Let’s Stop Elder & Dependent Adult Abuse!

1. Let’s StopElder & DependentAdult Abuse! Elder Abuse awareness training workshop conducted by Wake County Elder Abuse Task Force

2. Goals of Presentation How to stop Elder & Dependent Adult Abuse • Realize • Recognize • Report

3. REALIZE! The Ugly Truth: Elder Abuse Happens

4. Realize!Denial, Minimization, Blaming the victim • What we hear: • “Gladys was never a good mother. This must be her fault” • “Elder Abuse doesn’t happen in our community!” • I don’t believe that Jim could ever hurt her. She must be making it up”. • What we know: • Elder Abuse is never justified. • Elder Abuse happens in every zip code. • People don’t want to believe that elder abuse is real, so they often ignore the signs.

5. Realize!Often abuse goes unreported – WHY? • Reluctance of victim to admit because of: • Shame • Fear of losing independence • Fear of being moved • Unlike kids, older adults can quietly disappear from society without much inquiry. • May be too incapacitated to report • Sign of abuse may be missed or mistaken for “usual aging”.

6. Realize!ELDERS’ Vulnerabilities to mistreatment • Difficulty defending oneself, physically and emotionally. • May be more dependent on others for assistance than in the past • Fear of losing independence if a report is made, so more susceptible to threats

7. Realize!Who is abused? • In 66% of all reports of abuse, the victim is a woman. • People over 80 years of age are 2 to 3 times more likely to be victims. • People with cognitive difficulties. • People who are isolated. • People with behavioral issues.

8. Realize!Who abuses? • 90%of abuse of elders and dependent adults is perpetrated by family • 50% are adult offspring. • 20% are spouses/intimate partners. • 48% are women. • 52% are men. • 30% are themselves over 60 years of age.

9. Realize!Why Does elder abuse happen? • We don’t know for sure, but here are some theories and predictors. • Entitlement • Stress • Power and control • Ageism • Mental Illness/Drug & alcohol abuse

10. Realize! Anyone can be a victim. Anyone can be a perpetrator. “All I want to do is live a peaceful life, to regain my life and be happy. I pray to God each day to protect us, help us endure and guide those other senior citizens who are also suffering” Pictured: Mickey Rooney

11. recognize Beyond Denial: Everyone can learn to recognize Elder Abuse.

12. Recognize:an abused elder may …. • Express a sense of isolation – no access to friends, family or community. • Refer to a family member or caregiver’s “anger” or “temper”. • Have a history of alcohol or drug abuse or suicide attempts. • Be presented as a “difficult” patient

13. Recognize:an abused elder may …. • Have repeated “accidental” injuries that are suspicious. • Visit the doctor for vague complaints or acute anxiety. • Avoid seeking medical attention for injuries until days or weeks after injury occurred.

14. Recognize:signs of abuse • Caregiver or Family Member may: • Have excessive concern about costs • Attempt to dominate elder • Not let elder talk • Not let you see elder alone • Verbal abuse of elder or you • Exhibit controlling behavior

15. Realize:Most common types of Abuse • Most common types of abuse often occur together • PHYSICAL – 25% • Financial/material exploitation – 30% • Emotional/psychological – 36% • Neglect – 49% Let’s learn more about these types of abuse….

16. Recognize:physical abuse • The use of physical force that may result in bodily injury, physical pain or impairment. • May include striking, hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. • Inappropriate use of drugs and physical restraints, force-feeding and physical punishment.

17. Recognize: What Let’s talk about physical abuse What do you think may have happened to this person?

18. Recognize:is this physical abuse? • Rita’s son, Mark is her live-in caregiver. He gets frustrated because she take a very long time to do anything. Sometimes he gets so mad that he shakes her. • Mr. Brandon as Alzheimer’s Dementia and tends to wander. His caregiver has to go to the stores sometimes and is afraid he’ll leave so she tied him to his bed frame.

19. RECOGNIZE:Effects of physical elder abuse Life is Shorter Poorer More Painful

20. Recognize:Financial Abuse $$$$$ • The illegal or improper use of an elder or dependent adult’s funds, property or assets. • Examples include: • Cashing a person’s checks without permission • Forging a person’s signature • Misusing or stealing a person’s money or possessions • Coercing or deceiving a person into signing any document (e.g. contracts or will) • The improper use of legal documents

21. Recognize:Financial abuse Why are Seniors targeted? • Average net worth for those 65+ yrs of age in US is $250K. 70% own a car and house. • Those 50+ yrs of age own 70% of nation’s wealth • Seniors come from a generation where a handshake meant something. * Nationally, elder lose about $2.6 billion per year.

