PART III: EVALUATING LAWS, POLICIES AND PRACTICES2017-03-03T18:30:48+00:00

This Part brings together the elements from Parts I and II to create a practical guide for developing new laws, policies and practices or evaluating existing one. It is intended to assist in identifying existing or potential negative effects of current or planned laws, policies or practices on older adults. It sets out a series of questions that users of the Framework may ask themselves to assess the law, policy or practice in question. 

For ease of use, the questions are broken down into six sections:

  1. Taking into older adults into account in considering the potential effects of laws and policies.
  2. Learning about the law or policy which examines how we learn whether and how older adults are affected by a proposed or existing law or policy. 
  3. Identifying the older adults who may be affected by the law or policy.
  4. Evaluating how older adults are affected by the wording of the law or policy, including questions that consider whether the strategies selected for addressing the general purpose of the law or policy are consistent with the principles, and take into account the circumstances of older persons.
  5. Understanding how older adults are affected by the manner in which the law or policy is implemented, which asks questions that will assist in evaluating whether in practice the law or policy is having the intended effect and is having a positive or negative effect on the lives of older adults.
  6. Monitoring and evaluating the law or policy, once implemented. Monitoring and evaluation of laws and policies naturally connects to reviews of laws and policies, leading back to the first section and pointing to the need for regular reassessment of laws and policies. 

This Part provides guidance on applying the elements of the framework as outlined in Parts I and II to specific laws, policies and practices, through a series of questions for consideration. 

It is not the purpose of the questions to point to simple, definitive answers to all of the difficult issues that may arise in developing laws, policies and practices that may affect older adults. The law and the circumstances of older adults are complex and diverse. The nature of aging and our understanding of it are constantly evolving. Rather, the questions are intended to ensure that law and policy makers carefully:

  • Consider and apply a consistent set of principles in developing laws and policies that may affect older adults;
  • Ensure that potential sources of paternalism and ageism in laws and policies are identified and addressed;
  • Take into account the key aspects of the experiences and needs of older adults; 

A particular question may be based on more than one principle or more than one aspect of the lives of older adults. 

Given the variety of laws affecting older adults, not all questions will apply to all laws, policies and practices.  

Many of the questions in this Part are based on good general practice and are not necessarily specific to the law as it affects older adults. All laws and policy development will benefit from good consultation mechanisms and most laws would be improved by the inclusion of appropriate monitoring and evaluation mechanisms. Older adults, like all citizens, will benefit from the use of good practices in these and other respects. In addition however, failure to engage in good practice may have particularly significant effects on those who are already disadvantaged, including disadvantaged or marginalized older adults. 

The questions are broken down into six sections, reflecting different aspects of laws, policies and practices. A table showing the sections and their relationships to each other is appended below. 

 

A.   Evaluating Law and Policy – Taking Older Adults Into Account 

At the outset of the law or policy process, law or policy-makers generally identify an issue to be addressed through the law or policy – that is, the general purpose of the law or policy.  

This is a crucial stage for law reform: disadvantaged or marginalized groups often have difficulty bringing visibility or priority to their issues, so that the law is not infrequently silent on issues that are central to their concerns. As well, the potential impact of a law on groups that are not its main targets may be easily overlooked at this stage, leading to issues for those groups when the law or policy is implemented.  

It is therefore important that, during this stage, consideration be given to whether or not older adults may be affected by the potential law. Whether a new law is being developed, or an existing law reviewed, law and policy-makers should ensure, through their processes and deliberations, that adequate attention has been given to whether older adults or some group of older adults may be affected, and if so, what those effects might be.

 

QUESTIONS FOR CONSIDERATION

Have the potential effects of the law on older adults been considered, regardless of whether it is a law specifically referencing older age or a law of general application? 

Has the way in which the law may relate to the principles been identified? 

Has the way in which the law may affect older adults been identified? 

Has the group(s) of older adults who may be affected by the law been identified? 

Has consideration been given to how the proposed law may impact on particular groups of older adults, including:

  • Women? 
  • Lesbians, gays, bisexuals and transgendered persons? 
  • Aboriginal people, both urban and in First Nations communities? 
  • Racialized individuals? 
  • Low-income persons? 
  • Recent immigrants? 
  • Francophones? 
  • Those for whom neither of Canada’s official languages is a first language? 
  • Religious minorities? 
  • Persons with disabilities, including physical, sensory, psychiatric, cognitive, developmental or other disabilities? 
  • Those with significant caregiving responsibilities? 
  • Those living in long-term care facilities or other types of congregate living? 
  • Those who are widowed, divorced or single? and 
  • Those who are socially isolated? 

Has a life course analysis been applied in considering how the law may impact on older adults with various backgrounds and experiences?

 

 

B.   How Do We Learn About Effects On Older Adults?

This section focuses on the process by which laws and policies are developed or reviewed. Subsequent sections will consider the substance and implementation of laws and policies.  

It is as important to avoid ageism and the marginalization of older adults in the process of developing or reviewing laws and policies as it is to identify and avoid this in the substance of laws and policies. Indeed, a flawed development process may very well result in laws and policies that are flawed in their substance. Older adults must be considered during the process of developing laws, and included, respected and consulted during that process.  

The “Madrid International Plan of Action on Ageing” identifies three aspects of participation for older adults in decision-making processes:

  1. Taking into account the needs and concerns of older adults when making decisions,
  2. Encouraging the establishment of organizations to represent older adults in decision-making, and
  3. Taking measures to enable the full and equal participation of older persons, in particular women, in decision-making at all levels. 

Laws and policies may be analyzed and evaluated for their impact on older persons either:

  • at the time that they are being developed, or
  • later on as part of an assessment of their effectiveness or a law reform initiative.

The process of evaluation will differ somewhat depending on whether the law or policy is an existing one or is in development, since a review will naturally focus more heavily on analysis of the effectiveness and impact of the law or policy, and less on its original intent.  

The questions below address the two main means through which potential effects on older adults may be identified, and older adults may be involved in the law reform process: research and public consultation. 

Research

Research during the law or policy development process may take a variety of forms, but generally seeks to ensure a solid understanding of the potential implications and effects of a proposed law or policy. It is important that during this process potential effects on marginalized or disadvantaged groups not be overlooked, and that the research process not be tainted by stereotypes or assumptions.  

Depending on the scope and depth of a review of an existing law or policy, research may include a review and analysis of a wide range of data related to the implementation and impact of the law or policy, including, for example:

  • Levels of awareness about the law or policy among the general public or targeted groups,
  • Measurable effects on the issues the law or policy was intended to address,
  • Perceptions regarding the accessibility of complaints and enforcement mechanisms, and
  • The number and types of complaints regarding access to or implementation of the law or policy. 

