Prevention of Abuse and Neglect
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This best practice guideline is focused on preventing and addressing abuse and neglect of older adults throughout various health-care institutions and community settings in Canada. It outlines recommendations for nurses and other health-care providers, educators, health-care organizations, advocacy groups, nursing regulatory bodies and governments. Implementation resources in development include an e-learning course, a health education fact sheet, and a personal digital assistant (PDA) version of the guideline.
This guideline is part of an initiative funded by the Government of Canada’s New Horizons for Seniors Program and builds on a collaborative project between the Canadian Nurses Association (CNA) and RNAO, titled Promoting the Awareness of Elder Abuse in Long-Term Care.
Registered Nurses’ Association of Ontario. (2014). Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches. Toronto, ON: Registered Nurses’ Association of Ontario. Retrieved from https://rnao.ca/sites/rnao-ca/files/Preventing_Abuse_and_Neglect_of_Older_Adults_English_WEB.pdf -
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Abuse Gap Analysis
This tool determines where your organization is in relation to the implementation of the best practice guideline recommendations.
Registered Nurses' Association of Ontario. (July 2014). Gap Analysis: Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches. RNAO: Author.
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The College of Nurses of Ontario provides an e-learning opportunity for Abuse Prevention that includes videos, participant workbook and facilitators guide.
One Is One Too Many is a valuable tool for any organization employing nurses that is concerned about issues involving client abuse. The One is One Too Many program provides powerful re-creations of situations in which abuse occurs, as well as guides and materials to facilitate discussion about what tools nurses need to stop abuse.
Reference: College of Nurses of Ontario. (2005). Abuse Prevention: One is one too many Toronto, ON: College of Nurses of Ontario. Retrieved from http://www.cno.org/en/learn-about-standards-guidelines/standards-and-guidelines/
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Toolkit contains easy to use resources to support uptake of the guideline at practice, education, policy, organizational and systems levels. The toolkit includes a E-Learning course (4 modules) on Elder Abuse for leadership and staff with various knowledge-based activities and supplementary resources.
Reference: Registered Nurses' Association of Ontario. (2015). Addressing Abuse of Older Adults: An RNAO Initiative-Best Practice Success Kit. Toronto, ON: Author. Retrieved from http://rnao.ca/bpg/initiatives/abuse-and-neglect-older-adults-pan-canadian-best-practice-guideline-initiative
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This document contains a sample policy and procedures to support compliance and meet the requirements of s. 20(1) and (2) of the Long-Term Care Homes Act, 2007 and its Regulation.
AdvantAge Ontario Long-Term Care Homes Act (LTCHA) Implementation Member Support Project resources are confidential documents for AdvantAge members only. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon this information, by persons or entities other than the intended recipients is prohibited without the approval of AdvantAge.
Reference: Ontario Association of Non-Profit Homes and Services for Seniors. (2012). Zero tolerance for abuse and neglect: Sample policies and procedures. Retrieved from http://www.oanhss.org/MediaCentre2/LTCHomesActCentralseeSiteNavigation/LTCHA_Resources.aspx?WebsiteKey=112387af-5c3c-42f5-bfce-85c542bee396
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The ACE Website provides materials for public education on prevention of elder abuse. Materials include information on powers of attorney, consumer protection and legal issues affecting older persons.
Advocacy Centre for the Elderly (ACE) (2013) Retrieved from http://acelaw.ca
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This site describes elder abuse and provides a number of downloadable publications related to addressing and preventing elder abuse.
Any use of information in the web site should be accompanied by an acknowledgment of WHO as the source, citing the uniform resource locator (URL) of the article.
Reference: World Health Organization. Ageing and Life Course Elder Abuse. Retrieved from http://www.who.int/ageing/projects/elder_abuse/en/
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An extensive list of validated assessment and screening tools. Tools not only assess for history of abuse but also assess for possibility of future abuse, and quality of care being given.
Registered Nurses’ Association of Ontario. (2014). Appendix G of Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches. Toronto, Canada: Registered Nurses’ Association of Ontario. pp 105-110. http://rnao.ca/sites/rnao-ca/files/Preventing_Abuse_and_Neglect_of_Older_Adults.pdf
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Being Least Intrusive is an approach and a tool that front-line workers can use to guide them through a process of critical preparation, assessment and reflection in their care giving relationship with older First Nations people.
Reference: Struthers, A and Neufeld, L (2011) BLI: Being Least Intrusive – An Orientation to Practice for Front-Line Workers Responding to Abuse of Aboriginal Older Adults Retrieved from http://www.nicenet.ca/tools-bli-being-least-intrusive-an-orientation-to-practice-for-front-line-workers-responding-to-abuse-of-aboriginal-older-adults
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BASE assessment tool helps determine answers to questions such as: What kinds of abuse are more common? And, how quickly does intervention need to take place? It also provides a written assessment for the workers who subsequently become involved.
Retrieved from: http://www.nicenet.ca/tools-base-brief-abuse-screen-for-the-elderly
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This site provides information on recognizing scams, frauds and identity theft and how to address and report them.
