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An In tr odu ct ion to Eld er A bu se f o r Pr o fessi on a ls: Ne g l ect

This presentation aims to define and describe elder neglect, identify common indicators, and provide strategies to respond to possible neglect situations. Through case examples and learning objectives, professionals will gain a comprehensive understanding of neglect in elder abuse.

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An In tr odu ct ion to Eld er A bu se f o r Pr o fessi on a ls: Ne g l ect

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  1. AnIntroductionto Elder AbuseforProfessionals: Neglect NCEANeglect

  2. NCEANeglect

  3. LearningObjectives • Attheendofthispresentation,youwill be ableto: • Defineanddescribeneglect • Definewhatmakessomeoneacaregiver • Identifycommonindicators • Identifystrategiestorespondtopossible neglectsituations NCEANeglect

  4. CaseExample • 33yearoldElviraprovidescareforher94-year- oldgrandfatherSaleemwhorequiresconstant care. • Saleemisbroughttothelocal hospital emergencydepartment,comatose,with13severebedsoresincludingonethatissodeepthatSaleem’sartificial hipfromarecent surgeryisvisible. NCEANeglect

  5. CaseExample • Frankis 83andhasdementiawhichcannolongerbe caredforathome.Hemovedintoafacility6months ago. • Whileatthefacilityhehaslostconsiderableweight andspendsmuchofhistimelockedinhisroom becausehewanders.Staffdoesnotlikecaringforhim asheiscombative. • Heisfoundunconsciousinhisroombystaffanddies enroutetothehospital.Themedicalexaminerfinds evidenceof dehydration,malnourishment,and9 infectedpressureulcers.Causeofdeathissepsis. Neglect

  6. CaseExample(cont.) • Constance,a72yearoldtribal memberwithdementiaand arthritisreliesonherdaughter,Rose,toprovidecare,help hertakehermedications,andcookhermeals. • Rose,wholiveswithhermother,doesnotgiveConstance herpainmedications,keepsherlockedandaloneinadark bedroom,doesnottakehertotribalceremonies,andgives heronlycerealtoeat. • Constancehasbecomemoreconfused,isdepressed,haslostweight,and isinconstantpain. NCEANeglect

  7. Neglect • Therefusalorfailuretofulfillanypart ofaperson'sobligationsordutiesto anelder. • Neglectmayalsoinclude: • Failureofapersonwhohasfiduciaryresponsibilitiestoprovidecareforan elder(e.g.,payfornecessaryhome careservices),or • Failureonthepartofanin-homeserviceprovidertoprovidenecessary care(National CenteronElderAbuse) NCEANeglect

  8. Consideraddingstate, tribal,orterritorial statutes relatingtoneglect(includingstatutesandcase lawdescribingwhat makes someoneacaregiver in thisjurisdiction)here.These maybefoundin criminallaw,protectiveservices,orother, statutes. Considerinsertingelderabusereportinglawsin theResponsesection.The placeholderslide is *. NCEANeglect

  9. NeglectOftenCo-OccurswithOtherFormsofElderAbuse • Alwaysconsideriffinancialexploitationisoccurringor hasoccurred • Asaresultoffinancialexploitation,assetstoprovidefor elder’sneedsmaybegone • Abusermaykeepanelder’sassetstoprotecthis/her anticipatedinheritance NCEANeglect

  10. VictimsAreOften • Frail • Physicallyand/orcognitivelyimpaired • Dependentonothers • Isolated • Unabletoreport NCEANeglect

  11. Indicators:PotentialVictim • Confusionordelirium • Dehydration • Malnutrition • Decayedteeth • Overgrownnails • Matted,infestedhair • Over-orunder-ormis-medicated • Unexplainedweightloss • Pressureulcers NCEANeglect

  12. PressureUlcers • Alsoknownas“decubitusulcers,”“pressuresores”or “bedsores” • Resultofpressureonbonypartsofbodysuchas shoulderblades,buttocks,hips,ankle,heeloffoot • Mayoccurevenwhenelderisreceivingpropercare (Liao,etal(2010)) • Maybeoutcomeofanunderlying medical condition • Presencealonedoesnotproveneglectisoccurring • Isthewoundreceivingpropercare? NCEANeglect

