1 Awareness Tool for the Wellness of Quebec First Nations Elders 2 Lead author Maude Ostiguy-Lauzon Elder Wellness Coordinator, First Nations of Quebec and Labrador Health and Social Services Commission (FNQLHSSC) Collaborators Marjolaine Sioui Executive Director, First Nations of Quebec and Labrador Health and Social Services Commission (FNQLHSSC) Rosalie Sioui Social Development Manager, First Nations of Quebec and Labrador Health and Social Services Commission (FNQLHSSC) Kathleen Jourdain Program Agent – Services for Persons with Decreasing Independence, First Nations of Quebec and Labrador Health and Social Services Commission (FNQLHSSC) Pastien Mark Firstline Services Officer, Centre de santé Tshukuminu Kanani, Nutashkuan Marie-Ange Malek Elder, Nutashkuan Charlotte Ishpatao Elder, Nutashkuan Casimir Picard Stakeholder, Nutashkuan Claire Plante Coordinator dedicated to countering elder mistreatment, Côte-Nord region Translation Heidi Rooke Graphics and illustrations Patricia Carignan Appreciation In the interest of fairness, a call for all to participate was sent out for this project. With the help of interpreters, stakeholders and elders from Nutashkuan participated in the creation of this tool. The FNQLHSSC warmly thanks them. This document is available in electronic format in French and in English at www.cssspnql.com. Any reproduction, translation or dissemination, by any means whatsoever, even partial, are prohibited without the prior authorization of the FNQLHSSC. However, reproduction or use for personal and non-commercial purposes is permitted provided the source is acknowledged by the following: First Nations of Quebec and Labrador Health and Social Services Commission 2019. Awareness Tool for the Wellness of Quebec First Nations Elders, Wendake, 12 pages. Source: Program - It’s Not Right! Neighbours, Friends and Families for Older Adults, Best practices to counter elder abuse by the Centre-Ouest-de-l’Île-de-Montréal. All requests must be sent to the FNQLHSSC by mail or by email at the following address: First Nations of Quebec and Labrador Health and Social Services Commission 250 Place Chef-Michel-Laveau, Suite 102 Wendake, Quebec G0A 4V0 info@cssspnql.com ISBN: 978-1-77315-274-5 © FNQLHSSC 2019 1 My wellness, it’s up to me and my community is actively involved! Sweat lodge ceremo ny Sunrise ceremony n Shari Workshop on the emotions g c rci el Sessions with an elder ri psr o hea l itua er l Home wel nl ess v si ti s Stories and legends our community’s history and the origins of our culture Teachings about welln es s a nd th e medicine wheel Language teaching Snowshoeing Community walk community meal Traditional Ice-shing tournament for the children Creation story Teac hings on traditional medicines EMOTI ONAL SPIRITUAL PHY S ICAL Sharing of know edg l e about MENTAL 1 Transformations from a traditional lifestyle to today’s lifestyle Background Throughout the years, First Nations elders in Quebec have witnessed major transformations to their way of life. This tool emphasizes the importance of treating elders with thoughtfulness and respect. 2 The FNQLHSSC chose to represent the various forms of elder abuse and lack of respect around the theme of animals in order to remain neutral in this sensitive and difficult issue. 3 Psychological mistreatment/lack of respect Gestures, words or attitudes that negatively affect an individual’s psychological well-being or integrity. 2 3 Violence – Emotional blackmail – Manipulation – Humiliation – Insults – Infantilization – Belittlement – Verbal and non-verbal threats – Disempowerment – Excessive monitoring of activities – Etc. Neglect – Rejection – Indifference – Social isolation – Etc. Signs – Fear – Anxiety – Depression – Withdrawal – Hesitation to speak openly – Mistrust – Fearful interaction with one or several people – Suicidal ideation – Rapid decline of cognitive abilities – Suicide attempts – Etc. Examples 1 A relative intimidates an elder, tries to control them using physical aggression. 2 The elder is isolated, alienated and stranded in their home. 3 The elder receives verbal threats, insults or is the victim of emotional blackmail. 1 3 Material or financial mistreatment/lack of respect Fraudulent, illegal, unauthorized or dishonest acquisition or use of the older person’s property or legal documents; lack of information or misinformation regarding financial or legal matters. Violence – Pressure to change a will – Banking transactions without the person’s consent (use of a debit card, online banking, etc.) – Misappropriation of money or assets – Excessive price charged for services provided – Identity theft – Etc. Neglect – Failure to manage the person’s assets in their best interest or to provide the necessary goods and/or services as required – Failure to assess the person’s cognitive abilities, understanding and financial literacy – Etc. Signs – Unusual banking transactions – Disappearance of valuable items – Lack of money for regular expenses – Limited access to information regarding the management of the person’s assets – Etc. Examples 1 Pressure to make, amend or change a will. 2 Ask an exorbitant price for services. 