Reference: Canadian Anti-Fraud Centre, Government of Canada, 2015. This site provides information on recognizing scams, frauds and identity theft and how to address and report them. http://www.antifraudcentre-centreantifraude.ca/index-eng.htm
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The Caregiver Abuse Screen (CASE) is a screening measure for detecting abuse of seniors. It is intended for use with all clients who are caregivers of seniors, whether or not abuse is suspected.
Reference: National Institute for Care of the Elderly. (2010). Caregiver Abuse Screen (CASE). Retrieved from: http://www.nicenet.ca/tools-case-caregiver-abuse-screen
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Cinq mesures à adopter pour vous protéger Fiche de renseignements pour la sensibilisation en matière de santé. Association des infirmières et infirmiers autorisés de l’Ontario (2014, juillet).
Cinq mesures à adopter pour vous protéger . Toronto, ON, Canada: Auteur. Récupérée de http://rnao.ca/bpg/guidelines/fact-sheets/cinq-mesures-%C3%A0-adopter-pour-vous-prot%C3%A9ger
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This document was written by nurses for nurses to help them understand their own ethical beliefs and practice ethically when working with clients, families and within the confines of the public health system.
All rights reserved, no part of this document may be reproduced, transcribed or stored in a retrieval system in any forms or by any means. Electronical, mechanical, photocopying, recording or otherwise without written permission of the publisher. ©Canadian Nurses Association
Reference: Canadian Nurses Association (2008). Code of Ethics for Registered Nurses. Retrieved from https://www.cna-aiic.ca/~/media/cna/page-content/pdf-fr/code-of-ethics-for-registered-nurses.pdf?la=en
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This appendix outlines considerations, tips and resources to support effective communication when addressing issues of abuse and neglect of older adults.
Registered Nurses’ Association of Ontario. (2014). Appendix F of Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches. Toronto, Canada: Registered Nurses’ Association of Ontario. pp 103-104. http://rnao.ca/sites/rnao-ca/files/Preventing_Abuse_and_Neglect_of_Older_Adults.pdf
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The Comprehensive Geriatric Assessment (CGA) Toolkit is comprised of multiple resources for the personalized and person-centred care of the elderly. This link will take you to the page where you will find descriptions and possible signs and symptoms of the different types of abuse. A description and link for the Elder Assessment Instrument (EAI): Screening tool for elder mistreatment is provided as well as interventions that should be carried out based on the findings of the conducting clinician. Resources for the comprehensive geriatric assessment based on proactive and personalized primary care of the Elderly. Resources are provided on such geriatric syndromes such as falls, pressure injuries, incontinence, and sleep disorders. Hand-outs, videos and other tools are also available on this toolkit.
Reference: http://www.cgakit.com/elder-abuse
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Decision tree outlining the process to follow in the event of alleged, suspected or witnessed case of emotional abuse.
Reference: Ministry of Health and Long Term Care. (2012). Licensee Reporting of Emotional Abuse. Retrieved from http://www.fco.ngo/resources/decision-tree-licensee-reporting-emotional-abuse
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Decision tree outlining the process to follow in the event of alleged, suspected or witnessed case of financial abuse.
Reference: Ministry of Health and Long Term Care. (2012). Licensee Reporting of Financial Abuse. Retrieved from http://www.familycouncilmembers.net/resources/decision-tree-licensee-reporting-financial-abuse
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Decision tree outlining the process to follow in the event of alleged, suspected or witnessed case of neglect.
Reference: Ministry of Health and Long Term Care. (2012). Licensee Reporting of Neglect. Retrieved from http://www.familycouncilmembers.net/resources/decision-tree-licensee-reporting-neglect
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Decision tree outlining the process to follow in the event of alleged, suspected or witnessed case of physical abuse.
Reference: Ministry of Health and Long Term Care. (2012). Licensee Reporting of Physical Abuse. Retrieved from http://www.familycouncilmembers.net/resources/decision-tree-licensee-reporting-physical-abuse
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Decision tree outlining the process to follow in the event of alleged, suspected or witnessed case of sexual abuse.
Reference: Ministry of Health and Long Term Care. (2012). Licensee Reporting of Sexual Abuse. Retrieved from http://www.familycouncilmembers.net/resources/decision-tree-licensee-reporting-sexual-abuse
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Decision tree outlining the process to follow in the event of alleged, suspected or witnessed case of verbal abuse.
Reference: Ministry of Health and Long Term Care. (2012). Licensee Reporting of Verbal Abuse. Retrieved from http://www.familycouncilmembers.net/resources/decision-tree-licensee-reporting-verbal-abuse
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This resource describes the variety of abuse and neglect that can occur and will assist homes in planning a comprehensive education program.
Registered Nurses’ Association of Ontario. (2014). Appendix D of Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches. Toronto, Canada: Registered Nurses’ Association of Ontario. Pp 97-99.http://rnao.ca/sites/rnao-ca/files/Preventing_Abuse_and_Neglect_of_Older_Adults.pdf
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Les présentes lignes directrices sur les pratiques exemplaires, Développement et maintien des soins de santé interprofessionnels : optimisation des résultats pour le patient/client, l’organisme et le système sont conçues pour favoriser des milieux de travail sains. L’objectif de l’élaboration de ces lignes directrices était de déterminer les attributs des soins interprofessionnels qui permettront d’optimiser les résultats de qualité pour les patients/clients, les fournisseurs, les équipes, l’organisation et le système. Les présentes lignes directrices déterminent les pratiques exemplaires pour faciliter, améliorer et maintenir le travail d’équipe ainsi que la collaboration interprofessionnelle, et pour accroître les résultats positifs pour les patients/clients, les systèmes et les organisations. Elles sont fondées sur les meilleures données probantes existantes; lorsque ces données étaient limitées, les recommandations ont été fondées sur un consensus basé sur des opinions d’experts.