Often a major challenge in reviewing existing law or policy is locating information on the impact of the law or policy on older adults or on specific groups of older adults. In many cases, there is a dearth of information about the effectiveness of the law in general. Because there is often a lack of attention to issues affecting older adults, this lack of information is often exacerbated when it comes to older adults. Where there is a lack of information with which to assess the effectiveness and appropriateness of the law or policy, this in itself indicates an area for reform. It also makes it particularly important to include older adults and the organizations that represent them in the review of the law, as they may be able to provide insight into the operation and impact of the law as it affects older persons.  

QUESTIONS FOR CONSIDERATION 

Has research been carried out to ensure understanding of the particular circumstances of those older adults who may be affected? 

Is the law based on current research and evidence regarding the needs and circumstances of older adults, so as to avoid reliance on ageist assumptions, attitudes and stereotypes?

If the research relates to an existing law or policy, has research been carried out to determine:

  • Whether the law or policy has had its intended effect with respect to older adults? 
  • Whether the law or policy has had the effect of improving or reducing achievement of the principles for older adults? 
  • Whether implementation of the law has been affected by ageist or paternalistic attitudes on the part of those charged with implementing it? 
  • Whether older adults have been able to effectively access their rights or understand their responsibilities under the law? 
  • Whether any particular groups of older adults are differently affected by the law?

Public Consultation

Although their form and extent will vary depending on the nature of the proposed law and the resources available, public consultations are crucial in the law development process as they are the primary means by which those who may be affected by the law can draw their concerns to the attention of those responsible for developing the law. It is therefore important that all of those potentially affected have a meaningful opportunity to be involved in the consultations and to have their perspectives considered.  

While reviews of existing laws and policies generally do not involve the same extensive public consultations that accompany development of new laws and policies, the involvement in the review of those affected, including older adults, is crucial to understanding the impact and effectiveness of the law or policy under review.

QUESTIONS FOR CONSIDERATION

Have steps been taken to ensure that older adults and the organizations that represent them have had the opportunity to be meaningfully involved in the development or review of this law, including:

  • Providing accessible information about the issues and their potential impact to older adults and the organizations that represent them? 
  • Providing accessible opportunities for older adults and the organizations that represent them to make their voices heard on the issues? 
  • Ensuring respectful consideration of the contributions and perspectives of older adults that are gathered through the consultation process? 

Have outreach strategies regarding the development or review of the law been targeted to a wide range of older adults and organizations?

Have consultations about the law included a wide range of older adults and organizations?  

Has the process for public consultation around the development or review of the law ensured that:

  • Accommodations are provided to enable the participation of persons with disabilities including, for example, captioning or other accommodations for persons who are hard of hearing or deaf, physically accessible consultation sites for those with mobility disabilities, and large print materials for those who are low-vision? 
  • Plain language materials are available to explain the issues at stake and the means of participation in the consultation? 
  • Where relevant, information about the proposed law or policy and methods of consultation is disseminated in ways that can reach persons who are living in congregate settings, and consultations are carried out in ways accessible to those who live in these settings? 
  • Information about the proposed law or policy is disseminated in ways that can reach those who do not or cannot access information via the internet? 
  • Consultation mechanisms are accessible to those who are on low or fixed incomes? 
  • Consultation mechanisms are accessible to those who live in rural or remote communities? 
  • Consultation mechanisms are accessible to those whose first language is not English?

  

C.  Which Older Adults Are Affected?

As a starting point for understanding the relationship of a particular law or policy to the lives of older adults, one must of course begin by considering whether older adults are affected at all by a law or policy, and if so, whether all or most older adults may be affected, or, whether there are particular groups of older adults who may be impacted by a law or policy. 

For more information see the following sections of the Interim Report:

  • Laws Targeting Older Adults, see Chapter IV, Section B
  • Laws of General Application Affecting Mainly Older Adults, see Chapter IV Section C
  • Laws of General Application Affecting Older Adults Disproportionately or Differently, see Chapter IV, Sections D and E

1.       Identifying Which Older Adults May Be Affected

Laws may affect older adults in a variety of ways: in some cases, the law will explicitly and on its face target older adults, either through age-based eligibility criteria, or by focusing on an issue that is solely or mainly a concern of older adults. In other cases, however, laws of general application that seem, on their face, to have very little to do with older adults may in fact have significant effects on all older adults or some group(s) of older adults.

QUESTIONS FOR CONSIDERATION

Does the law include explicit age-based criteria for its application, either in providing or restricting rights? 

What age-ranges are targeted?  

Are the criteria permissive or mandatory? Can older adults attempt to rebut the presumption that they fall within the scope of the law or policy? Can younger persons apply to be included where appropriate?  

Is the criteria based simply on age, or are other factors, such as income or disability, included to reduce the number of older adults affected?  

Does the issue identified appear to be one that mainly affects older adults? Examples might include laws or policies related to retirement from the workforce or end of life planning.  

Does it affect all older adults equally, or does it affect some particular group of older adults identified by, for example, low-income, a particular life stage, health limitations or place of residence?                                                                                  

Does the issue identified appear to be one that affects large numbers of older adults? This may be the case even where the law does not affect most older adults, or where older adults make up a minority of those affected by the law.  For example, laws or policies dealing with disability-related or health-related issues will often affect significant numbers of older persons.  

Does the law appear to be one of general application? If so, might it have a different impact on older adults than it does on others?

Might any of the provisions of the law or policy have a different effect on persons whose income is fixed, and who are therefore exposed to greater risks in case of financial loss?  

Might any of the provisions of the law or policy have a different effect on persons who have withdrawn from the workforce?  

Might any of the provisions of the law or policy have a particular impact on persons whose level of numeracy or literacy, or whose comfort with technology is lower than average?  

Might any of the provisions of the law or policy have a particular impact on persons who have physical or sensory disabilities or impairments, health-related limitations, or reduced strength or stamina? 

Might any of the provisions of the law or policy have a particular impact on persons who lack legal capacity to make decisions, or who live with cognitive impairments?  

How might this law or policy impact on persons who are living in congregate settings, without easy access to the broader community? 

Does the law or policy presume relatively lengthy time periods for action to be taken, thereby impacting on persons who are reaching the limits of their life expectancy?  

How might this law or policy impact on persons who are reliant on formal or informal supports to maintain their security, dignity, independence and autonomy, or participation in the community?

