How to help

Gathering Information, Asking Questions About Abuse




It takes a great deal of courage for any abused person to disclose and discuss what is happening to him or her. A trusting relationship is essential if he or she is going to feel safe and comfortable enough to do so.

To build trust

  • Create a safe environment for discussion, where the person can talk to you alone without outside influence.
  • Allow ample time.
  • Listen carefully. This is the most important skill you have in providing support.
  • Be willing to allow periods of silence.
  • Allow the person time to get his or her thoughts together, and to respond to your comments and questions before you speak again.
  • Be mindful of hearing or vision difficulties.
  • Be sensitive to language difficulties. If the person is struggling with the language, ask if he or she would like an interpreter.
  • Be sensitive to cultural and religious values and gender differences.
  • Ask questions that make sense in context.


When abuse is disclosed

  • Treat the older adult as a person, not a victim.
  • Believe the person.
  • Accept what you have been told at face value.
  • Remain neutral.
  • Do not deny or underestimate what is going on.
  • Do not judge the person or the situation.
  • Do not make comments about the abuser.
  • Communicate your concern.
  • Establish from the outset what your role is and the limits of your role to avoid any misunderstanding.
  • Explain the person’s right to privacy and limits on privacy in certain circumstances (agency and legal requirements).
  • Ask the person how he or she would prefer the situation to be addressed.


It is important for individuals being abused to know

  • The abuse is not their fault.
  • They do not deserve to be abused.
  • Many types of abuse are against the law; all types of abuse are unacceptable.
  • Abuse is not tolerated in any culture or religion.
  • They have a right to live without fear.
  • They have the right to be safe and secure.
  • They have the right to control their own life and make their own decisions.
  • They cannot control the abusive person’s behaviour.
  • Abuse often gets worse over time.
  • They are not alone. Help is available.
  • Many people are abused, and many people have found ways to deal with these situations.
  • Addressing issues of abuse will not have an impact upon the immigration process.


Asking Questions

Many people feel uncertain about what questions to ask about abuse and how to ask them. The following suggestions are meant as a guideline in exploring an abused person’s experience. The potential questions are examples only and are not intended as a checklist or reference while talking to an older adult about his or her situation.

  • Ask questions in a calm, supportive manner, during the course of a conversation.
  • Allow the conversation to evolve rather than using pre-determined questions or an interrogative style.
  • Where possible, use open-ended questions, questions that require more than a one or two word or yes or no answer. Open-ended questions encourage a more in-depth response, ongoing discussion and expression of opinions and feelings. They typically begin with how, what, when and where.”Tell me about…,” although not a question, is a phrase that also encourages the same kind of response.
  • Using indirect questions about aspects of the person’s life, rather than direct questions about abuse, may help to begin a discussion about potential or suspected abuse.
  • If the person does not wish to talk about the abuse, respect that decision, but always leave the door open for future discussion when he or she is ready.


Potential Questions

Below are some examples of potential questions and follow-up questions, beginning with those that are more general and indirect, followed by questions related to specific types of abuse.


  • What does a regular day look like for you?
    What do you do? Who do you talk to?
  • How often do you see your family and friends?
    How often would you like to see them?
  • Who helps you when you need an extra hand?
    What does that help look like?
  • Who do you connect with when you need to talk to someone?
  • Have you ever felt restricted and unable to come and go as you please?
    In what way did you feel restricted?
  • Have you ever wished for more privacy at home?
    What were the circumstances?
  • How safe do you feel in your home?
    What makes you feel unsafe/safe?
  • When have you felt uncomfortable or afraid due to someone else’s behaviour?
    What were the circumstances?
  • Do you ever feel like a burden or that no one wants you around?
    What makes you feel that way? How do you experience that?
  • How are you currently managing your affairs?
    How does the current arrangement meet your needs?
  • Tell me about the things that make you feel sad or lonely.



