The Counterpoint Project:

Tools to Enhance Practice

Legal Theme TeamNICE NetworkCanadian Centre for Elder Law

CANADIAN CENTRE FOR ELDER LAW

• National non-profit• Legal issues that concern

older adults

1. Legal research

2. Law reform

3. Legal education

4. Public outreach

• National Centre of Excellence

• Knowledge Exchange

1. ~2000 members

2. Evidence-based

3. ~900K requests

4. ~200 tools

NICE NETWORK

Social Movements

• Expansion• Attenuation• Repetition

Fluid Growth

Women’s Rights

30 Years Ago…

Disability Rights

20 years ago…

Eco Rights

10 years ago…

Our Path

1927 / 1952 Old Age Security 1960s US Legislation – Great Society

1970s Grassroots Local Development

1980s Literature, Leaders, Organizations

1990s Broad Networks, Guardianship Laws

2000s Research, Inter-disciplinary Networks, Consciousness Raising

2010s Gov’t strategies, Financial sector, Community Responses, Tools and

Organization

PLANNING FOR FUTURE DECISIONS

CAPABLE INCAPABLE

YOU DECIDE

SOME ONE ELSE

DECIDES (SDM)

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Capacity Continuum

Capable Incapable

Vulnerability Redefined

• A social construct• Not an inherent quality

or individual flaw –

• Not a static concept 

More Vulnerable

Less Vulnerable

More Vulnerable

More Capable

www.knowledgemobilization.net 12

Context

Culture

Continuity

Capacity

2

The Counterpoint Tools

MOTIVATION FOR PROJECT

1. Uniquely positioned to respond

2. Practice involves difficult questions and ethical dilemmas

3. How can knowledge of the law support or assist practice?

WHERE DID THE EVIDENCE COME FROM?

1. Analyze select legal cases involving elder abuse and neglect,

2. Identify challenges to practice for social service and health practitioners

3. Produce a summary of key laws across the country that are relevant to practice

4. Develop helpful tools

QUESTIONS AND DILEMMAS

• What is my obligation to respond to abuse and neglect?

• What confidentiality rules apply?

• How can I respond to my concerns in a manner that respects an adult’s right to privacy and independence and a choice to live at risk?

• What is the impact of mental capacity?

• How can I support the older adults I work with to live with dignity, to age in place, without abandoning in abusive relationships?

3

Resources to Enhance Practice

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CONFIDENTIAL PATIENT AND CLIENT INFORMATION

• Brochure - print and fold

• Details of law vary a lot – recurring themes - focus on principles and key messages, eg

– The easiest way to comply with the law is to get consent before sharing personal or health information

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MENTAL CAPACITY AND CONSENT

• The right to make decisions: understanding information and consequences of decisions

– A medical diagnosis or disability does not necessarily mean a person does not have mental capacity .

– Failing to seek consent in certain circumstances is a form of elder abuse.

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FACTSHEETS

• Examples of abuse and neglect

• Identifies obligation to respond to abuse, neglect and risk

• Identify some existing assessment tools

• Doctors, nurses, facility administrators, personal support workers

• 1 page two-sided plus table

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CHARTING TOOL

• Two-sided 1 page sheet

• Form with tick boxes, questions and scales

• Ease of documentation of concerns about an older adult

• Team approach to care and response

• Patient/ client file

• Identifies existing assessment tools

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GUIDELINES FOR DEVELOPING IMPROVED PRACTICES

• Targets people who support health and social service practitioners (employers, institutions)

1. Recommendations for policy development, practices, tool development and education

2. Highlights some of the challenges front line staff face

3. Overview of the cases

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VIDEO PANEL DISCUSSIONS

• Leaders from various areas of practice

• social work, medicine, nursing, administration

• Discussing some of the challenges

• Offers some strategies for enhanced practice

• No simple answers

• 4-6 minutes each

6 ENGLISH VIDEOS

1. Confidentiality and Privacy Issues

2. Mental Capacity and Risk

3. Social Isolation and Elder Abuse

4. Asking Difficult Questions and Building Relationships of Trust

5. Risk, Vulnerability and Family Dynamics

6. Developing an Inter-Professional Practice

Video participants – NICE Members

1. Lynn McCleary, Associate Professor, Brock University, Department of Nursing

2. Dr. Tricia K. W. Woo, Associate Professor, Department of Medicine (Geriatrics), McMaster

3. Marie Beaulieu, Professor, Department of Social Work, University of Sherbrooke

4. Peter Donohue, Associate Professor, School of Social Work, Renison University College - Waterloo

5. Denise Koster, Koster Consulting & Associates

Canadian Centre for Elder Law

www.bcli.org/ccel

lwatts@bcli.org

kjames@bcli.org

NICE Network

www.nicenet.ca

lynn.mcdonald@utoronto.ca

admin@nicenet.ca