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Faith Leaders Respond to Faith Leaders Respond to Elder AbuseElder Abuse
1
““Honor Thy Father and Thy Mother”Honor Thy Father and Thy Mother”
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 2
The elderly are not valued in America. The elderly are not valued in America. Yet, they are our parents and grandparents, Yet, they are our parents and grandparents,
the soldiers who landed at Normandy, the soldiers who landed at Normandy, the women who taught us to read. the women who taught us to read.
The helped make this country what it is today. The helped make this country what it is today. They are my heroes…They are my heroes…
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 3
Why Learn About Elder Abuse? What is Elder Abuse? Who Must Report Elder Abuse? What is Adult Protective Services? When Should I Report? How Do I Make a Report? What Can I Do In My Congregation?
OverviewOverviewOverviewOverview
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 4
Why Learn About Elder Abuse?Why Learn About Elder Abuse?
Faith leaders: Are often the first stop for help;
May be the only other person (except the abuser) in the victim’s life;
Will be better prepared to help congregants;
May be required (by state law) to report.
Knowing the warning signs… may save a life.
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 5
What Is Elder AbuseWhat Is Elder Abuse?
Elder Abuse: any knowing, intentional, or negligent act
by a caregiver or any other person
that causes harm or a serious risk of harm to a vulnerable older person.*
Types of abuse
physical, emotional, sexual abuse, financial exploitation, abandonment, and neglect
*General definition used by the National Center on Elder Abuse. For more information see NCEAWeb site: http://www.elderabusecenter.org
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 6
A large problem—2-10% of older American population may be victims
A hidden problem—Only 1 in 5 victims are identified
A family problem—Perpetrators are often family members and people known to the elder
A serious problem—Abused elders four times more likely to die prematurely
What Is Elder Abuse?What Is Elder Abuse?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 7
In (your state), the following categories of abuse are defined in law:
What Is Elder Abuse?What Is Elder Abuse?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 8
Occurs whereverolder Americans live
Own home Apartment Public housing Nursing home Board and care Assisted living Relative’s home
Where Does Elder Abuse Occur?Where Does Elder Abuse Occur?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 9
Who Are the Victims?Who Are the Victims?
Men and women. Women more likely to be identified and reported
Socially isolated
Have dementia (stroke, Alzheimer’s disease)
Have mental illness or physical infirmities
Are trusting of others
Many are over 80 years old
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 10
• 4 –10 times higher risk of becoming a victim of crime
• 10 times more likely to be sexually assaulted
• Less likely to report abuse
• Lower rates of police follow-up, prosecution, conviction
What About Adults with Disabilities?What About Adults with Disabilities?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 11
Have alcohol or substance abuse problems
Have mental health issues
Dependent on the older person, unemployed – no personal income
Family members, friends, neighbors, new “best friend”
Provider of care (paid or unpaid)
What are Red Flags?What are Red Flags?
Potential AbusersPotential Abusers
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 12
Spouses
Adult Children
Other Relatives (grandchildren,
nieces, nephews)
Friends, Neighbors
Caregivers
Others
Who are the Abusers?Who are the Abusers?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 13
Facts and Figures in Our AreaFacts and Figures in Our Area
In (state/county), the data shows that:
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 14
More Facts and Figures…More Facts and Figures…
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 15
Why Abuse Is Not ReportedWhy Abuse Is Not Reported Ageism—Unfavorable attitude towards older people
Disbelief—“They’re such an upstanding family”
Lack of knowledge of signs of abuse
Lack of knowledge of reporting procedures
Reluctance or fear of confronting the offender
Fear of jeopardizing relationship with elder or elder’s family
Mistreated person requests it not be reported
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 16
SIGNS OF SIGNS OF ELDER ELDER ABUSEABUSE
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 17
What are some Warning Signs ofWhat are some Warning Signs of Neglect?Neglect?
Elder's report of being mistreated
Dehydration, malnutrition, untreated bed sores, poor personal hygiene
Unattended/untreated health problems
Hazardous or unsafe living conditions: improper wiring, no heat, no running water
Unsanitary living conditions—dirt, fleas, lice, soiled bedding, fecal/urine odors, inadequate clothing
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 18
Warning Signs Warning Signs AbandonmentAbandonment
Elder's own report of being abandoned
Desertion of an elder at a nursing facility or other similar institution
shopping center other public location
What are some Warning Signs ofWhat are some Warning Signs of Abandonment?Abandonment?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 19
Physical Abuse Physical Abuse Warning SignsWarning Signs
Elder’s report of being hit, slapped, kicked, etc..
Findings of medication over- or under-utilization
Signs of being punished or restrained
Elder's sudden change in behavior
Caregiver's refusal to allow visitors to see an elder alone
What are some Warning Signs ofWhat are some Warning Signs of Physical Abuse?Physical Abuse?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 20
What are some Warning Signs ofWhat are some Warning Signs of Physical Abuse?Physical Abuse?
