Abuse & Exploitation | Aging Matter | Npt Reports
Coming up on Aging Matters, abuse and exploitation: There are over five million elder abuse victims in the United States. That is more than the combined total of child abuse victims and domestic violence victims. It can happen to any family at any income level, any religious group, any ethnic group: Because there is a Child Protective Services system in this country people assume that a similar system is in place to protect older individuals.
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That’s not the case. In the area of elder abuse, neglect and exploitation we are 40 years behind Child Protective Services: Those of us who work in this field know the impact of elder abuse. These are crimes. In Georgia they are felonies and therefore they need to be treated as such.
People who have been financially exploited are three times as likely as other individuals to die at a younger age: Mostly perpetrators are people the victim knows, trusts, and or loves. It’s not strangers, it’s people who are very much in the center of that elder’s life: Once we have identified somebody who’s being abused, once we have identified what services are necessary to reduce the future risk of that abuse, the service is not always available for that person, either in the part of the community that they live in or in general across the state: To this day I remain amazed and outraged that abuse of older people and adults with disabilities gets so little attention and so few resources.
Major funding for NPT Reports Aging Matters is provided by the West End Home Foundation, improving the quality of life of seniors through the support of nonprofit organizations in middle Tennessee. The HCA Foundation, on behalf of Tri. Star Health. The Jeanette Travis Foundation, dedicted to improving the health and wellbeing of the middle Tennessee community. Cigna Health. Spring. Additional funding provided by The Community Foundation of Middle Tennessee and by members of NPT. Thank you.
It will never happen to me. We all want to say that but anyone can become a victim of abuse, neglect, or financial exploitation. It’s estimated that one in 10 adults over the age of 60 is a victim but the truth is we don’t know for certain how many older adults are suffering from abuse. Hi, I’m Kathy Mattea. Experts suggest that our understanding of elder abuse lies decades behind that of child abuse and domestic violence. Elder abuse is underreported.
It lacks clear legal definition and is complicated by ethical challenges. The system of response is different depending on where you live. What are the risk factors? What can we do to protect ourselves and our loved ones? What is our responsibility to intervene for those in need? Join me as we explore the issues behind elder abuse, neglect, and exploitation. Stay tuned: My name is Robert Gentzler. I’m grateful for your willingness to be here today and to give time to this serious and important topic which I believe is only going to continue to grow. With 76 million boomers aging and the leading edge has turned 70 I don’t believe that congregational leaders can put their heads in the sand any longer.
Today a small group of church leaders and members are meeting to learn about elder abuse, neglect, and exploitation. For many in the room, this will be their first in depth conversation about elder abuse: I’m not aware of many areas of the country that’s doing what we’re doing right here today. It’s just a void. It’s just been a void out there and people have not talked about it, and the information is just not readily available so somebody’s got to do it. Why learn about elder abuse? What is elder abuse? How do we define elder abuse and what are the signs of abuse? What should we be looking for? The questions are simple but the answers are not. There is no federal legal definition of elder abuse which means no national trends statistics and data are available: The National Center on Elder Abuse defines elder abuse this way.
Elder abuse is any knowing, intending, or careless act that causes harm or serious risk of harm to an older person physically, mentally, emotionally, financially. Where does elder abuse occur? Where does it occur? Typically elder abuse tends to happen outside of adult care facilities. Of course things happen in assisted living facilities or in nursing home facilities but elder abuse generally occurs in the vulnerable adult’s own home. Who are victims of elder abuse? Well, both men and women are victims of elder abuse. However the typical victim is a woman, normally between the ages of 70 and 89 who is frail and who is cognitively impaired in some way, shape, or form: Older people control the majority of wealth in this country and their kids know it, their grandkids know it, their neighbors know it and certainly the con artists know it so they go where the money is: I think often in the news the kind of strangers scams get a lot of attention.
However that is not the majority of what we see. The majority of all abuse, neglect and exploitation is perpetrated by caregivers, family members, those people who are closest to the individuals: It’s typically a son, a daughter, a granddaughter who is in the home under the role of a caregiver but in fact is either abusing the senior, they’re stealing their money, identity theft, neglect, things of that nature is what we typically see: Know the warning signs. An unusual degree of fear or submissiveness to the caregiver, isolation from family, friends and community, characterizes a loved one as Dr. Jekyll and Mr. Hyde.
