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Elder Abuse

Mental Health group project
by

Heather Oswalt

on 5 October 2012

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Transcript of Elder Abuse

Elder Abuse Physical Abuse
Sexual Abuse/Abusive Sexual Contact
Psychological or Emotional Abuse
Neglect
Abandonment
Financial Abuse or Exploitation
Self Abuse / Neglect Types of Abuse Domestic Violence Grown Old
Personal Problems of Abusers
Living with others or Living in Isolation
Caregiver Stress
Personal Characteristics of the Elder
Lack of Time Increased Risk for Abuse by others r/t Advocating for the Victim New to Care giving
Strains on Physical and Emotional Well Being
Strains on Family & other Relationships
Balancing Work & Daily Life
Coping Strategies
Facing the Tough Issues
Stop treatment?
Nursing home?
Experience Caregiver Burnout Caregiver Role Strain What would you do? 6 Signs of Caregiver Burnout
Withdraw from family and friends
Loss of enjoyment from previously enjoyed hobby
Feelings of no longer wanting to care for the patient
Change in appetite
Change in sleep pattern
Weakened immune system Support for the Caregiver Community Resources Includes:
Using Community Resources
Setting Limits
Self Care Identify what you can and cannot change.
Set realistic goals.
Prioritize, make lists, & a daily routine.
Ask for and accept help from family/friends
Say "no" to requests that are draining
hosting holiday meals
Don't feel guilty for less than "perfect." "Perfect" doesn't exist in human form. Setting Limits Stay in touch with family and friends.
Join a support group for caregivers.
Make time each week to do something that you want to do.
Try to find time to be physically active most days
Eat a healthy diet
Get enough sleep.
See your doctor for a checkup.
Try to keep your sense of humor. Self Care Transportation
Meal delivery
Home health services
Non-medical home services
Home modification
Legal and financial counseling
Adult Day Care Who can protect the elder?
The Caregiver
Family and Friends
The elder person Watch for the warning signs >> REPORT suspected abuse
Periodically check medication containers
Monitor bank/credit card statements regularly
Call/visit as often as possible
give abusers less opportunity
establish trusting relationship with elder
Offer help to the caregiver, allow them a break What family and friends can do Have financial/legal affairs in order and managed by trusted friend/relative if necessary
Avoid isolation; stay in touch with family/ friends
Speak up about mistreatment; don't assume poor treatment is to be expected Elder Self-Advocating Aging and In-Home Services of Northeast Indiana, Inc.
2927 Lake Avenue
Fort Wayne, IN 46805-5414
(260) 745-1200 or (800) 552-3662
E-mail: info@agingihs.org
Web Site: http://www.agingihs.org/

Adult Protective Services Unit 3
APS Hotline 1-800-992-6978
260-449-7989
602 South Calhoun Street
Fort Wayne, Indiana 46802

Coverage for Adams, Allen, DeKalb, Huntington, LaGrange, Noble, Steuben, Wells and Whitley Counties Local Agency Assistance Carol, 24, divorced, lived on the second floor of an apartment with her two young children. Living below her on the first floor was Beatrice, 86, a nice old lady who didn't leave her apartment very often because of her arthritic knees and poor eyesight. Carol and her children visited Beatrice frequently and often helped with her laundry in exchange for occasional babysitting. Beatrice loved their company.