Association des infirmières et infirmiers autorisés de l’Ontario (2013). Développement et maintien des soins de santé interprofessionnels : optimisation des résultats pour le patient/client, l’organisme et le système. Toronto, Canada: Association des infirmières et infirmiers autorisés de l’Ontario. http://rnao.ca/bpg/language/d%C3%A9veloppement-et-maintien-des-soins-de-sant%C3%A9-interprofessionnels-optimisation-des-r%C3%A9sul
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Practice standards are documents that help nurses understand their responsibilities and legal obligations to enable them to make safe, effective and ethical decisions when practising. This practice standard aims to help nurses understand the regulatory and legislative requirements for documentation.
College of Nurses of Ontario. (2008). Documentation, Revised 2008. Toronto, ON: Author. Retrieved from https://www.cno.org/globalassets/docs/prac/41001_documentation.pdf
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Elder Abuse Ontario (EAO)) (formerly known as ONPEA, The Ontario Network for the Prevention of Elder Abuse) is a provincial, charitable, non-profit organization focused on supporting the implementation of The Ontario Strategy to Combat Elder Abuse and has been doing so since 2002. EAO has resources that are useful for LTC homes under the ‘Help for Seniors’ section of their website.
Reference: Elder Abuse Ontario (EAO). 2017. Help for Seniors. Accessed Feb. 6, 2017 http://www.elderabuseontario.com/what-is-elder-abuse/help-for-seniors/
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This is a series of animated learning resources that have been created to enhance the capacity of those working with seniors and to adopt a common approach to identify and respond to elder abuse. As you move through each training module, you will be prompted by a coach who will act as your guide to make sure you maximize your learning.
Reference: Elder Abuse Ontario. (n.d.). Elder Abuse Training Tools: Interactive Animated Learning Resources_Recognizing Financial and Emotional Abuse. Retrieved from http://www.elderabuseontario.com/training-education/training/eao-training-curricula/
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This reference guide is a tool considered to be a promising approach for professionals, family and friends to use when working with seniors who may be experiencing abuse.
Reference: National Initiative for Care of the Elderly. (n.d.).Elder abuse: Assessment and intervention reference guide. Retrieved from http://www.nicenet.ca/tools-elder-abuse-assessment-and-intervention-reference-guide
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Une pratique efficace des soins infirmiers dépend d’une relation thérapeutique efficace entre le client et l’infirmière. Cette Ligne directrice porte sur les qualités d’une relation thérapeutique efficace, sur les possibilités qu’elle offre, sur l’état des connaissances et sur les connaissances requises afin de pouvoir travailler efficacement dans une relation thérapeutique. Afin qu’une relation thérapeutique puisse être instaurée avec succès, les valeurs du milieu de travail et les caractéristiques essentielles de l’établissement doivent être en place et doivent être compatibles avec cet objectif. Une feuille de travail sur le niveau de préparation de votre établissement est compris.
Association des infirmières et infirmiers autorisés de l’Ontario (2006). Établissement de la relation thérapeutique. Toronto, Canada : Association des infirmières et infirmiers autorisés de l’Ontario. http://rnao.ca/bpg/guidelines/establishing-therapeutic-relationships
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Practice standard are documents that help nurses understand their responsibilities and legal obligations to enable them to make safe, effective and ethical decisions when practising. This practice standard aims to help nurses understand the ethical values and practice standards that the nursing profession in Ontario must uphold. It also provides scenarios of ethical situations in which there is a conflict of values.
College of Nurses of Ontario. (2019). Ethics [PDF file]. Retrieved from https://www.cno.org/globalassets/docs/prac/41034_ethics.pdf -
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Cette ligne directrice fournit des recommandations fondées sur les données probantes à l'intention des infirmières et des autres membres de l'équipe pluridisciplinaire qui évaluent et prennent en charge des personnes qui ressentent ou qui courent le risque de ressentir n'importe quel type de douleur. Cette ligne directrices est approuvé par 'the International Association for the Study of Pain'.
Association des infirmières et infirmiers autorisés de l’Ontario (2013). Evaluation et prise en charge de la douleur, Troisième edition. Toronto, ON, Canada: Auteur. Récupérée de http://rnao.ca/bpg/translations/%C3%A9valuation-et-prise-en-charge-de-la-douleur
Ce travail est financé par le ministère de la santé et des soins de longue durée.
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This booklet can help understand your rights as a resident of a long-term care home. These rights are yours by law. Advocacy Centre for the Elderly & Community Legal Education Ontario. (2008).
Every resident: Bill of rights for people who live in Ontario long term care homes. Retrieved from: http://www.advocacycentreelderly.org/appimages/file/everyresEN%20-%20Dec%202011.pdf
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Nurses and other health-care providers want you to know they can help you deal with a serious threat to your health—abuse and neglect. Did you know that signs of abuse and neglect are not always easy to spot? You may not even know that you are being mistreated. That’s why it is so important to talk about the issue with a trained nurse or health-care provider.