  

Key Issue

Legal Capacity, Decision-Making and the Principles

Making decisions, whether simple ones about what to wear or eat or complex ones about where to live or how to manage one’s finances, is a fundamental element of daily life. The right to choose has often been identified as central to any approach to the rights of older adults, given the frequency with which older adults have been stereotyped as passive and incapable and treated with paternalism.  

The ability to receive and understand information and to assess risk, and therefore to make sound decisions, may be affected by various disabilities, some of which are congenital or acquired through injury, and others of which may develop later in life, such as the various forms of dementia. A relatively small but significant number of older adults in Ontario live with disabilities that affect their decision-making and therefore their legal capacity. 

Older adults who develop cognitive impairments later in life may have acquired some significant financial assets that can prove a temptation to financial exploitation or abuse. As well, there are difficult and confusing role reversals involved where adult children are called upon to provide support and assistance to the parents who were once responsible for guiding and providing for them. These facts create some unique challenges for the development and implementation of laws that will respect, protect and promote the principles.  

The ability to choose is of course central to the promotion of the principle of autonomy. It is also central to the principle of security: on the one hand, there is a risk that older adults whose cognitive abilities are impaired may be exploited; on the other hand, the ability to speak for oneself and decide for oneself is empowering and may reduce the risk of abuse and exploitation.  Because those with cognitive or intellectual disabilities are often disrespected, excluded or abused, the principles of inclusion and of dignity are also at stake. 

The issues surrounding legal capacity and decision-making are some of the most difficult in the area of elder law, and have implications for almost every area of law and policy that affects older adults, whether it is policies regarding the expression of sexuality in long-term care homes, the ability to exercise and enforce legal rights, or the ability to choose whether to continue to live in the community or in a long-term care home. Ontario has a complex and fairly comprehensive legal regime surrounding legal capacity and decision-making. There are ongoing calls for reform, whether based on differing views on the assumptions on which such laws should be based, or concerns about the effectiveness of the implementation of the current laws.  

Those developing laws and policies that may affect older adults must take into account this group of older adults, and consider approaches that will maximize the implementation of the principles for these often marginalized individuals.

Key Issue

Legal Capacity, Decision-Making and the Principles

Making decisions, whether simple ones about what to wear or eat or complex ones about where to live or how to manage one’s finances, is a fundamental element of daily life. The right to choose has often been identified as central to any approach to the rights of older adults, given the frequency with which older adults have been stereotyped as passive and incapable and treated with paternalism.  

The ability to receive and understand information and to assess risk, and therefore to make sound decisions, may be affected by various disabilities, some of which are congenital or acquired through injury, and others of which may develop later in life, such as the various forms of dementia. A relatively small but significant number of older adults in Ontario live with disabilities that affect their decision-making and therefore their legal capacity. 

Older adults who develop cognitive impairments later in life may have acquired some significant financial assets that can prove a temptation to financial exploitation or abuse. As well, there are difficult and confusing role reversals involved where adult children are called upon to provide support and assistance to the parents who were once responsible for guiding and providing for them. These facts create some unique challenges for the development and implementation of laws that will respect, protect and promote the principles.  

The ability to choose is of course central to the promotion of the principle of autonomy. It is also central to the principle of security: on the one hand, there is a risk that older adults whose cognitive abilities are impaired may be exploited; on the other hand, the ability to speak for oneself and decide for oneself is empowering and may reduce the risk of abuse and exploitation.  Because those with cognitive or intellectual disabilities are often disrespected, excluded or abused, the principles of inclusion and of dignity are also at stake. 

The issues surrounding legal capacity and decision-making are some of the most difficult in the area of elder law, and have implications for almost every area of law and policy that affects older adults, whether it is policies regarding the expression of sexuality in long-term care homes, the ability to exercise and enforce legal rights, or the ability to choose whether to continue to live in the community or in a long-term care home. Ontario has a complex and fairly comprehensive legal regime surrounding legal capacity and decision-making. There are ongoing calls for reform, whether based on differing views on the assumptions on which such laws should be based, or concerns about the effectiveness of the implementation of the current laws.  

Those developing laws and policies that may affect older adults must take into account this group of older adults, and consider approaches that will maximize the implementation of the principles for these often marginalized individuals.

2.    Identifying Effects on Particular Groups of Older Adults

Having identified that older adults are potentially affected by a particular law or policy, one should then determine how these effects might differ among older adults. This is an important step both for laws of general application and for laws that mainly or only affect older adults. Does the law only affect some subgroups of older adults? Or does it affect some older adults differently from others? Consideration of the following questions can assist in identifying the ways in which the law may impact, or impact differently on particular groups of older adults.

 

QUESTIONS FOR CONSIDERATION

How might the impact of the law differ for older women, given the effects of their: 

  • Longer life-expectancies?  
  • Marital patterns? 
  • Historical gender roles? 
  • Caregiving responsibilities? 
  • The particular stereotypes related to older women? 
  • Any other relevant factors? 

How might the impact of the law differ for Aboriginal older adults given their: 

  • Higher rates of disability and impairment? 
  • The legacy of the residential schools experience for those who are older adults today?
  • The effects of historical and continuing social and economic exclusion? 
  • Ongoing prejudice and discrimination, and cultural differences? 
  • Any other relevant factors? 

How might the impact of the law differ for LGBT older adults given:

  • Effects of historical and continuing stigma and discrimination? 
  • The effect of that stigma and discrimination on relationships and family structures? 
  • The effects of historical and continuing stigma and discrimination on the participation of older LGBT individuals in mainstream institutions? 
  • Any other relevant factors? 

How might the impact of the law differ for older adults in rural or remote settings given:

  • Their lesser access to supports and services? 
  • The challenges of transportation in these areas? 
  • Any other relevant factors? 

How might the impact of the law differ for racialized older adults given: 

  • The socio-economic impact of discrimination and racism?  
  • Needs associated with cultural or linguistic differences? 
  • Unique stereotypes and negative attitudes associated with particular groups of racialized older adults? 
  • Any other relevant factors? 

How might the impact of the law differ for older adults who have developed physical or sensory disabilities in older age given:

  • Continuing and widespread barriers to accessibility in accessing buildings, information, transportation, employment, housing, services and supports? 
  • Negative attitudes and lack of understanding towards persons with disabilities on the part of service providers, employers, landlords and others, and the way those attitudes interact with stereotypes regarding older persons? 
  • The lack of supports and services for persons with disabilities, including access to assistive devices or personal and homemaking supports? 
  • The additional disability-related expenses that are often encountered, which may place a strain on fixed or limited incomes? 

