Adult Abuse, Neglect and Exploitation. What you need to know

Transcription

1 Adult Abuse, Neglect and Exploitation What you need to know

2 Let Me Introduce you to Andy O Andy is an older gentleman who was incredibly successful in his chosen career. O Andy made a lot of money. O When he became older he let his grown step-son manage his finances. O Slowly over time that step-son took total control of his finances and his life. O Andy was no longer able to make a basic decision about his life. He was deprived of food, medicine and his ID was confiscated from him. Andy reports feeling a prisoner in his home.

3 O Andy is actually the late actor Mickey Rooney O In March, 2011, Rooney testified to congress about his experiences to bring attention to the issue of adult abuse and let others know that it could happen to anyone Andy

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5 The Golden Years? O How many people envisioned themselves as being abused, neglected/neglectful to self or exploited? O Unfortunately, the truth is it will happen to 1 in 10 of you. And of those 1 in 10 cases that come to the attention of the authorities, 1 in 14 cases will go unreported.(national Council on Aging).

6 Goals of Presentation O Help you to identify Abuse, Neglect and Exploitation and who is a victim O Educate you as to the state s role O Teach you ways in which you can help.

7 What is Abuse? Abuse is a form of mistreatment by one individual that cause harm to another person (National Adult Protective Services Association [NAPSA])

8 Physical Abuse O May include: O Slapping O Hitting O Beating O Causing physical pain, injury or suffering O Physical Abuse Includes: O Confining an adult against their will O Locking someone in their room O Tying them to furniture

9 Signs and Symptoms O Bruising/lacerationspossibly hidden by clothing O Object-shaped bruising O Bruises on neck, bottom of feet, genitals (bruises on extremities are often accidental). O Bruising on a nonambulatory person is questionable O Inconsistency between story and injury O Sudden change in victim and caregiver behavior

10 A word about bruising O Caution: beware some medications can thin blood and case small bruises to spread or appear as multiple bruises.

11 Emotional Abuse O Emotional Abuse: The infliction of anguish, pain or distress through verbal or nonverbal acts O Examples: O Insults O Yelling or threats of harm or isolation O Non-verbal actions like throwing objects, glaring

12 Signs and Symptoms O Social isolation O Fearful O Defers in the presence of the abuser O May question own capabilities O Difficulty concentrating O Increased use of drugs and/or alcohol O Suicidal thoughts and/or suicide attempts

13 Isolation/Abandonment O Isolation: O Keeping people from friends and family and preventing contact via phone or mail. O Abandonment: O Desertion by caregiver

14 Signs and Symptoms O Abandonment: O someone who is confused or who has dementia and has been left alone for days O Someone who is left in a public place such as a hospital or a shopping mall. O Someone who is unable to provide basic information about themselves and found wandering

15 Isolation Symptoms OSomeone who is socially isolated and withdrawn

16 Financial Exploitation O This is the illegal or improper use of a person s funds, property or assets which includes using another s assets without consent, under false pretense or through coercion and/or manipulation.

17 Signs and Symptoms O Inability to explain finances O Disparity between assets& lifestyle O Caregivers who are overly worried about the amount of money being spent on someone s care than the care itself O Sudden changes in banking practices O Misuse of a Power of Attorney- RSMo sets forth the duties of an attorney in fact.

18 Neglect O Neglect is the refusal or failure to fulfill a legal or contractual responsibility. This includes failing to provide life necessities such as food, water, clothing, shelter an facility to provide or pay for care.

19 Signs and Symptoms O Dehydration O Malnutrition O Poor hygiene O Unhealthy and hazardous living environment O Untreated health problems

20 Self-Neglect O The behavior of an elderly/disabled person that threatens his/her own health or safety

21 Signs & Symptoms O Not keeping medical appointment O Refusing medical attention O Inability to manage finances O Poor hygiene O Inadequate housing O Animal infested living conditions This excludes situations in which a mentally competent person makes a bad decisions or lifestyle choices

22 Who are we and what do we O Missouri Dept. of Health and Senior Services, Division of Senior & Disability Services do? O We investigate allegations of adult abuse, neglect and exploitation O We help adults to remain independent in their homes through the Medicaid funded in-home services program

23 Who are eligible adults? O Any Missouri resident who is: O 60 years or older O with a disability AND OUnable to protect their own interest or do not have the ability to perform (or obtain services) to meet their needs.