Retrieved from: http://rnao.ca/bpg/guidelines/fact-sheets/five-measures-you-can-take-protect-yourself-abuse-and-neglect%E2%80%94-be-used-wh
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This collaboration between LGBT and mainstream organizations examines why the LGBT population face additional obstacles to successful aging. It also looks at what groundwork needs to be in place for these obstacles to be overcome . Copyright © 2015 Movement Advancement Project ©
Reference: LGBT Movement Advancement Project (MAP), & Services and Advocacy for Gay, Lesbian, Bisexual, and Transgender Elders (SAGE). (2010). Improving Lives of the LGBT older adults. Retrieved from https://lgbtmap.org/improving-the-lives-of-lgbt-older-adults
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This report on the Public Guardian and Trustee of British Columbia Website examines the context of capacity assessments and commonly used tools.
Reference: O'Connor, D. (2009) Incapability Assessments: A Review of Assessment and Screening Tools Final Report. Retrieved from: http://www.trustee.bc.ca/documents/STA/Incapability_Assessments_Review_Assessment_Screening_Tools.pdf
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Video of recognizing the warning signs/attitudes present in elder abuse situations.
©2015 Centre For Research & Education On Violence Against Women & Children
Reference: Centre for research & education on violence against women & children. (n.d.). It's not right: Neighbours, friends & family for older adults. Retrieved from http://itsnotright.ca.
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The expert panel for the BPG Facilitating Client Centred Learning (2012) developed the L.E.A.R.N.S. Model, which describes how to support effective learning. LEARNS stands for Listen, Establish, Adopt, Reinforce, Name, Strengthen and refers to the nurse/client interaction.
Reference: Registered Nurses’ Association of Ontario (2012). Facilitating Client Centred Learning. Toronto, Canada: Registered Nurses’ Association of Ontario. pp. 19-20. http://rnao.ca/bpg/guidelines/facilitating-client-centred-learning
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The link will take you to the document that the Law Commission of Ontario released October 2015 it is entitled Legal Capacity, Decision-Making and Guardianship, this interim report provides a number of recommendations designed to reduce opportunities for elder abuse.
Retrieved from: http://www.lco-cdo.org/capacity-guardianship-interim-report.pdf
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Cette ligne directrice sur les pratiques exemplaires en soins infirmières et infirmiers est un document détaillé comportant les ressources nécessaires au soutien de la pratique basée sur des données probantes. Un milieu de travail sain, c’est un milieu de pratique qui maximise la santé et le bien-être des infirmières, des résultats de qualité chez le patient ou client, le rendement de l’organisation et du système, et les retombées sociales, y compris des collectivités en meilleure santé.
Association des infirmières et infirmiers autorisés de l’Ontario (2013). Lignes directrices sur le développement et le maintien du leadership infirmier, Deuxième edition. Toronto, ON, Canada: Auteur. Récupérée de http://rnao.ca/bpg/language/lignes-directrices-sur-le-d%C3%A9veloppement-et-le-maintien-du-leadership-infirmier
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Explains to employers, HCPs, nurses the purpose of mandatory reporting to the CNO, how the College addresses reports and what outcomes to expect when a report is submitted. College of Nurses of Ontario (CNO). 2012.
College of Nurses of Ontario. (2018). Mandatory reporting: A process guide for employers, facility operators and nurses. [PDF file]. Retrieved from: https://www.cno.org/globalassets/docs/ih/42006_fsmandreporting.pdf -
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Pauktuutit Inuit Women of Canada is the national organization that represents all Inuit women in Canada. Pauktuutit has been active in abuse prevention and building capacity to address abuse issues since its inception in 1984. Pauktuutit brought together individuals, agencies and groups who share a common interest in preventing abuse in Inuit communities, to collaborate on the development and implementation of this unique national,community-based strategy.
Reference: Pauktuutit Inuit Women of Canada. (2006). National Strategy to Prevent Abuse in Inuit Communities and Sharing Knowledge, Sharing Wisdom: A Guide to the National Strategy. Ottawa, ON: Author. Retrieved from http://pauktuutit.ca/wp-content/blogs.dir/1/assets/InuitStrategy_e.pdf
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The Office of the Privacy Commissioner of Canada provides provincial and territorial links to Oversight Offices and government organizations: The Privacy Commissioner of Canada is an Officer of Parliament who reports directly to the House of Commons and the Senate.
The Commissioner is an advocate for the privacy rights of Canadians and powers include:
- Investigating complaints, conducting audits and pursuing court action under two federal laws;
- Publicly reporting on the personal information-handling practices of public and private sector organizations;
- Supporting, undertaking and publishing research into privacy issues; and
- Promoting public awareness and understanding of privacy issues.
Reference: Office of the Privacy Commissioner of Canada Retrieved from: http://www.priv.gc.ca/resource/prov/index_e.asp
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These brochures help identify several key issues regarding managing the stigma and discrimination in housing, family and social support found in LGBTT population. The resource is available for free download. However, there is a cost recovery associated with this resource if you would like to order printed materials. They are sold in bundles of 25 for 5.00.