How might the impact of the law differ for older adults who have developed cognitive disabilities in older age given:

  • Widespread lack of understanding and negative attitudes towards persons with cognitive disabilities on the part of service providers, employers, landlords and others, and the way in which those attitudes interact with stereotypes regarding older persons?
  • The lack of supports and services for persons with cognitive disabilities? 
  • The additional difficulties that persons with cognitive disabilities face in accessing and understanding information about their rights and responsibilities under the law? 
  • The heightened risk of abuse faced by persons with cognitive disabilities? 

How might the impact of the law differ for older adults who have mental health disabilities given:

  • The lack of recognition, even among health care providers, about mental health issues for older persons? 
  • The lack of services and supports available for older persons with mental health disabilities? 
  • Widespread lack of understanding and negative attitudes towards persons with mental health disabilities and the way those attitudes interact with stereotypes regarding older persons?
  • The challenges that persons with mental health disabilities may face in understanding and accessing their rights and communicating their needs? 

How might the impact of the law differ for older adults who have aged with disabilities, in addition to the issues identified for those who have developed disabilities in older age, given the effects of long-term social and economic marginalization on education, income, social supports, health and other fundamental measures of security? 

How might the impact of the law differ for older adults who live in congregate settings given:

  • That persons living in congregate settings are generally at higher risk than other older adults due to the significant or multiple disabilities that have caused them to seek a congregate living environment? 
  • The reduced access that persons living in congregate settings have to the broader community? 
  • The dependence that older adults in these settings have on the staff and home operators for care and good treatment? 

How might the impact of the law differ for immigrant older adults given their

  • Legal dependence on their sponsors? 
  • Lack of knowledge of and access to supports? 
  • Lack of knowledge of Canadian laws and legal systems? 
    Relative social isolation? 
  • Language barriers?
  • Any other relevant factors? 

How might the impact of the law differ for Francophone older adults given the dearth of supports and services available in the French language, particularly in rural and remote areas?

 

Example: Differential Impact on Aboriginal Older Adults

Fees for Cashing Government Cheques

In 2008, the LCO completed a project on Fees for Cashing Government Cheques, examining the legal and policy issues related to the use by many individuals of cheque-cashing services for accessing government funds, such as social assistance benefits. During the LCO’s research and consultations, it appeared that the issue had a particular impact on Aboriginal older adults who received significant government payments through residential schools settlements. For those Aboriginal older adults living in remote communities without access to mainstream financial services, there was often no realistic alternative to paying large sums in order to cash the cheque and access the settlement funds.  

 

D.  How Are Older Adults Affected? Assessing the Substance of Laws and Policies

The following sections include questions to assist in evaluating the substance of the law, and ensuring that the law or policy is not tainted by ageism or paternalism, takes older adults and their circumstances into account, and values and prioritizes the needs of older adults equally with those in other age groups. Particular attention is paid to the use of eligibility criteria and to addressing the needs of disadvantaged or at-risk older adults, as these are challenging issues that arise in many laws and policies affecting older adults. 

For more information see the following sections of the Interim Report:

  • Identifying Ageism and Paternalism in the Law, see Chapter IV, Section G
  • Assessing the Use of Age-Based Laws, see Chapter IV Section B
  • Addressing Tensions and Conflicts, see  Chapter III, Section B.4
  • “Vulnerability”, Inequality, Risk and Older Adults see Chapter II, Section D

1.    Assessing the General Purpose of the Law or Policy 

As noted above, laws and policies generally begin with an issue, large or small, that is perceived to be of concern and that needs to be addressed. Where new laws and policies are being developed, the purpose may shift, broaden or narrow during the development process, as information is gathered and strategies are assessed. Existing laws and policies frequently explicitly identify their purpose; however, the review process may reveal that the purpose is no longer relevant, or is relevant to a larger or smaller (or different) group than was originally identified.  

In evaluating a law or policy, it is helpful to consider how its general purpose may relate to the lives of older adults. What might be the general effects of the issue raised by the law or policy on older adults? Might achievement of the general purpose of the law or policy contribute towards the achievement of the principles for older adults? At this stage, the analysis is focused on the general purpose of the law or policy and the issue it addresses, and not the specific strategies and mechanisms selected, which are considered in a subsequent section.

QUESTIONS FOR CONSIDERATION

How might the issue raised by this law or policy be connected to the dignity and worth of older adults? 

How might the issue raised by this law or policy be connected to the dignity of older adults and respect for them?  

How might effective law or policy in this area increase or diminish the value accorded to older adults, recognition of their contributions, and respect for them as members of the human family? 

How might the issue raised by this law or policy be connected to the independence and autonomy of older adults? 

How might effective law or policy in this area increase or diminish the ability of older adults to make choices for themselves?

How might effective law or policy in this area increase or diminish the ability of older adults to age in place? 

How might effective law or policy in this area increase or diminish the ability of older adults to continue to work or learn or otherwise do for themselves?                                                                                         

How might the issue raised by this law or policy be connected to the participation and inclusion of older adults?  

How might effective law or policy in this area increase or diminish the ability of older adults to be part of their communities?  

How might effective law or policy in this area increase or diminish the ability of older adults to have a meaningful role in affairs? 

How might effective law or policy in this area increase or diminish the ability of older adults to be consulted on issues that affect them? 

How might the issue raised by this law or policy be connected to the security of older adults?

How might effective law or policy in this area increase or diminish the physical, emotional, financial and social security of older adults?

How might effective law or policy in this area increase or diminish the  freedom of older adults from abuse or exploitation? 

How might effective law or policy in this area increase or diminish the access of older adults to the health, legal and social services they need to achieve and maintain their dignity and respect, independence and autonomy, and participation and inclusion? 

How might the issue raised by this law or policy be connected to respect for the diversity of older adults? 

How might effective law or policy in this area increase the recognition of older adults as individuals widely varying in needs, abilities, experiences, circumstances and perspectives? 

How might effective law or policy in this area increase the recognition of how the experiences of older adults may be affected by other aspects of their identities, such as gender, racialization, sexual orientation, Aboriginal identity, etc? 

In what ways does this issue involve connections between older adults and other groups or generations? 

How might effective law or policy in this area increase cooperation or understanding between generations? 

How might effective law or policy in this area assist in developing a society that is inclusive for people of all ages?                                   

Might this law or policy affect the dignity and respect, independence and autonomy, participation and inclusion, security or respect for diversity and individuality for persons who are not yet older, when they reach that stage of life?

