Recognizing mistreatment of older adults and vulnerable people

There are seven types of mistreatment. Sometimes several types of mistreatment can occur at the same time in a single situation of mistreatment:

• Psychological mistreatment
• Physical mistreatment
• Sexual mistreatment
• Material or financial mistreatment
• Organizational mistreatment
• Ageism
• Violation of rights

Psychological mistreatment refers to attitudes, words, acts or a lack of appropriate action that negatively affect a person’s psychological integrity or well-being, for example:

• emotional blackmail, manipulating, humiliating or insulting the person;
• infantilizing the person;
• making threats (verbal or non-verbal);
• depriving the person of their decision-making power;
• monitoring the person excessively;
• making discriminatory comments (xenophobic, racist, sexist, homophobic, biphobic, transphobic, etc.);
• rejecting the person, being indifferent or insensitive.

It is the most common and least visible type of mistreatment. It often accompanies other types and can have serious consequences.

Physical mistreatment refers to attitudes, words, acts or a lack of action that negatively affect a person’s physical integrity or well-being, for example:

• shoving, brutalizing, hitting or burning;
• force feeding;
• inadequate administration of medication;
• misuse or inappropriate use of physical or chemical control measures (restraints or medication);
• depriving the person of a reasonable level of comfort, safety or housing;
• neglecting a person in a situation of dependence for whom one is responsible (not feeding them, not providing basic hygiene care or dressing them properly).

Some signs of physical mistreatment can look like health problems. If in doubt, do not hesitate to ask questions.

Sexual mistreatment refers to acts, words, attitudes that disregard consent or a lack of action that negatively affect a person’s sexual integrity or well-being, for example:

• suggestive attitudes or remarks, jokes of a sexual nature;
• inappropriate proximity or exhibitionist behaviours;
• sexual assault (unwelcome touching, forced sexual intercourse);
• depriving the person of their privacy;
• preventing the person from expressing their sexuality or considering them asexual.

Cognitive impairment can lead to disinhibition or inappropriate sexual behaviour.

Material or financial mistreatment is the illegal, unauthorized or dishonest acquisition or use of a person’s property or legal documents. Hiding information or providing false financial and legal information is also considered material and financial mistreatment, for example:

• pressure to change a will;
• doing banking transactions without consent (using a bank card, online transactions) or misappropriation of money or property;
• charging an excessive price for services provided;
• having a contract or insurance signed under pressure or in a concealed manner;
• identity theft;
• having a lease signed under pressure;
• managing a person’s property without taking their interests into account, or depriving them of essential goods;
• failing to verify a person’s abilities, understanding or financial literacy.

People who are dependent on someone (physical, emotional, social or financial dependence) are more likely to experience this type of mistreatment. Material or financial mistreatment can also negatively affect a person’s physical or psychological health by limiting their ability to take responsibility or meet their needs.

Organizational mistreatment occurs when an organization (private, public or community) creates or tolerates practices or procedures that negatively affect people’s well-being, for example:

• excluding people from making decisions that concern them;
• not respecting their choices or limiting access to services or assistance programs without adequate justification;
• providing care or services that are not tailored to people’s needs;
• not giving clear instructions or not making sure staff understand instructions;
• imposing overly complex administrative procedures;
• inadequate training of staff or not mobilizing them sufficiently.

Organizational mistreatment can occur in all organizations and violate people’s individual and collective rights. These shortcomings can also negatively affect the work of staff responsible for providing care or services to people.

Ageism is discrimination based on age. It can take the form of hostile or negative attitudes, harmful actions or social exclusion, for example:

• imposing restrictions or standards based on age;
• reducing access to certain resources or services;
• showing prejudice, infantilizing or scorning a person because of their age;
• ignoring or tolerating ageist practices or remarks when they are witnessed.

The violation of rights is the infringement of a person’s individual or social rights and freedoms, for example:

• imposing medical treatment;
• denying the right to choose, to vote, to have one’s privacy, to be informed, to take risks or make decisions, to receive calls or visits, to practice one’s religion or spirituality, to express one’s sexual orientation;
• not informing or misinforming a person about their rights;
• not assisting a person in exercising their rights;
• refusing to provide care or services to which they are entitled.

All types of mistreatment involve a violation of rights. Regardless of their age, everyone fully retains their rights. Only a judge can declare a person incompetent and appoint a legal representative. Even if a person is incompetent, they retain their rights, which they can exercise to the extent of their abilities.