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The Neglect of the Elderly "Not Yet the Best to Be"

A Visible Minority Besieged

Beryl P. Wajsman

2 February 2004

Grow old along with me!

The best is yet to be,

 The last of life,

for which the first was made.”

~Robert Browning


“Youth could win, but had not learned to keep, and was pitiably weak against age.”

~ T.E. Lawrence ~



  1.  Society’s Tragedy
  2. The Policy Prejudices
  3. Forced Retirement and the Money Squeeze
  4. Government as Problem and Solution
  5. Financial Abuse and Protection
  6. The Impotence of Authority: A Pressing Concern
  7. Housing, Health and Home Care
  8. The Way Ahead



Society’s Tragedy


They built our cities, ploughed our farms, dug the mines and manned the workshops. Now so many of them are outcast and starving living in the midst of the wonders they helped build. At the time of their lives when they should have some leisure, some carefree years, they are forgotten, put upon and fleeced. If there is a “visible minority” that needs our help it is the elderly. In a society where 75% of wealth is inherited, our treatment of seniors is a litmus test of our civility as a people whose hallmark should be gratitude and genrosity to those who helped prepare, often during times of distress and deprivation, the relatively comfortable lives we enjoy today.



The Policy Prejudices


Statistics from the drug industry and the medical profession demonstrate that we, as a society, spend five times as much on surgical and pharmaceutical aids to keep us looking young than we do on the care and protection of the elderly. The reasons for our cult of youth are of no particular significance to this paper. What is relevant is that in our single-minded pursuit of pleasure we have systematically ignored that part of our population that will soon account for 35% of the nation. As was done to aboriginal peoples, blacks and other visible minorities, seniors are suffering from the oppression of being segregated, in thought and deed, from the rest of society’s agenda of social justice.


The problem in policy-making in this area has been that instead of integrating and increasing the flexibility of existing structures and programs, we tend to create endless new ones that deal with only narrow, particularistic aspects of the larger problems. The result of this fragmentation of services has not been to increase the number of approaches to the health and social care of the aged but to limit them rigidly to the existing administrative entities whose organizational and territorial imperatives are jealously and zealously guarded by bureaucrats whose only interest is protecting their own jobs and influence.


Most elderly who do not suffer from debilitating health maladies want to maintain a dignified independence and they have a right to it. They have paid for it their whole working lives. Our instinctual societal inclination towards institutionalization as a solution is morally unethical and economically unsound. A streamlining and strengthening of existing client-driven agencies and protective legislation would be a much more effective use of public revenues, to which seniors have so much contributed, and the appropriate expression of a public policy based on conscience and compassion.



Forced Retirement and the Money Squeeze


If an older man or woman dares to stay active in society, their time is made miserable. In most cases we force them to leave their job simply because they pass the “magic” age of sixty-five. We thereby dispose of their singularly unique storehouses of experience, exchanging them for the sheepskins of pimply-faced graduates. We forget that Clemenceau led France through a World War and Reagan helped the United States bring down the Soviet Empire at a time when most are 15 years into their “Sun City” years. As André Maurois wrote,

« Growing old is no more than a bad habit which a busy man has no time to form. »


Seniors’ independent livelihoods are forcibly replaced with pitifully small social security or welfare benefits and if they somehow find a new job we discriminate against them by “clawing” back part of the benefits they spent all their working lives paying for. And if they are too weak or sick to do anything, then truly only God can help them because next to nothing is available in broad programmatic terms of financial protection, integrative counselling or home care provisions.


This trend will soon lead to a national pension-funding crisis in addition to the individual psychological crises brought on by forced employment termination. We are moving toward earlier retirement at the same time that life expectancy is rising. Pension funds will not be able to keep up. If current labour force trends continue, one out of every six people aged 55-64 will no longer be in the work force by the time they reach their sixty-fourth birthday. Not that long ago that ratio was one out of eight.


The numbers tell a sad story. Increased mobility, evolving trends in family life, economic opportunity (or lack thereof) and political uncertainty have led to a situation where in many parts of this country some 40% of Canadians over 65 live alone. For many, life becomes a daily bout with an income that may once have been sufficient but is no longer and with tasks that once were simple but now seem Herculean. Add to these a glaze of unfamiliar and unfriendly loneliness. Leading psychiatrists such as Dr. A.I. Goldfarb, who specialize in the psycho-pathology of aging, point out that enforced retirement and the absence of social roles often cause a rapid deterioration in the mental health of seniors, even those just past sixty-five.