Has repeated accidental injuries. There is a new friend that is with mama and that new friend seems to be rather controlling, should be a warning sign that maybe something’s not right. When I’m out working with congregations and finding seminars for church leaders one of the most common questions that I receive is do we have to report it? If we’re not sure, what do we do? If you suspect elder abuse, you should call the police or Adult Protective Services right away: Adult Protective Services is on the frontlines of response to elder abuse: Adult Protective Services provides an investigation and assessment of reports of abuse and neglect and exploitation in all settings, private homes, long term care facilities, homeless, regardless of the location.
If we can get the report and we can find them, we’re there: Adult Protective Services is the invisible thread in the safety net. Very few people have ever heard of it although virtually everyone knows of Child Protective Services: Our role is to protect vulnerable adults in Tennessee. Our very first step is to go see the alleged victim to make sure that they’re okay. The goal of the investigation is to prevent further abuse and neglect from occurring and intervene to protect premature death.
We may talk to neighbors, friends, doctors, service providers as part of our investigation. Once we determine if the allegations are valid we would then offer some protective services if it’s indicated that there is a need for that: How and when APS responds depends on where you live in the United States: There’s no designated funding for direct services to elder abuse victims. There’s no national law about APS, no minimum standards. Every APS program differs. In county based systems, it can differ from county to county. It certainly differs from state to state.
This problem is so complex and overlaps health, money, longevity, housing, family relationships, so they really need a comprehensive response that enables them to make the decisions they want to make which is almost always to stay at home but to live safely and with some dignity: There’s no one single agency that can protect our vulnerable adults. We all work together in a system to create this protective services environment and provide the services that they need: The system that protects older adults is in the process of being built. Its foundation is the community where an elder lives.
The community plays an extremely important role in protecting our vulnerable adults. We rely on the community as our gatekeepers. They’re our eyes and ears. Everybody plays a role: Good morning, how are you? RT Williams volunteers with Bethlehem Center’s Meals on Wheels program. He sees the same clients week in and week out: I’ve been working for Meals on Wheels for seven years now.
I deliver once a week and I think it’s fair to say that I have while losing a great many people because many of my customers are elderly, I have become very close friends, almost indeed family with so many of the folks that I serve: Hello? Good morning: Already? On my way: Okay: Thank you: Meals on Wheels is just that, we deliver meals but it’s much more than that. The meals are a vehicle to knowing and learning more about the folks we serve.
Well, you look good and you look healthy: I’m feeling pretty good: It’s always good to see you dear. Well you take care: Alright: Most states have mandatory reporting laws requiring professionals who suspect abuse to report to authorities. In Tennessee everyone is a mandatory reporter: The common threads in the community that I serve is they all have friends that have their back.
Friends who will come over and help them with the house cleaning or perhaps bring them things that they need, even come and stay with them for a day or two but as they age those opportunities and those friends kind of fall by the wayside and they get into situations where they just want to see a friendly face. Hey, Henry: Hey Artie, how you doing? I’m okay, how you doing? I’m doing fine: Loneliness is the common denominator I see to easily half of the people that I serve. They just are so grateful to have someone bring a meal, but it’s not really the meal.
It’s the fact that you’re willing to come to their house and say how are you, that’s the important thing: All abuse occurs in isolate circumstances. That’s the first thing a batterer does is isolate his partner from her friends and family so she’s more under his control. The number one thing people can do is not let older people or adults with disabilities get isolated, that’s the number one risk factor is isolation.
That is the biggest risk factor that we can influence. It is to reduce isolation. If you suspect somebody like in a lot of families the abusive family member, let’s say a sibling will often isolate the older person from the other family members, tell the older person I’m the only one that cares about you, do you see anybody else here? Where they’re keeping the other people away saying Mom doesn’t feel well today, Mom can’t come to the phone. So if you start to see that kind of stuff going on in your family, you need to figure out how to intervene: When I ask how are you usually it’s going to be just fine, thanks. We all do that but you can tell if there’s something going on and this is where you have to be so on your game.