 

Example: Recognizing the Principles

Bill of Rights under the Long-Term Care Homes Act

The new Ontario Long Term Care Act, 2007 includes a “Resident’s Bill of Rights” which builds on similar language in predecessor statutes. The Resident’s Bill of Rights explicitly recognizes older adults who live in long-term care homes as individuals who have rights that must be respected and promoted. Rights include:

  • The right to be treated with courtesy and respect and in a way that fully recognizes the resident’s individuality and respects the resident’s dignity,
  • The right to exercise the rights of a citizen,
  • The right to have his or her participation in decision-making respected,
  • The right to receive care and assistance towards independence based on a restorative care philosophy to maximize independence to the greatest extent possible,
  • The right to form friendships and relationships and to participate in the life of the long-term care home,
  • The right to have his or her lifestyle and choices respected,
  • and many others.  

   

2.    Understanding the Issue in its Broader Context

As part of developing a general understanding of how the law may affect older adults, it is important to consider the particular context in which the law or policy will operate. For example, does the law or policy deal with employment, access to housing, income security, access to disability-related supports, or other areas?  Each of these areas raise specific issues, constraints and dynamics, and will have particular implications for the achievement of the principles.

 

QUESTIONS FOR CONSIDERATION

What areas of life does the law or policy potentially affect?  

Does the law or policy relate to living environments, income security, labour force participation, family and other relationships, safety and security, education, health or other areas? 

What are the particular contexts and concerns of older adults in this area of life?

How does the context for the law or policy relate to the dignity and worth, independence and autonomy, participation and inclusion, security, or diversity and individuality of older adults?

How does effective law or policy in this context potentially strengthen the implementation of the principles for older adults or some group of them? 

Are there aspects of the context that tend to limit the implementation of the principles? For example, participation and inclusion in the community may be more difficult to achieve for those living in long-term care settings.  

If so, what strategies can be employed to address this? 

How might law or policy in this one particular context affect other areas? For example, laws related to income security may affect access to housing or to supports. Laws related to access to supports may affect access to housing or employment.

 

 

3.    Evaluating the Use of Eligibility Criteria

Eligibility criteria for laws and policies raise complex issues. They are commonly found in laws and policies as a means of most effectively allocating scarce resources. There is a risk, however, that such criteria may be under- or over- inclusive, or may be based on or exacerbate negative attitudes or stereotypes. The eligibility criteria that most commonly affect older adults in their relationships with the law are those based on age, disability and income.  

 

Evaluating Age-Based Criteria

Where a particular issue affects mainly older adults or some specific group of older adults, law and policy makers may choose to use inclusive design to ensure that laws of general application effectively address the needs or circumstances of the older adults . Alternatively, law and policy makers may use age-based criteria, either on their own or in combination with criteria based on disability, income or other factors, in order to most efficiently target the use of resources. There is a risk that age-based criteria may be founded on, or perpetuate, ageist attitudes about the abilities, worth and contributions of older persons. On the other hand, age-based criteria may also be effective means of taking into account the ways in which older adults may have different needs or circumstances. The following questions are aimed at identifying circumstances where the use of age-based criteria are appropriate, and those where they are not.

QUESTIONS FOR CONSIDERATION 

What is the purpose of the law? Is the purpose of the law to promote one or more of the principles of dignity and respect, independence and autonomy, participation and inclusion, security, or diversity and individuality?

On what basis does the law treat older adults differently from the rest of the populace?

What are the assumptions about differences based on age that the law is based on?  

Are these assumptions based on current research and evidence?  

Are these assumptions based on stereotypes or negative attitudes about older adults?  

How has the particular age criterion been selected? 

Is the age criteria based on current research into the needs, circumstances and characteristics of older adults? 

Has the age been selected to minimize inappropriate over or underinclusion in terms of the benefits, supports or restrictions in the law? 

Might the law have the effect of reinforcing negative or ageist attitudes or stereotypes about older persons?

Does the law treat older adults as being of equal worth and consideration as other Canadians, or does the law subordinate the needs of older adults to those of others? 

If the focus of the law is on protecting the safety or providing opportunities for younger adults:

  • Has the impact of the restrictions on older adults been fully taken into account? 
  • Have the rights of older adults been equally respected with those of younger adults?  

Does the law prevent older adults from participating in key social areas, such as employment, education or democratic rights?  

Does the law lead to the involuntary social segregation of older adults?

Does the law undermine the economic, physical, financial or emotional security of older adults? 

Does the law recognize that older adults are diverse, and that needs and circumstances may vary across this broad group? 

Does the law make provision for individual assessment of older adults where appropriate?  

Does the law provide a mechanism for individual older adults to challenge the appropriateness of their inclusion or non-inclusion in the affected group? 

Has there been an effort to identify feasible non-age-based alternatives, such directly measuring the quality for which age is acting as a proxy, or using key life transition points instead of age? 

Are there alternatives that better address the needs, circumstances and experiences of older adults? 

Are there alternatives that better respect, promote and fulfil the principles for older adults?

 

Example: Age-Based Criteria

Benefits for Older Adults under the Employment Standards Act

Regulations under the Employment Standards Act permit employers to provide employees aged 65 or older with lesser or no benefits as compared with younger employees, presumably on the assumption that these older employees no longer have the same need for benefits that younger ones do. Considerable concern has been expressed by the seniors’ organizations and workers’ advocates regarding these provisions. In its submission to the Standing Committee considering the bill that brought these provisions into law, the Ontario Human Rights Commission stated that: 

“The provisions of Bill 211 respecting benefits and workers’ compensation are a form of age discrimination. They send a message that older workers are essentially of lesser worth and value than their younger co-workers, and reinforce negative and ageist stereotypes and assumptions about the abilities and contributions of older workers. They fail to recognize the contribution of older employees to their workplaces, or the importance of work to older workers. These provisions are offensive to dignity, and the Commission believes that they will be vulnerable to challenge under the Charter. “

 

Evaluating Income-Based Eligibility Criteria

Income-based eligibility criteria are frequently used to determine access to a variety of programs, policies and services, in order to target scarce resources to those most in need. Because the financial situation of older adults may differ from that of younger adults in a number of respects, there is a risk that income-based eligibility criteria may inadvertently be framed in a way that older adults who are truly in need are not included.  

Income-based eligibility criteria also are often used in combination with age-based eligibility criteria, in order to focus supports or resources on those older adults who are most in need.

 

QUESTIONS FOR CONSIDERATION

Do the income criteria take into account the situation of those who have withdrawn from the workforce and must make their current resources last until death? 