Going to the store or the bank becomes a major undertaking as seniors struggle with inadequate transportation, physical burdens, fear of street crime and concerns over basic financial transactions that once were simple, but are today so layered with systemic, technological complexities that the results for many are a vexation with the process and a resulting victimization by the system’s pariahs. The money game, as much as the money lost, is at the core of the financial abuse of the elderly.



Government as Problem and Solution


Recent government statistics demonstrate that some one-third of households in Canada’s urban centres live below the Federal poverty line. In households comprised solely by occupants over 65 years of age that number is over 40%. Labour statistics have demonstrated that old-age security benefits in 1950 covered about half the budget necessary for reasonable self-support. Today, they cover less than one-third. These monies were paid by seniors in trust to the government through their working lives. The funds were to be available for a life of dignity in their retirement years.


Instead, successive governments, of all parties, have made corporate grants and  subventions to special interest voting blocs priorities over their fiduciary responsibility to the proper maintenance of our core social security budgets. It is time for a re-alignment of our public purse. The financial administration of the contributions paid in by working men and women has failed to keep pace with the cost of living, and the governmental administrators have not kept a faithful pledge to our most vulnerable citizens.


Ø      One immediate solution is that we must stop penalizing seniors who are working through claw backs of parts of their pensions if they earn more than a certain amount of income. That pension fund money is theirs, held only in trust by government until 65, and they have a right to it.


Ø      We should also follow the example of many Western European countries where supplementary pensions, designed to bring a person’s income to minimum guaranteed weekly levels, is given to those above retirement age, work part-time, but still cannot manage on their pension and part-time incomes.


Ø      In addition, Federal and Provincial Human Resource and Employment Ministries should invest in broadening programs for job re-training of those 55 or older. Many want to work but just need a little help. One labour statistic has demonstrated that only 1% of people over 55 who are actually listed with Human Resources Canada have found any available program for job re-training. Another report demonstrated that 60% of persons between 65 and 70 want to work.


Ø      We should also institute computerized skills-matching registers in each regional Human Resource and Emploi Québec office to serve as a clearing-house for jobs and services for seniors. This service would provide government-sponsored job training programs concentrated on older peoples’ needs as well as their skills. They would also make outreach surveys to compile lists of employers willing to employ seniors. 


Ø      To ensure the success of these recommendations we would need a strengthening of age discrimination statutes, perhaps modeled after those that arose in the United States immediately following passage of the 1964 Civil Rights Act.


The need to be needed is central to human dignity.  And we need to act now so that the tricks of the Depression do not become the survival techniques of our new “Gilded Age”. While privilege and preference triumph at the public trough, seniors are ordering hot water in restaurants and pouring in ketchup to make tomato soup. If this crisis is not addressed we will become a people of shrivelled spirit and hardened heart wallowing in our bland smugness.



Financial Abuse and Protection


Another major problem area of the elderly is the exploitation and theft of their financial assets or property. Seniors tend to be more civil and trusting, having come to maturity in a gentler time. They fall prey to the purveyors of false pretence, deception and trickery. So many tragic cases occur each and every day of an elderly person’s cheque being cashed without authorization; forged signatures; coercion into signing wills, powers of attorney, and even bank loans. And how many have exchanged money and property for false promises of lifelong care or fallen for telemarketing schemes.


The perpetrators of these nefarious acts range from the typical con-artists to family members. They may be driven by everything from financial problems, gambling and drug addictions, garden variety greed or the feeling that since they stand to inherit anyway they feel justified in taking it now any way they can. To gain the confidence of their victims they may even profess how much they “love” them.


Of course provisions of the Criminal Code cover these crimes. But the elderly are often too weak and too meek to call the police. And sadly, when many do, many are not taken seriously or given priority. Most never even bother. One important step to rectifying this situation would be the creation of a corps of seniors’ welfare officers, much like the health and public welfare officers we discuss in the section below, to act as intervenors for the elderly.


They would have had experience working with seniors either as social workers or psychologists. People with experience in social activism bringing a sound knowledge of the system would also be able to make a great contribution. These civilian officers would respond to calls on a centralized seniors hotline based on a 911 model system, but they would then be able to call the relevant authorities, be they medical, police, social, existing elder abuse centers, the Ombudsman’s Office, the Human Rights Commission or the Office of Handicapped Persons, on a special high-priority internal network. They would be a link integrating the entire panoply of services available to the elderly that the latter may not even be aware of. They could work out of CLSC’s, Community Police Stations, or independent offices.


