Elder Abuse: Hidden Crimes, Hidden Victims

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Elder Abuse Hidden Crimes, Hidden Victims

• Presented by Ursel McElroy, M.A.
• ursel.mcelroy_at_ohioattorneygeneral.gov
• 614-995-5413

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Why Learn About Elder Abuse?

• As an advocate you
• Could be the victims first or only chance for
  help
  
• May be the only other person in the victims
  life
  
• Will be better prepared to help older victims
• Are required by Ohio Law to report elder abuse
• Knowing the warning signsmay save a life

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Objective

• Enhance the ability of victim service providers
  and
  
• allied professionals to identify and effectively
  
  
• respond to elder abuse victims.

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Agenda

• Examine the nature and scope of elder abuse
• Define elder abuse
• Identify signs of elder abuse
• Discuss challenges to serving elder abuse victims

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What Do We Know?

• Population is aging
• Reported cases of abuse are increasing annually
• Physical and financial recovery more difficult
• Elder abuse victims die earlier than other older
  adults

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What is Elder Abuse?

• Elder Abuse
• Any knowing, intentional, or negligent act
• By a caregiver or other in a position of trust
• That causes harm or a serious risk of harm to a
  vulnerable older person
  

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What is Elder Abuse? (cont.)

• Abuse
• Emotional, Physical, Psychological, Sexual
• Neglect
• Abandonment, Caregiver, Self
• Exploitation
• Financial
• Any of the above may co-occur with each other

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Who Are the Victims?

• Persons 60 years of age and older
• All racial, ethnic, socio-economic, and religious
  backgrounds
  
• Men and women
• Women more likely to be reported

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Who are the Abusers?

• Spouses or intimate partners
• Adult children
• Relatives
• Caregivers
• Friends
• Others in positions of authority

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Abuse Indicators

• Adult expresses fear or reports abuse
• Injuries inconsistent with explanation
• Injuries not in areas normally associated with
  accidents
  
• Restrained, tied or locked in

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Abuse Indicators (cont.)

• Bruises, welts, lacerations, rope marks
• Broken bones, sprains
• Difficulty walking or sitting
• Unexplained venereal diseases or infections

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Abuse Indicators (cont.)

• Unexplained vaginal or anal bleeding
• Withdrawn and non responsive
• Emotionally upset or agitated
• Not an exhaustive list

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Self Neglect Indicators

• Lack of self-care
• Lack of care to home environment
• Isolation
• Hoarding possessions or animals
• Financial mismanagement

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Neglect by Caregiver Indicators

• Adult reports the neglect
• Wandering
• Dehydration and/or malnutrition

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Neglect by Caregiver (cont.)

• Untreated medical conditions or bedsores
• Poor personal hygiene
• Desertion of an older adult
• Not an exhaustive list

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Exploitation Indicators

• Sudden changes in account or banking practices
• Inclusion of additional names on an account
• Abrupt changes in a will or other financial
  papers
  
• Checks signed by another without legal authority

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Exploitation Indicators (cont.)

• Expensive purchases unwanted or needed
• Utilities, rent or mortgage unpaid
• Prescriptions not paid for
• Disparities between assets and lifestyle
• Not an exhaustive list

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Challenges

• Some of the most complex cases to address
• Ethical and legal considerations
• Physical capacity considerations
• Mental capacity considerations
• Degree of cooperation from the victim
• Service delivery system

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Interacting with Older Victims

• An interview may be impacted by accuracy and
  credibility of victims account
  
• Victim may be discounted
• Statements are not consistent
• Victim appears confused
• They have a medical condition like dementia or
  other cognitive limitation
  

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Interacting with Older Victims

• An interview may be impacted by communication
  issues
  
• Difficulty seeing or reading written materials
• Difficulty hearing spoken communication
• Difficulty being understood when speaking

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Interacting with Older Victims

• An interview may be impacted by mobility issues
• Difficult or impossible to participate in
  interviews at police station or prosecutors
  office
  
• Difficult or impossible to attend court
  proceedings
  

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Interacting with Older Victims

• An interview may be impacted by victim stamina
• Victim may lack the strength or endurance to
  testify in court proceedings or participate in
  interviews

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Cognitive Function and Limitations

• Confusion
• Dementia
• Alzheimers Disease
• Depression
• Side effects of medication
• Medical conditions

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Interviewing Strategies

• Cognitive Limitations
• Determine the best time of day to interview
• Establish the victims daily routine without
  asking about the crime
  
• Construct each subsequent question building on
  what the victim has already told you
  
• Use the victims exact words and phrases

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Interviewing Strategies

• Cognitive Limitations
• Ask the victim if he/she can draw or show the
  object or what happened
  
• Ask process of elimination questions
• Ask more specific questions rather than broad
  questions

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Interviewing Strategies

• Cognitive Limitations
• Listen patiently and redirect as needed if the
  older victim digresses
  
• Use memory cues such as What were you doing
  before this happened?
  
• Do not discount the alleged abuse because the
  victim has made statements that seem untrue or
  the result of delusions

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Interviewing Strategies

• Communication Issues
• Ask victim how he/she prefers to communicate
• Read written materials to the individual
• Use an interpreter as needed
• Use visual aids, charts, or diagrams
• Ask short questions

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Interviewing Strategies

• Mobility Issues
• Conduct interviews in best location for victim
• Consider future needs for transportation and
  accessibility at police station and court
  
• Assist with arranging for assistive devices

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Interviewing Strategies

• Stamina
• Arrange interviews and testimony for the best
  time of the day for the victim
  
• Assist with arranging for assistive devices
• Collaborate with health care providers

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Other Sources of Information

• 911 tape
• Emergency medic or emergency room reports
• Police reports
• Health care records
• Trustworthy family, friends
• Aging network providers

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What Can Victim Advocates Do?

• Educate yourself and others on elder abuse
• Provide outreach to homebound elders
• Create a safe place for older adults to seek
  help
  
• Form relationships with aging network
  professionals
  
• Develop policies that are sensitive to older
  victims

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Ohios Reporting Structure

• It is important that you always report
• Contact the proper authority
• Adult Protective Services (community)
• Long-Term Care Ombudsman (facility)
• Ohio Department of Health (facility)
• Law Enforcement (community and facility)

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References

• National Center on Elder Abuse
• National Clearinghouse on Abuse in Later Life
• National Committee for the Prevention of Elder
  Abuse
  
• Office on Violence Against Women
• Office for Victims of Crime
• Ohio Elder Abuse Task Force