Elder Abuse

1. Elder Abuse The Forgotten Side of Domestic Violence Kay Hurd, RN, MSN

2. Who Is Being Abused • The US has: • 44 million persons age 60+. • 36 million people with disabilities. • 364,512 cases of people living at home were reported with 43% confirmed. • In the last 10 years abuse of elder persons has increases 150+%. • Domestic Elder Abuse is a family problem, almost 90% of the abusers were family members.

3. Who Are The Abusers • More than 2/3rds of the abusers are family members of the victims and are typically serving in the care-giving role.

4. Risk Factors • Domestic Violence grown old. • A partnership in which one member of the couple has traditionally exerted power and control over the other through emotional abuse, physical violence and threats, isolation and other tactics.

5. Risk Factors - Continued • Personal problems of the abusers. • Adult children who are still dependant upon parent for financial assistance, housing or other means of support. • Mental Illness. • Substance Abuse.

6. Risk Factors - Continued • Caregiver stress. • Cycle of violence is learned behavior transmitted from one generation to the next. • Personal characteristics of the elder. • Dementia. • Disruptive behavior. • Problematic personality traits. • Significant needs of assistance.

7. Amendments to Older Americans Act First appeared in 1987 and Provided Definitions

8. Domestic Elder Abuse • Domestic Abuse Grown Old. • Maltreatment of an older person by someone who has a special relationship with the elder. (e.g. spouse, sibling, child, friend, caregiver). • Spouses make up a large % of elder abusers. Partnerships in which one member of a couple has traditionally tried to exert power and control over the other.

9. Institutional Elder Abuse • Abuse that occurs in residential facilities for older persons. (e.g. nursing homes, foster homes, group homes, board and care facilities. • Abusers are persons who have legal or contractual obligation to provide elder victims with care and protection. (e.g. staff, professionals, paid caregivers).

10. Self-neglect – Self-abuse • Self Neglect is behavior of an elderly person that threatens his/her own health/safety. • *Self-neglect EXCLUDES a situation in which a mentally competent person who understands the consequences of his/her decisions, makes a conscious and voluntary decision to engage in acts that threaten his/her safety as a matter of personal choice.

11. Signs of Self-Neglect • Dehydration, malnutrition • Untreated medical conditions • Lack of necessary medical aids • Hazardous or unsafe living conditions • Unsanitary or unclean living quarters • Inappropriate and/or inadequate clothing • Homelessness

12. Physical Abuse • Physical force that may result in bodily injury, physical pain or impairment. • Striking with or without an object.

13. Signs of Physical Abuse • Bruises, black eyes, welts, lacerations. • Rope/restraint marks. • Open wounds, cuts, punctures, untreated injuries in various stages of healing. • Sprains, dislocations, internal injuries.

14. Signs of Physical Abuse –continued • Laboratory findings of medication overdose. • An elder’s report of being hit, slapped kicked or mistreated. • An elder’s sudden change in behavior. • The caregiver’s refusal to allow visitors to see and elder alone.

15. Sexual Abuse • Sexual abuse is non consensual sexual contact of any kind with an elderly person. • It includes unwanted touching • Sexual assault or battery such as rape, sodomy, coerced nudity and sexually explicit photographing.

16. Signs of Sexual Abuse • Bruises around breasts or genital area. • Unexplained venereal disease or genital infections. • Unexplained vaginal or anal bleeding. • Torn, stained, or bloody underclothing. • An elder’s report of being sexually assaulted or raped.

17. Emotional or Psychological Abuse • The infliction of anguish, pain, or distress through verbal or nonverbal acts. • Includes, verbal assaults, insults, threats, intimidation, humiliation, harassment • Treating the older person like an infant • Isolating an elderly person from his/her family, friends or regular activities. • Giving an older person the “silent treatment” or enforced social isolation.

18. Signs of Emotional/Psychological Abuse • Emotionally upset or agitated • Extremely withdrawn • Non-communicative or non-responsive • Unusual behavior usually attributed to “dementia” (e.g. sucking, biting, rocking)

19. Neglect • The refusal or failure to fulfill any part of a person’s obligations or duties to an elder. • Failure of a person who has fiduciary responsibilities to provide for an elder. • Failure to provide an elderly person with necessities, food water, clothing, shelter, personal hygiene, medicine, comfort, personal safety.

20. Abandonment • The desertion of an elderly person by an individual who has assumed the responsibility for providing care to the elder, or by the person who has physical custody of the elder.

21. Financial or Material Exploitation • The illegal or improper use of an elder’s funds, property, or assets. • Cashing an elder’s checks without authorization or permission. • Forging an elder’s signature, • Misusing or stealing an elder’s money or possessions, • Coercing or deceiving an elder into signing any document, (contracts or wills). • Improper use of guardianship or power of attorney.

22. Signs of Financial or Material Exploitation. • Sudden changes in bank account or banking practice. • Inclusion of additional names on a bank signature card. • Unauthorized banking, remaking of wills, advanced directives, or other legal matters of any kind.

23. Is Elder Abuse a Crime? • Physical, sexual, and financial/material abuses are considered crimes. • Certain emotional abuse and neglect are subject to criminal prosecution. • SELF-NEGLECT IS NOT CONSIDERED A CRIME.

24. Where to Find Help • Adult Protection Services. • Somerset County Adult Protective Services. Board of Social Services. Somerville, 08876. 908-526-8800. • Someone from the Agency will investigate reported cases. • Provide victims with treatment and protective services. • Local Police, sheriff’s offices and prosecuting attorneys will investigate and prosecute abuse. • Long distance caregivers can call a nationwide toll-free number. (1-800-677-1116).