  • How are you currently managing your finances?
    How do you feel about the manner in which they are currently being managed?
  • What, if any, concerns do you have regarding your income and/or assets being adequate for your needs?
    Has there been any recent change to your income/assets?
  • What is your understanding of your bank and credit card transactions?
    What concerns, if any, do you have?
  • How often do you review your bank and credit statements and your bills?
    Has the frequency of your review of these documents changed? If so when, and in what way?
  • What arrangements have you made to ensure your bills are paid?
    What, if any, concerns do you have about these arrangements?
  • How do you feel about the way your Power of Attorney is being used to make decisions on your behalf?
  • Have you ever felt pressured to help someone financially?
    If yes, tell me about the circumstances.
  • Does anyone depend on you for shelter or money?
    If yes, who? Tell me about the situation.
  • Have you ever felt pressured to sell your home or possessions?
    If yes, tell me about the circumstances.
  • Has anyone ever taken or used your money or credit cards without your knowledge or permission?
    If yes, tell me about the circumstances.
  • Has anyone ever asked you to co-sign a loan, make or change a will or POA, or to add his or her name to your bank account or other assets?
    If yes, tell me about the circumstances.


Emotional / Psychological

  • How do you currently make decisions for yourself?
  • When have you felt disrespected by those close to you?
    Tell me about the circumstances.
  • When have you been offended by someone shouting at or insulting you, or treating you in any other way that you found offensive?
    Tell me about the circumstances.
  • How often do you visit or speak with your family or friends?
    How has your contact with your friends and family changed over the past (period of time)?
  • How do you contact your friends/family/doctor, etc.?
    Has your access to your friends/family/doctor, etc. ever been restricted? If yes, tell me about the circumstances.
  • You seem a little tired; how are you sleeping?
  • When was the last time you felt nervous or afraid?
  • When was the last time you felt threatened or intimidated?
    What made you feel that way?



  • I see you have ______ (describe observed injury). This type of injury causes me to wonder if someone has hurt you?
  • What happens when someone gets angry with you or loses his or her temper?
  • When was the last time someone hit, slapped, or intentionally hurt you or threatened to hurt you?
  • When was the last time someone attempted to prevent you from doing something you wanted to do?
    Tell me about the circumstances.
  • Have you ever been forced to stay in a chair or in bed, or confined to a particular area of your home?
    Tell me about the circumstances.
  • What medications do you take?
    How do you obtain your medications?
    Who helps you with your medications?
    What, if any, concerns do you have about your medications?
  • Have you ever been forced to eat or do anything you do not want to do?
    Tell me about the circumstances.



  • Does anyone make lewd or offensive comments to you?
  • Does anyone approach you in a sexual way that causes you to feel uncomfortable?
  • Does anyone ever touch you in a sexual way without your consent?
  • Does anyone ever touch you in a personal way that makes you feel uncomfortable?
  • Are you ever forced to look at pornographic material or watch sex acts?


Neglect/ Abandonment

    • How do you feel about the amount of help you are receiving?
    • What do you feel you need to live comfortably?
    • Who can you depend upon when you need help?
    • Who makes decisions about what help you receive?
      What concerns, if any, do you have about this arrangement?
    • How do you get to your appointments?
      What difficulties, if any, do you have getting to your appointments?
    • What concerns, if any, do you have about the assistance/support that is currently available to you?
    • What would you need to feel safe?
    • What difficulties, if any, have you had obtaining assistive devices, e.g., hearing aids, walker, cane, glasses?


Violation/Denial of Human/Civil Rights

    • How often do you feel restricted from coming and going as you please?
      Tell me about the most recent times.
    • Do you have unrestricted access to a phone/computer?
    • Has anyone ever opened your mail without your permission?
      Tell me about the circumstances.
    • Have you ever felt pressure to include anyone in your visits to your doctor or lawyer?
      Tell me about the circumstances.
  • How do you currently make decisions regarding your personal affairs?
  • When was the last time you were afraid to express your opinions?
    Tell me about the circumstances.
  • Have you ever been or felt restricted from voting?
    Tell me about the circumstances.
  • Have you ever felt that your immigration status in Canada might change?
    Tell me what makes you feel this way.
  • Has anyone ever threatened to have you deported if you don’t do what he or she wants?
    Tell me about the circumstances.



Write it down!

Documentation of an abusive situation, whether suspected, confirmed, or potential, is critical.
It can be instrumental in the protection of an older adult’s autonomy, assets, health, or life.

