Wisconsin s Annual Elder Abuse and Neglect Report: 2006

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1 Wisconsin s Annual Elder Abuse and Neglect Report: 2006 A statewide summary of reports submitted by Wisconsin counties P (08/2007)

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 persons and help ensure their safety. After responding to an incident, county agencies file an incident report with the Department of Health and Family Services, using the web-based Wisconsin Incident Tracking System (WITS). A compilation of all county incident reports from 2006 are the basis of this statewide Annual Elder Abuse and Neglect Report.

3 New Reporting System In September, 2006, DHFS rolled out the Wisconsin Incident Tracking System (WITS), a web-based application county agencies use in reporting their responses to incidents of elder abuse, neglect, and financial exploitation. In addition to collecting all the information previously submitted to DHFS on paper forms, WITS collects new information on clients substitute decision makers, home and community-based waiver participation, and other topics. Because the software was provided late in the reporting year, county workers began the year collecting information on paper forms and later transcribed them into WITS. For incidents that took place before WITS was available, workers may not have had information about substitute decision makers, waiver participation, etc. Thus, the 2006 report is missing some information on these topics, and you will note frequent use of unknown as an answer to some of the new questions. Reports will be more complete in future years as WITS becomes the standard for data collection.

4 More Changes Ahead Effective December 1, 2006, the laws regarding reporting of abuse, neglect, and financial exploitation changed to create consistent reporting requirements for adults of all ages. The provisions to ensure the safety of older adults now extend to adults at risk of all ages. For more information about the new laws and their implications for response and reporting, use the link to the August, 2006 issue of Wisconsin Lawyer on the DHFS Adult at Risk webpage: Beginning in Fall, 2007, county adult-at-risk agencies will be able to use WITS to report on incidents of all abuse, neglect, and financial exploitation involving adults age 18 and over, not only those age 60+. DHFS will continue to provide separate annual reports on incidents of elder abuse, neglect, and financial exploitation, and on incidents involving younger adults at risk.

5 Growing Awareness of Elder Abuse A total of 4,372 cases of suspected abuse, neglect, and financial exploitation were reported in 2006, an increase of 3.3 percent from Tragically, 24 were fatal and another 260 were considered lifethreatening. About one in 11 incidents (6.5%) involved a lifethreatening or fatal situation. The increased number of reported incidents signals better communication between law enforcement, health care professionals and social services agencies, which leads to more people recognizing signs of abuse and helping to ensure the safety of our older residents. This report documents reported elder abuse incidents in Wisconsin, and provides information about the types of incidents reported, characteristics of the victims and abusers, and local responses which guide the State's efforts to prevent abuse, neglect, and financial exploitation.

6 Primary Reason for Call Type of abuse Number Percent of Incidents Self-Neglect % Financial Exploitation % Neglect by Others % Physical Abuse % Sexual Abuse % Emotional Abuse % Treatment without consent 1 0.0% Unreasonable confinement/restraint 9 0.2% Calls requesting information only* % Total % * NOTE: Calls for "information only" do not involve allegations of abuse, neglect, or financial exploitation, and are not included in the analytic tables. NOTE: This table includes several response options that are new to county workers and were not available on the data collection forms used for most of Thus, workers had not collected information about sexual abuse, treatment without consent, or unreasonable confinement or restraint for In future years, more complete information will be available about incidents involving these types of abuse.

7 Primary Reason for Call Financial Exploitation, 20.7% Self-Neglect, 53.4% Neglect by Others, 11.6% Physical Abuse, 5.7% Information Only*, 1.3% Treatment without consent, 0.0% Sexual Abuse, 0.6% Emotional Abuse, 6.5% Unreasonable confinement/restraint, 0.2%

8 Previous report on this individual? Number Percent Yes % No % Unknown* % Total % * In addition, 35 reports were missing this information. Location of Incident Number Percent At or near place of residence % Other place % Total % Life-Threatening and Fatal Incidents Number Percent Life-Threatening Incidents % Fatal Incidents % Fatalities as percent of life-threatening incidents 8.5%

9 Referral Source Source Number Percent ADRC/Aging Unit % Agency % Alleged abuser 6 0.1% Anonymous % Friend/neighbor % Law enforcement % Medical professional % Relative % Victim % Other source % Total %

10 Referral Source Relative 21.0% Agency Medical professional 18.3% 18.1% Other source 12.0% Law enforcement Friend/neighbor 8.8% 8.7% Anonymous Victim 6.2% 5.9% ADRC/Aging Unit Alleged abuser 0.9% 0.1%

