Elder Abuse and Neglect Caregiving Series

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1 Elder Abuse and Neglect Caregiving Series Objectives Upon completion of this program, the participant will learn: The definition, causes, and contributing risk factors of elder abuse The different forms of elder abuse and the signs and symptoms of each form How to help prevent abuse and the importance of reporting suspected elder abuse Outline 1. Definition of elder abuse 2. Causes and contributing risk factors of elder abuse: History of family violence Violence is a learned behavior Mental illness Alcoholism Drug addiction Financial difficulty Caregiver stress Lack of proper caregiving skills Ageism 3. The different forms of elder abuse and the signs and symptoms of each form: Neglect and self-neglect Financial exploitation Emotional/psychological Physical Sexual Abandonment 4. General signs of elder abuse 5. Characteristics of abusers and characteristics of the person being abused 6. What you can do to help: What to do when an elder confides in you about an abusive situation Proper training of family caregivers in basic caregiving procedures Report suspected elder abuse 7. How to report suspected elder abuse

2 Definitions and Key Points 1. Home is a place where most of us feel safe and comfortable. For some elders, however, home is not safe due to elder abuse. 2. Elder Abuse: The mistreatment of an older person by someone who has a relationship with the elder. It could be a spouse, adult child, friend, neighbor or caregiver. 3. According to the National Center on Elder Abuse, more than two thirds of abusers are family members. 4. The results of elder abuse can be seen in unnecessary suffering, injury and violation of the human rights of the elderly. 5. Elder abuse can happen to anyone by anyone regardless of his or her social class or ethnic background. 6. Elder abuse is very complex: Generally, a combination of factors contributes to elder mistreatment. It is often inflicted in a subtle way, especially if it is pre-meditated and deliberate. 7. Elder abuse can be difficult to identify because some diseases and chronic illnesses can mask or mimic the visible signs of abuse. For instance, some diseases cause people to bruise more easily. Weight loss can be a symptom of a disease, the caregiver's failure to provide meals or an elder who neglects to eat properly. 8. Violence as learned behavior: Violence is a learned behavior that in some families is passed on from one generation to the next. In these families, abusive behavior is their usual response to life because they have not learned other more appropriate ways to respond. If a person was verbally or physically abused by a parent as a child, he or she may repeat that behavior with a bedridden elderly parent. 9. Risk factors that may contribute to elder abuse are: mental illness, alcoholism, drug addiction, financial difficulty, caregiver stress, caregivers who lack proper caregiving skills and ageism. 10. Lack of caregiver skills can lead to unintentional injuries such as bruises and broken bones. 11. Ageism is a form of prejudice against older people based upon negative images and stereotypes. Ageism increases the risk of elder abuse. The abuser uses these prejudiced attitudes to justify mistreatment of an elder.

3 12. The legal definition of elder abuse varies from state to state but it is generally agreed that the forms of elder abuse include: physical abuse, sexual abuse, emotional and psychological abuse, financial exploitation, neglect and abandonment. 13. It's important to learn how to identify various kinds of abuse because the signs and symptoms of elder abuse are often hidden by both the abuser and victim. 14. Neglect is a leading form of elder abuse. Neglect typically means the refusal or failure to provide the necessary care to an elder by someone who has assumed that responsibility. It includes the refusal or failure to provide the elder with life necessities such as food, water, shelter, clothing, personal hygiene, medicine or personal safety. 15. Some signs and symptoms of neglect include: unsanitary living conditions, fleas, lice, smell of fecal or urine odors, soiled linens, poor hygiene, untreated bedsores, unsafe living conditions or dehydration. 16. Self-neglect occurs when elders who are taking care of themselves do so in a way that jeopardizes health and well-being. Examples include living in an unsanitary home, poor personal hygiene, not eating or drinking enough or eating non-nutritious meals and taking too much or not enough medication. 17. Questions to ask about possible financial exploitation: Who has check writing authority? What about authority for other legal documents? Has there been any sudden changes in bank accounts? Has there been unusual events, such as withdrawal of large sums of money? 18. Financial exploitation can take various forms, including theft of jewelry or money or unauthorized use of ATM cards. Bed or wheelchair bound elders or those with dementia are most at risk. Scams that target seniors also are considered financial exploitation. 19. Emotional/psychological abuse: Harsh speech, making the older person feel as if they are a bother or not important, acting as if their needs don't matter, withholding things elders need such as food or attention are all considered emotional/psychological abuse. This type of abuse can be as damaging as physical abuse. It drives the person who is being abused into an isolated state. 20. Physical abuse: The use of bodily force that can result in physical pain or injury. Hitting, shaking, kicking, pulling hair, inappropriate use of drugs and physical restraint are all considered physical abuse. 21. Signs and symptoms of physical abuse include: bruising, welts, black eyes, broken bones, rope marks, sprains and open wounds. Look for signs on the back and stomach as these are areas abusers may use to try to hide abuse.