Senior Pride Network. (2009). Opening the Closet on Aging: Working with older lesbian, gay, bisexual, transsexual, and transgender people. Retrieved from http://www.rainbowhealthontario.ca/resources/opening-the-closet-on-aging-working-with-older-lesbian-gay-bisexual-transsexual-and-transgender-people/
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Proper preparation can greatly decrease the risk of a violent incident with a potentially violent resident. Communication and other strategies are provided to considered when in contact with a resident who could potentially be violent.
Registered Nurses’ Association of Ontario. (2009). Appendix D-14 of Preventing and Managing Violence in the Workplace. Toronto, ON, Canada: Author. pp. 132-133. Retrieved from http://rnao.ca/bpg/guidelines/preventing-and-managing-violence-workplace.
OSACH Website: www.osach.ca/
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The fact sheet is a tool to increase awareness of the regulatory mandate on educating and preventing client abuse and provide further resources to support nurses in the prevention of abuse in practice.
College of Nurses of Ontario. (2011). Preventing client abuse fact sheet. [PDF file]. Retrieved from https://www.cno.org/globalassets/docs/ih/47008_fspreventabuse.pdf -
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Cette ligne directrice sur les pratiques exemplaires en soins infirmiers est axée sur la prévention et résolution des mauvais traitements et de la négligence envers les aînés dans divers établissements de santé et services communautaires à travers le Canada. Ces auditoires comprennent les infirmières, les gestionnaires, les éducateurs, les équipes d'amélioration de la qualité, les administrateurs, les décideurs, les organismes de réglementation des soins infirmiers et les organismes gouvernementaux. Financé par le programme Nouveaux Horizons pour les aînés du gouvernement du Canada.
Association des infirmières et infirmiers autorisés de l’Ontario. (2014). Prévention et résolution des mauvais traitements et de la négligence envers les aînés: approches axées sur la personne, coopératives et à l'échelle du système Toronto, ON, Canada: Auteur. Récupérée de http://rnao.ca/sites/rnao-ca/files/Preventing_Abuse_and_Neglect_of_Older_Adults_Final_French_0.pdf
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This link takes you to the prevention of abuse and neglect section 19 and 20 of the Long-Term Care Homes Act, 2007, S.O. 2007, c. 8. Government of Ontario. Retrieved from https://www.ontario.ca/laws/statute/07l08
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The link takes you to the prevention of abuse and neglect section 96 to 99 of the Ontario Regulation 79/10 made under the Long-Term Care Homes Act, 2007, Government of Ontario. Retrieved from https://www.ontario.ca/laws/regulation/r10079
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This Website provides local, provincial, federal and multicultural links to elder abuse resources. It also provides strategies to minimize the risk of elder abuse.
Reference: Prevention of Elder Abuse Committee of York Region This Website provides local, provincial, federal and multicultural links to elder abuse resources. It also provides strategies to minimize the risk of elder abuse. http://elderabuse-yorkregion.ca/prevention/
Disclaimer: The Prevention of Elder Abuse Committee of York Region has a mission to reduce elder abuse by increasing awareness. The committee does not provide services or assistance.
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This project was designed to identify relevant principles, screening and intervention tools and approaches and prevention strategies being used in First Nations communities to address/prevent abuse of older adults.
Reference: Struthers, A., Martin, G., & Leaney, A. (2009). Promising Approaches for Addressing/Preventing Abuse of Older Adults in First Nations Communities: A Critical Analysis and Environmental Scan of Tools and Approaches. BC Association of Community Response Networks (BCCRN). Retrieved from http://www.bccrns.ca/WebLibrary/General/Resources/First%20Nations/Public20130425160252.pdf
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The Website provides excellent resources focussed on the intersection of the LGBTQ community and aging. Some resources are available for download and some resources can be purchased.
Copyright with Rainbow Health Ontario
Reference: Rainbow Health Ontario Website (n.d.). Retrieved from http://www.rainbowhealthontario.ca/resource-search/
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The link takes you to the reporting and complaints section 100 to 107 of the Ontario Regulation 79/10 made under the Long-Term Care Homes Act, 2007, Government of Ontario. Retrieved from https://www.ontario.ca/laws/regulation/r10079
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This link takes you to the reporting and complaints section 21 to 28 of the Long-Term Care Homes Act, 2007, S.O. 2007, c. 8. Government of Ontario. Retrieved from https://www.ontario.ca/laws/statute/07l08
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This resource list helps you identify key contacts in addressing elder abuse. Complete the contact details for your local resources.
Reference:Registered Nurses’ Association of Ontario. (2014). Appendix H of Addressing and Preventing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches. Toronto, ON: Registered Nurses’ Association of Ontario. , pp.112-114. http://rnao.ca/bpg/guidelines/abuse-and-neglect-older-adults
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The manual contains a series of clearly written modules on violence against older persons. A focus is on recognizing abuse in all settings. Modules are interactive with case studies illustrating points. One module is on residential care (long term care). The manual is intended for use in a training program on preventing violence, but could be used for self-learning. Accompanying trainer manuals are available. References and resources are Newfoundland and Labrador based.