A written record can be used to

  • Communicate with and assist others who may become involved.
  • Decrease the potential for miscommunication and errors.
  • Protect the client, worker, and agency in the event of legal action or claims.
  • Provide evidence where charges may be applicable.
  • Assist in monitoring potential, suspected, or actual abuse.
  • Help both the older adult and the worker recognize patterns and/or escalation of abuse.
  • Monitor progress.
  • Aid in further assessment and development of appropriate responses.


When documenting

    • Be concise, accurate, and timely.
    • Remain objective and non-judgmental. Document only what you know for certain, what you yourself see or hear, not what is assumed or speculated.
    • Describe the situation in detail – who, what, when, where, how.
    • Indicate sources of information, e.g., client, family, co-worker, neighbours, landlord.
  • Record verbatim the comments of the older adult or others. Use his or her exact words in quotation marks, e.g., Name stated, “…..”.
  • Note any discrepancies in details obtained from different sources.
  • Note visible injuries. Include a detailed description, e.g., size, age, pattern, colour etc.
  • Describe what actions were taken, by whom, when, where, etc.
  • Record all contacts and referrals made on behalf of the older adult.
  • Ensure appropriate consent is obtained and recorded.
  • Regulated professionals must know documentation standards required by their regulatory bodies.



No amount of knowledge of elder abuse and available resources, nor the desire to help, will make a difference if barriers to accessing or providing that help are allowed to stand in the way. The following are examples of barriers that may be faced.

Barriers to Disclosure

The following points are from Human Resources and Skills Development Canada.
Why is abuse of older adults kept secret? Disclosing the abuse experienced may be difficult because the older adult: 1


  • Does not recognize the situation as abusive
    People who have lived in abusive circumstances over a period of time may stop recognizing abuse because it is a regular occurrence.
  • Does not know where to get help
    Older adults may not be aware of agencies or individuals who can assist; they may have tried to get help in the past and were unsuccessful.
  • Fears it will escalate
    Older adults may be afraid that if they say something or complain, the alleged abuser will find out and the abuse will get worse; older adults are often at a greater risk when the abuse is brought out into the open.
  • Takes blame for the abuse
    Older adults who are abused may feel that they deserve the abuse because they chose the wrong spouse or perhaps may feel guilty about how they functioned as parents.
  • Worries about what will happen if the abuse becomes known
    Older adults may worry that the person abusing them will be arrested; they often do not know that this may be an avenue for the perpetrator to get badly needed help. They may also worry about where they will live, and not want to leave their own homes. They may be fearful of having to move to a facility, which the person abusing them may have threatened.
  • Feels humiliated
    Older adults may feel humiliated because they mistakenly believe that they should be able to control or stop the abuse.
  • Fears a loss of connection
    Older adults may no longer have living siblings, relatives, or a spouse. The alleged abusers may be the only people with whom the older adults connect personally or are the only conduit to the outside world. Many alleged abusers threaten their victims with ending their contact with loved ones such as grandchildren.
  • Believes that family honour is at stake
    Older adults who are abused may believe that disclosing abuse will bring shame and dishonour to the entire family. In some communities, the family unit is considered more important than the individual; the older adult may feel a duty to suffer in silence rather than bring adversity or shame to the whole family.
  • Believes that privacy is at stake
    Older adults who are abused may believe that they should be able to solve their own problems (and not “air dirty laundry in public,” for example).
  • Has a history of abuse
    Older adults who are abused may have had previous experience in disclosing an incident of abuse and had a poor or unpleasant outcome.


Barriers or Perceived Barriers to Action


  1. Difficulty in determining what constitutes abuse
  • Inability to recognize behaviours and indicators
  • Challenges in distinguishing between abuse, ageing-related physical conditions, and memory impairments


  1. Complexity of situation
  • Language difficulties
  • Cultural issues
  • Capacity issues (see <Capacity)
  • Denial of abuse
  • Resistance to intervention
  • Older adult may not recognize the situation as abusive if it is not physical


  1. Personal Barriers
  • Uncomfortable asking about abuse
  • Do not know how or what to ask (see Asking Questions)
  • Fear of offending
  • Fear that raising concerns will make the situation worse
  • Fear of reprisal by the abuser toward the target
  • Believe someone else will respond


