Partners In Care: Preventing & Responding to Abuse, Neglect and Self-Neglect

On October 9th, 2024 the Vancouver Divisions Seniors and Frail Elder Care Committee partnered with the Vancouver Primary Care Networks to deliver an in-person event focusing on preventing and responding to abuse, neglect and self-neglect for seniors. This event was the second in the Partners in Care Series, the first one was in March of this year and focused on navigating resources for frail seniors. You can view the resource page for that first event here. 72 Primary Care Providers attended the session to receive valuable information from the Vancouver Coastal Health ReAct Team, the Public Guardian and Trustee, as well as Seniors First BC.

The infographic below gives a high level summary of the event.

Event Resources

Did you miss the event, or need a refresher? You can view helpful resources from the event below

Miscellaneous Q & A

Q: Are there any supports i.e. home care to support keeping elders at home, instead of retirement homes?

PCN interprofessional Team

Home Health: has an abundance of programs tailored to seniors’ needs to keep them at home.

Home and Community Care Access Lines – Vancouver (604) 263-7377 Fax:(604 267-3419

Once your client is connected with Home Health, the Home Health clinician may refer them to the following programs if necessary:

Adult Day Programs (Services provided in and out of home setting)
Senior Adult Day Programs
Home Support Services
End of Life/Palliative Care – Physician and Clinicians: CLICK HERE for your local palliative care program information.
Speech-Language Pathology and Swallowing Assessment Services
Overnight Respite
Choice in Support for Independent Living (CSIL)
Family/Caregiver Support
Medical Equipment Provisions Program (MEPP)

Better at Home Program: offers non-medical home support services through different community-based agencies, ranging from light housekeeping, grocery shopping, friendly visiting & more.

Meals on Wheels programs: provides home-delivered meals to support seniors, persons with disabilities, and those recovering from illness/surgery in the community. Volunteers delivering the meals may also offer friendly visiting as an informal check in on their safety and wellbeing.

Q: I have a few seniors in my practice who are living in poverty, alone, and isolated. I’m not worried about abuse or dementia. What would be a good resource for them?

Seniors Services Society of BC

Phone: 604.520.6621

Form and Tax Completion
Better at Home Programs (UWBC)
Meal Delivery
Housing Navigation Information
Homeless Outreach Services
Homeless Prevention Program
Temporary Housing Program

*Information provided in Q & A below is provided for general guidance only and does not constitute legal advice. If unsure about liability or legal issues pleas seek independent legal advice.

Speaker Q & A

When a suspected case is reported to PGT, what is the average timeline for response and investigation? (Ballpark? 2 weeks? 2 months? 6 months?)

The PGT aims to review a new referral within 1 business day to assess the risk and urgency. An investigation timeline varies depending on a number of factors including volume, complexity, and timely responses from third parties. It will usually take longer than 6 months for an investigation to conclude.

What is the average wait time to get the process started with PGT?

To start the process, you may complete an online referral form located here: https://www.trustee.bc.ca/services/referrals/assessment-investigation-services. The referral is typically completed within 5-10 minutes.

If the patient has a higher income, where do they get sent?

In all cases, the PGT seeks the least intrusive and most effective means of supporting individuals, regardless of their income and asset level.

Are there any supports I.e. home care to support keeping elders at home, instead of retirement homes?

When the PGT has authority to manage an incapable adult’s financial affairs, the PGT relies on the adult’s care team to determine what supports may be available to the adult. The PGT’s role would be to approve payment based on the adult’s financial position.

How should we ask patients for consent to disclose patient information? Is there a part of the law that mandates the release of medical information?

We have done some redesigning in our program to hit some better targets with the growing older population. We are using a triage tool and much like Home Health intake, it depends on the acuity of the client. We have clinicians that are able to reach out within 48 hours to the highest acuity. This can look different depending on our physician availability. Our Psychiatrist can also be triaged for acuity. It could be as quickly as a couple of days to a couple of weeks depending on the need. It is really helpful for that triage when risk and acuity are communicated.

When PGT requests the opinion of the Primary Care Provider or for records, what are the legal implications for the Primary Care Provider if they don’t have a patient's consent?

See above. Otherwise, we would suggest medical practitioners consult with the College, insurer, or other regulatory body as appropriate.

How can we protect ourselves if we do not document the name of the reporter anywhere or in the patient's file?

We suggest that medical practitioners consult with the College, insurer, or other regulatory body as appropriate. Ultimately, the PGT has authority to obtain information pursuant to s. 17 and 18 of the Public Guardian and Trustee Act.

I have a few seniors in my practice who are living in poverty, alone, and isolated. I'm not worried about abuse or dementia. Can PGT help with financing?

In keeping with the guiding principles of the Adult Guardianship Act, the PGT considers pursuing an authority to manage an adult’s affairs only as a last resort. The PGT would make inquiries to determine whether our services would benefit the seniors you have mentioned.

Is there a timeframe of past events you can aid with (how many years ago). Ex. If the abuse happened several years ago and is no longer active as the alleged perpetrator left (but assets were lost)

Depending on the situation, the PGT may be able to assist. However, it can be challenging to recover funds that were lost. The potential for recovery is weighed against the intrusiveness and cost to the adult.