Violence Prevention Initiative - Women’s Policy Office, Government of Newfoundland and Labrador. (2013). Respect Aging: An Education and Training Program for Recognizing, Preventing and Intervening in Violence Against Older Persons Participant Manual [PDF document]. Retrieved from https://www.respectaging.ca/training/Participant_Manual.pdf Copyright, Government of Newfoundland and Labrador
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The guideline contains recommendations for best nursing practices in the assessment and management of pain for Registered Nurses (RNs) and Registered Practical Nurses (RPNs). It is acknowledged that the individual competency of nurses varies between nurses and across categories of nursing professionals (RNs and RPNs) and is based on knowledge, skills, attitudes, critical analysis and decision making which is enhanced over time by experience and education. This guideline is endorsed by the International Association for the Study of Pain.
© Registered Nurses’ Association of Ontario (2013). Assessment and Management of Pain Third Edition. Toronto, ON: Author. This work is funded by the Ontario Ministry of Health and Long-Term Care. http://rnao.ca/bpg/guidelines/assessment-and-management-pain
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This new guideline is designed to apply to all domains of nursing practice, including clinical, administration, and education, to assist nurses to become more comfortable, confident and competent when caring for clients undergoing care transitions. It is important that nurses, working in collaboration with the interprofessional team promote safe and effective care transitions. Care transitions depends on effective communication and coordination of client care by all interprofessional team members and with the client, their family and caregiviers.
This guideline is endorsed by Accreditation Canada.
Registered Nurses’ Association of Ontario. (2014). Care Transitions. Toronto, ON: http://rnao.ca/bpg/guidelines/care-transitions
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For the purpose of this document, Interprofessional is defined as: Multiple health disciplines with diverse knowledge and skills who share an integrated set of goals and who utilize interdependent collaboration that involves communication, sharing of knowledge and coordination of services to provide services to patients/clients and their care-giving systems.
This best practice guideline, Developing and Sustaining Interprofessional Health Care: Optimizing patients/clients, organizational, and system outcomes is intended to foster healthy work environments. The focus in developing this guideline was identifying attributes of interprofessional care that will optimize quality outcomes for patients/clients, providers, teams, the organization and the system.
This guideline identifies best practices to enable, enhance and sustain teamwork and interprofessional collaboration, and to enhance positive outcomes for patients/clients, systems and organizations. It is based on the best available evidence; where evidence was limited, the recommendations were based on the consensus of expert opinion.
Registered Nurses’ Association of Ontario. (2013). Developing and Sustaining Interprofessional health care. Toronto, ON: http://rnao.ca/bpg/guidelines/interprofessional-team-work-healthcare
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Gain knowledge in leadership practices that result in healthy outcomes for nurses, patients/clients, organizations and systems. This guideline addresses:
- System resources that support effective leadership practices and behaviours for formal leaders and nurses at the point of care
- Organizational culture, values and resources that support effective leadership practices and behaviours at all levels
- Personal resources that support effective leadership practices across the continuum of care
- Anticipated outcomes of effective nursing leadership
2nd Edition, 2013
Registered Nurses’ Association of Ontario. (2013). Developing and Sustaining Nursing Leadership. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/developing-and-sustaining-nursing-leadership
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The BPG assists nurses in exploring how the decision making process can ensure that appropriate structures and supports are in place to maximize the nursing care and outcomes and minimize the potential for abuse of residents/patients/clients.
Registered Nurses' Association of Ontario. (2017). Developing and sustaining safe, effective staffing and workload practices. Toronto, ON: Author. Retrieved from http://rnao.ca/bpg/guidelines/developing-and-sustaining-effective-staffing-and-workload-practices
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Gain an overview of the most compelling evidence about diversity; understanding it, accepting the differences it brings to work settings, and finally, to seeking and embracing diversity.
This panel has been developing guidelines that recommend a congruent set of work place behaviours, management practices and institutional policies within a practice setting resulting in an organizational environment that is respectful and inclusive of cultural and other forms of diversity.
Reference: Registered Nurses’ Association of Ontario (2007). Embracing Cultural Diversity in Health Care: Developing Cultural Competence. Toronto, ON: Author. http://rnao.ca/bpg/guidelines/embracing-cultural-diversity-health-care-developing-cultural-competence
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Effective nursing practice is dependent on an effective therapeutic relationship between the nurse and the client. This guideline addresses the qualities and capacities of an effective therapeutic relationship, the state of knowledge, and the knowledge needed to be effective. To implement a therapeutic relationship successfully, an organization's characteristics and workplace values must be supportive and in place. An organization readiness assessment based on the best practice recommendations is provided. Supplement: 2006
Registered Nurses’ Association of Ontario. (2002). Establishing therapeutic relationships. Toronto, ON, Canada: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/Establishing_Therapeutic_Relationships.pdf -
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The purpose of this best practice guideline is to provide evidence-based recommendations related to nurses and other health care professionals providing effective client centred learning. This guideline will address the following areas: • How can nurses effectively facilitate client centred learning? • What are effective teaching delivery methods/ strategy for client centred learning? • How do nurses assess client learning? This guideline will be applicable to all domains of nursing including clinical, administration, and education.
