Detection

1
Detection
Of Elder Sexual Abuse

2
Physical Signs of Sexual Abuse

• Bruising on inner thighs
• Vaginal/anal bleeding
• Sexually Transmitted Infections/Diseases
• Difficulty in walking or standing
• Pain/itching in genital areas

3
Rape Trauma Syndrome Immediate Phase
DISORGANIZATION
Emotional Signs of Elder Abuse

• Immediate Impact
• ranges from composure to hysteria depending on
  the victim's coping mechanisms and immediate
  situation

4
Rape Trauma Syndrome Immediate Phase
DISORGANIZATION

• Emotional reactions
• Physical reactions
• Social responses
• Sexual disturbances

5
Rape Trauma Syndrome Long Term Phase
REORGANIZATION

• Psychological reactions
• Physical problems
• Social responses
• Sexual disturbances
• Post Traumatic Stress Disorder

6
Post Traumatic Stress Disorder (PTSD)

• Fear
• Anxiety
• Flashbacks
• Reoccurring memories/nightmares of the event
• Difficulty in concentrating
• Irritation
• Isolation
• Emotional numbness
• Depression

The National Women's Study reported that almost
1/3 of all rape victims develop PTSD sometime
during their lives and 11 of rape victims
currently suffer from the disorder.
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Factors influencing recovery include

• support systems
• relationship with offender
• degree of violence
• type of sexual violence
• perception of the abuse

8
Factors influencing recovery include

• social/cultural influences
• previous experiences with stress
• success in coping with previous crises
• immediate contacts after abuse

9
Prior Sexual Abuse
Elders who were sexually abused as children or in
other settings might experience triggers of the
abuse, such as

• Major life changes like moving to a long-term
  care facility
• Being out of control of a situation
• Television and movie violence
• Seeing someone who looks like assailant
• Sexual advances
• Reading or hearing about other sexual assaults
• Action, smell or sound, that reminds elder of the
  assailant or the place where assaulted

• Conditions such as dementia can make an
  individual more sensitive to triggers and/or
  bring up recessed memories.

10
Challenges to Identifying Elder Sexual Abuse

• High likelihood of elder to hide and deny abuse
• Illness/disease
• Cognitive diseases
• Communication deficits
• Prone to bruising, falling, etc.

An elder sexual assault victim may suddenly act
fearful, withdrawn, depressed, emotional,
unwilling to participate in the routines of a
typical day, have different reactions towards
certain caregivers, other residents or family
members, but these symptoms could also be
representative of other conditions like
depression or dementia. PA nursing home
staff member
11
Medical Treatment Arranging for medical
attention is important both to treat injury and
to collect evidence

• If the assault occurred within 3-4 days, the
  victim should be given a forensic rape exam.
• A victims clothes, bed sheets and any other
  possible evidence (if not washed) should be
  placed in a paper bag and taken to the hospital
  or treatment facility.
• Advise the victim to not shower, wash hands, eat,
  drink, brush teeth, smoke cigarettes or go to the
  bathroom (if necessary, save the toilet paper).
• If the assault occurred after 4-5 days, a victim
  should be examined and treated for injury, and
  evidence should be collected.

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Victims Compensation Program can cover

• Forensic rape exam
• Medical expenses
• Counseling
• Loss of earnings
• Loss of support
• Funeral expenses
• Cash loss of benefits
• Travel expense
• Home care and child care

Remember Crime Victims Compensation is the payor
of last resort
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Working with Elder Victims

• If you dont know the individual, introduce
  yourself and briefly explain your profession
• Speak slowly and audibly in a kind voice
• Be respectful
• Establish a rapport before asking about abuse
• Allow the individual to have
• control over the situation

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Handling a Disclosure

• Do not display alarm or disbelief
• Express concern
• Protect the survivors privacy
• Validate the survivors feelings
• Assess injuries
• Arrange for medical attention

15
ASKING ABOUT SEXUAL ABUSE

• Has anyone made you feel uncomfortable?
• Is there anyone in your life who you are afraid
  of?
• Has anyone made you do
• things you did not want to do?

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• Have you ever been forced to do or participate in
  sexual acts you did not wish to do? Is this
  going on now?
• If Yes, ask for additional information. Ask
  questions such as, Are you safe? Offer to call
  a sexual violence advocate and explain any other
  protective services you can offer.

• If No, state, If someone does hurt you or you
  know someone who is being hurt there are people
  who can help. Feel free to contact me for
  information, if you ever need it.

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Good Key Phrases

• I believe you.
• Im sorry this happened to you.
• It is not your fault.
• Im glad youre alive.
• You did the best you could.
• You have options.