11 Call Received By Number Percent ADRC % Aging Unit % Dept. of Community Programs (51.42/437) 4 0.1% Dept. of Human Services % Law enforcement % Publicized helpline number % Social Services Dept % Other % Total %

12 Call Received By... Dept. of Human Services 38.6% Publicized helpline number 18.7% ADRC 14.3% Aging Unit 14.2% Social Services Dept. 11.6% Other 1.3% Law enforcement Dept. of Community Programs 1.2% 0.1%

13 Initial Response and/or Investigating Agency Item Number Percent ADRC % Aging Unit % Animal Control/Humane Society 2 0.0% BOALTC/Ombudsman 2 0.0% Dept. of Community Programs (51.42/437) 3 0.1% Dept. of Human Services % Dept. of Justice 1 0.0% Dept. of Public Health 7 0.2% Dept. of Social Services % DQA/Licensing and Regulation 3 0.1% Housing inspection/zoning 4 0.1% Law enforcement % Other % Total %

14 Initial Response and/or Investigating Agency Dept. of Human Services, 42.1% Other, 1.1% Law enforcement, 1.8% ADRC, 5.6% Dept. of Social Services, 12.7% Aging Unit, 36.8%

15 Age of Elder Person Age Number Percent Under 60 years % years % years % years % 90+ years % Total % Note: The small number of individuals under 60 years of age are all in their 50s and have health or disabling conditions considered "infirmities of aging."

16 Elder Person's Age years, 18.2% years, 32.0% Under 60 years, 0.3% 90+ years, 10.3% years, 39.2%

17 Elder Person's Gender Number Percent Male % Female % Total % Elder Person's Race Age Number Percent White % Black/African American % Native American/Alaska Native % Asian % Hawaiian/Pacific Islander 1 0.0% Other race % Not reported or unknown % Total %

18 Elder Person's Living Arrangement Number Percent Adult family home % Adult family home/licensed 7 0.2% CBRF % Friend's home % Homeless % Nursing home % Own home/apt alone % Own home/apt with others % RCAC % Relative's home % Other % Total %

19 Elder Person's Living Arrangement Own home/apt alone, 49.9% Other, 2.2% Assisted Living, 3.9% Nursing home, 4.6% Relative's home, 5.5% Own home/apt with others, 34.1%

20 Waiver Participant? Number Percent Yes % No % Unknown % Total % Note: Prior to the release of WITS in September, 2006 workers did not collect information about the elder person's waiver participation. Thus, for many 2006 incident reports this status is "unknown." Is there a substitute decision maker? Number Percent Yes % No % Unknown % Total % Note: Prior to the release of WITS in September, 2006 workers did not collect substitute decision-maker information in this way. Thus, for many 2006 incident reports this information is "unknown."

21 Type of Substitute Decision Maker Number Percent Guardian of the Person % Guardian of the Estate % Representative Payee % Power of Attorney-Finances-Activated % Power of Attorney-Finances-Not Active % Power of Attorney-Health Care-Activated % Power of Attorney-Health Care-Not Active % Conservator 2 0.0% Note: Multiple responses were allowed. Percents represent share of all incidents showing this type of substitute decision-maker.

22 Type of Substitute Decision-Maker Power of Attorney- Finances-Activated Power of Attorney-Health Care-Activated 4.6% 5.6% Power of Attorney-Health Care-Not Active 2.8% Guardian of the Person 1.9% Guardian of the Estate Power of Attorney- Finances-Not Active 1.6% 1.5% Representative Payee 0.4% Conservator 0.0%

23 Elder Person's Characteristics Number Percent Frail Elderly % Dementia % Disoriented and confused % Developmental Disability % Physical Disability % Medical Condition (other) % Mental Illness (mentally ill) % Chronic mental illness % Diabetes % Morbidly Obese % Homebound % Incontinent % Alcohol abuse % Chronic alcoholic % Drug abuse % Blind/visually impaired % Deaf/hard of hearing % Stroke-related condition % Functionally illiterate % None of the listed characteristics % Note: Multiple responses were allowed so numbers do not add up to 100%

24 Elder Person's Characteristics Frail Elderly Dementia 22.5% 66.7% Disoriented and confused Other medical condition Physical Disability Homebound Sensory disability Any mental illness Incontinent Any AODA issue Diabetes Stroke-related condition 15.6% 15.5% 14.0% 10.1% 10.0% 9.7% 7.7% 6.9% 4.7% 3.6%

