Older, Wiser, Stronger Understanding Elder Abuse

© 2008 Elder Care Rights Alliance

Older, Wiser, StrongerUnderstanding Elder Abuse

Presented by:

ElderCare Rights Alliance


Objectives

Gain a comprehensive understanding of Minnesota’s Vulnerable Adult law and understand the process and aftermath of making a maltreatment report.


Objectives

Improve your ability to assess the risk for abuse in staff, care recipients, and facilities and learn how to address these challenges.


Objectives

Create innovative abuse prevention plans for individuals and families.


National Elder Abuse Statistics

90% know their perpetrator 6.

66% adult children/spouses 5.

Various authorities report for every 1 case of elder abuse reported 5 to 8 go unreported

Every 2 minutes someone is sexually assaulted1.

Every 2.7 minutes an elder is victimized2.


Minnesota Elder Abuse Facts

Abuse has been increasing at approximately 10% a year

Types of abuse investigated (2003)

•Neglect 45.8%

•Self-neglect 29.8%

•Abuse 12.4%

•Financial Exploitation 11.9%

•Sexual Assault 0.1%


Minnesota Elder Abuse Facts

Housing settings where abuse typically occurs:

•Licensed facilities 48%

•Other facilities 8%

•Home and Community 36%

•Unknown 8%


QUIZ


Who is the Vulnerable Adult?



Vulnerable Adult

Person 18 years or older who is:

• resident or inpatient of a facility

•one who receives services from a licensed home care provider, or

• from a personal care attendant provider under the Medical Assistance program


Vulnerable Adult

The law applies to persons 18 years of age or older who regardless of residence or whether any type of service is received, possesses a physical, mental, or emotional impairment which limits that person’s ability to provide adequately for his or her own care without help, and has an impaired ability to protect himself or herself from harm.


Vulnerable Adult

Categorical vs. Functional

•Categorical: automatically considered to be a vulnerable adult because they are a patient or resident of a facility

•Functional: person resides in the community or assisted living facility


Vulnerable Adult

Situational vs. Chronic

• Situational: temporary illness or recovering from a broken bone

• Chronic: long-term such as Parkinson’s disease, dementia, or developmental disability


What Are the Types of Abuse


What Are the Types of Abuse

Neglect Physical Abuse Verbal Abuse Emotional Abuse Sexual Assault Financial Exploitation Self-Neglect


Warning Signs

Unexplained bruises

Sudden decline in hygiene

Sudden withdrawal or isolation

Crying spells Hoarding

Medications not being filled

Unexplained transfer of assets or possessions

A vulnerable adult’s report of being abused


Who Abuses?


Who Abuses?

Care givers (formal and informal) Adult children and other family

members Spouses Friends


Who are Mandated Reporters


Who are Mandated Reporters

Professionals such as:

•Social Workers

•Law Enforcement

•Nurses

•Healthcare Professionals


What is Reportable

(1) Two residents of assisted living facility (both have dementia) get into a pushing/shoving altercation in the dining room.


What is Reportable

(2) A care provider witnesses another staff person yelling and swearing at a resident.


What is Reportable

(3) On your daily walk, you hear a neighbor yelling and cursing at their elderly next door neighbor.


What is Reportable

(4) A resident is walking down the hall using his walker, trips, falls and breaks his hip.


What is Reportable

(5) A resident is walking down the hallway with her walker, trips on some broken tile (that had been there for a while), falls and breaks her ankle.


What is Reportable

(6) A nurse is transferring a resident, when she accidentally drops the resident.


What is Reportable

(7) A resident needs a two-person transfer, however only one staff person assists transferring the resident from their wheelchair to the bed, drops the resident and the resident sustains injuries.


Where to Report?


Where to Report?

Common Entry Point (CEP) Office of Health Facility Complaints

(OHFC) Adult Protective Services (APS) Law Enforcement (911) Supervisor (if you are in a facility that

has an internal reporting process)


What Happens Next?

True or False: Vulnerable Adult is removed from

the dangerous situation. Abuser is removed or arrested. Law enforcement is called to

investigate? Nothing happens.


End of Quiz


What is Reportable?


What Should be Included in Reports

Name and address of the vulnerable adult What makes the person vulnerable? What harm has been done? Who is doing the harm?

Always be thinking of why does this person need protection and how can

they be helped.


Duties of Designated Facility Reporters

Facility must have an established and enforced written policy on internal reporting.

The initial reporter meets their statutory requirements by reporting internally.

Facility is responsible for complying with immediate reporting requirements.



After a report has been made to the designated reporter, the facility MUST give the initial reporter WRITTEN notice whether or not the facility reported the incident to the Common Entry Point (CEP).



This written notice must be provided within two working days and in a manner that protects the confidentiality of the initial reporter.

The written notice MUST note that if the initial reporter is not satisfied with the action taken by the facility to report to the CEP, the reporter can report externally.



The written notice MUST also inform the initial reporter that they are protected from retaliatory measures by the facility if they chose to report externally.

A facility MAY NOT prohibit a mandated reporter from reporting externally.


Risk Factors

Elders Caregivers Housing


Elder Risk Factors

Argumentative Demanding Hostile Mute Verbally abusive Incontinent Intrusive

Combative History of multiple

incidents History of

substance abuse Manipulative


Caregiver Risk Factors

Alcohol drug use Excessive absenteeism Financial problems Poorly trained Family problems Mental illness Chronic physical illness Insubordination Role reversal


Housing Risk Factors

Accepting residents whose needs cannot be met by facility adequately

Frequent “reorganizations” High personnel turn-over High overtime demands Inadequate and uninformed response

to abuse


Housing Risk Factors

Crowding/concentration of vulnerable adults Inconsistent and unclear expectations of

staff:

• Lack of staff training

• Lack of clear role definition

• Poor communication – admin and staff

• Underpaid staff


Cultural, Gender, & Generational Considerations


What Will You Do Differently Now?


Promising Practices

Home administration communicates clearly and consistently that all residents and staff be treated with dignity and respect.

Employees feel comfortable about personnel problems with their supervisors.

Staff deal with minor incidents of abuse immediately. No level of abuse is tolerated.

Administration provides orientation and ongoing training programs for staff.


Questions?


Thank You!

Documents

Older, Wiser, Stronger Understanding Elder Abuse