Bruises, black eyes, welts, lacerations, rope marks
Broken or fractured bones, skull fractures
Open wounds, cuts, punctures, untreated injuries in various stages of healing
Sprains, dislocations, bleeding
Broken eyeglasses or frames
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 21
Sudden changes in bank account or banking practice
Inclusion of additional names on bank signature card
Unauthorized withdrawal using elder's ATM
Abrupt changes in will or other financial documents
Unexplained disappearance of funds or valuable possessions
What are some Warning Signs ofWhat are some Warning Signs of Financial Abuse?Financial Abuse?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 22
Warning SignsWarning Signs Financial AbuseFinancial Abuse
Disparity between assets and living conditions
Forged signature on financial transactions or titles of possessions
Sudden appearance of previously uninvolved relatives claiming rights to elder's affairs and possessions
Unexplained sudden transfer of assets to a family member or someone outside the family
Elder's report of financial exploitation
What are some Warning Signs ofWhat are some Warning Signs of Financial Abuse?Financial Abuse?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 23
Warning SignsWarning Signs Emotional AbuseEmotional Abuse
Elder's report of being verbally or emotionally mistreated.
Emotionally upset or agitated
Extremely withdrawn, non-communicative, non-responsive
Unusual behavior usually attributed to dementia—sucking, biting, rocking
What are some Warning Signs ofWhat are some Warning Signs of Emotional Abuse?Emotional Abuse?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 24
Warning SignsWarning Signs Sexual AbuseSexual Abuse
Bruises around the breasts or genital area
Unexplained venereal disease or genital infections
Torn, stained, or bloody underclothing
Elder's report of being sexually assaulted or raped
Elder's report of being sexually assaulted or raped
Bruises around the breasts or genital area
Unexplained venereal disease or genital infections
Torn, stained, or bloody underclothing
What are some Warning Signs ofWhat are some Warning Signs of Sexual Abuse?Sexual Abuse?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 25
When the person because of depression, confusion, dementia or alcoholism does not take care of him or herself.
Dehydration, malnutrition, untreated or improperly attended medical conditions, poor personal hygiene
Hazardous or unsanitary living conditions
Inappropriate or inadequate clothing
Lack of the necessary medical aids—eyeglasses, hearing aids, dentures
Homelessness
What are some Warning Signs ofWhat are some Warning Signs of Self Neglect?Self Neglect?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 26
Is Elder Abuse a Crime?Is Elder Abuse a Crime?
Penal Code Section ____ provides that:
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 27
If I Suspect Abuse…If I Suspect Abuse… What Should I Do?What Should I Do?
You play an important role as a “sentinel” or “gatekeeper” for an abused person in your community
If you suspect that something is amiss, call your local Adult Protective Services Program. It is not your responsibility to investigate abuse
APS will consult with you about the case. If they believe a report needs to be made, they will take the necessary information from you
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 28
Are Clergy Required to Report?Are Clergy Required to Report?
In (your state) the reporting policy:
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 29
An essential part of our community safety net.
Helps vulnerable adults who are in danger of being mistreated or neglected
Helps those unable to protect themselves
Adult Adult Protective Protective
Services (APSServices (APS)
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 30
What Does APS Do?What Does APS Do?
Prevents and alleviates harm resulting from abuse, neglect or exploitation: Receives reports Investigates needs and risks Develops case plans Provides and monitors services
Offers needed services Competent adults may refuse APS help
Collaborates with other services to meet elders’ needs
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 31
Our (state/area) APS program includes:
What Does APS Do?What Does APS Do?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 32
To report abuse that occurs in the Community (i.e. private home, hotel, senior center)
Call:
Who Should I Call?Who Should I Call?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 33
Adult Protective
Services (APS)
LTCO is a unique, nationwide program
Provides advocacy for residents of nursing homes, board and care, and other long term care facilities.
Long Term CareLong Term CareOmbudsmanOmbudsman
(LTCO(LTCO)
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 34
What Does the LTCO Do?What Does the LTCO Do?
Advocate for Residents Receives and resolves complaintscomplaints about
resident care
EducatesEducates residents, families and communities on Resident Rights Quality Care
CollaboratesCollaborates on policy change to meet resident needs
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 35
What Does the LTCO Do?What Does the LTCO Do?
Our LTCO program includes:
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 36
To report abuse that occurs in a Long Term Care Facility (e.g., nursing home, assisted living facility)
Call:
Who Should I Call?Who Should I Call?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 37
Be patient
Do not act shocked, keep your demeanor calm
Reassure the person that he or she is not to blame
Let him or her know that he or she is not alone.
If someone tells me about abuse… If someone tells me about abuse… What Should I Do?What Should I Do?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 38
I have never reported before…I have never reported before…
What is Involved?What is Involved?
In (state/area), the protocol for reporting elder abuse includes:
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 39
What information do I give?What information do I give?