 And their role would not stop with the call itself. They would also do follow-up and establish the kind of non-threatening relationship with the client that would form the basis for an on-going relationship. The elderly respond much better to those not in uniform.


These officers could be involved in the following matters, among others, for their clients:


Ø      Liaison with all relevant professionals, officials or authorities.


Ø      Organizing community conferences and information session for the elderly where public officials might be brought to speak so that vulnerable seniors would get a more comfortable feeling dealing with authority.


Ø      Maintain social contact with the client and the client’s family if there is one.


Ø      Play a role in minor dispute resolution and mediation.


Ø      Introduce the client to the methods of approach to MP’s, MNA’s and municipal officials when required for the welfare of the client.



The Impotence of Authority: A Pressing Concern


The necessity for a corps of interventionist welfare officers becomes particularly apparent when one considers the critical deficiencies in the Public Curator system and related authorities impacting on the elderly. Set up to protect society’s most vulnerable, it may have become too cumbersome, bureaucratic and uncaring. The Curator’s office has hundreds of complaints lodged against it every year, including complaints of financial misfeasance. Last year alone the Québec Ombudsman found that 27.5% were justified.


The Curator has some  $200,000,000 dollars under administration, yet stubbornly refuses to co-operate with the annual Quebec Auditor-General’s survey on the pretext that it manages private, not public, funds and is therefore exempt. Many complaints have been lodged with the Quebec Human Rights Commission against the Curator’s office as well. The complaints have ranged from financial exploitation, Charter violations and breaches of confidentiality. Yet none have been acted upon. It is telling that at various times, officials of the Commission have served on the Advisory Council of the Curator’s Office.


The Office is technically under the control of the Ministry of Citizen Relations. Yet the Chief Curator is appointed for a five-year term with no requirements for accountability and may be dismissed only for gross misconduct. Even the Access to Information Act makes a specific exclusion regarding files under curatorship.

Perhaps most troubling of all is that wards of the Curator have lost the right of free speech. They cannot represent themselves, choose their own legal counsel, and any complaint they may want to make to a public authority must be done through the Curator himself.


Yet with all this power, if a person is feeble or vulnerable or only physically handicapped but has not been declared incompetent by a court, the Public Curator will not intervene. It is clear that though the Curator mechanism can have a positive effect,  the way it is currently operating leaves much to be desired in terms of clarity, efficiency and transparency, and this private fiefdom needs some foundational and fundamental reforms. Particularly in light of the following restrictions in the performance parameters and organizational imperatives of other existing authorities.



Ø      Police interventions are restricted to criminal matters. In elder abuse it
takes more effort to get a clear picture from the victim who often is feeble
and has difficulty in articulating the matter. Victims are not given great
credibility because of deficits related to age and their complaints tend to
go uninvestigated and ignored.


Ø      Under article 48 of the Québec Charter, the Quebec Human Rights
has jurisdiction over exploitation of handicapped and elderly
people. However,  outside of professionals, few people are aware that the
Commission has authority in this field. The procedure is cumbersome and
lengthy. It can easily take half a year and the victim must be
able to articulate and defend his claim. If it is accepted, only at that
stage does the Commission begin handling it. Handicapped and elderly people
often don't have the tools to start writing nor the mental acumen and
physical energy to pursue and persevere. The Commission has few
investigators to look into the complaints. The process is slow and lengthy.

Ø      The Office of Handicapped People deals not specifically with seniors but
with all handicapped, mostly the physically. It is supposed to defend the
interests of handicapped people but generally concerns itself with programs of
social integration, employment, transportation and accessibility to public
spaces. It chooses not to intervene in cases of abuses does

Ø      The Ombudsman (Protecteur du citoyen) handles all complaints of
government misconduct. It has no jurisdiction if the problem does not
emanate from a government department, public agency or civil servant. It can
be accessed by telephone but, again, the problem must be clearly articulated
so as to be easily grasped. Its 140 total staff handle over 22,000
complaints a year so a file must be clear, concise and and simple. At best,
the Protecteur du ciotyen can only make unenforceable recommendations and it
has no police powers.

