Day 18: Preventing Abuse and Neglect

November 18, 2011

By Elaine Chen, MSG, National Center on Elder Abuse

“I never expected to find myself in this position,” the woman told me with frustration overlying the sadness in her voice. Her mother, Mrs. P, had moved into an independent living community, and recently began displaying increasingly worrisome behaviors. The property managers called with warnings about her misuse of the washing machine. Family friends shared concerns about her increasing confusion and uncharacteristic combativeness. Mrs. P’s companion caregiver told of the stove burner being left on. As Mrs. P’s neighbor, I had called her adult daughter after I heard pacing and crying next door. When I went to find out what was happening, the usually upbeat Mrs. P had collapsed in a heap on the floor, sobbing about a lost shoe.

Like almost everyone, Mrs. P’s daughter had no training in caring for an older family member. She responded to each emergency as it arose. She had the stove disconnected. She thought it might help for Mrs. P to visit the doctor, but Mrs. P did not want to go. Mrs. P’s daughter felt resentful of her mother’s strange behavior and sometimes feared she might lose control.

Research indicates close to half of community-dwelling elders with dementia experience abuse or neglect. The best combination of factors for predicting which people with dementia have been mistreated is physical assault and psychological aggression by the person with dementia toward the caregiver. If this describes the situation of someone you know, consider offering or getting help. Medical and social services can avert a crisis.

In every state, Adult Protective Services programs receive reports of suspected adult abuse, exploitation or neglect. According to the client’s needs and wishes, APS caseworkers may arrange for the provision of medical, social, economic, legal, law enforcement or other protective, emergency or supportive services. To learn more about Adult Protective Services and what happens when a report is made, go to http://www.ncea.aoa.gov/ncearoot/Main_Site/Find_Help/APS/About_APS.aspx.

“I can’t think of another issue that affects more people in this country where less is being done,” elder justice advocate and MacArthur fellow MT Connolly recently told USA Today. For the first time ever, U.S. Congress passed a federal elder abuse prevention law, the Elder Justice Act, just last year, to support agencies’ response to elder abuse. However, the law is powerless because Congress has not funded the $21.5 million budgeted for the work to happen. Society’s avoidance and minimizing of the problem perpetuates suffering in silence.

There are things that anyone can do to help prevent elder abuse, neglect and exploitation.

1.Stay in touch with caregivers and loved ones receiving care. Isolation is a major risk factor for elder mistreatment.

2.Talk about and plan ahead for cognitive impairments.

3.Know the signs and reach out for help.

If you suspect your older loved one is at risk, call your local Adult Protective Services or Area Agency on Aging. To get connected to local help, call Eldercare Locator at 1-800-677-1116 or visit www.eldercare.gov

As for Mrs. P, her daughter remained unable or unwilling to take action, until Adult Protective Services was called for suspected neglect. The daughter agreed that the medical situation was urgent, and used some tips provided by the Alzheimer’s Association to get her mother to the doctor. The doctor confirmed that Mrs. P had a dementing illness, and began treatment. Mrs. P’s daughter got help to find a more appropriate placement for Mrs. P where she could get the increased supervision that she needed.

Resources

1) Building a Care Partnership: A Special Series Offered for Family Caregivers
The Alzheimer’s Association Orange County Chapter organized a team for elder abuse prevention, which teamed with the Center of Excellence on Elder Abuse & Neglect to develop a workshop: “Building a Care Partnership: A Special Series Offered for Family Caregivers.” The class helps caregivers to avoid misunderstandings and frustration with hired caregivers through effective communication. Check their Family Education Calendar to learn more. It is offered at least every six weeks.
http://www.alz.org/oc/in_my_community_education.asp

2) Red Flags of Elder Abuse and Neglect
Center of Excellence on Elder Abuse and Neglect
Warning signs of mistreatment and information on how to get help.
http://www.centeronelderabuse.org/Red%20Flags%20of%20Elder%20Abuse.asp

3) Frequently Asked Questions about Elder Abuse and Neglect
National Center on Elder Abuse
http://www.ncea.aoa.gov/ncearoot/Main_Site/FAQ/Questions.aspx

4) Screening for abuse and neglect of people with dementia.
Wiglesworth A, Mosqueda L, Mulnard R, Liao S, Gibbs L, Fitzgerald W. Journal of the American Geriatrics Society. 2010 Mar;58(3)493-500.
http://www.centeronelderabuse.org/docs/ScreeningAbuseNeglectPwDementia_Wiglesworth2010.pdf

5) Elder Abuse and Self-neglect: “I Don’t Care Anything About Going to the Doctor, to Be Honest. . . . ”
Mosqueda L, Dong XQ. Journal of the American Medical Association. 2011;306(5):532-540.
http://jama.ama-assn.org/content/306/5/532.abstract

6) Elder Abuse and Neglect: In Search of Solutions
American Psychological Association, Office on Aging
http://www.apa.org/pi/aging/resources/guides/elder-abuse.aspx#

7) MacArthur Fellow Leads the Fight on Elder Abuse
Janice Lloyd, USA Today, November 10, 2011
http://yourlife.usatoday.com/parenting-family/caregiving/story/2011-11-10/MacArthur-fellow-leads-the-fight-against-elder-abuse/51149920/1

Please Give Credit
Creative Commons License
Day 18: Preventing Abuse and Neglect by By Elaine Chen, MSG, National Center on Elder Abuse is licensed under a Creative Commons Attribution-NoDerivs 3.0 Unported License.

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