  13. PressureUlcers(cont’d) NCEANeglect

  14. PressureUlcer– FourStages • NOTE: • Location(esp.ifnota bonyprominence) • Multiplelocations andonmultiple planesofthebody • Stinking wound • Attemptsat care/treatmentand documentation NCEANeglect

  15. Indicators:Caregiver • Caregiver • Missingorabsent • Living insignificantlybetterconditionsthanelderin sameresidence • Morefocusedoncostof carethanneedsofolder adult,especiallywheneldershould beabletoafford itemsorcare • Feelsoverburdenedand/orresentful NCEANeglect

  16. Indicators:TheEnvironment • Residenceispoorlymaintained,unsafe,orunclean • Lackofheatingorcooling • Lackofappropriatefoodforelder • Foulodors • Infestationsofverminand/orinsects • Lackofassistivedevices(e.g.,hearingaids,glasses, dentures,mobilityaids)thattheolderpersonshould haveorhashad NCEANeglect

  17. Indicators: In Facilities • Failuretoprovide: • Adequatenutritionandfluids • Safetymeasuressuchasbedrails,asordered • Neededservices,e.g.,turningabedriddenpatient,cleaning beddingandclothingforanincontinentpatient • Failuretonotifyaresponsiblepartywhen: • Asignificantchangeinaresident’ssituationhasoccured • Aresidentisinjured • Withholdingservicestopunishordiscipline • Ignoringcallsforassistance NCEANeglect

  18. Impact • Neglectmaybetheresultofinactionorpoor caregivingbycaregiverswholackthenecessary resources,skillsorsupport • Insomeinstancesneglectmaybeacrime • Irrespectiveofthereasonfortheneglect,suspected neglectshouldbereportedorreferredinorderto increasehealthcareandservicesfortheolderadult andtotriggeraninvestigation NCEANeglect

  19. NCEANeglect

  20. VictimSafety Allresponses and interventions mustconsiderandprioritizevictim safety. ElderAbuseOverview

  21. WhatYouCanDo • RecognizetheSignsofNeglect • Ask • ReportorRefer NCEANeglect

  22. If TheOlderAdultCanAnswerQuestions, ConsiderAsking: • Whatcanyoudoforyourselfandwhatdoyou need helpdoing? • Whoprovidesthathelp? • Isthatpersonpaid? Bywhom?Howmanyhoursadaydotheyhelpyou? • Whatmedicationsshouldyou betaking? Doyoutakethemall?Ifnot,why? • *Askprivatelyinanareawhereyouwill notbeoverheard NCEANeglect

  23. IfTheOlderAdultCanAnswerQuestions, ConsiderAsking: • Howdoyoufeel? Areyou inpain?Doyoutakepainmedications? • Areyou leftalone? Howoften? • Doyouhaveglasses?Dentures?Walker? Cane? • Wheelchair? • Doyouoftenfeel hungry?Thirsty?Tellmemore aboutthat. • *Askprivatelyinanareawhereyouwillnotbeoverheard NCEANeglect

  24. Report -Refer • REPORT • 911 or law enforcement (life threatening or possible crime) • Adult protective services • Licensing board (if abuse occurs in a facility • REFER • Domestic violence or sexual assault organization • Aging network agency • Ombudsman (if abuse is in a facility) NCEANeglect

  25. ConsiderInsertingSlides DescribingtheLocal Jurisdiction’sElderAbuse/ Vulnerable AdultReportingLaw NCEANeglect

  26. Consideraddinglocalresourcesandprograms.(See“AGuideto PlanningYourElderAbuse Presentation”at *****formoreinformation.) NCEANeglect

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

  28. Foradditionalresources,visitncea.acl.gov ThisslidesetwascreatedfortheNational ClearinghouseonAbuseinLaterLifeforthe National Centeron ElderAbuseandissupportedinpartbyagrant(No.90AB0002/01)fromtheAdministrationonAging, U.S.DepartmentofHealthandHumanServices(DHHS).Granteescarryingoutprojectsundergovernmentsponsorshipareencouragedtoexpressfreelytheirfindingsandconclusions.Therefore,pointsofvieworopinionsdonotnecessarilyrepresentofficial Administration onAgingorDHHSpolicy.” NCEANeglect

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