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© 2008 Elder Care Rights Alliance
Older, Wiser, StrongerUnderstanding 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 sexually assaulted1.
Every 2.7 minutes an elder is victimized2.
© 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%
© 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%
© 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 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
© 2008 Elder Care Rights Alliance
Who Abuses?
© 2008 Elder Care Rights Alliance
Who Abuses?
Care givers (formal and informal) Adult children and other family
members Spouses Friends
© 2008 Elder Care Rights Alliance
Who are Mandated Reporters
© 2008 Elder Care Rights Alliance
Who are Mandated Reporters
Professionals such as:
•Social Workers
•Law Enforcement
•Nurses
•Healthcare Professionals
© 2008 Elder Care Rights Alliance
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.
© 2008 Elder Care Rights Alliance
What is Reportable
(3) On your daily walk, you hear a neighbor yelling and cursing at their elderly next door neighbor.
© 2008 Elder Care Rights Alliance
What is Reportable
(4) A resident is walking down the hall using his walker, trips, falls and breaks his hip.
© 2008 Elder Care Rights Alliance
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.
© 2008 Elder Care Rights Alliance
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
© 2008 Elder Care Rights Alliance
Elder Risk Factors
Argumentative Demanding Hostile Mute Verbally abusive Incontinent Intrusive
Combative History of multiple
incidents History of
substance abuse Manipulative
© 2008 Elder Care Rights Alliance
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
© 2008 Elder Care Rights Alliance
Cultural, Gender, & Generational Considerations
© 2008 Elder Care Rights Alliance
What Will You Do Differently Now?
© 2008 Elder Care Rights Alliance
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.
© 2008 Elder Care Rights Alliance
Questions?
© 2008 Elder Care Rights Alliance
Thank You!