Developed by the Canadian Nurses Association and the Registered Nurses’ Association of Ontario
Adapted for use by [name of PEACE site]
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MODULE 4:
INTERVENTION
and STRATEGIES
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Promoting Awareness of Elder Abuse in
Long-Term Care Homes
• Two-year national project between Canadian Nurses Association
and the Registered Nurses’ Association of Ontario from April 2010
– March 2012
• A series of education sessions implemented in 10 PEACE Sites
across Canada
• Topics included are recognizing elder abuse; when and how to
report elder abuse; how to intervene; and what you can do to
prevent elder abuse
• Resources and materials on NurseONE
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What have we learned so far?
Objectives
By the end of this module, the learner will be able to:
1. Explain the de-escalation strategy as an immediate
intervention
2. Discuss Next Step intervention strategies
3. Apply resident centred care and the therapeutic
relationship as preventative strategies for elder
abuse
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Understanding Intervention
• Definitions:
– Intervene: To involve yourself in a situation with the intention
of influencing the outcome
– Intervention: The act of intervening
• Each situation must be looked at with its own contributing
factors and the individuals involved
• Think about the needs and desires of the Resident
• Team based, interprofessional approach
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Immediate Intervention:
De-escalation
Defined here as: “Use of a phrase to break the flow
of an abusive or potentially abusive situation”
• It serves to alert the individual that the situation
appears to be abusive and helps keep the
Resident safe
• Example:
Can I help you?
Can I see you for just a minute?
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Alternate Exercise
If you walked into this situation, what would you
do/say to de-escalate:
Example 1
Staff A goes by a resident’s room and sees a co-worker,
Staff B, heaving a resident onto the bed.
What should happen next?
Should this be reported as abusive behaviour?
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Example 1
Staff A enters the room to first ensure the resident is
all right, then offers support to Staff B in order to
break the abusive situation.
Presuming the resident is all right, Staff A says to
Staff B, “Can I help you?” or “Can I see you for just
a minute?”
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Example 2
Staff C passes by Staff D’s office and hears Staff D
shouting at a resident.
What should happen next?
Should this be reported as abusive behaviour?
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Example 2
Staff C enters the office and asks the resident if he
or she was all right and does a quick assessment
to determine if the resident is in danger.
Then Staff C asks Staff D “Can I see you for a
minute?”
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Next Step Intervention
• Does your long-term care setting have a zero
tolerance for abuse?
• Who must the incident(s) be reported to?
• What internal supports can be drawn on?
• What external supports exist in your community?
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Strategy: Therapeutic Relationship
• A therapeutic relationship requires reflective practice
• Self-awareness
• Self-knowledge
• Empathy
• Awareness of ethics
• Boundaries and limits of the professional role
• Show respect, talk to residents as you would like to be
talked to.
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Strategy: Resident Centred Care
•Respect for residents
•Residents deserve to be treated with dignity
•Residents are experts on their own lives
•Residents are leaders (they can help us as we provide care)
•Residents’ goals should coordinate the way that the health care
team provides care
•Residents deserve continuity and consistency of care and
caregiver
•Resident care should be timely and responsive
•Residents deserve fair/proper access to care they need
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Strategy: Interacting with the
Resident
•Resident focused
•Respectful
•Provided with dignity
•Your behaviour may help you give better care
to residents
•Quality talking is a good way to reduce or
prevent elder abuse
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Case Scenario Comparisons
• Scenario 1
Resident Mrs. E seeks
out resident Mr. F to sit
with him and hold his
hand. Mr. F greets her
warmly and ensures
there is room for her to
sit beside him.
• Scenario 2
Resident Mrs. E seeks
out resident Mr. F to sit
with him and hold his
hand. Mr. F pushes her
away and shouts for
staff to intervene.
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Optional Case Study
An 80 yr old female resident has had a long standing intimate
relationship with a younger man. This relationship started prior to
her admission to LTC.
 The relationship was primarily sexual in motivation with consent
 Resident was cognitively intact and told staff to “mind your own
business” when asked about visits
 As time passed, the resident’s condition deteriorated and staff
noticed that she was more confused and withdrawn after his visits
How would you explore this resident’s rights and wishes?
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Key Points
• Establish a word or phrase to use in situations
that may appear to be abusive
• Consider appropriate Next Step interventions
• Using resident centred care values, beliefs and
therapeutic relationships may help prevent elder
abuse from occurring
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Questions?
Resources
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What’s Next?
•
•
•
•
Module 1: Understanding Elder Abuse
Module 2: Recognizing Elder Abuse
Module 3: Learning the Law
Module 4: Strategies and Interventions
Module 5: Healthy Work Environments
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