Transcript The Hamilton County Family Violence Prevention Project

Elder Abuse and APS
Tom Welch
Hamilton County Job and Family
Services
Adult Protective Services
What is elder abuse

Michael slaps his
80-year-old mother
for urinating on the
carpet.
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What is elder abuse

Phil, a 75-year old
retired teacher,
forgets the boiling
soup and the
kitchen catches
fire.
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What is elder abuse

Carol, 98-years
old, receives an
eviction notice after
giving the rent
money to her
grandson.
4
What is elder abuse

Sam, 82 years-old,
loves his bedridden
wife, Sara, but he
is too weak to lift
her to change the
soiled bed sheets.
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Fast Facts
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Statistics:

It’s estimated that between 2-10% of
older adults, or up to five million
Americans, are victims of elder abuse
and neglect, and about half of these
situations represent domestic
violence in later life.
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Statistics
 An
estimated 5 out of 6 cases of elder
abuse, neglect, and exploitation remain
unreported.
Abuse
situations are more often discovered
and reported by others than admitted to by
the abused or the abusers.
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Ohio Reporting Statistics


From 1986 to 2005,
reporting rates
increased 102%
(rose from 7,382 to
14,969)
Recent Ohio reports:
 self-neglect
52%
13%
13%
52%
22%
Self-Neglect
Neglect
Abuse
Exploitation
 neglect
22%
 abuse 13%,
 exploitation 13%
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Mandated Reporters
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Reporting Neglect, Elder Abuse and
Domestic Violence in Later Life

Ohio law mandates 22 categories of
professionals to report immediately to the
County Department of Jobs and Family Services
any suspected cases of elder abuse, neglect, or
exploitation,
 Anyone

can report elder abuse.
Reporters can remain anonymous, if they
choose.
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Mandated Reporters of Neglect and
Elder Abuse
Attorney

Peace

Officers
Dentists
Chiropractors
Physicians
Podiatrists



Osteopaths
Clergy
Coroners
Senior service
providers
Psychologists
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Mandated Reporters of Neglect and
Elder Abuse
Hospital
Employees
Nurses
Employees
of ambulatory health facilities
Employees
of home health facilities
Employees
of adult foster care facilities
Employees
of community mental health facilities
Persons
engaged in social work or counseling who have reasonable
cause to believe that an adult is being abused, neglected, exploited, or is
in a condition resulting from abuse, neglect, or exploitation.
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Adult means any person 60 years or
over whose is impaired with physical
or mental impairments which prevent
them from providing for their own care
or protection or be handicapped by the
infirmities of aging and reside in an
independent living arrangement.
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Types of elder abuse
Abuse-physical, sexual and emotional
 Neglect and self-neglect
 Exploitation

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Abuse

Abuse is the infliction upon an older adult
 injury
 unreasonable
confinement
 intimidation
 cruel


punishment
with resulting physical harm, pain or mental anguish
It can be physical, emotional or sexual
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Indicators of abuse
 Bruises
 Sleep
disturbances
 Eating problems
 Injury and pain
 Headaches
 Signs of traumatic hair and tooth loss
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Neglect

The failure of an older adult to provide for
himself/herself the goods or services necessary to
avoid
 physical

harm
 mental
anguish
 mental
illness
or the failure of a caretaker to provide such services
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“Active Neglect”
 Behavior
that is willful - that is, the caregiver
intentionally withholds care or necessities.
 Neglect may be motivated by financial gain
(e.g. the caregiver stands to inherit) or reflect
interpersonal conflicts
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“Passive Neglect”
 Situations
in which the caregiver is
unable to fulfill his or her care giving
responsibilities as a result of illness,
disability, stress, ignorance, lack of
maturity, or lack of resources.
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Self-Neglect

Self neglect refers to situations in which
there is no perpetrator and the neglect is a
result of the older person refusing care or
being unable to access care.
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Indicators of Neglect & Self Neglect
Exacerbation of chronic diseases
 Worsening dementia
 Home in state of filth or dangerous
disrepair
 Absence of necessities including food,
water, heat
 Animal or insect infestations

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Indicators of Neglect & Self Neglect
Obvious malnutrition or dehydration
 Physically unclean and unkempt
 Dirty, ragged clothing
 Decubiti (bedsores)
 Excessive fatigue
 Unmet medical or dental needs

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Exploitation
Use of an older adult’s resources or
property for another’s profit or advantage.
 Misappropriation of an older adult’s
money, assets, or other valuables. It
ranges from misrepresentation and deceit
to fraud and theft.