Do the income criteria take into account the situation of older adults who may be “house-rich” but without other significant resources?

Do the income criteria take into account how the economic status of older women may have been shaped by gender role expectations, caregiving responsibilities, and historical barriers to educational and labour force participation?

 

 

Evaluating Disability-Based Eligibility Criteria 

Disability-based eligibility criteria raise complex issues, and will be more fully dealt with in the LCO’s sister project on the law as it affects persons with disabilities. These questions are not meant to address all of the issues related to disability-based eligibility; rather they focus on the intersection of age and disability. 

In considering how disability-based eligibility criteria may affect older adults, two groups must be kept in mind: those who have aged with disabilities, and those who have developed disabilities in old age. As these two groups will enter older age with very different social and economic resources, their situations may be quite different. 

Disability-based eligibility criteria may operate on their own, or may exist in combination with age-based criteria.

 

QUESTIONS FOR CONSIDERATION

Do the disability-based criteria take into account those disabilities and impairments that disproportionately affect older adults, such as arthritis, dementia, diabetes, loss of hearing and others?

Do the criteria take into account the ways in which the experience of disability or impairment are shaped by the life course, and by the experience of aging?

Do the criteria take into account the ways in which assumptions and attitudes regarding aging may affect the treatment and experiences of older persons with disabilities?

 

 

4.    Assessing the Approach Selected for the Law or Policy

The questions below address the means selected by the law or policy for addressing its key purpose.  The questions relate both to laws that are targeted to or mainly affect older adults and to laws of general application, although the answers may be easier to identify in the former case, than in the latter. 

Given the wide range of laws and policies that may affect all older adults, not all the questions below will be relevant to all laws and policies.  

Adapting the international framework of “respect, protect, fulfil”, at minimum laws and policies should respect the principles – that is, they should not themselves violate the principles. Depending on the purpose of the law or policy, they may aim to go further and ensure that private actors respect the principles, or take positive steps to promote the dignity and worth, independence and autonomy, participation and inclusion, security, and respect for the individuality and diversity of older adults.

 

QUESTIONS FOR CONSIDERATION

Dignity and Worth

Is the law based on respect for the past and ongoing contributions of older adults?

Does the law respect the fundamental dignity and worth of older adults as part of the human family, regardless of disability, health status, gender, income level, place of residence or other factors?

Is the law explicitly or implicitly based on negative attitudes or stereotypes about older adults as burdensome, passive, dependent, backwards-looking or resistant to change, or inevitably frail and declining? Characterizations of older adults as “bedblockers” or “the grey tsunami” are common examples of influential negative assumptions about older adults.  

If appropriate given the nature of the law, does the law include measures to respect the privacy of older adults?

 

Independence and Autonomy 

Is the law based on the premise that older adults are entitled to, and able to make choices about their lives? 

Where older adults are considered to be “at risk”, does the law take into account the older person’s assessment of their level of risk?

Does the law include effective mechanisms to ensure that older adults have adequate information to make meaningful choices?

Does the law provide effective decision-making structures, supports and protections for those whose cognitive, psychiatric or intellectual disabilities affect their legal capacity?

Does the law increase or reduce supports for those older adults who need them to maintain independence due to disability or other issues?

Does the law support or promote technologies or devices that can assist older adults in increasing or maintaining their independence and autonomy?

 

Participation and Inclusion

Does the law reduce the options or restrict opportunities for older adults with respect to their opportunities for education, employment, or political or civic engagement? 

Does the law impose barriers, whether physical, financial, technological, institutional or attitudinal to the participation of older adults or some groups of older adults?

Does the law protect or promote the ability of older adults to participate in social spheres such as education, employment, and democratic institutions?

Does the law protect or promote the ability of older adults to directly communicate their needs and wishes?

Does the law protect or promote the ability of older adults to develop and maintain social bonds?

Does the law protect or promote the ability of older adults to remain part of the larger community? 

Does the law protect, support or promote a sense of belonging for older adults? 

Does the law support older adults in maintaining the familial and other relationships that are important to them?

 

Security

Does the law expose older adults or particular groups of older adults to unnecessary risks?

Does the law expose older adults or particular groups of older adults to victimization or abuse? 

Does the law ensure that older adults are provided with sufficient supports to maintain their independence and autonomy to the greatest extent possible? 

Does the law ensure that formal and informal caregivers whose supports are necessary to maintain the dignity and respect, autonomy and independence, participation and inclusion of older adults are not subjected to undue financial, psychological or safety burdens?

 

Diversity and Individuality

Does the law take into account the impact on older adults of their varying life courses and multiple identities?

Does the law allow for modifications or specific programs to address unique needs of diverse groups of older adults, as the evidence supports?

 

Membership in the Broader Community

Does the law or policy take into account the various roles that older adults play within the broader community, and the impact on the wellbeing of others of initiatives aimed at older adults?

Has inclusive design, whereby the benefits and responsibilities of a law or policy may be shared across generations, been considered as a strategy for the law or policy? 

Taking into account the relations between generations, does the law or policy promote mutual respect and understanding between generations? 

 

Progressive Realization

Have constraints have been identified that prevent the law or policy from fully achieving its intended aims at the current time?

Have specific measures been identified that would make it possible for the law to fully or more fully achieve its intended aims in the future? 

Have plans and commitments been made to achieve full or fuller implementation within a specified time frame? Are those plans specified and detailed, with clearly outlined responsibilities and timelines?

 

  

5.    Addressing Tensions or Conflicts

At times, during a review of the adherence of a  law or policy to the principles, either tensions between two or more of the principles or tensions between the needs of older adults and the needs of other groups may be identified.

 

QUESTIONS FOR CONSIDERATION

If multiple principles are at play in the issue addressed by the law or policy: 

  • Has consideration been given to context of the tension, and whether adjustments to the broader context may resolve the tension without a need to trade off or balance the principles at stake? 
  • Has consideration been given to the relationship between the principles, and how reducing or increasing adherence to the principles in tension may impact on the achievement of other principles or of the principles as a whole? 
  • Has consideration been given to the specific groups of older adults who may be affected by different resolutions of the tensions, and of the types and levels of disadvantage experienced by those older adults? 
  • Has consideration been given to whether solutions exist that may permit at least partial expression of both or all of the principles in tension? 

If other groups are affected by laws or policies affecting older adults, and the needs of the two groups are seen to be in tension:                                                                              

  • Have the sources of the tension been examined to be sure that a tension truly exists?
  • Have alternatives been considered that may meet the needs of both groups, such as inclusive design or providing greater options within the law or policy?

