Kerstin Roger on Elder Abuse

Stuart Murray  0:00  
This podcast was recorded on the ancestral lands, on treaty one territory, the traditional territory of the Anishinaabe Cree, Oji Cree, Dakota and the Dene peoples, and on the homeland of the Metis nation.

Amanda Logan (Voiceover)  0:20  
This is humans on rights, a podcast advocating for the education of human rights. Here's your host. Stuart Murray,

Stuart Murray  0:31  
elder abuse isn't just a private or domestic issue, it's a human rights issue. It affects our parents, our grandparents, our neighbors, and it can take many forms, physical, emotional, financial and even systemic neglect, and in many cases, it happens behind closed doors, in silence. As our population ages, the need to address this issue becomes more urgent. The rights of older adults to live in safety, dignity and respect must be upheld in our communities, in our institutions and in our policies. Joining me is Dr Kirsten Roger, someone who has done important work in this field and brings both research and advocacy to this conversation. Dr Roger, welcome to humans on rights.

Dr. Kerstin Roger  1:23  
Thank you. Thank you for the opportunity to talk about this issue.

Stuart Murray  1:27  
So can you just go a little deeper on the base of introducing yourself and explain some of the things you are doing, and then we'll start chatting about that in our conversation?

Dr. Kerstin Roger  1:38  
Sure, and I thought I might start just with a brief reflection about human rights. Because even though we have sort of, you know, the first reference to human rights might have been by Hamra by 4000 years ago, and we have the incredible history since 1945 of the development of human rights as a more sort of formal document and set of principles that we abide by. It's interesting to note that age has not always been declared, either in writing or in people's conceptualizing around human rights. And so this idea that you're bringing together human rights and abuse of older adults is actually a fairly contemporary and current thinking around the dynamic of how human rights might apply to older adults. So that's one way that I wanted to start reflecting on the fact that some really good work has been done around the neglect of adding age. As you know, we have race and gender and other other principles that we think about around human rights. So that's something that I began to be aware of maybe 10 years ago or more, when I started thinking more about this work, and I thought, well, that was actually quite a shock to me. I have been doing work around abuse in older adults for a longer period of time, and so thinking about human rights, I might also just historically add that in 1994 we have the Cairo plan of action, and that's a long time ago, for a lot of folks who might be listening. And you know, they say, Oh, 1994 we if we've had a plan of action that is globally and endorsed by the United Nations, that's a long time ago. Why has it taken so long? And we have one other very important legislation, the Madrid plan of action, which came out in 2002 which, again, is already over 20 years ago. And there also we said, you know, we need to pay attention to human rights for people across the lifespan. So these are really important things to take note of, because when we talk about abuse of older adults, either here locally in Manitoba or across Canada, the precedent hasn't really been set very well. And it's a fairly recent thing to think about,

Stuart Murray  4:12  
and it's interesting to put it into that perspective, Kirsten, because you've been after this for quite a while, in terms of your your advocacy, and the lectures that you do, and the research that you do, why do you think it's been so slow to sort of gather kind of the level of importance that clearly, clearly it deserves?

Dr. Kerstin Roger  4:33  
Well, I think taking note that while I deeply respect the principles around human rights, that even in this very principled case, age has been left out is kind of a really good example of how we don't think of older adults, how they might be invisible, how they might not come to the attention of the United Nations or other lobbying groups. Or advocacy groups to say, Oh, we actually have to think about aging and ageism as something to put on paper and to take note of so it shows a very deep kind of social lack of consciousness around aging as perhaps a vulnerable group of people. I don't think all older adults are vulnerable, and I don't think aging always renders one vulnerable, but as a category and as it intersects with other things like race and poverty and sex, we might bring those together and say, Actually, aging can be a very vulnerable time that we need to protect folks who are older, and we need to talk about that, and we need to bring that to light.