Every Saturday, Carol offered to do the grocery shopping for Beatrice. Because she could not do it herself, Beatrice was happy to accept Carol's help. Carol thought it was okay to keep $20 of the change each week because she was taking the time and trouble to help Beatrice; although, she was never offered any money. Carol thought Beatrice would never realize the money was missing because of her poor eyesight. Scenario 1 You have known Lydia for quite some time and when you see her by herself she is always quite talkative and welcomes your support. However, on the few occasions you have seen Lydia with her daughter, who lives around the corner and is her primary caregiver, Lydia is a different person. She is totally withdrawn and flinches if her daughter comes near her. When you have talked to Lydia about this she denies that she is frightened of her daughter. Scenario 2 Your cousin David, age 85, totally blind from childhood, has always lived alone and independently. He is mentally alert and adamant about not making any change in his living arrangements. Since he cannot see, he does not like strangers coming into his apartment to clean, cook, or provide other services. When you visit, the apartment not only smells of urine, but it is infested with ants and cockroaches. His refrigerator is full of spoiled food, which he doesn’t hesitate to consume. The apartment is cluttered with piles of Braille books, soiled laundry, and supplies from his hobbies. Scenario 3 References Presented by:
Angela, April, Michelle, Miranda, & Heather The following slides present signs and symptoms to be assessed to determine if the elder is being abused and in which form... Potential Indicators of Abuse Evidence that personal care is lacking or neglected
Signs of malnourishment (e.g. sunken eyes, loss of weight)
Chronic health problems both physical and/or psychiatric
Dehydration (extreme thirst)
Pressure sores (bed sores) Passive & Active Neglect Overt signs of physical trauma (marks on body)
Signs of restraint trauma (rope burns, gag marks, welts)
Injury - particularly if repeated and "unexplained" (e.g. sprains, fractures, detached retina, dislocation, paralysis)
Inconsistent explanations of injuries
Additional physical indicators - hypothermia, abnormal chemistry values, pain upon being touched
A physical examination reveals that the older person has injuries which the caregiver has failed to disclose
A history of doctor or emergency room "shopping"
Repeated time lags between the time of any "injury or fall" and medical treatment Physical Abuse Material or Financial Abuse Unusual banking activity
Bank/credit card statements no longer come to the older adult
Elder asked to sign documents for which he/she does not know purpose
Elder's living situation not commensurate with size of estate
Caregiver expresses concern regarding financial status and not physical/mental health status of elder
Personal belongings "disappear"
Forged signatures on checks and other documents
Recent acquaintances, housekeepers, "care" providers:
become overprotective of elder and isolate elder from long-term friends or family
make promises of lifelong care in exchange for deeding all property and/or assigning all assets over to them Psychological Abuse Psychological Signs:
Ambivalence, deference, passivity, shame
Anxiety (mild to severe)
Depression, hopelessness, helplessness, thoughts of suicide
Confusion, disorientation
Behavioral Signs:
Trembling, clinging, cowering, lack of eye contact
Evasiveness
Agitation
Hypervigilance Sexual Abuse Trauma to the genital area (bruises)
Venereal disease
Infections/unusual discharge or smell
Indicators common to psychological abuse may be concomitant with sexual abuse Additional Indicators of Abuse
or Neglect Elder is not given the opportunity to speak without the caregiver being present.
Caregiver exhibits high levels of indifference or anger towards the older adult
Overmedication or oversedation Violation of Basic Rights Caregiver withholds or reads the elder's mail
Caregiver intentionally obstructs the older person1s religious observances (e.g. dietary restrictions, holiday participation, visits by minister/priest/rabbi etc.)
Caregiver has removed all doors from the older adult's rooms.
As violation of basic rights is often concomitant with psychological abuse the indicators of basic rights violations are similar indicators as those for psychological abuse. Long-Term Chronic Self-Neglect
Dementia
Illness, Malnutrition, & Overmedication (accidental or intentional)
Depression
Substance Abuse
Poverty Self Abuse/Neglect (Support groups and education)
https://www.nrd.gov/family_and_caregiver_support/caregiver_support/support_groups National Assistance National Resource Directory Adult Protective Services Unit 3. Retrieved from http://www.allencountyprosecutor.com/aps%20brochure.pdf
Aging & In Home Services | Welcome. (n.d.). Retrieved from http://www.agingihs.org/

Area Agencies on Aging. Retrieved from http://www.in.gov/fssa/da/3478.htm

Family & Caregiver Support:National Resource Directory. (n.d.). Retrieved from https://www.nrd.gov/family_and_caregiver_support

Minar Driscoll, D. (2006, January). Elder abuse in Oregon: Building awareness and encouraging action (S. Bowman, Ed.). Retrieved September 15, 2012, from http://extension.oregonstate.edu/fch/sites/default/files/documents/fcd06-04_elder_abuse_leaders_guide.pdf
National Family Caregivers Association. (n.d.). Retrieved from http://www.nfcacares.org/

Risk factors for elder abuse. (2011, September 21). Retrieved from http://www.ncea.aoa.gov/ncearoot/Main_Site/FAQ/Basics/Risk_Factors.aspx

Robinson, Benedictis, & Segal (2012, June). Elder Abuse and Neglect. Retrieved September 16, 2012 from http://www.helpguide.org/mental/elder_abuse_physical_emotional_sexual_neglect.htm

Woolf, Linda, (1998). Elder Abuse and Neglect. Webster University, Retrieved from http://www.webster.edu/~woolflm/abuse.html
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