Thursday, May 29, 2008

How to Deal with Elderly Abuse

How to Deal with Elderly Abuse Print E-mail
May 26, 2008 10:06 AM


DR THOMAS: This morning the Genius of Aging turns its attention to an important topic that frankly, doesn't get talked about enough, and that's elder abuse. And luckily, we've got Scott Spallina and Lei Shimizu. Thank you for coming in and talking with me about this, and you know, a lot of people don't really understand how big a problem elder abuse is, and I know you guys are hip deep in it every day. What's the story?

SCOTT: Well, you're absolutely right, that this is a grossly under-reported crime.

DR. THOMAS: It's a crime.

SCOTT: It is a crime, definitely. And that's why the Office of the Prosecuting Attorney set up the Elder Abuse Unit to deal specifically with these crimes, focusing on victims over the age of 60 years old.

DR. THOMAS: You know, a lot of times, bad things happen, between even people who love each other. It really is a crime. In a sense, it really is domestic violence, a different kind of domestic violence. Lei, you've worked with this for a long time.

LEI: A lot of times it's intergenerational transmission of family violence. You know like being a victim of child abuse, becoming a parent who's abusive, becoming a parent or a couple who abuses each other, like spousal abuse. And then, as an elder, you are abused and neglected and maltreated because of the generation of abuse.

DR. THOMAS: Right. And we've got to break the cycle.

SCOTT: They say that one fifth of all elder abuse crimes happen in a family. And we're talking about not only spouses but about adult children. In a case I was recently prosecuting in Hawaii, was an elder adult son who beat up his 69-year-old mother, because she did not clean the bathroom to his liking, and be broke her orbital bone. When the police arrived at the scene, she was forced to crawl out the window.

DR. THOMAS: Wow. I'm a geriatrician, I mean I love elders, it's my calling in life. It makes my blood boil. It must be tough, getting through a day at work sometimes, but, even all of the details you're dealing with, there's a whole bunch more that's not being reported.

SCOTT: Exactly. Elder abuse right now is where domestic violence was 30 years ago. And even now we're having trouble convincing the public that there's a problem with domestic violence. So, to even mention elder abuse, we're like 30 years behind the curve. We're trying to model our program after successful programs on the Mainland, but they've been working at it for over a decade.

DR. THOMAS: We will, we will catch up. I mean I am swearing. This is really important, and you know Lei, you said that a lot of times people don't report the crime because they're dependant on the person who's committing the crime.

LEI: They're dependant on their caregiver. It's the cultural nature that we have in Hawaii, and you know that it's shameful to say that you are abused by your son or your daughter. You know it's just incredible…

DR. THOMAS: So neighbors, I mean I think both of you agree. Neighbors, other family members, friends, ministers, anybody should have their eyes pealed, really.

SCOTT: Exactly. And there's that saying that what happens behind closed doors, every man's home is his castle. That doesn't apply to domestic violence. It does not apply to elder abuse. There's no shame when you're the victim of a crime. You need to get help. That's whey the Office of the Prosecuting Attorney is working with the police department, is working with Elder Affairs, is working with Adult Protective Services.

DR. THOMAS: I am so with you on this and I, you know, I'd love to see the day come when this, when the sunlight is out on the topic, people can talk about it, there's no shame, people can report it, because quite frankly, it's one of the great dangers people face in old age is winding up in a situation where you're dependant on somebody who commits acts of violence or neglect against you, so…

SCOTT: Well you remember that the seniors of our community are our greatest resources. And they need the protection, they need every protection we can give them.

DR. THOMAS: I'm like so proud, I mean I want to come to your office, I want to work with you guys, I love you!

SCOTT: We'll give you a badge.

DR. THOMAS: I'm on it.

Elder Abuse (Care) Part 1

Elder Abuse (Care) Part 1

Every year, tens of thousands of elderly Americans are abused in their own homes, in relatives’ homes, and even in facilities responsible for their care. You may suspect that an elderly person you know is being harmed physically or emotionally by a neglectful or overwhelmed caregiver or being preyed upon financially.