  1. Systemic Barriers


  • Lack of training on agency policies
  • Confusion regarding privacy legislation (see Privacy and Confidentiality)
  • Lack of support from supervisor and/or management
  • Fear of job loss
  • Fear of getting someone (e.g., co-worker) in trouble
  • Fear of retribution from the suspected abuser toward the service provider (fear of violence to themselves or to their families)
  • Fear of litigation
  • Lack of time and resources
  • Lack of a protocol
Barriers can only be removed in an environment that encourages their identification, acknowledges their significance, and provides an action plan and the personal support necessary to address these barriers.
There is no one method for overcoming barriers. The most effective approach or approaches will depend on the specific people, organization, or situation involved.
First and foremost, become informed. Education increases our awareness, understanding, and general comfort level relating to the issue of elder abuse. Education expands our capacity to explore these complex situations and to advocate for integration of practices to overcome barriers and respond to the abuse.


Privacy and Confidentiality

Privacy is a basic human right, protected in Canada by the Canadian Charter of Rights and Freedoms as well as federal and provincial laws and statutes governing the collection, use, disclosure, and retention of personal information.2 These regulations are often cited as a barrier to responding effectively to abuse, seen as limiting the ability to involve others who may help. This, quite simply, is not the case.
It is important to understand fully what, if any, your legal and ethical obligations are, as well as the rules and regulations regarding privacy regulations in your workplace, or where you volunteer. It is equally important to recognize that none of these need stand in the way of accessing help.
Consent is central to the concept of privacy. Granting or withholding consent to the collection, use, or disclosure of their personal information provides individuals with the means to protect their privacy rights.3
In certain circumstances, defined in privacy laws, disclosure can be made without consent. In most cases where there is a legal or ethical obligation, an individual can expect that their personal information will only be revealed to others with their full knowledge and consent and only in ways that have been agreed upon.
Building a trusting relationship (see Trust) can make the difference between an abused person giving or refusing consent. Clearly explain your reasons for wanting to share information with anyone else, and why you need the person’s consent.
When someone refuses to allow information to be disclosed, take the time to explore and understand his or her reluctance. Look at ways of possibly easing any concerns or determining more acceptable options. Do not allow misunderstandings about privacy and confidentiality to prevent moving forward.


We must enter a relationship with someone with the assumption they are capable. An individual can be quite capable in some areas of his or her life, and challenged in others. It is very important to consider multiple domains of an individual’s life in the context of his or her present circumstances. Even when someone is assessed incapable of financial or personal care decisions, it is critical to consider and respect their wishes. If someone is incapable in certain areas of his or her life, it is important that we work together to protect the integrity and well-being of the individual.
If you wish further and detailed information on legal and legislative issues on capacity, substitute decision-making, etc., refer to:


Mandatory Reporting of Abuse

      In Ontario, reporting of suspected elder abuse is mandatory only under the following two Acts:


  1. Long-Term Care Homes Act 20074 and
  2. Retirement Homes Act, 20105


For information on reporting harm to a resident:

  1. Long-Term Care Homes: Call the Ministry of Health and Long-Term Care’s toll free Long-Term Care ACTION Line at 1-866-434-0144 or see
  2. Retirement Homes: Call toll free 1-855-ASK-RHRA (1-855-275-7472) or see


Assessment & Screening Tools

It is essential to understand the specific concerns surrounding screening and assessment as well as the pros and cons of using existing assessment tools. There are also important issues to be aware of, and questions to be answered when developing or modifying tools.
For detailed information on these points, refer to:


Case Studies

The following case studies illustrate various scenarios in which one or more types of abuse could be occurring. In each scenario we have identified the warning signs or “flags” (see Abusive Behaviours and Possible Indicators) that alert us to the possibility of abuse, the type of abuse that may be occurring, and things to explore (see Gathering Information, Asking Questions About Abuse).
Please note: All characters, situations and events depicted in the case studies are fictitious. Any resemblance to actual persons, living or dead, or actual situations or events, is entirely coincidental.

Case Study #1

“Doug,” age 68, father of three, widowed, lives in a rural community approximately an hour’s drive from his children and is no longer able to drive due to medical conditions. Doug has recently purchased a car from a young female friend who, with her family, has been frequenting his home often in recent months.


