Aging and Long Term Care ( 3 Hours) > Chapter 6 - Abuse of the Elderly & Resources

Chapter 6 - Abuse of the Elderly & Resources

VI. Abuse of the Elderly

The Administration on Aging provides the following information on Elder Abuse (AoA, 2006):

A. Range of the Problem

Each year hundreds of thousands of older persons are abused, neglected and exploited by family members and others. Many victims are people who are older, frail, and vulnerable and cannot help themselves and depend on others to meet their most basic needs.

Legislatures in all 50 states have passed some form of elder abuse prevention laws. Laws and definitions of terms vary considerably from one state to another, but all states have set up reporting systems. Generally, adult protective services (APS) agencies receive and investigate reports of suspected elder abuse.

The 1998 National Elder Abuse Incidence Study funded in part by AoA found the following:

  • 551,011 persons, aged 60 and over, experienced abuse, neglect, and/or self-neglect in a one-year period;
  • Almost four times as many new incidents of abuse, neglect, and/or self-neglect were not reported as those that were reported to and substantiated by adult protective services agencies;
  • Persons, aged 80 years and older, suffered abuse and neglect two to three times their proportion of the older population; and
  • Among known perpetrators of abuse and neglect, the perpetrator was a family member in 90 percent of cases. Two-thirds of the perpetrators were adult children or spouses.

B. Definitions of Elder Abuse

To report elder abuse, contact APS through your state's hotline. The APS agency screens calls for potential seriousness, and it keeps the information it receives confidential. If the agency decides the situation possibly violates state elder abuse laws, it assigns a caseworker to conduct an investigation (in cases of an emergency, usually within 24 hours). If the victim needs crisis intervention, services are available. If elder abuse is not substantiated, most APS agencies will work as necessary with other community agencies to obtain any social and health services that the older person needs.

The older person has the right to refuse services offered by APS. The APS agency provides services only if the senior agrees or has been declared incapacitated by the court and a guardian has been appointed. The APS agency only takes such action as a last resort.

C. Reporting Elder Abuse

To report elder abuse, contact APS through your state's hotline. The APS agency screens calls for potential seriousness, and it keeps the information it receives confidential. If the agency decides the situation possibly violates state elder abuse laws, it assigns a caseworker to conduct an investigation (in cases of an emergency, usually within 24 hours). If the victim needs crisis intervention, services are available. If elder abuse is not substantiated, most APS agencies will work as necessary with other community agencies to obtain any social and health services that the older person needs.

The older person has the right to refuse services offered by APS. The APS agency provides services only if the senior agrees or has been declared incapacitated by the court and a guardian has been appointed. The APS agency only takes such action as a last resort.
(AoA, 2006)

Elder abuse, as spousal abuse and child abuse, is a significant problem in the United States. This abuse can include physical and sexual abuse, neglect and emotional abuse. Financial abuse on the elderly is also a prevalent problem in the United States. This abuse is committed by fraud on the part of strangers and exploitation of finances by family members and caregivers. The elderly are very vulnerable to all types of abuse. (Johnson 2004) It is important for the healthcare worker to be aware of the potential of abuse and assess for it. An added problem is sometimes the elderly person's diminished mental capacity can result in false claims of abuse, so when valid claims are made they are not taken seriously. It is better to investigate a false claim than to allow abuse to continue as a result of not investigating it.

The National Center on Elder Abuse (NCEA) is a comprehensive resource for issues of Elder Abuse. Here is a link to their site: http://www.elderabusecenter.org HIssues

In California, as in other states, laws provide regulations regarding mandated reporters and penalties. Those from California are provided her as an example for the healthcare practitioner. The NCEA (linked above) provides links to each state's laws regulating Elder Abuse. The healthcare professional needs to investigate for signs and symptoms of abuse and report any reasonable suspicion of abuse as stated in the following statutes:

CALIFORNIA WELFARE AND INSTITUTIONS CODE
SECTION 15630

Who is a mandate reporter of Elder Abuse?