Stuart Murray  5:46  
So, you know, it's interesting, you when you talk about, you know, they just the term human rights. And you know, when I spent a bit of time, I was surrounded by a lot of very intelligent, passionate people at the Canadian Museum for Human Rights. And you know, it always struck me that the Universal Declaration of Human Rights, which is a very legal kind of codified, you know, document International in so many levels. But it always occurred to me that the word human being does not necessarily come into the Universal Declaration of Human Rights. And so, you know, you looked at it and said, I know people talk about rights, because those things can be adjudicated, you know, maybe in a court of law. But you know, the notion about the being, the human being, the person, you know, where does that fit into all of this? And I think when you talk about what you're learning and talking and, you know, sort of teaching about Kirsten with elder abuse and being aged. You bring aging into it. I think that's so important because, you know, a lot of times people look at these rights and, you know, yes, they're, you know, sexual discrimination, and there's racial discrimination, but from an ageism standpoint, when did that start to, from your perspective, become something that needed more attention? And what did you first? What did it first kind of tweak to you to say, wow, we're missing a major element here in this conversation.

Dr. Kerstin Roger  7:15  
One example I can think of is as we began to understand dementia better, which in many cultures, historically, was seen as just a biological condition that rendered an older adult kind of as a non person. And so in some cultures, that's very extreme, where you're just, you know, seen to be you're de legitimized if you start to have dementia or memory loss. And in some cultures, interestingly, historically indigenous cultures, you're actually seen to be taking a step into the next world. So when we look at some of those cultural variations, and then we look from a very scientific and Western viewpoint, I think with dementia, we began to sort of say, Well, shouldn't we still respect the personhood of someone who has dementia? And this whole discussion of personhood, in my way of understanding, comes out of the Bradford center in England, and they did a lot of fantastic research around personhood and dementia and aging. And so that discussion really started to evolve around, well, let's respect older adults who have dementia and see them as persons because of their history and their likes and dislikes and maybe their place of faith, or, you know, they love to play violin. So how can we begin to think about older adults with dementia as having personhood and that specifically Never overlapped with human rights. But I think it, it did begin that discussion in my understanding of thinking about aging and ageism in the sense of autonomy and capacity. And I mean, there's, there's a big body of literature now around that thinking about autonomy and capacity as a way to consider older adults as having the right to make decisions on their own behalf.

Stuart Murray  9:08  
You know, it always I was curious when I, you know, I looked at the video that you were involved in called, who should I tell which is to talk to you about that right? You know, again, very, very simple but very powerful Kirsten. And one of the things I just wondered about when you talk about ageism and the term elder that comes before the word abuse, is, there, is there a rough age that you look at and say, This is because, I mean, some people can get early dementia, you know? And I just wondered, you know it, I again, I'm not looking to sort of say, well, this is a 60 plus, but is there sort of research show that there's an age, roughly age, where these things start to occur?

Dr. Kerstin Roger  9:51  
Well, this is a very tricky question. And I published a chapter in a book maybe a year ago that kind of. Problematized that exact question, and I talk about the many variations in which, when we look at different communities, aging is seen to start. And that's not biological, it's more cultural or social or historical. So when we look at indigenous communities in Canada, it's not too long ago that an older indigenous woman would be seen to be 46 on average, because of their lifespan, the history of colonization, the history of lack of health care services and the trauma that came out of truth and reconciliation. And so that's just a beautiful, tiny metaphor of saying, well, in mainstream society, we wouldn't necessarily say a 46 year old woman is aging, but for some communities, that's the case. If we look at folks who are living in poverty, their lifespan can be much shorter. If we look at folks living around the world, for example, one of the groups that I talk about in that chapter is adults with living with HIV. There was a time that you wouldn't expect to live to be 60, and so aging was considered to be again, 4045, you were happy to turn 50 now, because of all the excellent treatment and the progress we've made around HIV, people think turning 60 is a great celebration and success, but they expect to live longer. So when we think about aging and the cutoff points, it's a very controversial point. Actually, it comes up when we talk about ethics and research studies. You may have heard of the Canadian longitude longitudinal study in aging, which is a major study. I think it started in 2009 in Canada. And there's 50,000 adults who are part of this study over a 20 plus period of time. And I think their starting point is 40 or 45 so what they're trying to measure is, you know, all different aspects of changing of the body and your views and your activities, starting with 4045 so we can really have many different cutoff points. And our lifespan is increasing around the world. And I think globally, we're seeing more and more people turn over 100 but the two communities that have the healthiest older adult by way of example, are Sweden and northern China. Now those are very different communities and very different reasons. In northern China, it's being outdoors, less pollution, very family oriented people are working in their communities until they really can't anymore. The diet is very healthy. One of the reasons people live a very long and healthy life in Sweden is because of the excellent health care system they have there. So you can see there's many factors that will shape a long life.