  • Loss of driver’s license due to medical conditions
  • Recent purchase of a car
  • Rural location
  • Widower
  • New friendship with a young woman


Possible abuse occurring

  • Psychological/emotional – Doug lives alone in a rural community without family close by. Doug was recently befriended by a young woman and her family who have become very involved with him, suggesting the possibility of a coercive, dependent relationship.
  • Financial – Doug no longer holds a valid driver’s license, yet he recently purchased a car from his new friend, indicating the possibility of impaired reasoning and/or coercion.
  • Violation of human rights – Doug has medical concerns and lives alone without family support close by. Doug lacks transportation.


Things to explore

  • Capacity – What are the medical conditions that resulted in the loss of Doug’s driver’s license? Are the medical conditions being managed and/or treated? Are Doug’s medical issue(s) affecting his capacity?
  • Psychological – What is Doug’s understanding of the relationship with the young woman and her family? Has Doug ever felt nervous or afraid of the young woman or her family? Has he ever felt threatened? Has he ever felt dependent upon his new friend?
  • Financial – What is the reason for the purchase of the car? What were the circumstances that led to the purchase? Did Doug feel pressured to purchase the car?
  • Violation of Human Rights – What is the nature of Doug’s relationship with his children? How involved are Doug’s children? Does Doug feel isolated in any way? Does Doug have access to family and community supports? How has access to his family and community supports changed?


Case Study #2

“Cathy,” age 70, widowed, has one married daughter and one eight-year-old grandson. Cathy lived independently in the same home for 20 years, but sold her house and has since moved several times in the past few years. She now resides with her daughter, son-in-law, and grandson in a two-bedroom home. Since moving in with her daughter, Cathy frequently comments that she cannot afford to attend social events.


  • Frequent moves in recent years that are uncharacteristic of Cathy
  • Residing with daughter and her family in a home that appears to lack sufficient space
  • Comments from Cathy that she cannot afford to attend social events
  • Widow


Possible Abuse Occurring

  • Financial – Cathy sold her house and moved several times in the past few years after a long period of stability. Cathy’s comments may suggest access her to finances is restricted.
  • Psychological/Emotional – What is the quality of the relationship between Cathy and her daughter? Has Cathy ever felt threatened or coerced? Has she ever felt unsafe?
  • Neglect/Violation of Rights – Cathy is living in a situation that appears to lack sufficient space and privacy for the household.


Things to Explore

  • Financial – What were the circumstances/reasons for her recent moves? Has she ever felt pressured to help anyone out financially? Did she experience any pressure to sell her house? Does she feel she has sufficient funds to meet her needs? Has she ever felt restricted in accessing her funds?
  • Psychological/Emotional – What is the nature of the relationship with her daughter? What were the circumstances that led to Cathy moving in with her daughter? Has she ever felt threatened, nervous, or afraid of her daughter or son-in-law?
  • Neglect/Violation of Rights – Is Cathy comfortable/satisfied with her living conditions? Does she feel that she has sufficient privacy? Does she feel restricted in any way? Are her basic needs being met?


Case Study #3

“Anne,” age 84, divorced, has two sons who have infrequent contact with her. She has lived in her own home for several years. Anne has shared her home with a boarder for the past nine years.
Recently Anne obtained a mortgage on her home, and moved from the main area of the house to a basement apartment. The boarder and his family are now living on the main level. Anne requires a walker. There are no formal resources involved with Anne.


  • Recent move to the basement of the house
  • New mortgage on house at age 84
  • Mobility issues
  • Lack of family involvement and formal community supports


Possible Abuse Occurring

  • Psychological/Emotional – Anne has been living with an unrelated family for some time. The recent move to the basement, despite mobility issues, indicates the potential for coercion.
  • Financial – Anne recently obtained a mortgage on her home, an action that is uncharacteristic for someone of her age. This indicates the possibility of coercion, misuse, or theft of her financial resources.
  • Neglect – Anne recently moved to the basement of her home despite mobility issues, potentially isolating her from social supports and resources.