Anybody who has assumed care for an elderly person is a mandated reporter:

"15630. (a) Any person who has assumed full or intermittent responsibility for care or custody of an elder or dependent adult, whether or not he or she receives compensation, including administrators, supervisors, and any licensed staff of a public or private facility that provides care or services for elder or dependent adults, or any elder or dependent adult care custodian, health practitioner, clergy member, or employee of a county adult protective services agency or a local law enforcement agency, is a mandated reporter.

(b) (1) Any mandated reporter who, in his or her professional capacity, or within the scope of his or her employment, has observed or has knowledge of an incident that reasonably appears to be physical abuse, as defined in Section 15610.63 of the Welfare and Institutions Code, abandonment, abduction, isolation, financial abuse, or neglect, or is told by an elder or dependent adult that he or she has experienced behavior, including an act or omission, constituting physical abuse, as defined in Section 1 5610.63 of the Welfare and Institutions Code, abandonment, abduction, isolation, financial abuse, or neglect, or reasonably suspects that abuse, shall report the known or suspected instance of abuse by telephone immediately or as soon as practicably possible, and by written report sent within two working days, as follows:

(A) If the abuse has occurred in a long-term care facility, except a state mental health hospital or a state developmental center, the report shall be made to the local ombudsperson or the local law enforcement agency."

What are the penalties for failure to report?

Penalties for failing to report becomes more severe if it is determined that as a result of the failure to report the elderly person is injured or killed:

"(h) Failure to report physical abuse, as defined in Section 15610.63 of the Welfare and Institutions Code, abandonment, abduction, isolation, financial abuse, or neglect of an elder or dependent adult, in violation of this section, is a misdemeanor, punishable by not more than six months in the county jail, by a fine of not more than one thousand dollars ($1,000), or by both that fine and imprisonment. Any mandated reporter who willfully fails to report physical abuse, as defined in Section 15610.63 of the Welfare and Institutions Code, abandonment, abduction, isolation, financial abuse, or neglect of an elder or dependent adult, in violation of this section, where that abuse results in death or great bodily injury, shall be punished by not more than one year in a county jail, by a fine of not more than five thousand dollars ($5,000), or by both that fine and imprisonment. If a mandated reporter intentionally conceals his or her failure to report an incident known by the mandated reporter to be abuse or severe neglect under this section, the failure to report is a continuing offense until a law enforcement agency specified in paragraph (1) of subdivision (b) of Section 15630 of the Welfare and Institutions Code discovers the offense." (Bolding font added)

VII. Other Resources of Information Regarding the Elderly and Caregivers

Website of Errold F. Moody, a financial planner and instructor. This website provides information and links to a comprehensive array of information regarding care for the elderly and those that care for them. http://www.efmoody.com

Milbank Memorial Fund ( Article) http://www.milbank.org/0008stone/

California State Website on Aging and Care
http://www.aging.state.ca.us/html/programs/ombudsman.html

Help guide to mental health and lifelong wellness http://www.helpguide.org/elder_care.htm

National Senior Citizens Law Center http://www.nsclc.org

The National Hospice and Pallative Care Organization http://www.nhpco.org/templates/1/homepage.cfm

References

Administration on Aging, Statistics: A Profile of Older Americans 2004 from http://www.aoa.gov/(June 2005)

Administration on Aging, Fact Sheet: Caring for Someone in the Last Years of Life in http://www.aoa.gov/press/nfc_month/2004/fact_sheets/Fact Sheet - Caring for someone in the last years of life.pdf (2006)

Administration on Aging, Statistics: Elder Rights & Resources: Elder Abuse in http://www.aoa.gov/(2006)

Alexopoulos, George S. M.D.; Katz Ira R., M.D., Ph.D.; Reynolds, III, Charles F. M.D.; Ross, Ruth M.A.: Depression in Older Adults: A Guide for Patients and Families, 2001 from http://www.psychguides.com/Geriatric Depression LP Guide.pdf (June 2005)

Alzheimers Association (ALZ), Understanding Early Stage Alzheimers: A Guide for Healthcare Professionals (1999) as found in http://www.alz.org/Resources/FactSheets/FSEarlystageguidecare.pdf(July 2005)