That becomes something that you might report. Maybe there’s a warning there: Suspecting abuse is enough to require a call to Adult Protective Services. It’s their job to investigate and validate claims. If there is an immediate danger a call to 911 means law enforcement will respond but do have police have the training necessary to identify signs of elder abuse? Are they aware of the laws and resources available? States across the country are testing ways to prepare police for what they will find in the field: Good morning, my name is Ramona Smith.
I’m a special agent with the Tennessee Bureau of Investigation. I am assigned to the Medicaid Fraud Control Unit. This is what I do for a living. Okay? At the Tennessee Law Enforcement Training Academy, the latest class of police officers is receiving training on the signs of elder abuse by the TBI’s Medicaid Fraud Control Unit, which investigates abuse, neglect, and exploitation where federal funds are involved.
For about a year and a half now we’ve had agents present to local basic police training classes what comprises elder abuse and things to be on the lookout for because they’re the first responders and they’re out on the streets daily: TCA 71 6 117, this is in your handout. I want you to circle it. When I started at the Bureau in 2002, abuse of a vulnerable adult was a Class A misdemeanor. Now it’s a Class D felony. So what is elder abuse? Physical abuse, sexual abuse, neglect, exploitation, and drug diversion. Put a big star next to these. Find the page, recognizing abuse.
This is one of the hardest things in the world to do. You need to document what you see. Burns or bruises, think about it. You walk into someone’s home and you see these weird bruises and you’re like, how did she get those? Is she a smoker? Is it possible she burned herself? Yeah. If it’s on the back of her neck, no.
So why don’t they report it? In the area of elder abuse one of the big challenges is just getting it reported because a lot of times people are embarrassed or ashamed or don’t want to say anything because they fear they may be placed in a nursing home or another healthcare institution or facility. Some of the things that do happen, they don’t necessarily want to talk about and those are challenges for us to try to overcome: Training is not universal and presents its own limitations: Sometimes the training is not available. Sometimes it costs a lot of money and sometimes it’s just training that might be a two hour block or a four hour block once in your career. We’re all expected to remember all that and sometimes it gets a little difficult so what we try to do is we’ve got to come up with other options: The staff at Georgia Adult Protective Services wanted law enforcement to have tools available on demand especially on nights and weekends when the doors at APS are closed.
Working with medical experts and partners they created an app to guide officers in the field: What to look for, who to call when you do see it, who’s appropriate to call so that even those individuals who have not gone through in class training would have a basic knowledge of abuse, neglect, and exploitation: One key part of the app addresses whether a victim may be experiencing some cognitive impairment, such as dementia: Dementia is a common disorder. The older you get the more likely you are to have it. You’re 85 there’s a 50 50 chance you’ve got it, sight unseen: Living with dementia or cognitive impairment is a significant risk factor for abuse.
There is important research that was done in southern California looking at elder abuse between caregivers and their care recipients, most of whom or many of whom had dementia. Almost half of cases where you had a care recipient where that person had dementia resulted in abuse: People living with dementia are at a high risk for self neglect where a person is unwilling or unable to meet their needs: There have been a number of instances all across the US where folks with dementia with Alzheimer’s disease were stopped and in a moment of clarity gave a reasonable answer to an officer who allowed to leave and didn’t survive the night for whatever reason and those are the things we want to try to avoid: People who are cognitively impaired, demented, whatever, for any number of reasons how do they detect that? What are they supposed to do when they pick it up? Doctor Larry Tune with Emory University School of Medicine helped to create a set of questions that law enforcement could use to quickly evaluate an individual’s cognitive ability: I tell you my name is Officer Tune and then I ask you two questions and then I ask you, do you remember my name? If the guy doesn’t, well, that’s not a diagnostic test but it should raise your suspicion that this person has an impairment and something needs to be done further: Establishing whether or not we’re dealing with an abused, neglected, exploited individual allows us to go to the next step.