Stuart Murray  13:01  
Just out of curiosity, Kirsten, when you talked earlier about different societies, and you mentioned for say, indigenous or First Nations, women, some of them could be considered an elder at 46 does there research that match that with respect to the male side of that conversation, like, were they also considered to be an elder at a younger age? Also, yes,

Dr. Kerstin Roger  13:28  
I think Indigenous men have been thought to live longer, and I would have to look up the actual research to really give you a citation. Fair

Stuart Murray  13:39  
enough. Yeah, fair enough. I just curious. I mean, because, as you know well, and I've been learning over the course of this podcast, and again, my, you know, I was very blessed to be the president and CEO of the Canadian Museum for Human Rights, blessed because I was surrounded by so many incredible people, and I learned so much, particularly from First Nations, where not every member who starts to age in that community is referred to as an elder, to be an elder in a First Nations community, as you know, has a tremendous amount of respect with it, and it's not up to me. It's up to that community to decide who an elder is and how they reach out. But the number of times when during conversations with, you know, First Nations people, and they say we have to talk to our elders, and we want to see what they think and what advice they get. You know, it's a beautiful it's a beautiful relationship. And, you know, I just have these horrific sort of memories of going to see my grandmother when she was in in a nursing home, and you would go and visit them in, you know, three in the afternoon, and there would be eight of them in a circle sitting in wheelchairs with a television on, and that was their form of interaction. And you know, you think that in today's world, when you realize that you know these elders. These, these aging people, some of them laid down their life or were prepared to in a war. Some of them have done amazing things. I mean, they've laid groundwork for us as a society move ahead, and that's the best that we can do. I

Dr. Kerstin Roger  15:14  
mean, right, yeah, yeah. I have a couple of comments on that. You know, I teach a lot of people who are 2025, sometimes I have older professionals also in my classes. But usually, you know, we sort of, there's different reasons they might sign up for a class, not always because that's a topic they want to take, but it works for the schedule or something. So usually, one of the first units we talk about age and ageism, you know, I think in general, there's this sort of still a very systemic sense of ageism around even taking the topic, what could there be to learn, or what could be important about this? And so we sort of start talking about aging and ageism. And when I ask people to remember a grandparent that they loved. The story is so rich and meaningful. Their faces light up. They have such meaningful connection to that person. And I say, but that is an older adult. And when you talk about aging people being, you know, noisy or opinionated or all the stereotypes that come up around aging, I say you don't actually have those stories about your own loved ones, and so slowly, we kind of begin to merge the stories. And say it appears that you have a lot of stories about people that you love and connect with, who are in your family or your community, but that doesn't match some of the stereotypes that you're sharing with me. So I think there is a kind of consciousness raising that does happen and needs to happen. And the other piece I wanted to say, which is a very linguistic challenge for us to think about, is this word elder and elder abuse that I think mostly now I'm, you know, I'm asking people not to use the word senior. We see in the literature, and this has come up a few times, we should talk about older persons and not use the word senior. And then for many years, and I, I heard this that, you know, we're not to use the word elder abuse. And I understand why. Because indigenous peoples use the word elder with a capital E as a form of respect. And so even when we look at global organizations, there's the international network for the prevention of elder abuse. It has sounded it has been named that for many, many years, we have the international elder abuse day on June 15 here in Canada. And yet, so even though there's been this sort of plea from the ground up, can we please not use the word elder abuse? I think it sort of stayed there. So I always try very hard to say, let's talk about abuse of older persons, because there is that need to respect an elder with a capital E who is indigenous,

