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A n I n t r o du c t i o n t o E l de r A buse f o r P r o f e ss io n al s: O v e r v i e w

A n I n t r o du c t i o n t o E l de r A buse f o r P r o f e ss io n al s: O v e r v i e w. U nd e r s t and i ng E ld e r A buse. NC EA El d er A bu se O v er v iew 2013. L e a r ni n g Ob j e c ti v e s. B y the e n d o f thi s p r e s e n t a t i o n , y o u wi l l b e a ble t o :

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A n I n t r o du c t i o n t o E l de r A buse f o r P r o f e ss io n al s: O v e r v i e w

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  1. AnIntroductiontoElderAbuseforProfessionals: Overview NCEAElderAbuseOverview 2013

  2. UnderstandingElder Abuse NCEAElderAbuseOverview 2013

  3. LearningObjectives • Bytheendofthispresentation,youwill beableto: • Defineanddistinguishelderabuseand relatedphenomena(e.g.,self-neglectand abuseinlaterlife) • Describeoldervictims,theirabusersandthe impactofelderabuse • Identifystrategiestorespondtopossible elderabusesituations NCEAElderAbuseOverview 2013

  4. CaseExample • Bernard(age68)livesathome.Heisretiredand enjoysgolfandtravel.His42yearoldson,David, movedinwithhimafterlosinghisjobandbeing unabletofindwork. • Bernarddiscoveredthathissonhadusedhisdebit card totake$22,000withoutBernard’sknowledge. • BernardconfrontedDavidanddemandedrepayment. • Davidthreatenedtokillhim,knockedBernardintoa wall,andthreatenedtotelltherestofthefamilythat Bernardhadabusedhimasachild. NCEAElderAbuseOverview 2013

  5. CaseExample • Anna(age75)hasdiabetesandmoderatedementia. • Shelivesinaskillednursingfacility. • Staffconsidersher“difficult”and“demanding”sothey routinelyignoreherwhensheringshercallbutton. • Inthelastweekshehassoiledherself3timeswaiting morethan20minutesforstafftocometoherroom. • Staffhavecalledherderogatorynames,hither,and thrownheronthefloor. Shehaspressureulcersfrom beingleftinherownwaste. NCEAElderAbuseOverview 2013

  6. CaseExample(Cont.) • Mr.and Mrs.Khanareadevotedcoupleintheir80s. • Mr.Khanhadastroke,usesawalker,and iseasily confused.Mrs.Khanaccompanieshimtothebankto getcashfortheweek. • TwoyoungadultsfollowedtheKhansfromthebankto theirapartmentbuilding.AstheKhansusedtheirkey toenterthebuilding,thetwomenattackedthem, knockedthemdownandrobbedthem. NCEAElderAbuseOverview 2013

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  8. ElderAbuse:UndertheRadar Foreveryonecaseof elderabusethatcomestotheattentionofaresponsibleentity. . . 1 Anothertwentythree casesnevercometo light. 23 • Source:NYSElderAbusePrevalence Study;WeillCornell MedicalCollege,NYC DepartmentfortheAging;Lifespan;(2011) SlidecourtesyofLifeLong Justice NCEAElderAbuseOverview 2013

  9. Elder Abuse • Physical,sexualorpsychologicalabuse,aswellas neglect,abandonmentandfinancialexploitation ofanolderpersonbyanotherpersonorentity, • Thatoccursinanysetting (e.g.,home,community orfacility), • Either • Inarelationshipwherethereisanexpectation oftrust;and/or • Whenanolderpersonistargetedbasedonage ordisability. Cite: DOJ/HSSElderJusticeRoadmapProject NCEAElderAbuseOverview 2013

  10. RelatedPhenomena • AbuseinLaterLife(termoftenusedbydomestic violenceandsexualassaultadvocates– 50+) • Abuseof vulnerableadults(somestatutes/APS– adultsaged18+) • Allcrimesagainstpersonsage60andolder • (criminal justice) • Self-neglect NCEAElderAbuseOverview 2013

  11. Consideraddingstate, tribal,orterritorial statutes relatingtoelderabuse.These may befoundin criminallaw,protectiveservices,orother, statutes. Considerinsertingelderabusereportinglawsin theResponsesection.The placeholderslide is *. NCEAElderAbuseOverview 2013

  12. Multipleforms ofelderabuseoftenoccurat thesametime NCEAElderAbuseOverview 2013

  13. IndicatorsofElder Abuse Ifyouwanttoaddindicatorsforvarious formsofelderabusetothisslideset,please refertotheotherNCEAspecificslidesets forindicatorsforeachformof abuseand relatedphenomenon(e.g.,financial exploitation,self-neglect) NCEAElderAbuseOverview 2013

  14. Older Victims • Diverse: Allraces,religions,ethnicities, culturesandsocio-economicgroups • Gender: Femaleand male • Socialstatus: Oftensociallyisolated NCEAElderAbuseOverview 2013

  15. Older Victims(Cont.) • Healthstatus: Rangefromactiveand healthytoneeding24-hourcare • LivingArrangements:inprivatehomes, congregatelivingarrangements,and facilities,etc. • Cognitivestatus: Somevictimshavesome cognitiveand memoryimpairment NCEAElderAbuseOverview 2013

  16. Abusers • Mostoldervictimsareabusedbysomeonethey knowandtrustorwouldexpecttotrust. • Familymembers • Spousesorpartners • Caregivers(family,paidstafforvolunteers) • Personsinpositionsoftrust/authoritySometargetolderadultsfortheirageandperceived orrealfrailty • Strangers NCEAElderAbuseOverview 2013

