ETHICS MADE REAL

Gordon Self

November 28, 2011

Imagine the following: An elderly couple asks their niece to pick up some groceries for them. They give her their debit card and tell her to get some cash from the bank machine too.

She has committed to memory their PIN to use the card, and they trust her implicitly. After all, she looks after all their banking needs and reconciles every financial statement. Little do they know but she has been bilking hundreds of dollars for herself each month, not quite enough that the bank will become suspicious.

Or this: A middle age son tells the doctor looking after his mother in hospital that she always wanted to live in her small house as long as she could. He moved in with her a few years ago after his dad died around the same time she was diagnosed with an advanced form of dementia.

He was in between jobs anyways and had to give up his apartment, and thought it would do them both good to stay with her for awhile.

The health care team believe she is a good candidate for placement in a designated assisted living facility where her health needs could be optimized, and asks the son whether it's time to sell the family home. The son disagrees, insisting they spend lots of quality time together and he looks after all her cooking, laundry and cleaning.

ABUSED, ABANDONED

A home visit after her discharge from hospital reveals otherwise. The front door is ajar and she is found stooped over in a chair, hair unkempt and clothes covered in feces. There is only a half empty pizza box in the fridge and some cans of beer. The son is nowhere to be found.

The report of the Parliamentary Committee on Palliative and Compassionate Care released earlier this month estimates from four to 10 per cent of seniors in Canada will experience some form of abuse in their lifetime.

Elder abuse has been described as a silent epidemic, often going underreported, especially when incidents of neglect and outright physical, emotional, sexual and financial abuse are often perpetuated by the elderly person's own family member, evoking shame and conflicted sense of loyalty that makes it difficult to confront the abuser.

In a press conference at the Grey Nuns Community Hospital, Covenant Health endorsed the parliamentary report, entitled Not to be Forgotten: Care of Vulnerable Canadians. We presented to the committee last year in Ottawa, as well as participated in a local round table - one of many hosted by MPs in their constituency offices across the country to ensure Canadians were heard on the needs of the vulnerable.

Dr. Marjan Abbasi, chief of geriatric medicine at the Misericordia Hospital in Edmonton, argued during our round table presentation that we "need to put elder abuse on the same footing as child abuse. Both are egregious criminal acts."

Elder abuse is indeed one of the most serious moral issues of our times. Sadly, as our society ages so will reports of abuse, requiring strategies such as the Elder Abuse Intervention Team in Edmonton to bring the coordinated resources of police, social services and health care professionals to intervene on behalf of vulnerable seniors.

As effective as this team is, however, they require the public's support and readiness to talk about the issues. This is not an easy conversation to have, but unless we give voice to these silent crimes, acts of abuse are only bound to occur.

The real world of ethics must encourage honest conversation, even if it may be controversial or shatters our sensibilities. To think children can abuse their elderly parents is as unthinkable as imagining parents stealing young children of their innocence.

Yet it happens. Pretending otherwise is not going to make either crime go away. We will not be able to find our way through the conundrums of our lives unless we are prepared to engage the difficult conversations, and to do so in a way that invites solutions.

SPEAK UP

It is easy to say things are bad. It is another thing to say, "yes, but here is what we can do about it." Dedicated professionals like the Elder Abuse Intervention Team are a powerful witness of what we can, and must do for seniors. It is a matter of moral imperative.

For the MPs who laid aside partisan differences to convene this critically important conversation so vulnerable Canadians are not forgotten, we must all say, thank you. Let's do our part and not forget them ourselves.

(Gordon Self is vice president, mission, ethics and spirituality for Covenant Health and can be reached at mes@covenanthealth.ca.)