ELDER AND DEPENDENT ADULT ABUSE

1
ELDER AND DEPENDENT ADULT ABUSE

• CHALLENGES
• AWARENESS
• IDENTIFICATION
• REPORTING

2
CHALLENGES

• PROVIDER EDUCATION
• MISPERCEPTIONS Elder will not want help, or will
  not take action against abuser, dependency
  creates submission
• CONCERNS ABOUT CONFIDENTIALITY

3
CHALLENGES

• ELDER RESPONSES
• Shame
• Fear of being weak/dependent
• Desire to protect abuser
• A belief they cannot leave an abusive situation
  because of money, family pressure or culture
• May not perceive the abuse as such
• Lack of trust in the system, no outside law
  enforcement
• Beliefs that discourage confrontation,
  intervention or accepting help from outsiders

4
AWARENESS

• Aging population will increase
• For every reported case of abuse it is estimated
  that there are 5 more that are not reported
• Locally, Placer and El Dorado counties have
  reported a 16 18 increase in open cases of
  abuse and neglect.
• Across all socio-economic and cultural lines
• Application of law in State Penal Codes
• Mandated reporting and failure to report

5
IDENTIFICATION

• MAJOR TYPES OF ELDER ABUSE
• PHYSICAL (15)
• SEXUAL (1)
• EMOTIONAL/PSYCHOLOGICAL (8)
• NEGLECT (55)
• ABANDONMENT (see neglect)
• FINANCIAL/MATERIAL (12)
• SELF-NEGLECT (9)

6
IDENTIFICATION

• PHYSICAL Use of physical force that may result
  in bodily injury, pain, or impairment.
• Bruises, black eyes, welts, lacerations, rope
  marks
• Bone fractures, skull fractures
• Open wounds, cuts, punctures, untreated injuries
• Sprains, dislocations, internal bleeds
• Broken eye glasses, signs of punishment and
  restraint
• Lab findings of over or under utilization of
  prescribed medications
• Self report or sudden changes in presentation
• Caregivers refusal to let client be seen alone

7
IDENTIFICATION

• SEXUAL ABUSE Non-consensual sexual contact of
  any kind.
• Bruises around breasts or genital areas
• Unexplained STD or genital infection
• Unexplained vaginal or rectal bleeding
• Torn, stained, or bloody undergarments
• Self report

8
IDENTIFICATION

• EMOTIONAL/PSYCHOLOGICAL ABUSE Infliction of
  anguish, pain or distress through verbal or
  nonverbal acts
• Agitation, anxiety and fear
• Non communicative and withdrawn
• Regressive behaviors usually attributed to
  cognitive withdrawal sucking, biting, rocking
• Self report of mistreatment

9
IDENTIFICATION

• NEGLECT Refusal or failure to fulfill any part
  of a persons obligations or duties to an elder
• Dehydration, malnutrition, untreated bed sores,
  poor personal hygiene
• Unattended or untreated health problems
• Hazardous or unsafe conditions
• Unsanitary and unclean living conditions
• Elders self report

10
IDENTIFICATION

• ABANDONMENT Desertion by one who has assumed
  care responsibility or has physical custody.
• Desertion at a hospital, ER, or nursing facility
• Desertion at any public venue
• Self report by elder

11
IDENTIFICATION

• FINANCIAL (FIDUCARY) OR MATERIAL EXPLOITATION
  Illegal or improper use of elders funds,
  property or assets.
• Sudden changes in bank activity and practice
• Inclusion of additional names to accounts
• Unauthorized withdrawals from accounts ATM
• Abrupt Will or Trust changes
• Substandard care despite funds availability or
  provision of services that are unnecessary
• Unexplained balance transfers
• Elders self report

12
IDENTIFICATION

• SELF-NEGLECT Self threatening behaviors to
  health and safety. Diogenes Syndrome. Excludes
  one who is mentally competent.
• Evidence of serious mental illness
• Poor personal hygiene, dehydration, malnutrition,
  untreated medical conditions
• Hazardous, unsanitary or unsafe living conditions
• Hording behaviors
• Inappropriate or inadequate clothing
• Lack of necessary medical aides (glasses,
  dentures)

13
IDENTIFICATION

• CHARACTERISTICS OF ABUSERS
• 40 Adult children, 15 Spouse, 9 grandchildren,
  36 other (relatives, siblings, parents, friends
  and service providers)
• Domestic violence grown old
• Abusers often dependent on elder for finances,
  housing, and material support
• Mental illness and substance abuse
• Isolation of abuser and elder
• Caregiver stress - burden
• Elder characteristics dementia, disruptive
  behaviors, significant needs
• Intergenerational standards for violence in the
  family

14
IDENTIFICATION

• IDENTIFYING CAREGIVER BURDEN
• Rest and self care (health)
• Degrees of surveillance required
• Drug and alcohol intake
• Increase in negative feelings
• Elder abusive to you
• Financial-legal assistance needed

15
IDENTIFICATION

• BURDEN (CONTINUED)
• Feeling overwhelmed
• Old family problems resurfacing
• Does anyone resent the time your spending as a
  caregiver?
• Confused, fearful or angry
• Does family divide responsibilities

16
REPORTING

• ADULT PROTECTIVE SERVICES 530-886-5401 (Placer),
  530-621-6300 (El Dorado)
• LAW ENFORCEMENT (Cross Report)
• MANDATED REPORTER
• NON-MANDATED REPORTER
• STATE OMBUDSMAN (Facility Abuse)
• SOC Form 341 (Within 2 working days)
• CONSULTATION WITH BEHAVIORAL HEALTH

17
RESPECT FOR ELDERS

• MAY YOU LIVE AS LONG AS I HAVE AND WHEN YOU GROW
  OLD MAY THE YOUNG ONES TREAT YOU WITH HONOR AND
  RESPECT
• EVERYONE AND EVERYTHING IS CONNECTED

18
RESPECT FOR ELDERS

• ELDERS ARE THE ONES WHO HAVE LIVED THROUGH MANY
  CHANGES AND NOW SEE THINGS THROUGH WISER EYES
• WHEN WE TREAT ELDERS WITH HONOR AND RESPECT, WE
  TEACH THE YOUNG HOW TO TREAT US WHEN WE REACH
  THAT LIFE STAGE

19
(No Transcript)