Stuart Murray  17:58  
yeah. And you know, thank you so much for that piece of this conversation, because I was just remarking to the fact that, you know, we have a world elder abuse day as you talk about and first and foremost, you know how horrific that we even have to have that as a day? I mean, where is World celebration of our aging population day or world celebration? I mean, you know, it just, it's jarring, Kirsten, but I, you know, the linguistic piece is extremely important. And so I can understand this notion about using the term elder abuse and understanding in mostly indigenous First Nations culture, the elders with a capital E. I mean, it's a sign of ultimate respect. And so I think, you know, abuse of aging populations, or however we start to become more familiar, so that we can talk about the issue, rather than being slightly thrown off by what it's called, is super important, and I appreciate you bringing that forward. Yeah,

Dr. Kerstin Roger  18:53  
and you know, one of the things I also wanted to mention is that we do live in a somewhat. There are many communities in Canada who do have the privilege of aging well, and so we really need to look at that. I mean, in Canada, there are older adults who cannot age well. And when we look globally, also, there are many differences. And one example I wanted to mention is there, and it might be a surprise to some listeners, there are many countries that still do not have a pension for older adults, and that was one strong difference, you know, between Canada and many other countries where older adults have to depend on their children, their adult children, they have to depend on, in some cases, begging or being unhoused or not having any kind of dental care or health care. And so when we sometimes see pictures of older adults around the world, you know they might look like they're well over. 100 but they're actually 60, and one of the reasons for that is they don't have dental care, so their teeth are missing. They don't have access to good nutrition or clean water, and so when we begin to think about the rights of older adults around the world, in fact, many of those things will speed up aging and how vulnerable we are when we don't have access to those things? Yeah,

Stuart Murray  20:25  
no, and that's that's a great perspective, and thank you for for sharing that. I wanted to make reference to this video, this multi language Awareness video called, who should I tell? And I watched it. It's a three minute evidence based video raising awareness about abuse of older people. What made you dr Roger, what made you put that together? Why was that important, and what was the reason behind making that video, and it's available in I don't know how many languages, but super well done, and maybe you can tell me how many. But let's talk about the video first. Why the video,

Dr. Kerstin Roger  21:01  
right? So as we apply for grants, we have to produce numbers. And in the case of seeking good evidence that abuse of older adults is happening, you're looking for people before you, researchers before you who have counted those numbers or who have collected them, either through archival research or through, you know, Stats Canada or different bodies that collect statistics, so those numbers are really not available when we began to look at community based organizations, they said, Well, we do intake, and so we can collect some information about people when we do intake, but our data is very messy, and you know, it's not always really tidy and clean. So you could apply for a grant, they said to me, to tidy up our data, because we don't have time we keep the data, but someone else needs to compile it and pull it together and since synthesize it, yeah. So that became a major effort, which we tried to do. So we did apply for funding to try and work on some of that data, and it became, quite honestly, a little unwieldy. And so in talking with, you know, some of the amazing social workers in the province who are doing the intake and filling out those intake forms, but then they proceed to do the counseling, they provide the older adult with the resource, the safe housing, the options, I thought, Well, my passion is much more in line with, how do we help older adults, versus the actual effort of tidying up, you know, 40 years of intake forms? Yeah. So it was a decision that I made, so the data isn't really being collected. So I thought, well, but all these social workers are telling me they know it's happening because people are calling every day. So I said, let's focus there. So we got funding from the prairie action Foundation, which allowed us to do this amazing work. And we did many other things as well as the video and through collecting data in Alberta, Saskatchewan in Manitoba on disclosure was a different kind of data collection. We knew that people don't know how to talk about abuse, right? So they talk about it as mistreatment and so on. So we formulated this question of, well, what we're really interested in is disclosure. If no one discloses abuse. If no one calls it abuse, is it abuse? You know that old saying, if a tree falls in the forest and nobody's there to hear it, is it really falling? So this is the idea, is that we thought, Well, let's think about disclosure, and how do we get people just to talk about it? So over time, we developed this video, and I'm going blank on the folks who helped us with the video, but it's at the end of the video, in the in the credits. So we really looked at the interviews that we did across three prairie provinces. We found, how do people talk about disclosure? The themes that were highlighted in the video, were the main themes that we heard. And we then, as a research team across three provinces, developed a kind of a script that we thought was a composite of a number of different stories. And so the three vignettes in the video are kind of composite stories of a script that we created out of the actual interviews that we did across three prairie provinces. And I think they really reflect, well, the three main ways in which we saw disclosure being an issue for older adults. And so we really. Realize that one of the main things that we wanted to summarize that video with is you should just talk about it. It doesn't matter how you talk about it or which words you use. You know, some people can say, well, they, you know, it's not abuse, if they don't call it abuse, but it can be many different things to someone. They don't have to use that a word. So then to just have a way of saying, you know, talk to someone, talk to your hairdresser, talk to anyone, yeah, and that's what I love so much about the video,