  17. VictimsLivinginFacilitiesareAbusedBy: • Caregiversandotherfacilitystaff and volunteers • Otherresidents • Spousesandpartners • Familymembers • Strangers NCEAElderAbuseOverview 2013

  18. EffectsofElderAbuse onVictims • Mortality: Ratesthannon-abusedolderpeople,upto 300%higher(Lachs,etal,1998; National Academies,2010) • Distress:Significantlyhigherlevelsofpsychological distressandlowerperceivedself-efficacythanother olderadults(Comijs,etal, 1999;Dong 2005) • Health:Boneorjointproblems,digestiveproblems, depressionoranxiety,chronicpain, highblood pressure,andheartproblems(Dyer,etal, 2000; Stein & Barret- Connor,2000) NCEAElderAbuseOverview 2013

  19. ComplexDynamics • Nosingledynamicexplainselderabuse • “Dependingonthevictim-offenderrelationship andthetypeof elderabuse,elderabusemayresembledomesticviolence,childabuse,orfraudorthephenomenoncanstandonitsownwiththecomplexityoftherelationships,individual vulnerabilities,and contextsinwhichitoccurs.” (Amendola,etal,2010) NCEAElderAbuseOverview 2013

  20. VictimsWanttheAbusetoEnd • But oftenmaintainarelationshipwithor protecttheabuser because: • Fear(ofretaliation,death,facility placement) • Love/careabouttheabuser(especiallyan adultchild) • Economicreasons • Healthconcerns NCEAElderAbuseOverview 2013

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  22. VictimSafety Allresponses and interventions mustconsiderandprioritizevictim safety. NCEAElderAbuseOverview 2013

  23. WhatYouCanDo • RecognizetheSignsofElderAbuse • Ask • ReportorRefer NCEAElderAbuseOverview 2013

  24. WhatYouCanDo(Cont.) • Listentoolderadultsandotherswhomaytellyou aboutsuspicionsofabuse • Donotdiscountanolderadult’sclaimsimply becauseofacognitiveimpairment • Look forelderabuseindicatorsandbehavior changes • Askquestionsevenifyoudonotsuspectabuseto encouragedisclosures NCEAElderAbuseOverview 2013

  25. IfTheOlderAdultCanAnswerQuestions, ConsiderAsking(Cont.) • Doyoufeelsafe? Isanyonehurtingyouorscaringyou? • Isanyoneaskingyoudothingsthatyoudonotunderstand orthatmakeyouuncomfortable? • Hasanyonetakenthingsthatbelong toyouwithoutaskingorwithoutyourapproval? • Doyourelyonanyoneelseforhelp?Whatkindofhelp? • Doesthatpersoneverfailtohelpyoumeetyourneeds? • *Askprivatelyinanareawhereyouwillnotbeoverheard NCEAElderAbuseOverview 2013

  26. IfTheOlderAdultCanAnswerQuestions, ConsiderAsking • Doyou regularlyseefriendsandfamily?Whenis thelasttimeyousawthem? • Dofriendsandfamilyvisityou?Howlonghasit beensincetheyvisited? • Areyouconcernedaboutyourfinances? • Areyouafraidofanyoneinyourlife? • *Askprivatelyinanareawhereyouwill notbeoverheard NCEAElderAbuseOverview 2013

  27. Report -Refer • REPORT • 911orlawenforcement(lifethreateningorpossiblecrime) • AdultProtective Services • Licensingboard(if abuseoccursinafacility) • REFER • Domesticviolenceorsexualassault organization • Aging networkagency • Ombudsman(if abuse isinafacility) NCEAElderAbuseOverview 2013

  28. ConsiderInsertingSlides DescribingtheLocal Jurisdiction’sElderAbuse/ Vulnerable AdultReportingLaw NCEAElderAbuseOverview 2013

  29. Consideraddinglocalresourcesandprograms.(See“AGuideto PlanningYourElderAbuse Presentation”formoreinformation.) NCEAElderAbuseOverview 2013

  30. AdditionalResources NationalCenteronElderAbuse(NCEA) https://www.ncea.acl.gov/ NationalAdultProtectiveServicesResource Center (NAPSRC) https://www.napsa-now.org/ TheNationalConsumerVoiceforQualityLong-termCarewww.theconsumervoice.org National Long-Term CareOmbudsman ResourceCenter http://www.ltcombudsman.org/ NCEAElderAbuseOverview 2013

  31. AdditionalResources(Cont.) NationalClearinghouseonAbuseinLaterLifewww.ncall.us AmericanBarAssociation,CommissiononLawand Aging https://www.americanbar.org/ NationalDomesticViolence Hotline 1-800-799-SAFE NationalSexualAssaultHotline 1-800-656-HOPE NCEAElderAbuseOverview 2013

  32. StandforDignityandRespect • Speakoutforjustice • Collaboratewithotheragenciesand disciplines • Educatethepublic,otherprofessionalsand policymakers • Initiatechangesinpolicyandprotocols • Promoteresourcesforvictimservices NCEAElderAbuseOverview 2013

  33. For moreinformation,visitus! ncea.acl.gov AlsoonFacebook,Twitter, YouTube centeronelderabuse.orgAlso on Facebook, YouTube

  34. Foradditionalresources,visit ncea.acl.gov ThisslidesetwascreatedfortheNational ClearinghouseonAbuseinLaterLifeforthe NationalCenteronElderAbuseandissupportedinpartbyagrant(No.90AB0002/01)fromtheAdministrationonAging,U.S.DepartmentofHealthandHumanServices(DHHS).Granteescarryingoutprojectsundergovernmentsponsorshipareencouragedtoexpressfreelytheirfindingsandconclusions.Therefore,pointsof vieworopinionsdonotnecessarilyrepresent official AdministrationonAgingorDHHS policy.”

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