By learning the signs and symptoms of elder abuse and how to act on behalf of an elderly person who is being abused, you’ll not only be helping someone else but strengthening your own defenses against elder abuse in the future. As elders become more physically frail, they’re less able to stand up to bullying and or fight back if attacked. They may not see or hear as well or think as clearly as they used to, leaving openings for unscrupulous people to take advantage of them. Mental or physical ailments may make them more trying companions for the people who live with them.. Tens of thousands of seniors across the United States are being abused: harmed in some substantial way often people who are directly responsible for their care More than half a million reports of abuse against elderly Americans reach authorities every year, and millions more cases go unreported.

Where does elder abuse take place?

Elder abuse tends to take place where the senior lives: most often in the home where abusers are apt to be adult children; other family members such as grandchildren; or spouses/partners of elders. Institutional settings especially long-term care facilities can also be sources of elder abuse. The different types of elder abuseAbuse of elders takes many different forms, some involving intimidation or threats against the elderly, some involving neglect, and others involving financial chicanery.

The most common are defined below.

Physical abusePhysical elder abuse is non-accidental use of force against an elderly person that results in physical pain, injury, or impairment. Such abuse includes not only physical assaults such as hitting or shoving but the inappropriate use of drugs, restraints, or confinement.

Emotional abuseIn emotional or psychological senior abuse, people speak to or treat elderly persons in ways that cause emotional pain or distress.

Verbal forms of emotional elder abuse include intimidation through yelling or threats humiliation and ridicule habitual blaming or scapegoating

Nonverbal psychological elder abuse can take the form of ignoring the elderly person isolating an elder from friends or activities terrorizing or menacing the elderly person

Sexual abuseSexual elder abuse is contact with an elderly person without the elder’s consent. Such contact can involve physical sex acts, but activities such as showing an elderly person pornographic material, forcing the person to watch sex acts, or forcing the elder to undress are also considered sexual elder abuse.

Neglect or abandonment by caregiversElder neglect, failure to fulfill a caretaking obligation, constitutes more than half of all reported cases of elder abuse. It can be active (intentional) or passive (unintentional, based on factors such as ignorance or denial that an elderly charge needs as much care as he or she does).

Financial exploitationThis involves unauthorized use of an elderly person’s funds or property, either by a caregiver or an outside scam artist. An unscrupulous caregiver might misuse an elder’s personal checks, credit cards, or accounts steal cash, income checks, or household goods forge the elder’s signature engage in identity theft

Typical rackets that target elders include Announcements of a “prize” that the elderly person has won but must pay money to claim Phony charities Investment fraud Healthcare fraud and abuseCarried out by unethical doctors, nurses, hospital personnel, and other professional care providers, examples of healthcare fraud and abuse regarding elders include Not providing healthcare, but charging for it Overcharging or double-billing for medical care or services Getting kickbacks for referrals to other providers or for prescribing certain drugs Overmedicating or undermedicating Recommending fraudulent remedies for illnesses or other medical conditions Medicaid fraud Signs and symptoms of elder abuse

At first, you might not recognize or take seriously signs of elder abuse. They may appear to be symptoms of dementia or signs of the elderly person’s frailty — or caregivers may explain them to you that way. In fact, many of the signs and symptoms of elder abuse do overlap with symptoms of mental deterioration, but that doesn’t mean you should dismiss them on the caregiver’s say-so. General signs of abuse The following are warning signs of some kind of elder abuse: Frequent arguments or tension between the caregiver and the elderly person Changes in personality or behavior in the elder Risk factors for elder abuseIt’s difficult to take care of a senior when he or she has many different needs, and it’s difficult to be elderly when age brings with it infirmities and dependence. Both the demands of caregiving and the needs of the elder can create situations in which abuse is more likely to occur.Risk factors among caregivers

Many nonprofessional caregivers — spouses, adult children, other relatives and friends — find taking care of an elder to be satisfying and enriching. But the responsibilities and demands of elder caregiving, which escalate as the elder’s condition deteriorates, can also be extremely stressful. The stress of elder care can lead to mental and physical health problems that make caregivers burned out, impatient, and unable to keep from lashing out against elders in their care.