Housing, Health and Home Care


We cannot be satisfied while our older citizens are accorded half measures. They should not be expected to settle contentedly for discounts, reduced bus fares and charity from volunteer agencies. The special needs of other segments of our population have been rightfully understood and met. But seniors own agenda for mobility, for increased socialization and for the sense of worth which comes from productive capacity goes largely unheeded or is addressed in fits and starts.


Dr. Robert N. Butler has written that “…the quiet despair affecting most elderly stems not just from the process of aging, for that process affects us all to one degree or another, but from the physical and spiritual poverty caused by the chilling realization of a lack of empowerment and enfranchisement.” Though they form such a large part of our population, they rarely form effective political organizations. They almost never vote as a bloc. And they have few advocacy groups giving vision and vigour to their special needs. Since their needs are rarely formulated as political issues, many social programs, and budgets, which benefit other groups omit the elderly entirely. As an example, the percentage of our national research budgets on aging phenomena, physical and psychological, has just surpassed a paltry 10%.


When programs affecting the elderly are formulated they are usually “segregated” programs. This creates another layer of problems onto an already difficult situation. Affordable housing, for example, is a special need of the elderly. Upon retirement they take severe income cuts thereby limiting their housing options. In addition, ailments and maladies that come with age require many to seek specially designed accommodations. Yet every senior housing development has a long waiting list, not because older people like to live apart from other age groups, but because so little affordable housing is available in society at large.


Ø      Affordable housing with features such as easy-to-open windows, kitchens and baths that require little stooping, handrails in bathrooms and common area corridors, low cupboards and bell alarms to the superintendent should no longer be built in isolated buildings designed only for the aged, but should be integrated into the wider community for they would benefit young and old alike.


Ø      Expanded affordable housing throughout all our urban neighbourhoods would also solve the problems faced by many single senior women, who comprise some 30% of the elderly population, now forced into unsafe neighbourhoods with high crime rates or inconvenient areas far from the medical and other services they require, simply because those are the only areas within their budgets. A shocking statistic is that 60% of senior women living alone have incomes below the poverty line.


Ø      Home care and maintenance services also need to be expanded. And it is not just a matter of throwing money at these programs. It is also not just a question of all components to total care outside a hospital be available. The chief difficulties in our home care system through the CLSC’s seem to be administrative and financial. No ministry or agency seems to have the mandate to develop a comprehensive home care and health policy. Each program seems to be developed independently and to operate fragmentally and when they are in synch, it appears as if it is just fortunate coincidence. It is unjust that until the time comes when these disparate parts are joined into a whole, society’s most vulnerable, and most valuable, citizens will have to trust to luck.


Ø      The aged can be free. Maladies and ailments come with the territory, but for those who have chronic conditions, rather than illnesses requiring hospitalization, we must find solutions other than institutionalization. We believe the key lies in following the Western European model of day hospitals that offer physical and occupational therapy. Expansion of the current MediCar services can solve the problem of transportation. Many of these facilities also have Psycho geriatric Assessment Units where a patient can be examined by both a geriatric physician and a socio-psychiatric specialist and monitored on an ongoing basis to determine what care is necessary.


Ø      Finally, we need to train a corps of public health and welfare officers who regularly inspect nursing homes, chronic-care facilities and are also available to inspect patients needs at home and have the authority to act as facilitators with the appropriate public authorities to provide what may be needed efficiently and expeditiously since so many seniors are too reticent about calling government and social agencies.



The Way Ahead


It is well to remember that although creative, flexible programs will immeasurably improve life for seniors, no strategy, however imaginative and integrated, can solve all problems. Contact between young and old is deteriorating, family patterns are breaking down, urbanization has left rural areas with many more older people than younger ones, and suburbanizaton has left many of our most vulnerable elderly alone in poorer areas of our central cities while the young migrate to the suburbs. No social security program could meet all the difficulties of a society segregated by age. A segregation due to the fact that we forget Tryon Edwards’ injunction that “Age does not depend upon years, but upon temperament and health. Some men are born old, and some never grow so.”


But that is no excuse for the intolerable neglect foisted on so many of our seniors. In the continued absence of a coherent, thoughtful and holistic national policy, even the most well-intentioned efforts of governments, organizations and individuals will miss the mark as often as they hit it, and confusion and ineffectiveness will continue. Our citizens of mature years deserve better than that. They contributed unheralded heroism through their toil when we needed them. We dare not exercise a haughty disregard for their concerns when they need us. Without acting as condescending saviours, we must all contribute to free their spirits from their cells.



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