in pairs (older adult and caregiver).
• Revision of tools in the light of focus groups’ results and individual interviews in pairs (older adult and caregiver).
• Conducting of face to face interviews with older adults living at home with the aim of testing the questionnaire (second validation).
• Revision of tools in the light of these results.
• Conducting telephone interviews with older adults living at home or in accommodation (third validation).
• Final revision of tools in the light of these results.
• International working seminar to conclude the project.

The Research Chair on Mistreatment of Older Adults’ team was responsible for the implementation of the French section of this research project, while the English part was the responsibility of NICE and Westat. The following is the inventory of the Research Chair’s contributions:

• Participate in the development of a conceptual definition of mistreatment of older adults and its forms (physical abuse, psychological abuse, sexual abuse, financial abuse and neglect).
• Inventory the literature on the definitions of mistreatment of older adults.
• Participate in the consensus meeting, bringing together international researchers, concerning the definition of mistreatment and its forms.
• Validate the questionnaire in focus group with older adults and in pairs (older adult and caregiver).
• Revision of the questionnaire resulting from these interviews.
• Conduct face to face interviews with older adults living at home.
• Revision of the questionnaire in the light of these interviews.
• Administration of the questionnaire in telephone interviews with older adults living at home.
• Final revision of the questionnaire resulting from the telephone interviews.
• Participate in the seminar of closure of the project.

Results or impact

Production of two questionnaires ready for a population-based study in Canada (people living at home or in accommodation).

The results of the telephone interviews allow identification of preliminary results on the scope of mistreatment of older adults. These results have to be qualified, for this study was conducted by convenience sampling (participants were not recruited at random). It covers, therefore, the response of interested people willing to talk of their experiences.

References

Beaulieu, M., Brunet, C., & Crevier, M. (2010). Définir et mesurer la maltraitance envers les personnes aînées. Travail préparatoire en vue d’une étude pancanadienne de prévalence. Résultats du groupe de discussion et des entrevues individuelles au sein d’une dyade aîné et proche aidant. Collectes de données en français. Rapport remis à NICE pour une étude subventionnée par HRSDC. 79. p.

Beaulieu, M., & Brunet, C. (2011). Définir et mesurer la maltraitance envers les personnes aînées. Travail préparatoire en vue d’une étude pancanadienne de prévalence. Résultats des entrevues en face à face. Collectes de données en français. Rapport remis à NICE pour une étude subventionnée par HRSDC. 21. p.

Beaulieu, M., & Brunet, C. (2011). Définir et mesurer la maltraitance envers les personnes aînées. Travail préparatoire en vue d’une étude pancanadienne de prévalence. Résultats des entrevues téléphoniques. Collectes de données en français. Rapport remis à NICE pour une étude subventionnée par HRSDC. 26. p.