Wisconsin s Annual Elder Abuse and Neglect Report: 2008

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1 Wisconsin s Annual Elder Abuse and Neglect Report: 2008 A statewide summary of reports submitted by Wisconsin counties P (09/2009)

2 Introduction: The Annual Elder Abuse and Neglect Report In Wisconsin, county agencies receive elder abuse, neglect, and financial exploitation referrals and respond to them, determining whether a situation of abuse, neglect, or financial exploitation exists and creating individualized service plans to assist elder adults at risk and help ensure their safety. After responding to a referral, county agencies file an incident report with the Department of Health Services, using the webbased Wisconsin Incident Tracking System (WITS). A compilation of all county reports from 2008 are the basis of this statewide Annual Elder Abuse and Neglect Report.

3 Growing Awareness of Abuse, Neglect, and Financial Exploitation In ,898 cases of suspected abuse, neglect, or financial exploitation involving older adults were reported, an increase of 2.8 percent over Tragically, 26 incidents were related to a death, and a total of 376 incidents were considered life-threatening. About one in 12 incidents involved a life-threatening or fatal situation. The increased number of reports signals better communication between law enforcement, health care professionals and social service agencies, which leads to more people recognizing signs of abuse and neglect and helping to ensure the safety of our older residents. This report documents reported incidents in Wisconsin, providing information about the types of abuse and neglect reported, characteristics of elder adults at risk and alleged abusers, and local responses which guide the State s efforts to prevent elder abuse.

4 Primary Reason for Call/Issue Identified Self-Neglect 2, % Financial Exploitation % Neglect by Other(s) % Emotional Abuse % Physical Abuse % Sexual Abuse % Treatment without Consent 5 0.1% Unreasonable Confinement/Restraint % Information Only* % Total 5, % * Note: Calls for "information only" do not involve allegations of abuse, neglect, or financial exploitation, and are not included in the analytic tables. Wording of this question changed near the end of Table combines responses to the question titled "Primary Reason for Call" with responses to "Primary Issue Identified."

5 Primary Reason for Call/Issue Identified Financial Exploitation 19% Neglect by Other(s) 12% Emotional Abuse 8% Self-Neglect 49% Physical Abuse 6% Sexual Abuse 1% Information Only or Other 5%

6 Previous Report on This Individual? No 3, % Yes 1, % Unknown % Total 4, % Where Incident Occurred Place of residence 4, % Other place % Place of employment/day services % Transportation 8 0.2% Total 4, %

7 Referral Source Aging and Disability Resource Center (ADRC) % Social/Human Services Agency % Alleged abuser % Anonymous % Employer 4 0.1% Friend/neighbor % Housing inspection/zoning % Law enforcement % Medical professional % Mental health service provider % Other provider % Other referral source % Regulatory authority (DHS/DQA) % Relative 1, % Residential support provider % Substance abuse service provider 4 0.1% Victim % Vocational/day service provider 5 0.1% Total 4, %

8 Referral Source Relative Medical professional 18.8% 21.0% Social/Human Services Agency Other referral source Friend/neighbor Other service provider Law enforcement Anonymous Victim 11.4% 10.8% 8.8% 7.1% 7.0% 5.1% 4.8% ADRC Residential support provider Mental health service provider 2.0% 1.1% 2.3%

9 Call Received By Aging and Disability Resource Center (ADRC) 1, % Aging Unit % Department of Community Programs-51.42/437 Board % Human Services Department 1, % Law Enforcement % Other Agency % Social Services Department % Total 4, % Initial Investigating Agency Aging and Disability Resource Center (ADRC) 1, % Aging Unit % Department of Community Programs-51.42/437 Board % Housing Inspection/Zoning 3 0.1% Human Services Department 1, % Law Enforcement % Other Agency % Public Health Department 3 0.1% Social Services Department % Total 4, %

10 Call Received By ADRC 40.1% Human Services Department 31.2% Social Services Department 12.5% Aging Unit 12.5% Other Agency 2.4% Law Enforcement 1.3%

11 Initial Investigating Agency Human Services Department 39.3% ADRC 25.6% Aging Unit 17.3% Social Services Department 13.3% Other Agency 2.9% Law Enforcement 1.5%

12 Was Incident Life Threatening? No 4, % Yes % Unknown % Total 4, % Has Elder Adult at Risk Died? No % Yes % Unknown 0 0.0% Total % Note: s represent share of all life-threatening incidents Was Death Related to the Incident? No % Yes % Unknown % Total % Note: s represent share of all incidents involving a death. Was Death Directly Caused by Incident? No % Yes % Unknown % Total % Note: s represent share of all incidents involving a death.