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Indicators of exploitation






Unusual activity in bank/savings accountschecks, ATM withdrawals
Unauthorized power of attorney
Unpaid/Overdue bills
Lack of necessities for personal care, clothing,
food, medical attention
Personal belongings that are missing, lost, or
“loaned”
Changes in a will or POA
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Indicators of exploitation




Elder who has been kept isolated from friends or
family members by a caregiver
Sudden poverty or recent changes in assets
Caregivers who are evasive about the older
adult’s finances.
Recent acquaintances or caregivers who talk
about an alert elder’s sudden confusion, lapses
in memory, or inability to handle affairs without
their help
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Domestic Violence in Later Life

A pattern of assaultive or coercive
behaviors that adults use against their
elderly intimate partners or family
members with whom they live.
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Risk Factors
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Risk Factors and Characteristics
Lack of Coping Skills
 Suddenness of dependency
 Interdependency and resentment of
dependency
 Conflicting demands
 Lack of financial resources

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Risk Factors and Characteristics
Family dysfunction
 Substance abuse and mental health
issues
 Environmental conditions
 Provocative behavior and personality
conflicts

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Detection is everyone’s business.
The elderly rarely seek help when they
have been victims.
 They feel ashamed or embarrassed, or
hide the abuse out of a sense of family
loyalty, fear of retaliation, resignation or
powerlessness, lack of credibility, and fear
of institutionalization.

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Adult Protective Services
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Adult Protective Services
The
County Department of Jobs and Family
Services is responsible for the investigation of
reports of suspected elder abuse, neglect, selfneglect or exploitation.
To
report elder abuse in Hamilton
County, call 421-LIFE (5433).
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Adult Protective Investigation
The
investigations are completed by social
workers.
The investigation includes a face-to-face
visit with the client generally in their home.
Often other sources are contacted with the
client’s permission.
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Adult Protective Investigation
Investigations
must begin within 24 hours
of the report of an emergency situation, or
within 3 working days of the report of a nonemergency situation.
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Adult Protective Assessment
The degree of endangerment
 Personal vulnerability
 Social vulnerability

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Adult Services Case Planning
The degrees of restriction on the client’s
freedom of choice
 The degrees of disruption to the client’s
lifestyle
 The levels of care needed to achieve
safety and well-being for the client

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Adult Protective Interventions
Legal-APS law, guardianships, mental
health statutes
 Other agencies-Mobile Crisis, Health
Department, Council on Aging, Police,
Cincinnati Area Senior Services

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Outcomes
The
majority of elder abuse cases are
resolved to everyone’s satisfaction.
Sometimes,
however, the action taken in a
given case does not always meet with a
reporter’s or the community’s expectations
of what should be done.
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Outcomes
Adult
Protective Services functions under
strict guidelines which protect the rights and
choice of older adults involved in abuse and
neglect situations.
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Principles of Adult Protective Services
Freedom over safety
 Self-determination
 Participation in decision-making
 Least restrictive alternative
 Primacy of the adult

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Principles of Adult Protective Services
Confidentiality
 Benefit of doubt
 Do no harm
 Avoidance of blame
 Maintenance of family

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Issues in Elder Abuse
Elder Justice Act
 Funding
 Council on Accreditation
 Hamilton County Multi-disciplinary Team
 Family Violence Prevention Project

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Prevention Strategies:
Understanding & Utilizing
Community Resources
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How Can We Prevent Elder
Abuse?

Through awareness and education about
risk factors and warning signs

It’s a community effort:
 Family
members
 Friends
 Faith leaders
 Neighbors
 Community members
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How Can We Prevent Elder
Abuse?

We can all help older adults:
Reduce
social isolation
Express feelings to:
 Healthy family members
 Friends
 Neighbors
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