Among caregivers, significant risk factors for elder abuse are:inability to cope with stress (lack of resilience) depression, which is common among caregivers lack of support from other potential caregivers the caregiver’s perception that taking care of the elder is burdensome and without psychological reward substance abuse

Even caregivers in institutional settings can experience stress at levels that lead to elder abuse. Nursing home staff may be prone to elder abuse if they lack training, have too many responsibilities, are unsuited to caregiving, or work under poor conditions. The elder’s condition and history

Several factors concerning elders themselves, while they don’t excuse abuse, influence whether they are at greater risk for abuse: The intensity of an elderly person’s illness or dementia Social isolation; i.e., the elder and caregiver are alone together almost all the time The elder’s role, at an earlier time, as an abusive parent or spouse A history of domestic violence in the home The elder’s own tendency toward verbal or physical aggression In many cases, elder abuse, though real, is unintentional. Caregivers pushed beyond their capabilities or psychological resources may not mean to yell at, strike, or ignore the needs of the elders in their care.

Reporting elder abuse

If you are an elder who is being abused, neglected, or exploited, tell at least one person. Tell your doctor, a friend, or a family member whom you trust. Other people care and can help you. You can also call Eldercare Locator at 1-800-677-1116. The person who answers the phone will refer you to a local agency that can help. The Eldercare Locator answers the phone Monday through Friday, 9 am to 8 pm, Eastern Time.

How do I report suspected elder abuse?

The 500,000 to 1,000,000 reports of elder abuse recorded by authorities every year (the vast majority of which are proven to be true) are only the tip of the iceberg; according to data from different states, for every case of elder abuse reported, another 12 or 13 are not. Accordingly there’s a great need for people to report suspected abuse. In every state, physical, sexual, and financial abuses targeting elders that violate laws against assault, rape, theft, and other offenses are punishable as crimes. With some variation among states, certain types of emotional elder abuse and elder neglect are subject to criminal prosecution, depending on the perpetrators' conduct and intent and the consequences for the victim. States differ on who is required to report suspected elder abuse (there’s no federal standard), though the categories of mandatory reporters are expanding. Typically, medical personnel, nursing home workers, peace officers, emergency personnel, public officials, social workers, counselors, and clergy are listed as mandatory reporters, and that responsibility is spreading to financial institutions and other entities that work with seniors. While it’s important for elders to seek refuge from abuse, either by calling a local agency or telling a doctor or trusted friend, many seniors don't report the abuse they face even if they’re able. Many fear retaliation from the abuser, while others believe that if they turn in their abusers, no one else will take care of them. When the caregivers are their children, they may be ashamed that their children are behaving abusively or blame themselves: “If I’d been a better parent when they were younger, this wouldn’t be happening.” Or they just may not want children they love to get into trouble with the law.

The first agency to respond to a report of elderly abuse, in most states, is Adult Protective Services (APS). Its role is to investigate abuse cases, intervene, and offer services and advice. Again, the power and scope of APS varies from state to state.

However, every state has at least one toll-free elder abuse hotline or helpline for reporting elder abuse in the home, in the community, or in nursing homes and other longterm care facilities. In addition, information and referral are also available from the national Eldercare Locator: 1-800-677-1116

Elder (Care) Abuse part 2

Elder (Care) Abuse part 2

Preventing elder abuse and neglect

We can help reduce the incidence of elder abuse, but it’ll take more effort than we’re making now. Preventing elder abuse means doing three things:

  • Listening to seniors and their caregivers
  • Intervening when you suspect elder abuse
  • Educating others about how to recognize and report elder abuse
What you can do as a caregiver to prevent elder abuse

If you’re overwhelmed by the demands of caring for an elder, do the following:

  • Request help, from friends, relatives, or local respite care agencies, so you can take a break, if only for a couple of hours.

  • Find an adult day care program.

  • Stay healthy and get medical care for yourself when necessary.

  • Adopt stress reduction practices.

  • Seek counseling for depression, which can lead to elder abuse.

  • Find a support group for caregivers of the elderly.

  • If you’re having problems with drug or alcohol abuse, get help.

And remember, elder abuse helplines offer help for caregivers as well. Call a helpline if you think there’s a possibility you might cross the line into elder abuse.

What you can do as a concerned friend or family member
  • Watch for warning signs that might indicate elder abuse. If you suspect abuse, report it.
  • Take a look at the elder’s medications. Does the amount in the vial jive with the date of the prescription?
  • Watch for possible financial abuse. Ask the elder if you may scan bank accounts and credit card statements for unauthorized transactions.
  • Call and visit as often as you can. Help the elder consider you a trusted confidante.
  • Offer to stay with the elder so the caregiver can have a break — on a regular basis, if you can.
How you can protect yourself, as an elder, against elder abuse
  • Make sure your financial and legal affairs are in order. If they aren’t, enlist professional help to get them in order, with the assistance of a trusted friend or relative if necessary.
  • Keep in touch with family and friends and avoid becoming isolated, which increases your vulnerability to elder abuse.
  • If you are unhappy with the care you’re receiving, whether it’s in your own home or in a care facility, speak up. Tell someone you trust and ask that person to report the abuse, neglect, or substandard care to your state’s elder abuse helpline or long term care ombudsman, or make the call yourself.