Where the needs of two groups must be balanced, have the needs and circumstances of older adults been considered with equal attention and given equal respect?

 

 

6.    Addressing the Needs of Older Adults Who Are Disadvantaged or at Heightened Risk

As noted above, changes associated with aging, together with the social, legal and institutional environment may create or exacerbate disadvantage or risk of harm for some older adults. 

As part of taking the circumstances of older adults into account, and of moving towards full realization of the principles for all older adults, it is important to identify and address the needs of those older adults who are disadvantage or at risk. Care must be taken to ensure that responses to disadvantage or risk are not based in ageism or in paternalism and do not actually increase negative outcomes for older adults or violate their rights. Therefore, this aspect of law or policy warrants careful scrutiny.

 

QUESTIONS FOR CONSIDERATION

Does the law potentially affect older adults who are disadvantaged or at heightened risk due to their:

  • Living environment? 
  • Low socio-economic status? 
  • Health or activity limitation or disability? 
  • Social isolation? 
  • Compounded disadvantage due to their gender, sexual orientation, racialization, Aboriginal identity, language, immigration or citizenship status, geographic location, or other factors? 

If so, does the law take into account the circumstances of these older adults in the:

  • Level of or access to supports or benefits under the law? 
  • Measures to ensure access to information and education about the law? 
  • Access to supports and advocacy with respect to the law? 
  • Access to complaint and enforcement mechanisms with respect to the law? 

With respect to these older adults, does the law increase or decrease the respect for, protection and fulfilment of the principles?

Does the law potentially increase risk or disadvantage for these older adults by:

  • Increasing stigmatization of them? 
  • Reducing options for them? 
  • Exacerbating the sources of risk or disadvantage? 
  • Restricting or reducing access to redress for violations of their rights? 

Does the law potentially decrease risk or disadvantage for these older adults by:

  • Addressing the sources of risk or disadvantage? 
  • Enhancing access to rights or supports? 
  • Enhancing access to complaints or enforcement mechanisms?

  

E.  How Are Older Adults Affected? Assessing the Implementation of Laws and Policies 

The previous section included questions to assist in evaluating the substance of the law or policy. Equal attention must be paid to both the substance and also to the implementation of the law or policy, as many laws, practices and policies affecting older adults are positive on their face, but problematic in practice. Of particular concern are provisions related to information, training and education, and to access to complaint and enforcement mechanisms. 

For more information see the following sections of the Interim Report:

  • Identifying Ageism and Paternalism in the Law,  see Chapter IV, Section G
  • Enhancing Access to the Law for Older Adults, see Chapter V, Section C

 

1.    General Considerations

Provision of adequate, appropriate human and fiscal resources are recurring issues for the effective implementation of laws, whether they are laws of general application or laws focused on older adults.

 

QUESTIONS FOR CONSIDERATION 

Have sufficient human and financial resources been allocated for effective implementation and enforcement of the law?

Are there mechanisms in place for identifying significant unmet needs for services or supports? 

Where resources are limited, are there clear, transparent  and principled criteria and priorities for how scarce resources should be allocated? 

In programs of general application, where resources are limited, have the needs of older adults been given equal consideration with those of other groups?  

Does the law include safeguards against its abuse?

Does the law clearly identify the individual or organization who is accountable for its fair and effective implementation?

 

  

2.    Communication, Training and Education

Those working in the field of elder law have repeatedly emphasized the importance of developing and implementing strategies for combating ageism and paternalism, both in the populace at large and among those charged with designing laws, policies and practices that affect older adults. Unless these attitudes are addressed, they will inevitably affect the implementation of the law, no matter how well designed.  

As well, those charged with implementing the often complex laws and policies affecting older adults must receive adequate ongoing training and education on the content of those laws and policies.  

Finally, for older adults to be able to access laws and policies, and to meet their responsibilities, they must have meaningful access to information about their rights and responsibilities provided in a way that acknowledges and addresses their circumstances.

 

QUESTIONS FOR CONSIDERATION

Will anti-ageist implementation be supported through the provision of education for those charged with implementation on: 

  • Anti-ageism, including common negative stereotypes and attitudes towards older adults?
  • The experiences and circumstances of older adults, including those of female, LGBT, racialized, Aboriginal, rural, newcomer, immigrant and other disadvantaged older adults? 

Have those charged with implementation and enforcement for been provided with: 

  • Adequate training on the substance of the new law or policy? 
  • Regular ongoing training and education on the law, as staff turns over or new issues emerge? 

Are mechanisms for informing individuals of their rights and responsibilities under the law accessible to all older adults, including through: 

  • Strategies for providing information to older adults living in remote areas? 
  • Specific information distribution mechanisms for older adults living in congregate settings?
  • The provision of accessible materials for persons with disabilities? 
  • Plain language materials or non-written materials for those with low literacy levels? 
  • Culturally appropriate materials for diverse communities? 
  • Strategies to provide information to older adults for whom English is not their first language?

 

Example: Providing Accessible Information for Older Adults and Service Providers – NICE Net 

The National Initiative for the Care of the Elderly (NICE) is an international network of researchers, practitioners and students with a mandate to improve the care of older adults through initiatives related to networking and knowledge transfer. NICE has developed a range of practical tools to help older adults and those working in the field to better understand rights and responsibilities under the law. NICE has developed clear, plain-language resources for Ontario grandparents raising their grandchildren, for service providers concerned about potential elder abuse, for family members facing end of life issues, on consent to treatment, and other issues.  

  

3.    Ensuring Access to and Enforcement of Rights under the Law or Policy  

Concerns regarding access to the law are, of course, not confined to older adults. Many disadvantaged groups find their access to their rights under the law limited in a variety of ways that may also affect older adults. There are also some circumstances that may particularly affect older adults. Barriers to access to the law may include ageism, paternalism and stereotypes; lack of information, training and education for both older adults and service providers; lack of adequate oversight mechanisms; lack of adequate mechanisms for recourse where a right has been violated; difficulties in accessing complaints-based systems; and failure to recognize and accommodate the needs of older adults and the limitations of adversarial dispute resolution systems. 

 

QUESTIONS FOR CONSIDERATION

Have mechanisms been developed to ensure that older adults are informed about their rights and responsibilities under the law, and that they have access to the information necessary to seek access to their rights? 

Do they clearly set out how individuals can seek redress where they believe their rights have been infringed or the law not respected?  