24 Purpose of Adult Protective Services OTo promote independence OTo Empower the client to attain or maintain optimal self-determination OTo provide quality alternatives to institutional care OTo maximize individual choice

25 How we get our reports O Abuse and Neglect Hotline-Central Registry Unit (CRU) O 7:00am-12:00am seven days a week including holidays O Who can Report O Anyone!!!!!!! O Certain professions are mandated by law to report O HIPAA rule waived when state laws mandates suspected A/N/E be reported

26 How we get our reports O By reporting in Good Faith the reporter is immune from criminal/civil liability O Reporter Confidentiality is Protected Unless: O Reporter authorizes disclosure AND O Disclosure prevents further harm Or O Disclosure is Court ordered

27 The Investigation: It starts with a call O Once a report is received that report will be assigned to a geographic area and to an Adult Protective and Community Worker (APCW) for continued investigation. O That APCW will O Review the report and conduct a background check of the subjects of the report. O Develop an investigative plan which includes but is not limited to:

28 The Investigation: It starts with a call O Assessing the need to involve law enforcement, mental health professionals (primarily CIT officers) and E.M.S. O Determining who to interview and in what order O Determining what records or documents will be needed to (dis)prove the allegations O Determining each agency or entity which will need to be contacted to co-investigate or provide support

29 The Investigation O The APCW will conduct a thorough investigation to determine the safety of the victim by: O Obtaining all information necessary to determine whether the alleged abuse or neglect occurred. O Evidence is obtained through interviews, records and documents O The APCW will Evaluate and analyze the information obtained to determine if legal intervention or protective service are needed

30 Determining if Abuse or Neglect has occurred O Based on the information gathered during the investigative process, the APCW will determine if the alleged abuse, neglect or exploitation occurred. O If a report is substantiated, then we are required by law to notify the appropriate law enforcement agency.

31 Other Factors to Consider O The Right to Self-Determination- All Missourians have the right to make decisions regarding the course of their life and the state has a duty to respect the rights of others. O Our agency has the statutory authority to protect eligible adults from risk of injury or harm. O APCWs must balance these essential ethical principles when providing protective services

32 Other Factors to Consider O So What does it mean? O It means that when an APCW determines that a person may need protective services, the person, who is competent can choose to receive or refuse services.

33 Protective Services O Protective Services are offered when an eligible adult gives consent to receive services. O Protective Services are a combination or public, private and individual services O The purpose of the intervention is to remedy abuse, neglect or exploitation or assist in meeting basic needs

34 Protective Services Examples O Assistance locating emergency shelter, food, clothing or domestic violence shelters O Crisis intervention O Coordinating emergency medical intervention O Referring to local food pantries O Referring to Medicaid funded home and community based services program O Involvement of law enforcement

35 HOW WE CAN & CANNOT INTERVENE We Can: O Provide protective services interventions; O Authorize in-home services when criteria met We Can: O Intervene when an adult is incapacitated and is in need of medical or mental health intervention O Intervene on behalf of incapacitated adult to identify a representative or explore legal interventions

36 HOW WE CAN & CANNOT INTERVENE We cannot O Transport under any circumstances O Remove or evict an adult from their home We cannot O Place an adult in a mental health facility, nursing home or hospital O Force a competent adult to change their behavior or lifestyle

37 DHSS Statistics

38 Allegation Statistics

39 Community Partnership O We need your help! O Know the indicators of abuse, neglect and exploitation, and CALL US if you suspect it is happening to an eligible adult O How we rely upon you: O Direct services for our eligible adults O Transportation O Co-investigations O Copies of your records and reports regarding interactions with Reported Adults

40 DSDS Website& Helpful Numbers O O Toll Free Hotline to Report Abuse of Seniors and Adults with Disabilities: O Referral for home and community based services :

41 Questions? Megan Phillips Adult Protective and Community Supervisor (816)

42 The Kansas City Elder Abuse Prevention Task Force Training Awareness Events World Elder Abuse Awareness Day June 15 th For more information and a toolkit: D/Tools-Tips-Resources/Index.aspx Multidisciplinary Team (MDT)

43 Questions? Judy Gibbs Kansas City Missouri Prosecutors Office

44 Resources & Services O Be aware! O Ask questions. O Refer the older adult AND their caregiver for services. O Take part in training e_vatonline.cfm

45 Questions? Michelle Brown MARC Department of Aging & Adult Services Information & Referral Line (816)