Registered Nurses’ Association of Ontario. (2012). Facilitating client centred learning Toronto, ON: https://rnao.ca/sites/rnao-ca/files/BPG_CCL_2012_FA.pdf -
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The Person-and Family-Centred Care best practice guideline can be used to enhance the quality of partnerships between health-care providers with individuals accessing care, ultimately improving clinical outcomes. It is important to acknowledge that person- and family-centred care focuses on the whole person as a unique individual and not just on their illness or disease. By viewing the individual through this lens, health-care providers come to know and understand the person’s life story, experience of health, the role of family in the person’s life, and the role they may play in supporting the person to achieve health. This guideline provides best practice recommendations in three main areas: •Practice recommendations are directed primarily to those who provide direct care to persons in health-system settings and in the community. •Education recommendations are directed to those responsible for staff and student education. •System, organization, and policy recommendations apply to managers, administrators, policy-makers, nursing regulatory bodies, academic institutions, and government bodies. Recommendations in these three areas are most effective when implemented together. This guideline replaces the previous BPG Client Centred Care.
Registered Nurses’ Association of Ontario. (2015). Person-and family-centred care. Toronto, ON, Canada: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/FINAL_Web_Version_0.pdf -
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Learn about four types of violence encountered by nurses and other health-care professionals. It provides evidence-informed strategies to plan, implement, and evaluate outcomes related to recognizing and assessing the risk of violence in the workplace.
This guideline provides evidence-informed individual, system, and organizational recommendations to recognize, prevent and effectively intervene in workplace violence, thereby fostering healthy work environments. It also identifies individual, organizational, and system resources that support prevention, recognition, early detection and effective interventions related to preventing and managing violence in the workplace.
Registered Nurses’ Association of Ontario. (2009). Preventing and Managing Violence in the Workplace. Toronto, ON: http://rnao.ca/bpg/guidelines/preventing-and-managing-violence-workplace
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Nurses require knowledge and evidence on the use of alternative approaches to the use of restraints. The promotion of safe evidence based care is the goal to prevent the untoward incidents from the use of restraints. This guideline offers nurses a model which will help them to examine their approach to the use of restraints within their practice.
Registered Nurses’ Association of Ontario. (2012). Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/promoting-safety-alternative-approaches-use-restraints.
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Increase your knowledge in promoting family health through interventions and supports provided during expected (i.e. birth, school, adolescence, aging, and death) as well as unexpected (i.e. trauma/accidents, chronic illness, developmental delay and disability) life events. Focusing on the family is an integral component of nursing practice. This guideline was developed to promote and facilitate continuing education, reflection and reaffirmation of the importance of caring for families. Supplement: 2006
Registered Nurses’ Association of Ontario. (2002). Supporting and Strengthening Families Through Expected and Unexpected Life Events. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/supporting-and-strengthening-families-through-expected-and-unexpected-life-events
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The Relating to Older People Evaluation (ROPE) is a self-report measure of the frequency and type of ageist behaviours. ROPE is a 20-item questionnaire that measures personal discrimination through 14 statements that reflect negative types of ageism, and 6 statements that reflect positive types of ageism.
Reference: Cherry, K., & Palmore, E. (2008)). Relating to Old People Evaluation (ROPE). Retrieved from http://www.nicenet.ca/tools-rope-relating-to-old-people-evaluation
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Le but de la présente ligne directrice est de promouvoir les pratiques fondées sur des données probantes, qui sont associées aux soins axés sur les besoins de la personne et de la famille, et d'aider les infirmières et d'autres fournisseurs de soins de santé à acquérir les connaissances et les compétences nécessaires pour améliorer leur pratique de ces soins. Les recommandations aideront les infirmières et d'autres fournisseurs de soins de santé à obtenir le savoir requis pour collaborer et établir des relations habilitantes avec des personnes et leur famille qui font appel aux services de santé, afin d'optimiser la santé et le bien-être au cours de leur vie. Cette approche fondée sur des données probantes, et combinée à une perspective qui reconnaît la place de la personne au centre des soins de santé, permettra d'améliorer l'expérience de cette personne et sa satisfaction à l'égard des soins et des services offerts par le système de santé. Elle s'applique à tous les domaines de la pratique des soins infirmiers, y compris les secteurs clinique, administratif et éducatif.
Cette ligne directrice recommande des pratiques exemplaires dans trois domaines principaux : ■ Les recommandations au sujet des pratiques exemplaires ont été rédigées principalement à l'intention des infirmières et d'autres fournisseurs de soins de santé dans l'équipe interprofessionnelle qui offre des soins directs à des personnes dans les milieux de soins du système de santé (p. ex., soins actifs, soins de longue durée et soins à domicile) et dans la collectivité (p. ex., soins primaires, équipes de santé familiale et santé publique). ■ Les recommandations en matière d'éducation s'adressent à ceux qui sont responsables de la formation du personnel et des étudiants, tels que les éducateurs, les équipes d'amélioration de la qualité, les gestionnaires, les administrateurs ainsi que les établissements d'enseignement universitaire et professionnel. ■ Les recommandations sur le système, l'organisation et la politique s'appliquent à divers publics selon le type de recommandation. Les publics comprennent les gestionnaires, les administrateurs, les décideurs, les organismes de réglementation en soins infirmiers, les établissements d'enseignement et les organismes gouvernementaux. Pour obtenir une efficacité optimale, les recommandations dans ces trois secteurs doivent être mises en œuvre simultanément. Cette ligne directrice remplace le soin centré au client précédent .