3 An elder is robbed of cash or improper use of a debit/credit card. 2 3 1 4 5 Physical mistreatment/lack of respect Inappropriate gestures or actions, or absence of appropriate actions, which harm physical well-being or integrity. Violence – Shoving – Bullying – Hitting – Burning – Force-feeding, Inadequate medication administration – Inappropriate use of restraints (physical or pharmacological) – Etc. Neglect – Failure to provide a reasonable level of comfort and safety – Failure to provide assistance with eating, grooming, hygiene or taking medication when the older person is in a situation of dependency – Etc. Signs – Bruises – Injuries – Weight loss – Deteriorating health – Poor hygiene – Undue delay in changing of incontinence briefs – Skin conditions – Unsanitary living environment – Atrophy – Use of constraints – Premature or suspicious death – Etc. Examples 1 Shoving, hitting, bullying or injuring an elder by a relative. 2 Lack of hygiene (bath or shower). 3 Force-feeding or inadequate medication administration. 2 3 1 5 Violation of rights mistreatment/lack of respect Any infringement of individual and social rights and freedoms. Violence – Forced medical treatment – Denial of the right to: choose, vote, enjoy one’s privacy, take risks, receive phone calls or visitors, practice one’s religion, express one’s sexual orientation, etc. Neglect – Lack of information or misinformation regarding the older person’s rights – Failure to assist the person in exercising his or her rights – Failure to recognize the person’s cognitive abilities – Etc. Signs – Preventing the older person from participating in making choices and decisions that affect his or her life – Failure to respect the decisions made by the person – A family member answering on behalf of the older person – Restricting visits or access to information – Isolation – Complaints – Etc. Examples 1 A family member takes over control of an elder’s house effectively leaving them segregated in their own home. 2 A relative prevents the elder from exercising their right to vote in band council, provincial or federal elections. 3 The elder is forced to babysit grandchildren even though they are in fragile health. 2 3 1 6 7 Sexual mistreatment/lack of respect Non-consensual gestures, actions, words or attitudes with a sexual connotation, which are harmful to the person’s sexual well-being, integrity or identity. Violence – Suggestive comments or attitudes – Jokes or insults with a sexual connotation – Promiscuity – Exhibitionist behaviours – Aggressive actions of a sexual nature (unwanted touching, non-consensual sex) – Etc. Neglect – Failure to provide privacy or to recognize a person’s sexuality and sexual orientation – Etc. Signs – Infections – Genital and/or anal wounds – Anxiety when being examined or receiving care – Mistrust – Withdrawal, depression – Sexual disinhibition – Sudden use of highly sexualized language – Denial of older persons’ sexuality – Etc. Examples 1 A relative tries to forcefully kiss or get physically close to an elder. 2 A relative laughs while pointing to an elder’s body parts. 3 An elder is made to change in front of family members or others. 2 3 1 7 Violence – Organizational conditions or practices that do not respect older persons’ choices or rights (e.g., services are provided in a perfunctory manner, etc.). Neglect – Services are not adapted to older persons’ needs – Instructions are not given or are not properly understood by staff – Lack of resources – Complex administrative procedures – Inadequate training of staff – Staff are not mobilized – Etc. Signs – Treating the person as a number – Inflexible care schedules – Undue delays in service delivery – Deterioration of the person’s state of health (wounds, depression, anxiety), complaints, etc. Examples 1 An elder does not understand the physician who is providing information in a language other than their mother tongue. 2 Administrative procedures are burdensome, complex and time-consuming for elders waiting for care. 3 Lack of medical or adapted transportation to drive an elder to their appointments. Organizational mistreatment (care and services) Any harmful situation created or tolerated by private, public or community institutions providing all types of care and services, which compromise older persons’ ability to exercise their rights and freedoms. 2 3 1 8 9 Ageism Discrimination based on age, resulting in hostile or negative attitudes, harmful actions or social exclusion. Violence – Imposition of restrictions or social standards based on age – Limited access to certain resources – Prejudice – Infantilization – Scorn – Etc. Neglect – Failure to recognize or respond to ageist practices or comments – Etc. Signs – Failure to recognize a person’s rights, skills or knowledge – Use of condescending language 9 Elder Mistreatment Helpline Important Dates October 1 International Day of Older Persons reaffirms the commitment to promoting the full and equal enjoyment of all human rights and fundamental freedoms by older persons. June 15 World Elder Abuse Awareness Day The United Nations General Assembly designated a day to draw attention to this reality that now affects 1 in 10 older persons each month (in 2017). Last week of May Quebec Intergenerational Week During this week, Quebec celebrates and pays tribute to initiatives that promote closer bonds between the generations. 1 888 489-2287 7 DAYS A WEEK 8:00 A.M. TO 8:00 P.M. The service is confidential, free and accessible in French and English throughout the province. It is available to a varied clientele, including the general public and professionals dedicated to countering mistreatment of older adults.