Welcome to CHNET Fireside Chat #362
January 23, 2014 1:00 – 2:30 PM Eastern Time
(Teleconference open for participants at 12:50 ET)
Exploring Social Isolation and
Mistreatment of Older Adults
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Please introduce
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Name
Organization
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Healthcare Sector
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Social Workers,
Physicians, etc.)
Education / Research
Sector
(Faculty / Staff / Student)
Federal / Provincial /
Territorial
Government / Ministry
Legal Sector
NGO / Voluntary and
Private Sectors
Aging Field
(Service Providers)
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Presenter
Charmaine Spencer
Gerontology Research Centre,
Simon Fraser University,
Vancouver, BC, Canada
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
Defining social isolation
o
What are we talking about?

Abuse pathways

Current tools, interventions & prevention

Policy and practice
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Social isolation (SI) is considered one of the more robust
risk factors for abuse and neglect in later life (Bonnie &
Wallace, 2003).

How does it function, and why?

How are we addressing it?
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A changing world?
 About 1 in 4 seniors in Canada live alone, proportion
expected to grow
Some noteworthy trends:
 Smaller, more geographically dispersed families
 Higher divorce rates
 Smaller & less stable family networks for aging
Canadians than historically recorded
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
Used in a very general way in the abuse field

Carries multiple meanings
◦ absence of trusted others
◦ lack or inadequacy of social support
◦ absence of a social network
◦ degree of social embeddedness, etc.

Sometimes used to express social exclusion
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
Loneliness

Social support

Ethnic attachment

Absence of an accessible social network

But also sometimes means social perception that the
person is not connected to agencies (access to
information)
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
As part of an abuse definition:
◦ “emotional abuse - subjecting older adult to isolation,
punishment, confinement”

As an indicator of mistreatment
◦ such as a sign of neglect

In our assessment tools
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Young adult
Older adult living
alone
Older person in rural
community
Middle aged
Older adult living with
spouse or partner
Older person in
small town
Older men
Older adult living with
family
Older women
Older person in big
city
Older adult living in
care facility
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Understanding Our Assumptions
Is abuse in later life
hidden?
Or are we simply not
acknowledging it
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Preexisting
Abuser
caused
Condition/
Stress
Mediated
(dementia)
Protective/
emergent
Socially
created
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
The abuser’s behaviour – e.g. purposefully cutting
person’s existing ties
◦ may be a power & control technique, part of emotional
abuse
◦ may also reflect personality, psychopathology,
depression, health issues
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What examples come to mind for you?
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
Isolation: Deprives the person of all social support
necessary for the ability to resist (deprivation)

Develops an intense concern for self (self focus)

Causes victims to depend on the victimizer
(dependence)
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The mistreated older adult as socially isolated

Abuse stigmatizes
◦ Withdraws from others- fear, embarrassment
◦ Withdraws from peer or family contact
• Peer judgement of the current or past action of the
victim

Other pathways
◦ personality, dementia, underlying depression (preexisting or consequence of abuse)

And are there gender differences?
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
Response of others to the older adult (others withdraw
from the older adult)
◦ victim blaming
◦ frustration, sense of helplessness
◦ protect own mental health
◦ sometimes safety concerns
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


Being abused or neglected is a stigmatized state
Victim blaming, judgmental, “...must have raised her
children wrong”, “Why do you put up with this? Just kick
him out”
◦ Peers and family can be very good at this
Internalized blame
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

“Social exclusion” (people pushed to the margins)
Understand the social conditions under which abuse occurs.
◦ financial & linguistic barriers,
◦ immigration & settlement issues
These limit access to appropriate resources and services,
contribute to marginalization and a diminished sense of
personhood. Tam & Neysmith (2006)

Address abuse and the social conditions
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
Occasionally explored in screening and assessment,
e.g. “Is the care receiver socially isolated?”

Cautions:
o Open to interpretation, our social and cultural
stereotypes, biases
o Do
we equate other elements such as physical frailty
with social isolation?
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
Overall, much of the information on SI in the EA field is
still being framed within a caregiving perspective, and
the intervention focus for social isolation is on supports
to caregiver, respite
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What does social isolation cut the person off from?