4 22. Sexual abuse: Includes unwanted sexual contact, sex with someone unable to give consent, sexually degrading acts and forced sex. Elders are often reluctant to speak about sexual abuse. 23. Signs and symptoms of sexual abuse: Upset at being dressed or undressed, torn, stained or bloody underclothes, vaginal or anal bleeding. 24. Abandonment: Deserting an elderly person at a mall, hospital or other location with no intention of returning for them. 25. Take any complaints seriously. It may be difficult for the person to express what is happening. Be open and sensitive. Listen and do not bombard the person with questions. 26. Be aware of sudden changes in behavior, such as when a once talkative person becomes withdrawn and depressed. Notice any fear or agitation. 27. Abusers may use any means possible to deflect attention from the abuse. They may try to prevent home health nurses and others from entering the home. 28. No single characteristic identifies an abuser. Abusers may be charming, humorous and leaders in the community or church. 29. Most victims do not report abuse because of shame, denial, fear and isolation. They may be unable to report abuse because of physical disabilities or dementia. 30. Become aware and educated about elder abuse. Patients should have private time with their health care provider so that they feel safe in confiding any concerns they may have. Providers must do very good screening, being careful and sensitive in the interview process. 31. Many states have mandatory reporting laws for health care professionals who suspect elder abuse. Follow your agency's policy for reporting abuse. 32. Adult Protective Services is the agency that receives reports of abuse. Their professional staff follows through with an investigation.

5 QuickTime and a TIFF (Uncompressed) decompressor are needed to see this picture. Test Your Understanding of Elder Abuse and Neglect Name Date 1. Elder abuse is complex because: A. Some diseases and chronic illnesses can mask or mimic the visible signs of abuse. B. The victim and abuser may hide the abuse. C. No single characteristic identifies an abuser. D. All of the above. 2. Understanding the complexities of elder abuse is important because: A. It can help you to identify elder abuse. B. You would know how to intervene and fix the problem yourself. C. How you respond to an abuser could help the abuser to justify the abuse. D. A and C above 3. One of the signs and symptoms of neglect is: A. Yelling at the elder B. Pulling hair C. Untreated bedsores D. Bloody underclothing 4. Contributing risk factors for elder abuse include: A. Mental illness B. Drug addiction C. Financial stress D. All of the above 5. Types of elder abuse include: A. Physical, emotional, financial B. Emotional, dietary, neglect C. Neglect, dietary, family D. Physical, family caregivers, financial A Division of Institute for Professional Care Education Elder Abuse and Neglect, Copyright

6 6. Some examples of physical abuse include: A. Force feeding B. Physical restraints C. Inappropriate use of drugs D. All of the above 7. One of the general signs that may indicate abuse is occurring is: A. An elder has more than one caregiver B. A sudden change in an elder s behavior C. An elder with dementia who repeats him or herself D. An elder who watches TV for hours 8. Stressed caregivers will always be abusive to elders. 9. According to the National Center on Elder Abuse, family members account for a small percentage of abuse against elders. 10. Violence is a learned behavior that in some families is passed on from one generation to the next. 11. Most elders who are victims of abuse will report it. 12. Most health care professionals who work with the elderly are mandatory reporters and must report all cases of suspected abuse according to their state guidelines. 13. It is the responsibility of the home care agency to investigate suspected elder abuse. 14. Some victims of sexual abuse will give clues that they are being abused. We need to be aware of these clues and ask further questions. Elder Abuse and Neglect, Copyright

7 15. Elder abuse is never pre-meditated and deliberate. 16. It is important that the elder have private time with his or her health care professional. True False Elder Abuse and Neglect, Copyright

8 Elder Abuse and Neglect Answer Key 1. D 2. D 3. C 4. D 5. A 6. D 7. B 8. F 9. F 10. T 11. F 12. T 13. F 14. T 15. F 16. T Elder Abuse and Neglect, Copyright

9 for continuing education is hereby presented to for viewing the program, study of the support materials and successful completion of the test for Elder Abuse and Neglect Total Course Time = 60 minutes (includes video, support materials, review and testing) Date Authorized Signature 5109 NE 82nd Ave, Ste 201 Vancouver, WA help@ipced.com (877)

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