These are things we want to get involved in. It gives us another tool to establish a suspicion and then build on from there. It allows investigators to make home visits to start even a potential criminal proceeding to help those innocent people: Law enforcement knows what their job is which is to figure out who did it and hopefully stop that perpetrator and then hopefully an arrest and a conviction. However, what social service do we call in to deal with the person themselves, the victim and to make sure that their situation is stabilized and that they’re no longer at risk? So that can be confusing: When the crisis or the incident or the crime occurs, after the police respond then what does the senior do? Now what? How do I feel safe? How do I get counseling if I’m feeling scared? How do I get the food that I need? All those things come up: Lauren Angelo operates a program offered by 50 Forward in middle Tennessee called Victory over Crime.
If the police and Adult Protective Services are the frontline of response, Victory over Crime is a second line of defense: We at that point will swoop in and we will offer that support. We’ll offer those services to help the victim get back on their feet and our main goal is to leave them in a better state than we found them: One of the most common and least reported forms of elder abuse is financial exploitation. A study out of New York showed that only one in 44 cases of financial exploitation is reported: Being frail is a risk factor for abuse.
At the same time that victim is less able to report, is less likely to be believed and is less likely to be called as a witness in a criminal case. When we look at financial exploitation the reality is when an older person has lost their life savings and no longer has the wherewithal to live comfortably as they had hoped to do and had planned to do a lot of bad things happen. They’re never going to recoup those financial losses: We know in many instances elderly individuals when they find that their funds are tight one of the first things they do is stop taking their medication and then that affects their health and we also know that people who have been financially exploited are three times as likely as other individuals to die at a younger age: It’s not benign just because it’s about money. It changes lives. It destroys relationships with family.
It undermines self confidence and the ability to live independently: It is estimated that 90% of elder abuse is perpetrated by family members or trusted individuals. The relationship between victims and perpetrators means that even when resources are available elder victims may refuse services: If we have a senior whose daughter is their caretaker and that daughter is neglecting the senior, abusing the senior, financially exploiting the senior how do we remedy that situation? There is no emergency housing for situations like this. We have a few victims who struggle daily with deciding whether or not whey want their abuser to leave the home. All you can do is support them and arm them with as much confidence and resource and support as you can and hope for the best: A long time ago we used to think the danger came from outside the home.
The reality is what we’ve learned is the people the victim will willingly open their front door to and invite in are the greatest danger. Victims are very forgiving. If it’s my child or my grandchild the last place I really want to see that child or grandchild is in jail: It’s a complex situation because then the senior doesn’t want to be even more alone.
Well, if I have her arrested for stealing this money then who’s going to be there when I eat breakfast? What if I have a heart attack and no one’s there to call 911? If I could change anything to help seniors become safer and more secure it would be emergency housing. Emergency shelter for those in a volatile situation who need to be removed for their own safety. That would be the number one thing: We need more resources. Until we get funding to directly address the needs of vulnerable adults we are always going to be behind the eight ball.
We need advocates for one another out of our faith based communities that help look after each other and if we’re not doing that are we being faithful if you will to our faith? Hey Mom, how are you today? If I had a magic wand and could change only one thing, all of us, myself included would call our family and friends at least as frequently as the scam artists do: There are things you can do now to protect yourself and your loved ones from abuse, neglect, and exploitation. First, ask questions. If something sounds too good to be true it generally is. Second, talk to neighbors and loved ones. Check in when you can. Third, reach out for help when you need it before you need it.
In Tennessee, If you suspect someone may be at risk for abuse, neglect, or exploitation call Adult Protective Services toll free at 1 888 277 8366 And if there’s an immediate danger call 911. It takes a community of support and a willingness to speak out to prevent abuse of all forms. Do your part. For more information and to see all of Nashville Public Television’s Aging Matters series, visit our website WNPT. org/agingmatters and thanks for watching.
Major funding for NPT Reports Aging Matters is provided by the West End Home Foundation, improving the quality of life of seniors through the support of nonprofit organizations in middle Tennessee. The HCA Foundation, on behalf of Tri Star Health. The Jeanette Travis Foundation, dedicated to improving the health and wellbeing of the middle Tennessee community. Cigna Health. Spring. Additional funding provided by the Community Foundation of Middle Tennessee, and by members of NPT.