If someone reports an abuse to PGT, do you need the name and contact information of the reporter?

The referral form requires you to provide your name, phone number and relationship with the adult you are concerned about, but your identity is protected from disclosure by law.

Who has access to the information and documents that folks have uploaded to the NIDUS Registry?

When people register their documents, they give permissions to consent to who has access. In some cases, the Public Guardian and Trustee has the right to access information without consent as well. The Public Guardian and Trustee will use the registry to determine whether there is a Representation Agreement.

If a neighbour or a friend reports an abuse to PGT, other than the name do you need the PHN or DOB of the victim? What if the reporter does not have that info?

No, the PGT does not require the PHN or DOB (although this information is very helpful!).

What is the age limit for SAIL? (Is it only 65 and older?)

Anyone (regardless of their age) can call SAIL for information, referral, and support for elder abuse and neglect, and self-neglect. To receive Victim Services support 50+ and to receive Legal Services 55+

If a patient uses SAIL is the Primary Care Provider informed that the patient has made this connection?

No, Primary Care Providers are not informed of the use, this is a confidential service.

When should we report suspected abuse to Sail vs ReAct.

Contact the SAIL line, or encourage your patient to contact the SAIL line, if they can seek help on their own. If the patient cannot seek help due to physical handicap (that limits their ability to seek help) or any conditions that affect their ability to make decision about abuse, contact ReAct.

If a neighbour or a friend reports an abuse to SAIL other than the name do you need the PHN or DOB of the victim? What if the reporter does not have that info?

Personal information is not needed to access SAIL services. SAIL can provide information, guidance, direction on next steps.

When a suspected case is reported to ReAct, what is the average timeline for response and investigation?

ReAct Adult Protection Program is Mon to Fri 0800-1700. Reports are triaged for urgency and assigned to a Designated Responder usually within 48 hours. The Designated Responder will begin the investigation, depending on the urgency of the case, type of reported abuse, and caseload demands, anywhere between 24 hours and 3 weeks. The resolution of the case may take 3 weeks to 6 months, depending on the case and type of abuse.

Is there a special form we need to use for VCH ReAct services?

Call 1 (877) REACT-99 (1-877-732-2899) or (604) 904-6173 or email react@vch.ca

How should we ask patients for consent to disclose patient information? Is there a part of the law that mandates the release of medical information?

The Adult Guardianship Act (AGA) stipulates that anyone who has information indicating that an adult is abused or neglected, and unable to seek support and assistance may report the circumstances to a designated agency (DA) (Section 46). Furthermore, the DA, in conducting the investigation may obtain any information required, including from a health care provider. (Sec. 48)

If someone reports an abuse to ReAct do you need the name and contact information of the reporter?

The name and contact of the reporter may be essential for the designated agency (DA) to conduct the investigation so you will be asked to provide it. However, the DA must not disclose or be compelled to disclose the identity of a person who makes a report. There may be some limits to keeping the reporter’s identity confidential, but designated agencies will make every effort within the limits of the law to not disclose this information. Reports may be made anonymously

When ReAct requests the opinion of the Primary Care Provider or for records, what are the legal implications for the Primary Care Provider if they don’t have a patient's consent?

Section 48 (2) of the Adult Guardianship Act (AGA) stipulates that the designated agency (DA) may: (b)obtain any information that the circumstances require, including a report from (i)a health care provider who has examined the adult, (ii)any agency that provides or has provided health or social services to the adult, And Section 62 further states: 62 (1) A designated agency, a qualified health care provider and the Public Guardian and Trustee have the right to all the information necessary to enable them to perform their duties, powers and functions under this Act. (2) Any person who has custody or control of information that a designated agency, a qualified health care provider or the Public Guardian and Trustee is entitled to under subsection (1) must disclose that information to the designated agency, qualified health care provider or Public Guardian and Trustee, as applicable. (3) This section overrides (a) any claim of confidentiality or privilege, except a claim based on solicitor-client privilege, and (b) any restriction in an enactment or the common law about the disclosure or confidentiality of information, except a restriction in section 51 of the Evidence Act.

How does ReAct recommend we protect ourselves if we do not document the name of the reporter anywhere or in the patient's file?

If a physician is provided the identity of the reporter from the designated agency (DA) they are not to release that information to anyone, including the patient. If a physician receives a report about suspected abuse/neglect of a vulnerable adult from another source, that information, including the identity of the reporter should be provided to the DA for investigation and follow up.

If a neighbour or a friend reports an abuse to ReACT, other than the name do you need the PHN or DOB of the victim? What if the reporter does not have that info?

Write down all relevant information. Include names, dates, times, observations, details of the incident(s), location, and other pertinent information and contact (1-877-732-2899) or (604) 904-6173 or email react@vch.ca for further details

Related Resources

Partners In Care: Preventing & Responding to Abuse, Neglect and Self-Neglect

Event Resources

Miscellaneous Q & A

Speaker Q & A

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