Transcript Presented by: ElderCare Rights Alliance

Older, Wiser, Stronger
Understanding Elder Abuse
Presented by:
ElderCare Rights Alliance
© 2008 Elder Care Rights Alliance
Objectives
 Gain a comprehensive understanding
of Minnesota’s Vulnerable Adult law
and understand the process and
aftermath of making a maltreatment
report.
© 2008 Elder Care Rights Alliance
Objectives
 Improve your ability to assess the risk
for abuse in staff, care recipients, and
facilities and learn how to address
these challenges.
© 2008 Elder Care Rights Alliance
Objectives
 Create innovative abuse prevention
plans for individuals and families.
© 2008 Elder Care Rights Alliance
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
1.
sexually assaulted
 Every 2.7 2.minutes an elder is
victimized
© 2008 Elder Care Rights Alliance
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%
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© 2008 Elder Care Rights Alliance
Minnesota Elder Abuse Facts
 Housing settings where abuse typically
occurs:
Licensed facilities 48%
Other facilities 8%
Home and Community 36%
Unknown 8%
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© 2008 Elder Care Rights Alliance
QUIZ
© 2008 Elder Care Rights Alliance
Who is the Vulnerable Adult?
© 2008 Elder Care Rights Alliance
© 2008 Elder Care Rights Alliance
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
© 2008 Elder Care Rights Alliance
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.
© 2008 Elder Care Rights Alliance
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
© 2008 Elder Care Rights Alliance
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
© 2008 Elder Care Rights Alliance
What Are the Types of Abuse
© 2008 Elder Care Rights Alliance
What Are the Types of Abuse
 Neglect
 Physical Abuse
 Verbal Abuse
 Emotional Abuse
 Sexual Assault
 Financial Exploitation
 Self-Neglect
© 2008 Elder Care Rights Alliance
Warning Signs
 Unexplained

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bruises
Sudden decline in
hygiene
Sudden withdrawal
or isolation
Crying spells
Hoarding
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 Medications not


being filled
Unexplained
transfer of assets or
possessions
A vulnerable adult’s
report of being
abused
Who Abuses?
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Who Abuses?
 Care givers (formal and informal)
 Adult children and other family
members
 Spouses
 Friends
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Who are Mandated Reporters
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Who are Mandated Reporters
 Professionals such as:
• Social Workers
• Law Enforcement
• Nurses
• Healthcare Professionals
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What is Reportable
(1) Two residents of assisted living
facility (both have dementia) get into a
pushing/shoving altercation in the
dining room.
© 2008 Elder Care Rights Alliance
What is Reportable
(2) A care provider witnesses another
staff person yelling and swearing at a
resident.
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What is Reportable
(3) On your daily walk, you hear a
neighbor yelling and cursing at their
elderly next door neighbor.
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What is Reportable
(4) A resident is walking down the hall
using his walker, trips, falls and breaks
his hip.
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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.
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What is Reportable
(6) A nurse is transferring a resident,
when she accidentally drops the
resident.
© 2008 Elder Care Rights Alliance
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.
© 2008 Elder Care Rights Alliance
Where to Report?
© 2008 Elder Care Rights Alliance
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)
© 2008 Elder Care Rights Alliance
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.
© 2008 Elder Care Rights Alliance
End of Quiz
© 2008 Elder Care Rights Alliance
What is Reportable?
© 2008 Elder Care Rights Alliance
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.
© 2008 Elder Care Rights Alliance
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.
© 2008 Elder Care Rights Alliance
Duties of Designated Facility
Reporters
 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).
© 2008 Elder Care Rights Alliance
Duties of Designated Facility
Reporters
 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.
© 2008 Elder Care Rights Alliance
Duties of Designated Facility
Reporters
 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.
© 2008 Elder Care Rights Alliance
Risk Factors
 Elders
 Caregivers
 Housing
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Elder Risk Factors
 Argumentative
 Demanding
 Hostile
 Mute
 Verbally abusive
 Incontinent
 Intrusive
© 2008 Elder Care Rights Alliance
 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
© 2008 Elder Care Rights Alliance
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
© 2008 Elder Care Rights Alliance
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
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© 2008 Elder Care Rights Alliance
Cultural, Gender, & Generational
Considerations
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What Will You Do
Differently Now?
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Promising Practices
 Home administration communicates clearly
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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.
© 2008 Elder Care Rights Alliance
Questions?
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Thank You!
© 2008 Elder Care Rights Alliance