When Adults Abuse Elderly & Disabled Family Members Beyond the Bruises; When Caregiving Crosses the Line. Ruth A. Force MS, LSW, CMC Client Services Director of Angel Corps Auburn Office Professional Geriatric Care Manager, Dorian Maples & Associates How do we define an Elder? An Elder is a person who is still growing, still a learner, still filled with potential, and whose life continues to have within it promise for and connection to the future. An Elder is still in pursuit of happiness, joy and pleasure, and their birthright to these remains intact. Moreover, an Elder is a person who deserves respect and honor and whose work it is to synthesize wisdom from long-life experience and formulate this into a legacy for future generations. From - The Live Oak Project, Barry Barkan, founder of the Live Oak Project How do we define Elder Abuse? An intentional or neglectful act by a caregiver or trusted individual that leads to, or may lead to, harm of a vulnerable elder. The 3 Plagues of an Elder Helplessness Loneliness Boredom Source: The National Center on Elder Abuse
Risk Factors: The Elder or Disabled Individual There are no boundaries between socioeconomic groups, cultures, and races. Women and Older Elders Dementia Mental Health/Substance Abuse issues Isolation/Boredom/Loneliness/Helplessness Common Questions Why do people abuse others? What where they thinking?!? How could anyone harm a loved one? (they must be an animal!) Risk Factors: The Caregiver Adult Daughter of the Elder Only Male child and in the main caregiver role Spouse of the Disabled Those who are not educated to caregiving Crosses all socio-economic boundaries, cultures and races Red Flags Is the caregiver in denial? Is there heightened anger? Are they socially withdrawn? Anxiety noted Depression Exhaustion Sleeplessness Irritability Are they having trouble concentrating? Health Problems
Variations of Elder Abuse 1. Physical Abuse ~ slap marks, unexplained bruises, certain types of burns or blisters. 2. Neglect ~ filth, lack of personal hygiene, lack of medical attention, malnutrition or dehydration, no heat in the winter, no air in the summer. Neglect? Yes. Son charged in elder abuse case Woman trapped for weeks; her son accused Family members told police it might have been a year since the woman was last bathed. "It was nasty. You could smell it today. It smelled like sewage because she was laying in her own feces. Source: woodtv.com Grand Rapids, MI 3. Emotional Abuse ~ verbal attacks, threats, rejection, isolation, belittling. 4. Sexual Abuse ~ contact that is forced, tricked, or otherwise coerced upon a vulnerable elder. 5. Exploitation ~ theft, fraud, undue influence to gain control of finances and/or property. (Take Charge: Fighting back Against Identify Theft www.ftc.gov/idtheft ) 6. Abandonment ~ desertion of a frail elder by anyone in the caregiving role.
6. Self-neglect ~ hoarding, poor hygiene, failure to take essential medications and not wearing suitable clothing for the weather. Examples of Abuse from the Newspapers Bruce Lemoine's family was told he would be cared for at a (Nursing Home), but he died from exposure after he was left outside, strapped in his wheelchair in near 100-degree heat. Nadine Howden, 68, a bedridden, diabetic woman died of gangrene in her filth-filled home might be a victim of homicide by abuse. She was found dead in her bed by a police officer last month. She was lying in her own feces, and her foot was infested with maggots even prior to her death. Detectives are looking at charging Howden's 36- year-old son, who was her caretaker. Her developmentally disabled daughter appears to be living there alone, now. Faith or Fake? Emotional and/or exploitation Control issue Source: www.karisable.com
Barriers Cultures How you can prevent abuse Keep in contact. Talk with your older friends, neighbors, and relatives. Maintaining communication will help give them an opportunity to talk about any problems they may be having. Be aware of the possibility of abuse. Look around and take notice to what may be happening to your older friends and neighbors. Are they more withdrawn and nervous around certain people? How you can react to the Abuser Stay calm and respond in a calm voice Don t let your anger become part of the interaction; maintain professionalism Never be in the area alone with them; buddy up if able Decrease the level of danger. Assess the level of danger to yourself and the patient. Harm can often be avoided by simply stepping back and standing away from the person. Statistics National ~ In 2007 it was reported that between 1 million and 2 million Americans aged 65+ have been abused, mistreated, or exploited by a caregiver. As few as 1 in 15 cases of abuse are identified.
Statistics cont d. Indiana ~ In 2004, the State of Indiana reported that adult abuse caseworkers investigated 15,080 reports, an increase of about 12 percent from 2003. Statistics cont d. Nine Northeastern Counties of Indiana ~ Adult Protective Services Unit 3 reported between 1/01/08 and 12/31/08 there were 1,157 allegations with 729 substantiated claims. Statistics cont d. Adams County ~ Statistics were unavailable through APS. In my opinion, I think elder abuse is the best-kept secret out there. KPC news interview of Ruth A. Force MS, LSW, CMC 10/09/09. Laws and Elder Abuse Laws against physical abuse ~ Battery Class B Misdemeanor if no injury results. Class D Felony if injury results to the Endangered Adult Class C Felony if injury results in Serious Bodily Injury (Disfigurement, unconsciousness, or extreme pain) Class C Felony if injury occurs with a weapon Class B Felony if the battery results in death
Laws against sexual abuse ~ Rape Class B Felony under no other circumstances Class A Felony if achieved through threat/use of deadly force Class A Felony if achieved with a weapon or a drug Class A Felony if it results in Serious Bodily Injury ~ Sexual Battery Class D Felony to start Class C Felony if achieved with deadly force; weapon or drugs Laws against neglect Class D Felony to start Class C Felony if results in bodily injury Class C Felony if confinement occurs with deprivation of water, food, or sanitation. Confinement in a place not intended for human habitation. Through unlawful restraints. Class B Felony if results in Serious Bodily Injury Laws against exploitation Miscellaneous Laws Class A Misdemeanor to start Class D Felony if exploitation exceeds $10,000.00 or the victim is 60 years or older in age. ~ Failure to report known or believed Battery, Neglect, Exploitation of the Endangered Adult ~ Class B Misdemeanor ~ Nonsupport of a Parent: A person who knowingly or intentionally fails to provide support for a parent who cannot support him/herself when the child is over 18 and can provide support ~ Class A Misdemeanor
Resources What you can do to prevent Elder Abuse ~ Report suspected mistreatment to your local Adult Protective Services agency or Law Enforcement. Adult Protective Services Unit 3 (260) 449-7989 (State of Indiana Helpline 1-800-992-6978) Contact your local Area Agency on Aging office to identify local programs and support such as Meals on Wheels. Volunteer. There are many local opportunities to become involved in programs that provide assistance and support. Local Area Resources Retired Senior Volunteer Program Sexual Assault Center County Council on Aging Women s Bureau Other Professionals who can help Professional Geriatric Care Mangers Elder Law Attorneys Prosecuting Attorney Office County Health Department
Learning all you can about Elder Abuse is essential! Visit the National Center on Elder Abuse website at: www.ncea.aoa.gov