Finally, if you aren’t in a position to help an elder personally, you can volunteer or donate money to the cause of educating people about elder abuse, and you can lobby to strengthen state laws and policing so that elder abuse can be investigated and prosecuted more readily. The life you save down the line may be your own.

References and resources about elder abuseGeneral Information on Elder Abuse

Preventing & Reporting Elder Abuse – 39-page PDF booklet covering many aspects of elder abuse. (California Department of Justice)

Elder Abuse and Neglect: In Search of Solutions – Covers the facts about elder abuse, as well as signs of abuse and steps to take if abuse occurs. (American Psychological Association)

What is Elder Abuse? – Site provides definitions of different types of elder abuse, along with signs and risk factors. (National Committee for the Prevention of Elder Abuse)

Elder abuse: Signs to look for, action to take – Overview of elder abuse: types, signs, and interventions. (Mayo Clinic)

Nursing Home Abuse An Ombudsman is an advocate for residents of nursing homes, board and care homes, and assisted living. Ombudsmen provide information about how to find a facility and what to do to get quality care. They are trained to resolve problems. If you want, the ombudsman can assist you with complaints. However, unless you give the ombudsman permission to share your concerns, these matters are kept confidential.

Under the federal Older Americans Act, every state is required to have an Ombudsman Program that addresses complaints and advocates for improvements in the long term care system. To find the ombudsman nearest you, contact your State Ombudsman office.

Nursing Home Abuse News – Provides information about elder abuse in nursing homes and steps you can take to protect a loved one from neglect or abuse. (Nursing Home Abuse News)

Resources used in researching this article

Distinguishing Between Abuse, Neglect, And Self-Neglect – Defines the different categories of elder mistreatment and resulting psychological symptoms. (University of Missouri at Kansas City)

Elder Financial Abuse – PDF brochure summarizes financial abuse, warning signs, who might exploit an elder, and what to do to prevent elder financial abuse. (San Bernardino County Department of Aging and Adult Services)

Ellen Jaffe-Gill, M.A., Tina de Benedictis, Ph.D., and Jeanne Segal, Ph.D., contributed to this article. Last modified on: 2/13/08.

Wednesday, May 28, 2008

California Law Provides New Rights for Victims of Financial Elder Abuse

California Law Provides New Rights for Victims of Financial Elder Abuse

May 06, 2008 - 11:02 PM
Category: Nursing Home & Elder Abuse
Tags: elder abuse, financial elder abuse, san luis obispo, banks, annuity sales, trust mills
Posted by: Ray Mattison

With an aging and affluent population of elders, California is a fertile ground for those committing financial elder abuse. The California Advocates for Nursing Home Reform have an excellent summary of the various forms of elder abuse and what to watch out for.

A New Bill authored by Senator Steinberg allows victims to freeze the assets of the wrongdoers before trial, an unusual remedy in personal injury and other civil cases. This is a constant problem we face when the abuse is by a family member or individual rather than an institution such as an insurance company: By the time we can obtain a judgment the money is long gone.
On the reporting side, a recent law requires banks and credit unions to report suspected elder financial abuse to the authorities. In one case we handled the abusive relative was holding her senile mother's hand as she signed the loan papers at the finance company. Yet, at that time the company had no responsibility to report the conduct.

We were able to establish the liability of the finance company in this case of elder abuse in San Luis Obispo County; but, this was made difficult as the law imposed no specific duty on the company to prevent or report such activity.

We have represented thousands of seniors in class actions against annuity insurers, such as Allianz and National Western, and have yet to find a case where an annuity was a suitable investment for a senior. They have hidden charges and are never understood by the buyer. Often these policies are sold by people posing as "financial advisers" at free-lunch seminars.

Another common scam is the "trust mill" where seniors are enticed to attend seminars and to buy inexpensive "living trusts" - when the real goal is to sell them an expensive annuity with huge commissions and even bigger early surrender charges and other penalties.