22. Recognize:signs of financial abuse • Financial • Irregular pattern of spending/withdrawals • Frequent purchases of inappropriate items • Withdrawals made in spite of penalties • Bills not paid • Utilities turned off • Presence of “new best friend” or “sweetheart”

23. Recognize:is this financial abuse? • A 55 year old woman threatens her mother with placement in a nursing home if she doesn’t buy her a car. • A 30 year old man befriends a widow who is feeling lonely & depressed. He obtains the password for her ATM card so that he can “help” her buy groceries and then “helps” himself to extra cash.

24. Recognize:Emotional abuse The infliction of anguish, pain or distress through verbal or nonverbal acts. Acts such as: verbal assaults, insults, threats, intimidation, humiliation, harassment or isolating a person from their family or friends.

25. Recognize:Emotional abuse What do you think some of the effects of elder emotional abuse could be?

26. Recognize:neglect ne·glect (n-glkt) tr.v. ne·glect·ed, ne·glect·ing, ne·glects • To pay little or no attention to; fail to heed; disregard: neglected their warnings. • To fail to care for or attend to properly: neglects her appearance. • To fail to do or carry out, as through carelessness or oversight: neglected to return the call.

27. Recognize:neglect Not providing for life necessities such as: Food & Water Clothing Shelter Personal Hygiene Medicine Comfort Personal Safety

28. Recognize:signs of neglect • Person is lying urine and feces for hours or days • Person is dirty, has elongated nails and matted hair, is living in filth • Person becomes malnourished and dehydrated because food and water are not provided • Person develops deep, open pressure sores on their back and heels because no one repositions them.

29. Recognize:signs of neglect Signs of possible neglect in the home: • Newspapers/mail accumulating • Lack of attention to house • Large numbers of people using home • Drug activity – people going in and out of the home with frequency • Odd noises • Bad odors (what do your senses tell you?)

30. Recognize:signs of neglect Have you ever seen a situation that you now think may have been neglectful?

31. Recognize:is this neglect? • Angie is the busy caretaker of her mother, Violet. Violet has been ill and is quite weak. She cannot sit up on her own in the bed and can only get out of bed with assistance.Each morning, Angie leave a bottle of water and an apple on her mother’s bedside before she leaves for work.

32. Recognize:self-neglect • The behavior of an elder or dependent adult that threatens his/her own health or safety: for example, refusal or failure to provide himself/herself with adequate food, water, clothing, shelter, personal hygiene, medication, and safety precautions. • A social worker will look for signs of dementia, depression, drug or alcohol abuse, untreated mental illness.

33. report You can make a difference: Reporting & Resources

34. Reportadult protective services (aps) Responsible for taking reports of abuse for persons 65+ yrs old and younger adults with disabilities living in the community. Protective Services (919) 212-7264 After hours, weekends or holidays Call 911

35. Report If I think someone is being abused, what do I do? • If the elder is living in the community, call Wake County Adult Protective Service(919) 212-7264 • If the elder is living in a licensed facility, call Long-term Care Ombudsman 919 855-4500 or call toll free 1-800-624-3004

36. ReportWhat happens if I make a report? • An intake worker will listen to your concerns. • Most often a social worker is assigned and will respond within 10 working days or more quickly. • The social worker will look into the concerns. Their priorities are to stop abuse from happening and to help get services in place to keep it from recurring. • If not abuse is happening and there are other needs for service, they will offer to assist in getting the person connected to services

37. ReportWhat happens if I am not sure? • You don’t need to be sure. • You simply need to suspect the abuse. • APS will investigate the alleged abuse. • You can always call APS to consult about a situation. • APS intake workers are happy to listen and to give you advice and recommendations.

38. ReportDo I have to give my name? • No – you do not have to give your name. • Only mandated reporters are required to give their name when reporting abuse. • Your name is kept CONFIDENTIAL! Names are NEVER revealed to the victim or to the alleged abuser. • However, it is helpful if you are willing to share your contact information in case the intake staff member needs further clarification or has additional questions.

39. ReportCan a client refuse aps services? • Yes, APS remains a voluntary service and can only act with the consent of the client. • If you are a mentally competent adult, who understands the consequences of your decisions, and you choose to engage in acts that threaten your health or safety, you have the “right to folly” and may refuse services offered by APS.

40. Local resources • Triangle J Council of Governments P.O. Box 12276 Research Triangle Park, NC 27709 Main Telephone: (919) 549-0551 http://www.tjaaa.org

41. National resources • UCI Center of Excellent in Elder Abuse & Neglect: www.centeronelderabuse.org • Administration on Aging: www.aoa.gov • National Center on Elder Abuse: www.ncpea.aoa.gov • American Bar Association Commission on Lawy and Aging: www.aganet.org/aging • American society on Aging: www.asaging.org • www.generationsjournal.org • Family Caregiver Alliance: www.caregiver.org • Clearinghouse on Abuse and Neglect of the Elderly: http://db.rdms.udel.edu:8080/CANE • AARP: www.aarp.org

42. Let’s Stop Elder & DependentAdult Abuse! Get Involved Learn More Spread the Word