Good information/reality check

Social connectedness- emotional wellbeing

Social support
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
Seniors helplines - Social isolation as the need to talk,
the need for information (help restore knowledge/power
balance)

Public education- around abuse, information to
redress bad information (power/control). Some basic
efforts to address stigma. “Don’t blame yourself. It’s not
your fault.”
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
Support groups- to help the OA re-engage and
connect with others in similar situation

General- transportation

Note: general approaches (seniors’ drop-in) do not seem
to help abused/neglected seniors as much (Lithwick)
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
If social isolation is tied to abuse, should we examine
our approaches to helping?
◦ ASSESSMENT & CRISIS INTERVENTION – the
SWARM of hornets- swoop in, attack, and leave –
◦ Consider the effect on the isolated older adult; high
rate of declining services
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
The abused or neglected
senior

The person causing harm
- in family, care workers?
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What are the implications of this particular focus on
SI?

The idea that the senior who is active & obviously in
our midst can’t or won’t be abused or neglected?

If abused or neglected older people are hidden or
isolated, we then need outreach and case finding at
policy/practice level?
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
May mention SI in a specific context such as
◦ Caregivers experiencing social isolation
◦ (Newfoundland and Labrador)
◦ Culture (Alberta)
◦ Isolation and exclusion - focus on representation in
groups, recreation (re-engagement), home visits
(NWT)
◦ Protective measure - Adequate social and support
networks allows seniors to counter isolation (Quebec)
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
The case of sponsored older immigrants
◦ Length of sponsorship - forced dependency
◦ Lack of language support - isolating (Koehn &
Spencer)

The case of long term care facilities
◦ Socially isolated and isolating - separate from
community
◦ Isolated care workers
◦ Structural issues – e.g. health care policies, such as
“First available bed” can remove older adult from
existing support
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
Social isolation talked about primarily in the context of
caregiver stress

Inadequate collaboration with other services

Training in these areas and supervision can create a
sense of isolation for individual workers
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
Being alone or living alone is not the same as being
socially isolated

The persistent stereotype of older age as a time of
increasing loneliness, social isolation and family neglect

Important to distinguish between
◦ SI created by the abuser’s behaviours and abuse
dynamics, from
◦ SI facilitated by the older adult’s circumstances
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
SI may also be facilitated by
◦ systemic or institutional policy and practice or
◦ reinforced by social responses, including blaming and
stereotyping

The role of policy in creating or reinforcing SI
remains on the back burner. Ethnocultural context
and responses are important as well
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
A need for reflection
◦ What factors influence the likelihood of social isolation
and exclusion?
◦ How do we best offer support and help to older
adults without becoming an ”interventionist society”
◦ What values do we impose on concepts such as
“social isolation” and “social exclusion”.
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
Beaulaurier, RL, Seff, LR & Newman, F. (2008) Barriers to Help-Seeking
for Older Women Who Experience Intimate Partner Violence: A Descriptive
Model. Journal of Women & Aging, 20(3/4), 231-248.

Nicholson, N.R. (2009) Social isolation in older adults: an evolutionary
concept analysis Journal of Advanced Nursing 65(6), 1342–1352.

Montminy, L. Older women's experiences of psychological violence in their
marital relationships. Journal of Gerontological Social Work, 2005; 46 (2): 322

COTA New South Wales Draft Policy on Social Isolation.

Wolf, RS. & Pillemer, KA. (Fall 1986). Maltreatment of the elderly: a
comparative analysis Pride Institute Journal of Long Term Home Health
Care. 3 (4),10-17

Kiconco, G. (Spring 2010). Amidst Domestic Violence- An Analysis of the
Psycho-Socio Stigma and Feelings of Isolation faced by Women in
Göteborg and neighboring Municipalities
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Charmaine Spencer
Gerontology Research Centre,
Simon Fraser University,
Vancouver, BC, Canada
cspencer@shaw.ca
In Partnership with
Seniors Policy Directorate
Employment and Social Development Canada
http://seniors.gc.ca
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