Stuart Murray  25:31  
yeah, you know, that's what I think is so it means so well done, because I think that it just, it's very comfortable to, I don't know, allow you to give people a reason how they can talk about it, yeah,

Dr. Kerstin Roger  25:45  
and then, I guess, around the languages, you know, we got excited because we had a little extra money left. So we were able to work with a couple of different translation companies, and including, I think we have one or two indigenous languages, and we were able to look at who are the major groups in Manitoba, Saskatchewan and Alberta, who reside here, who maybe don't speak English as a first language. And so we were able to do the translation at least verbally. We weren't able to do it in written form. But that was really exciting, because then we really felt that we had a much broader reach, and we were able to reach many more Manitobans and Prairie folks through those translations.

Stuart Murray  26:29  
Yeah, that's that's fantastic. I mean, it's a great thing. I think that one of the elements that is always challenging on this subject is talking to people you trust. You know that. I mean, there was just a story the Winnipeg Free Press about a fellow who was befriended by somebody in a church and during the course of a couple of years, made him do investments that were not in his best interest. And so in the end of the day, no, you're out all this money, and there's nothing you can do about it. And that always comes down to somebody using in a very, very immoral way, you know, the word of trust to try to sort of work with somebody, and that's unfortunate,

Dr. Kerstin Roger  27:08  
yes. And I think, you know, we don't know enough about financial abuse. It's certainly considered to be the newest, biggest, but also most unknown kind of form of abuse with all the social media and the financial scams that can happen online. And, you know, I get regular messages that are telling me that, you know, perolator package. I have to log in my address, and then the perolator package will show up. I mean, all of these things can be hard for an older adult, and if they don't speak English, or if they're not sure what's going on, it can be quite scary. Yeah,

Stuart Murray  27:45  
no, for sure. And, and there's so much to sort of cover on this, on this subject, Dr Roger, but I wondered if there's anything important as we kind of wrap this up, that you would say, here's something I really would like listeners to know.

Dr. Kerstin Roger  27:59  
I think that one piece, which is a principle, which I feel underpins all of this work. Well, there's two parts. One is a little more didactic, so I'll start with the first one. So I believe in the idea of citizenship, and I think that's a hotly debated topic nowadays, and we need to pay a lot of attention to what that means in general. But I'm using that word in a more you know, traditional sense of older adults are citizens. They are citizens who deserve to be equal and active participants in our communities. And that's not just whether they want to decide on this type of car or, you know, all the decisions we make as we age, but it's also about being informed and being allowed to work and being allowed to make decisions which will really enhance your own quality of life. So I think this idea of citizenship is very important. We need to pay more attention to that as we go forward in terms of aging. But the real final word, I guess, I would give is it is a luxury to age, and we have really come to see it as a possible burden to us and others. And you know, all the fears and dramas of aging can be real, and it maybe it's not easy, and maybe there are hardships, but we also need to think about the opposite possibility that we don't age. So I think we really need to reinforce this idea that actually getting older is a luxury and a privilege, and there's so much room for growth and celebration and adventure and whatever that means to you as an individual. So that's that's probably my underlying message to folks, is that, you know, it's a real honor to age, and we need to do it in the best way we possibly can. Thanks so much

Stuart Murray  29:57  
for doing this. I really appreciate it.

Matt Cundill  29:59  
Thank you. Thanks for listening to humans on rights. A transcript of this episode is available by clicking the link in the show notes of this episode. Humans on rights is recorded and hosted by Stuart Murray, social media marketing by Buffy Davey, music by Doug Edmond. For more, go to humanrightshub.ca.

Tara Sands 30:20  
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