25 Age of Alleged Abuser(s) Age Number Percent Unknown 126 n/a Under 25 years % 25 to 44 years % 45 to 59 years % 60 to 79 years % 80 years or older % Note: Abusers with unknown ages are excluded from these percents. Total 2, %

26 Alleged Abusers' Gender Number Percent Male % Female % Unknown % Total %

27 Alleged Abusers' Relationships to Elder Person Number Percent Spouse % Son % Daughter % Sibling % Grandchild % Other Relative % Friend/Neighbor % Home agency or facility staff % Other service provider % Other % Unknown % Total %

28 Alleged Abuser's Relationship Son, 22.3% Service provider, 5.1% Grandchild, 6.6% Other Relative, 9.0% Daughter, 20.8% Friend/Neighbor 10.3% Spouse, 14.2% Other or unknown, 11.6%

29 Are Alleged Abusers Caregivers? Number Percent Yes % No % Unknown % Total % Do Alleged Abusers Live with Elder Person? Number Percent Yes % No % Unknown % Total % Do Alleged Abusers Have Any Legal or Substitute Decision Maker Status? Number Percent Any legal/subs dec maker status listed % No status listed % Total %

30 Alleged Abusers' Characteristics Number Percent Frail Elderly % Dementia % Disoriented and confused % Developmental Disability % Physical Disability % Medical Condition (other) % Mental Illness (mentally ill) % Chronic mental illness % Diabetes % Morbidly Obese % Homebound % Incontinent 4 0.2% Alcohol abuse % Chronic alcoholic % Drug abuse % Blind/visually impaired 4 0.2% Deaf/hard of hearing % Stroke-related condition 3 0.1% Functionally illiterate 4 0.2% Financially dependent on elder % Unemployed % None of the listed characteristics % Note: Multiple responses were allowed so numbers do not add up to 100%. Percents refer to share of all alleged abusers.

31 More than One Alleged Abuser? Number Percent Yes % No % Total %

32 Was Hurt or Harm Substantiated? Number Percent Substantiated % Unsubstantiated % Unable to substantiate % Missing answer 3 0.1% Total %

33 Was Hurt or Harm Substantiated? Unable to substantiate, 12.3% Unsubstantiated, 34.1% Substantiated, 53.5%

34 Actions Taken Action Number Percent Guardian referral % Investigation not accepted % Mental health commitment % Outreach continues % Protective services placement % Referral made to other agency % Referral made to state agency % Services needed are not available % Services not needed % Services offered but not accepted % Services offered-all accepted % Services offered-some accepted % Other legal action % Other disposition % Note: Multiple responses were allowed so numbers do not add up to 100%

35 Actions Taken Services offered-all accepted Services not needed Referral made to other agency Outreach continues 14.2% 13.5% 13.2% 11.5% Other disposition Guardian referral Investigation not accepted Protective services placement 7.2% 6.3% 5.6% 5.5% Other legal action 3.2% Mental health commitment Services needed are not available Referral made to state agency 0.7% 0.7% 1.5%

36 Services Planned for Elder Person Service Number Percent Advocacy/Legal services % Community Based aids,svcs % Day care svcs, treatment % Domestic violence/assault victim services % Emergency response services % Facility based care % Medical services % Service coordination % Substitute decision making % Transportation % Other services planned % Note: Multiple responses were allowed so numbers do not add up to 100%

37 Services Planned for Elder Person Service coordination 40.0% Community Based aids,svcs 28.2% Advocacy/Legal services Facility based care 17.9% 15.9% Day care svcs, treatment Medical services Other services planned Substitute decision making Transportation Emergency response services 11.4% 8.4% 7.9% 6.7% 5.2% 3.5%

38 Services Planned for Alleged Abuser(s) Service Number Percent Advocacy/Legal services % Community Based aids,svcs % Day care svcs, treatment % Domestic violence/assault victim services 1 0.0% Emergency response services 5 0.2% Facility based care % Medical services % No services planned % Service coordination % Substitute decision making % Transportation 8 0.4% Other services planned % Note: Multiple responses were allowed so numbers do not add up to 100%. Percents refer to share of all incidents in which abuse was alleged.

39 Services Planned for Abuser(s) No services planned 67.7% Service coordination Advocacy/Legal services Community Based aids,svcs Day care svcs, treatment Other services planned Facility based care Medical services Substitute decision making Transportation Emergency response services 15.6% 9.9% 4.7% 4.4% 3.6% 2.1% 1.1% 0.9% 0.4% 0.2%

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

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