Association des infirmières et infirmiers autorisés de l’Ontario. (2015). Soins axés sur les besoins de la personne et de la famille. Toronto (Ontario) : Association des infirmières et infirmiers autorisés de l’Ontario http://rnao.ca/bpg/language/soins-ax%C3%A9s-sur-les-besoins-de-la-personne-et-de-la-famille
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The Staff Mix Decision-making framework for quality Nursing Care is a comprehensive and evidence informed resource that presents a systematic approach to staff mix decision making. It can be used in all clinical practice settings. It is a Joint Position statement between the CNA, Canadian Council for Practical Nurse Regulators, and the Registered Psychiatric Nurses of Canada.
Reference: Canadian Nurses Association. (2012). Staff Mix Decision Making Framework for Quality Nursing Care. Retrieved from: http://cna-aiic.ca/~/media/cna/files/en/jointps_staff_mix_partnership_e.pdf
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Long-Term Care Task Force on Resident Care and Safety- Developing an Action Plan to Address Abuse and Neglect in Long-Term Care Homes.
An action plan and progress reports that examine and address the factors contributing to incidents of abuse or neglect in long-term care homes with the goal of helping to prevent these incidents.
Reference: Long-Term Care Task Force on Resident Care and Safety Ontario (2012) Developing an Action Plan to Address Abuse and Neglect in Long-Term Care Homes. Retrieved from: http://longtermcaretaskforce.ca/
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This resource describes the variety of theories as to why elder abuse and neglect can occur and will assist homes in planning a comprehensive education program.
Registered Nurses’ Association of Ontario. (2014). Appendix E of Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches. Toronto, Canada: Registered Nurses’ Association of Ontario. Pp 100-102. http://rnao.ca/sites/rnao-ca/files/Preventing_Abuse_and_Neglect_of_Older_Adults.pdf
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At the core of nursing is the therapeutic nurse-client relationship. The College's Therapeutic Nurse-Client Relationship, Revised 2006, practice standard describes the expectations for all nurses in establishing, maintaining and terminating a therapeutic relationship.
Retrieved from: http://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf
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At the core of nursing is the therapeutic nurse-client relationship. The College's Therapeutic Nurse-Client Relationship, Revised 2006, practice standard describes the expectations for all nurses in establishing, maintaining and terminating a therapeutic relationship.
College of Nurses of Ontario. (2006). Therapeutic nurse-client relationship. [PDF document]. Retrieved from https://www.cno.org/globalassets/4-learnaboutstandardsandguidelines/prac/learn/modules/tncr/pdf/tncr-chapter3.pdf -
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The link takes you to the COllege of Nurses of Ontario webcast on Therapeutic Nurse-Client Relationship – Maintaining Boundaries
College of Nurses of Ontario. (2011). Therapeutic Nurse-Client Relationship – Maintaining Boundaries. [Webcase]. Retrieved from https://www.cno.org/en/learn-about-standards-guidelines/educational-tools/webcasts/therapeutic-nurse-client-relationship/ -
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Cette nouvelle ligne directrice est conçue pour tous les domaines de la pratique des soins infirmiers, y compris le volet clinique, l'administration et l'éducation, dans le but d'aider les infirmières à se sentir plus à l'aise, plus confiantes et plus compétentes lorsqu'elles prodiguent des soins à des clients pendant une transition des soins. Il est important que les infirmières, lorsqu'elles collaborent avec leur équipe pluridisciplinaire, connaissent les clients, leur famille et leurs aidants et travaillent avec eux pour encourager les transitions de soins sûres et efficaces. L'efficacité des transitions des soins dépend de soins pluridisciplinairesG coordonnés qui mettent l'accent sur une communication continue entre les professionnels et les clients. Cette recommandation est approuvée par Agrément Canada.
Association des infirmières et infirmiers autorisés de l'Ontario (2014). Transitions des soins. Toronto : Association des infirmières et infirmiers autorisés de l'Ontario. http://rnao.ca/bpg/language/transitions-des-soins
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This is a brightly coloured, one page pamphlet/poster that describes signs of elder abuse and gives resources. This is one of a suite of resources from Elder Abuse Ontario in the Helping Seniors section of their website.
Reference: Elder Abuse Ontario. 2015. Warning Signs of Elder Abuse. Accessed Feb. 2, 2017 from http://www.elderabuseontario.com/what-is-elder-abuse/help-for-seniors/educational-materials-for-seniors/
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This pamphlet has an algorithm to help decide on whether and to whom to report elder abuse, as well as elder abuse resources in Ontario. This is one of a suite of resources from Elder Abuse Ontario in the Helping Seniors section of their website.
Web Source: Elder Abuse Ontario. 2015. What To Do If You Suspect Elder Abuse. http://www.elderabuseontario.com/what-is-elder-abuse/help-for-seniors/educational-materials-for-seniors/
Reference: Elder Abuse Ontario. 2015. What To Do If You Suspect Elder Abuse. Accessed Feb. 2, 2017 at file:///C:/Users/sumani/Downloads/What-To-Do-If-You-Suspect-Elder-Abuse-2016.pdf