Your name Victim’s name Victims address/location Your observations and concerns Who is the suspected abuser? Can the victim walk, hear, see, etc.? Anyone else who should be contacted. Contact information.
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 40
In (state/area) the policy includes:
Do I have to make a written report?Do I have to make a written report?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 41
What happens after I report?
You can expect a professional & confidential response:
What happens after I report?What happens after I report?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 42
I am not a trained investigator…I am not a trained investigator… How can I recognize abuse?How can I recognize abuse?
No one expects you to be the experts on abuse or to know all the warning signs
Sometimes abuse is so obvious that there is no question whether to report it
If you are concerned and you think something is going on, call the professionals at APS. They are trained to investigate and make that decision
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 43
What if I don’t report?What if I don’t report?
In (your state), if a mandated reporter fails
to report abuse:
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 44
Are there times when…Are there times when… I should not report?I should not report?
The short answer is, no:
Some Faith Leaders believe that they can assist an elder or a family without reporting abuse
If you have been told, or reasonably believe that abuse is taking place, it is very importantvery important that you report it
Let the experts assist the elder and the family.
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 45
What about my relationship with my What about my relationship with my congregation member?congregation member?
Abused persons will often drop hints or tellsomeone about the abuse because they knowthey need help
If, having been told about the abuse, you do not report it, you may be sending a message to the older person that what is happening to them is not serious
In addition, in (your state), if you do not report reasonable suspicions, there are/are not legal consequences
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 46
You can help prevent it before it gets serious:
Take time to meet alone with the older person. Tell him or her what you know about some of the risk factors of elder abuse (e.g., adult child who is financially dependent).
Tell him/her of your concern.
Explain the role of APS. Encourage him/her to seek help before abuse occurs or worsens.
What if I see early warning signs What if I see early warning signs of abuse?of abuse?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 47
What if the elder wants help but…What if the elder wants help but…
The elder may want help but doesn’t want to get the alleged abuser in trouble.
This is a very common response of older abused people, especially when the abuser is a family member
Remind the abused person that help is available to him or her and that it is better to seek help than to try to handle a difficult situation alone.
Encourage them to talk with APS
APS may be able to refer the alleged abuser to services (e.g., drug or alcohol treatment), however, these are also voluntary and may be rejected by the abuser
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 48
The elder may seem confused. It’s not clear The elder may seem confused. It’s not clear that he/she understands the situation.that he/she understands the situation.
Sometimes dementia, mental illness, or other factors may hamper an older person’s cognition
An assessment may indicate that the elder does not have the capacity to make informed judgments about his or her care. Adult Protective Services, may, on an emergency basis, or with court approval, act on behalf of the elder’s best interest, even without his or her consent. The procedure for such actions varies from state to state
What if the elder seems confused…What if the elder seems confused…
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 49
What about “caregiver stress” and What about “caregiver stress” and elder abuse?elder abuse?
The abuser says that “caregiver stress” is causing the abuse, how can I help?
Caregiving is, without question, a stressful endeavor. However, research shows that stress related to caregiving is not the cause of elder abuse. Some people should not be entrusted with care of an elder. If these people become caregivers, they may abuse and blame the stress for the abuse.
Be careful not to come to the support of the caregiver without also seriously considering the safety of the older person. The safety of the older person should be your foremost concern.
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 50
What about forgiveness?What about forgiveness?
Shouldn’t the abusers be forgiven? Forgiveness does not mean returning to an
abusive situation.
An abused person may one day find that forgiveness is possible.
However, no one should be told to put up with an abusive situation because their faith calls on them to forgive the abuser’s transgressions.
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 51
What Can Faith Leaders Do?What Can Faith Leaders Do?
Educate yourself and other Faith Leaders about elder abuse
Create a Safe Place for Elders by making your place of worship a place where elderly victims can come forward for help.
Educate the Congregation on the subject of
violence against and fraud and abuse of elders.
Talk with other Faith Leaders about a regular meeting on issues of family violence.
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 52
Establish a Friendly Visitor Program
Create a Nurse Program for homebound elders
Break the silence about abuse Give a sermon that mentions abuse in vulnerable
populations Make it clear that this type of behavior is not condoned
Intervene Do not turn a blind eye or a deaf ear to the clues of
abuse
What Can Faith Leaders Do?What Can Faith Leaders Do?
Faith Leaders Respond to Elder AbuseNCEA, 2005 Grant #90 AM 2457 53
An ElderAn Elder
A person whose life continues A person whose life continues
to have promise for and to have promise for and
connection to the future:connection to the future: … …still growing,still growing,
… …still a learner,still a learner,
… …still with potentialstill with potential
A person whose life continues A person whose life continues
to have promise for and to have promise for and
connection to the future:connection to the future: … …still growing,still growing,
… …still a learner,still a learner,
… …still with potentialstill with potential