13 Elder Adult at Risk's Age years 1, % years 1, % years 1, % 90 years or more % Total 4, % Elder Adult at Risk's Gender Female 3, % Male 1, % Unknown 1 0.0% Total 4, % Elder Adult at Risk's Race Age White 3, % Black/African American % Native American/Alaska Native % Asian % Hawaiian/Pacific Islander 2 0.0% Other race % Not reported or unknown % Total 4, % Notes: Race and Ethnicity are optional fields, so some reports are missing this information. Although data may be incomplete, percents represent the share of all complete reports that showed each race/ethnicity category.

14 Elder Adult at Risk's Age years 22% years 29% 90 years or more 11% years 38%

15 Elder Adult at Risk's Living Arrangement Own home/apartment alone 2, % Own home/apartment with others 1, % Relative's home % Friend's home % Adult family home % Adult family home (licensed) % Nursing home % Community Based Residential Facility (CBRF) % Residential Care Apartment Complex (RCAC) % Homeless % Other setting % Institution 7 0.1% Total 4, %

16 Elder Adult at Risk's Living Arrangement Own home/apartment alone 47% Friend's home 1% CBRF 2% Other setting 3% Relative's home 5% Nursing home 6% Own home/apartment with others 36%

17 County/State Funded Programs That Have Served This Elder Adult at Risk Community Support Program % Comprehensive Community Services % Family Care % Home and Community Based Waiver % Medicaid (Title 19, Card Services) % Unknown % Other % None 2, % Note: Elder adult at risk may be served by more than one program, so sum does not equal 100%.

18 Public programs that have served this Elder Adult at Risk None 58.8% Medicaid (Title 19, Card Services) Unknown Other Family Care Home and Community Based Waiver Community Support Program Comprehensive Community Services 15.6% 14.0% 10.4% 4.0% 3.4% 0.9% 0.4%

19 Does Elder Adult at Risk Have a Substitute Decision- Maker? No 2, % Yes 1, % Unknown % Total 4, % Type(s) of Substitute Decision-Maker Conservatorship 6 0.4% Guardian of the Person % Guardian of the Estate % Representative Payee % Power of Attorney (POA) for Finances (Activated) % Power of Attorney (POA) for Finances (Not activated) % Power of Attorney (POA) for Health Care (Activated) % Power of Attorney (POA) for Health Care (Not activated) % s represent share of all those with any kind of substitute decisionmaker. Multiple responses are allowed, so percents do not total 100%.

20 Type of Substitute Decison-Maker POA-Finances (Activated) POA-Health Care (Not activated) POA-Health Care (Activated) 41.9% 41.9% 37.4% POA-Finances (Not activated) 19.5% Guardian of the Estate Guardian of the Person 8.0% 10.0% Representative Payee 3.3% Conservatorship 0.4%

21 Elder Adult at Risk's Characteristics Alcohol or drug abuse % Blind/visually impaired % Challenging/dangerous behavior % Deaf/hard of hearing % Dementia 1, % Developmental disability % Diabetes % Disoriented and confused % Frail Elderly 2, % Homebound % Incontinent % Medically fragile % Mental Illness (MI)/Chronic MI % Mobility impaired % Physical Disability % Stroke-related condition % Other medical condition % Other characteristic % None of listed characteristics % s refer to share of all adults at risk having this characteristic. Multiple responses are allowed, so percents do not total 100%.