Things to Explore

  • Psychological/Emotional – What is Anne’s understanding of the nature of her relationship with her tenants? What were the reasons for the recent change of living arrangements within the house, and did she feel pressured or coerced to comply? Has her relationship with her family changed since the boarder moved in?
  • Financial – Does Anne have sufficient financial resources to meet her needs? Have her financial circumstances changed? What were the circumstances/reasons for borrowing funds? What is Anne’s understanding of the contract with the lender? Has she ever felt threatened or coerced to help someone out financially?
  • Neglect – Anne uses a walker. Do the recent changes have an impact upon Anne’s freedom within the house? Does Anne feel restricted or isolated since moving into the basement apartment? Does Anne feel comfortable with the change? Are her needs being met? Is there increased risk of injury?


Case Study #4

“Lydia” is a 72-year-old immigrant woman. She was sponsored five years ago by her son and lives with him, his wife, and two grandchildren who are both under the age of 10. She has just recovered from a stroke. She is fluent in English.
Lydia had an active social life before coming to Canada, but since her arrival she rarely leaves the home without her son and his family. She has learned about programs in the community, but says she does not have the money for bus tickets. Also, she says that she has too much housework to do, and has to babysit the grandchildren after school.


      • Change in social life
      • Lack of access to community programs
      • Medical changes
      • Housekeeping and babysitting expectations


Possible abuse occurring

  • Financial – Lydia states she cannot afford the cost of bus tickets to participate in social activities, suggesting access to finances may be restricted or insufficient.
  • Psychological/Emotional – Lydia no longer maintains an active social life due to domestic responsibilities, which may suggest she is being pressured to comply.
  • Neglect – Lydia has recently experienced a stroke; however, she states she has many domestic responsibilities, suggesting the possibility that she is not receiving appropriate aftercare/rehabilitation.
  • Violation of Rights – Family expectations of on-going domestic duties.


Things to explore

  • Financial – What is her source of income and has she ever felt restricted in accessing her funds? Does she feel she has sufficient financial resources? Does she have any concerns about how her finances are being managed?
  • Psychological/Emotional – Has she ever felt threatened or intimidated by her family to comply with domestic expectations to maintain her immigration status? How does she perceive her relationship with her family?
  • Neglect – Is Lydia receiving appropriate aftercare for her stroke? Are her medical needs and self-care needs being met? Does Lydia have access to supports/devices she requires for rehabilitation?
  • Violation of Rights – How does she feel about being responsible for domestic chores and childcare? Has she ever felt pressured or coerced into performing these duties? Does Lydia feel restricted from participating in social activities?



No individual or organization needs to respond to an abusive situation alone. Where there are concerns about possible or actual abuse, or a need for more information, there are readily available resources and highly qualified and caring people to talk to.
Here are some simple steps to responding to the possibility abuse is occurring..
  1. Be alert to the warning signs – Know the warning signs and be alert to these signs in the community. Warning signs are your invitation to ASK. Please refer to the section “Types of Abuse.”
  2. Ask – You cannot know if abuse is occurring unless you ask questions. Abuse will not be present in every situation. Where abuse is not present, the older adult will know that he or she could talk to you if he or she later felt that he or she were being abused. Be helpfully nosey.
  3. Listen – Listen in a calm, caring, and respectful way to what the individual has to say. You do not have to solve the individual’s problems. Let him or her know that you care and are there to listen.
  4. Connect – Inform the individual of community resources that may be useful and offer to assist the individual in making a connection. Be respectful of the person’s right to choose.


Elder abuse is a community issue that requires a community response. We cannot assume it is none of our business or that someone else will deal with it. We need everyone working together to reduce the stigma, and to bring an end to elder abuse and its consequences.
Elder Abuse London Middlesex invites you to use this guide to increase your awareness of abuse, promote conversation and take action.
  1. Human Resources and Skills Development Canada. Elder Abuse Modules, Module 3: Intervention, A. Barriers to Disclosure. Copy of an official work that is published by the Government of Canada. This reproduction has not been produced in affiliation with, or with the endorsement of, the Government of Canada.
  2. Treasury Board of Canada Secretariat. PIA (Privacy Impact Assessment) e-learning tool (September 26, 2003). Canadian Privacy Legislation and Policy.
  3. Office of the Privacy Commissioner of Canada. (April 2006) The Privacy Act and public interest disclosures. Online:
  4. Long-Term Care Homes Act (2007). Online
  5. Retirement Homes Act, 2010. Online