Transcript Responding to Vulnerable Adult Neglect in King County

Responding to Vulnerable Adult
Neglect in King County
Page Ulrey
Senior Deputy Prosecuting Attorney
April 20, 2016
1
King County Prosecutor’s Office
Elder Abuse Project
• Prosecutes cases of elder financial
exploitation, neglect, sexual assault, and
homicide
• Trains first responders, medical
community, and public
• Works to improve systemic response to
elder abuse
2
Elder Abuse, Neglect, and Exploitation
For every one case
that is reported,
1
another twenty-three cases
never come to light.
23
Source: NYS Elder Abuse Prevalence Study; Weill Cornell Medical College, NYC Department for the Aging; Lifespan; (2011)
3
Of the 9 million Americans over age 65
who live alone, 2 million say they have
no one to turn to if they need help.
U.S. Administration on Aging
4
Even mild abuse, neglect, or exploitation
increase premature deaths
in the elderly by 300%.
Mark Lachs, MD
5
From 1 to 2 million Americans aged 65 or
over have been harmed by a caretaker in a
domestic or institutional setting.
National Research Council
6
Forms of Elder Abuse
•
•
•
•
•
Neglect*
Physical Abuse
Sexual Abuse
Financial Exploitation (often co-occurring)
Emotional/Psychological Abuse (often cooccurring)
7
Indicators of Neglect
(usually multiple are present)








Untreated medical conditions
Dehydration
Malnutrition
Unavailability of food and water
Soiled clothing
Poor hygiene
Poor dental, nail care
Pressure ulcers
8
Pressure Ulcers (Bedsores)
9
Pressure Ulcers
10
More Indicators of Neglect






Unsanitary, cluttered living conditions
Soiled bedding / undergarments
Smell of urine, feces
Withholding of medications
Overmedicating
Absence of medical necessities/ assistance
devices
11
Common Justifications by
Perpetrators of Neglect
•
•
•
“I was just following her wishes.”
“I promised I’d never put him in a nursing
home.”
“He refused my help and didn’t want to go to
the doctor.”
12
Crimes of Neglect in Washington
• Criminal Mistreatment 1, 2, 3, and 4
• Abandonment 1, 2, and 3
13
Criminal Mistreatment Crimes
• (1) Defendant recklessly/negligently caused
harm, or imminent and substantial risk of harm,
by withholding any of the basic necessities of life;
• (2) Victim was a dependent person;
• (3) Defendant was employed, entrusted with
physical custody of, or assumed responsibility to
provide to victim the basic necessities of life;
• (4) Any of these acts occurred in the State of
Washington
14
Basic Necessities of Life
•
•
•
•
Food and water
Shelter and clothing
Health care
Medication
15
Neglect May be Criminal When Some
of These Signs / Symptoms are Present
• Multiple, large / deep pressure sores
– Untreated or improperly treated
– Odorous
– Infected
•
•
•
•
Sepsis
Malnutrition
Dehydration
Poor hygiene
16
Mandatory Reporting
in Washington
17
Mandatory Reporting in Washington
RCW 74.34
• Persons who are designated as mandatory
reporters of vulnerable adult abuse must
immediately report abuse, neglect, and
exploitation to DSHS and, in many cases, law
enforcement.
• In death cases, must also immediately report
to the medical examiner/coroner.
18
Who is Included in Definition of
“Mandated Reporter”
RCW 74.34.020
•
•
•
•
•
•
DSHS employee
Law enforcement officer
Social worker
Individual provider
Employees and operators of a facility
Employee of a social service, welfare, mental health,
adult day health, adult day care, home health, home
care, or hospice agency
• County coroner or medical examiner
• Health care provider subject to chapter 18.130 RCW
– Paramedics and EMTs
19
Definition of “Vulnerable Adult”
RCW 74.34.020
• (a) Sixty years of age or older who has the
functional, mental, or physical inability to care
for himself or herself; or
• (b) Found incapacitated under chapter 11.88
RCW; or
• (c) Who has a developmental disability as
defined under RCW 71A.10.020; or
20
Definition of “Vulnerable Adult”
• (d) Admitted to any facility; or
• (e) Receiving services from home health, hospice,
or home care agencies licensed or required to be
licensed under chapter 70.127 RCW; or
• (f) Receiving services from an individual provider;
or
• (g) Who self-directs his or her own care and
receives services from a personal aide under
chapter 74.39 RCW.
21
Specific Reporting Requirements
RCW 74.34.035
• Physical and sexual assault:
Immediately report to LE and DSHS
• Death as result of abuse, neglect, or abandonment:
Report to ME, LE, and DSHS in the most expeditious manner
possible
• Neglect, financial exploitation and other abuse:
Immediately report to DSHS
22
How to Report to DSHS
King County contact numbers:
• In homes and long-term care facilities:
– 1-866-221-4909 (Adult Protective Services)
• DSHS hours: 8 a.m. – 5 p.m., Monday – Friday
– Answering machine if after hours
23
When in doubt, report it
• Failure to report is a gross misdemeanor
– RCW 74.35.053
• If you report in good faith, you are immune
from liability
– RCW 74.34.050
24
How You Can Help Us
• Consider
– The possibility that exploitation, abuse or
neglect may be occurring
– Abuse, neglect, or exploitation as a possible
explanation for what you are seeing
25
How You Can Help Us
• Document
– Signs of neglect
– Signs of cognitive impairment
– Concerns about behavior of caregiver
– Concerns about undue influence,
financial exploitation, neglect, or abuse
– Statements of patient and caregiver
26
How You Can Help Us
• Request law enforcement at the scene when:
– Serious neglect
• Multiple severe pressure sores; or
• Sepsis / Osteomyelitis; or
• Death or near death
– Sexual assault
– Serious physical assault
27
Feel Free to Contact Us
• Page Ulrey
– [email protected]
– 206-477-1943
• Amanda Froh
– [email protected]
– 206-477-1872
28