22 Age of Alleged Abuser(s) Under 25 years % 25 to 44 years % 45 to 59 years % 60 to 79 years % 80 years or older % Unknown % Total 2, % Total includes all alleged abusers; some incidents involve more than one. Alleged Abusers' Gender Male 1, % Female 1, % Unknown % Total 2, %

23 Alleged Abusers' Relationships to Elder Adult at Risk Son % Daughter % Spouse % Other or unknown % Friend/Neighbor % Other Relative % Grandchild % Service provider % Total 2, % Are Alleged Abusers Caregivers? Yes 1, % No 1, % Unknown % Total 2, %

24 Alleged Abusers' Relationships to Elder Adult at Risk Son, 22.7% Service provider, 4.6% Grandchild, 5.1% Daughter, 21.9% Other Relative, 8.2% Friend/Neighbor, 10.9% Spouse, 14.6% Other or unknown, 12.0%

25 Do Alleged Abusers Live with Elder Adult at Risk? Yes 1, % No 1, % Unknown % Total 2, % Do Alleged Abusers Have Any Legal or Substitute Decision-Maker Status? Any legal/substitute decision-maker status listed % No status listed 1, % Total 2, %

26 Abusers' Legal Status Conservator 0 0.0% Guardian of the Person % Guardian of the Estate % Temporary Guardian 1 0.0% Representative Payee % Power of Attorney (POA) for Finances (Activated) % Power of Attorney (POA) for Finances (Not activated) % Power of Attorney (POA) for Health Care (Activated) % Power of Attorney (POA) for Health Care (Not activated) % Other legal status % Unknown legal status % No legal status 1, % s represent share of all abusers who have this legal status. Multiple responses are allowed, so percents do not total 100%.

27 Alleged Abusers' Characteristics Alcohol or drug abuse % Challenging/dangerous behavior % Communication disorder 5 0.2% Dementia % Developmental disability % Disoriented and confused % Financial dependence: abuser on elder AAR % Frail Elderly % Limited English proficiency % Medically fragile % Mental Illness(MI)/Chronic MI % Mobility impaired % Physical disability % Unemployed % Other medical condition % Other characteristic % None of the listed characteristics 1, % Multiple responses allowed - numbers do not add up to 100%. s refer to share of all alleged abusers.

28 More than One Alleged Abuser? Yes % No, one alleged abuser only 2, % Total 2, % Was Hurt or Harm Substantiated? Substantiated 2, % Unsubstantiated 1, % Unable to Substantiate % Total 4, %

29 Actions Taken to Assist Elder Adult at Risk Guardian referral % Investigation not accepted % Mental health commitment % Outreach continues % Protective services placement % Referral made to other agency % Referral made to state agency % Referral to Caregiver Misconduct Registry (DHS/DQA) % Referral to law enforcement/department of Justice % Referral to detoxification services % Referral to protection/advocacy agencies % Referral to regulatory authority (DHS/DQA) % Services needed are not available % Services not needed % Services offered but not accepted % Services offered-all accepted % Services offered-some accepted 1, % Response/investigation continues % Other legal action % Other disposition % s refer to share of all reports showing this action. Multiple responses are allowed so numbers do not add up to 100%.

30 Services Planned for Elder Adult at Risk Advocacy/legal services % Community based aids/services 1, % Day care services/treatment % Domestic violence/sexual assault services % Emergency response services % Facility based care % Medical services % Service coordination 1, % Substitute decision-making % Transportation % Other services planned % s refer to share of all reports showing this service planned. Multiple responses are allowed so numbers do not add up to 100%.

31 Services Planned for Elder Adult at Risk Service coordination Community based aids/services 24.5% 32.8% Facility based care Advocacy/legal services Substitute decision-making 11.8% 16.1% 16.1% Day care services/treatment Medical services Other services planned Emergency response services Transportation Domestic violence/sexual assault services 7.7% 7.3% 5.9% 5.1% 4.4% 2.7%

32 Services Planned for Alleged Abuser(s) Advocacy/legal services % Community based aids/services % Day care services/treatment % Domestic violence/sexual assault services 3 0.1% Emergency response services % Facility based care % Medical services % Service coordination % Substitute decision-making % Transportation 5 0.2% Other services planned % None 1, % Multiple responses were allowed so numbers do not add up to 100%. s refer to share of all incidents in which abuse, neglect or financial exploitation was alleged (n=2,328).

33 Services Planned for Alleged Abuser(s) None 77.7% Service coordination Advocacy/legal services Other services planned Day care services/treatment Community based aids/services Facility based care Substitute decision-making Medical services 9.7% 9.0% 3.7% 3.4% 3.1% 2.1% 1.0% 0.6%

34 Contact Information Jane A. Raymond, Advocacy and Protection Systems Developer Wisconsin Department of Health Services Division of Long Term Care Bureau of Aging and Disability Resources P.O. Box 7851, Madison WI Voic FAX:

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