Alzheimers Association as found in
http://www.alz.org/ July 2005

Bureau of Labor Statistics, Current Population Survey as found in as found in Federal Interagency Forum on Aging-Related Statistics: Older Americans 2004: Key Indicators of Well Being from http://agingstats.gov/ (June 2005)

California Welfare and Institutions Code Section 15360 as linked to from the National Center on Elder Abuse as found in http://www.elderabusecenter.org HIssues

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics, National Health Interview Survey (2002) as found in Federal Interagency Forum on Aging-Related Statistics: Older Americans 2004: Key Indicators of Well Being from http://agingstats.gov/ (June 2005)

Centers for Medicare & Medicaid Services (CMM), Medicare claims and enrollment data 2002, as found in Federal Interagency Forum on Aging-Related Statistics: Older Americans 2004: Key Indicators of Well Being from http://agingstats.gov/ (June 2005)

Cormier, W., & Cormier, L. (1979) Interviewing Strategies for Helpers: A guide to assessment, treatment and evaluation. Monterey, CA: Brooks/Cole as found in Hepworth, Dean H. and Larsen, Jo Ann. Direct Social Work Practice: Theory and Skills, Chicago: The Dorsey Press, 1986.

Dietary Guidelines for Americans 2005 was released January 12, 2005, by HHS Secretary Tommy G. Thompson and USDA Secretary Ann M. Veneman in
http://www.health.gov/dietaryguidelines/dga2005/document/html/executivesummary.htm#fn1

Federal Interagency Forum on Aging-Related Statistics (FIFARS): Older Americans 2004: Key Indicators of Well Being from http://agingstats.gov/ (June 2005)

Health and Retirement Study as found in Federal Interagency Forum on Aging-Related Statistics: Older Americans 2004: Key Indicators of Well Being from http://agingstats.gov/ (June 2005)

Holmes & Rahe (1967). Holmes-Rahe life changes scale. Journal of Psychosomatic Research, Vol. 11, pp. 213-218. as found in http://www.geocities.com/beyond_stretched/holmes.htm

Johnson, Kelly Dedel, U.S. Department of Justice, Office of Community Oriented Policing Services: Financial Crimes Against the Elderly, August 2004 from
http://www.cops.usdoj.gov/mime/open.pdf?Item=963 June 2005

Johnson, Marsha K., as found in From Studying the Mind VHS, Psychological Science: The Mind, Brain and Behavior published by W.W. Norton 2003 from
http://www.wwnorton.com/psychsci/activity/ch11_activity4.htm June 2005

Kirschner, Charlotte, Senescence as found in Adult Psychopathology: A Social Work Perspective, pp. 527-551, edited by Turner, Francis, J. New York: The Free Press 1984

U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement, 2003 as found in Federal Interagency Forum on Aging-Related Statistics: Older Americans 2004: Key Indicators of Well Being from http://agingstats.gov/ (June 2005)

United States Department of Health and Human Services, Center for Medicare ad Medicaid Services, Quick Facts about Medicare’s New Coverage for Preblockedion Drugs from http://www.cms.hhs.gov/medicarereform/newcovprescdrug.pdf June 2005

The Author

Lance Parks, LCSW has a rich and diverse history of educational, clinical, training and administrative experience. Mr. Parks is a certified Group Home Administrator in the state of California and serves as an Associate Director and Licensed Clinical Social Worker at a residential placement facility for adolescents ages 13-18. Mr. Parks' counseling experience includes the following populations and settings: HIV positive inmates at CIM in Chino, California, outpatient Spanish speaking clinic, private psychiatric hospital, skilled nursing facilities (nursing homes), private family counseling clinic, and adolescent residential placement.

In addition, Mr. Parks has helped plan, develop and/or present training programs and conferences for the following personnel: group home staff, state certified group home administrators, probation officers, social workers, mental health personnel, LCSWs and MFTs. Since 1999 Mr. Parks has served on the continuing education committee, residential care committee and juvenile justice committee for a statewide association of private nonprofit child and family serving agencies.

Mr. Parks received his Bachelor of Science in Family Sciences with a minor in Spanish from Brigham Young University, and his Master of Social Work from the University of Southern California.
 
Aging and Long Term Care ( 3 Hours) > Chapter 6 - Abuse of the Elderly & Resources
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