Do the materials clearly set out where individuals can seek further information or supports for the complaints process? 

Is information available in disability-accessible formats?  

Is information available in multiple languages?  

Is information available to persons living in rural or remote settings? 

Is it available in plain-language? 

Is information available in non-written formats?  

Is information available to persons living in congregate settings?  

Does the law include meaningful and effective complaint mechanisms to ensure that older adults who feel that their rights under the law have not been respected have avenues for redress? 

If the complaints and enforcement system is a complex or multi-layered one, have sufficient information and advocacy supports been provided to ensure that older adults are able to navigate the system? 

Does the complaints and enforcement mechanism include supports or advocacy measures to assist older adults who are disadvantaged or at heightened risk due to low-income, impairment or disability, social isolation, living environments or other factors in accessing and navigating the system?

Are support or advocacy mechanisms available for these older adults?

If older adults must attend in person to access or enforce their rights:  

  • Are all offices accessible for persons with disabilities? 
  • Are all offices accessible to persons who do not have access to a vehicle? 
  • Are special provisions made for those who live in remote areas? 
  • Are special provisions made for those who are living in long-term care facilities? 
  • Are access or enforcement mechanisms sufficiently low-cost to be within the means of low-income persons?

If not, are financial supports or exemptions available to low-income older adults?  

Have assessments of the impact of costs taken into account potential impacts on persons who are living on fixed incomes, or whose only significant asset is their home?

 

 

Example: Information for Vulnerable Older Adults

Mandatory Rights Advice

Rights advice is a protection to ensure fairness and access to justice for individuals who are experiencing a significant change in legal status that affects their rights. In Ontario, there are a limited number of situations where rights advice is mandatory, which mainly involve patients in psychiatric institutions. Where rights advice is mandated, a formal rights advisor, who cannot be someone involved in the direct clinical care of the person in question, must provide information about rights to a person whose legal status has changed. If requested, the rights advisor can take steps to assist the person to challenge the change in the individual’s legal status, for example by assisting the individual to apply for Legal Aid. Failure to provide timely rights advice can be a basis for invalidating the change in legal status. 

Are forms for complaint processes available:

  • In plain language and/or non-written formats? 
  • In a manner that will reach persons living in congregate settings? 
  • For persons who cannot access information via the internet? 
  • With supports for those who are unable to complete them without assistance? 
  • In the language of the persons affected? 

Are mechanisms sufficiently timely to ensure that they have the capacity to provide meaningful remedies to older adults, particularly those who are of advanced age and may have relatively short life expectancies? 

Where there are large, complex systems with significant impact on disadvantaged or at-risk older adults, have oversight mechanisms been put in place to ensure compliance with the law, particularly with respect to those particular groups of older adults who have been identified as disadvantaged, and who may not be able to access complaint-based mechanisms?  

Do the complaint and enforcement mechanisms provide options that respect and support older adults who wish to enforce their rights in a way that preserves ongoing valued relationships and social bonds? 

Is the complaints system transparent, so that information about processes and outcomes are easily available to individuals? 

Where violations of the rights of older adults are found to have occurred, does the law provide remedies that:

  • Meaningfully recognize the harm that has been done to the older adult?
  • Where appropriate, can ensure that steps are taken to prevent future violations of the rights of older adults?
     

 

 

Example: Respecting the Relationships of Older Adults

Elder Mediation

Elder mediation is a voluntary, non-adversarial dispute resolution process where one party to the dispute is an older adult. The process is specifically designed in order to facilitate the dynamics of the older adult’s conflicts, and to generate solutions which respect both the parties’ ongoing relationship, and to protect the older adult’s interests. Elder mediators typically have knowledge of ageing and the ageing process, and are so ideally situated to create processes which enhance older adults’ capacity to deal with conflict.

Despite its potential, resolving conflicts through elder mediation can create risks for older adults. Older adults are often dependent upon the other party to the conflict, which will distort the power dynamic between the parties. Elder mediation will therefore require high degrees of skill and awareness on the part of the mediator, and will not be appropriate in all circumstances. 

There are still few specialized elder mediation programs in Canada, and little research exists on the operation of these programs, making this an important area for further exploration. 

 

F.   Monitoring and Evaluating the Effect of the Law

Implementation and enforcement systems affecting older adults, particularly those older adults who are disadvantaged or at heightened risk, would benefit from consistent use of mechanisms to ensure accountability, transparency and effectiveness. Because there is a lack of monitoring and oversight for many systems disproportionately affecting older adults, it is difficult or impossible to determine whether older adults have effective access to those laws or the degree to which older adults are subject to abuses or violations of their rights.  

Monitoring of the law and regular evaluation of its effects provides a strong foundation for effective law reform for the law as it affects older adults. 

  • For more information on Monitoring and Evaluating the Effect of the Law, see Chapter V, section C.7  of the Interim Report

 

QUESTIONS FOR CONSIDERATION 

Does the law include a mechanism to allow those affected, including older adults, to provide feedback on the effectiveness of the law and on any unanticipated negative consequences for older adults?

Does the law require that information about its operation and effectiveness be gathered and made publicly available?

Where the law provides significant discretion to those charged with its implementation, does it include additional reporting and monitoring mechanisms to ensure that this discretion is exercised consistently, fairly, transparently and in a principled manner? 

Are those charged with implementing and oversee the law, program or policy required to regularly report on their activities and the effectiveness with which the law, program or policy is administered?

Does the law require regular review of its goals, to determine whether they are still meaningful and appropriate? 

Does the law require regular review of the effectiveness of the implementation, whether the aims of the law are being achieved, and whether those aims remain appropriate and relevant? 

If the law was developed as a partial response to an issue because of resource or other constraints, are there mechanisms in place to ensure that the issue is regularly reviewed and that  progress is made towards better fulfilment of the law’s aims?  

Are the resources allocated to the law or policy regularly reviewed to ensure that they remain adequate and appropriate for its effective implementation?

 

 
Example: Oversight Mechanisms

Long-Term Care Ombudsman Program

In the United States, each state must, in order to receive funding under the Older Americans Act, establish a Long Term Care Ombudsman which can respond to the needs of long-term care residents. These Ombudsman have several responsibilities, including identifying, investigating and responding to resident complaints, protecting the legal rights of residents, advocating for systemic change, and providing information to residents and their families. Ombudsman programs vary in effectiveness from state to state, and often struggle with underfunding, and lack of authority to assess penalties. However, their combination of advocacy, systemic focus and individual complaint receiving mechanisms makes them a valuable complement to government survey agencies and private advocacy.
 

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