AUTHORS' DISCLAIMER
The material contained in this course is not a substitute for legal, ethical or clinical advice or consultation. This is NOT a legal document. This material is solely for the purpose of continuing education; it is not a substitute  for personal or clinical consultation, or legal advice.

 

Elder abuse

Florida:

Elder Abuse and How To Report It, Prevent It
Florida Law requires that any person who knows, or has reasonable cause to suspect, that a vulnerable adult has been or is being abused, neglected, or exploited shall immediately report such knowledge or suspicion to the Florida Abuse Hotline on the toll-free telephone number, 1-800-96-ABUSE (1-800-962-2873). The TDD (Telephone Device for the Deaf) number for reporting adult abuse is 1-800-955-8770. Vulnerable adults are persons eighteen and over (including senior adults sixty and over) who, because of their age or disability, may be unable to adequately provide for their own care or protection. The Florida Abuse Hotline accepts calls 24 hours per day, seven days a week. The Abuse Hotline counselor is required to let the person calling know whether the information provided has been accepted as a report for investigation.
Abuse may be physical, mental, emotional, or sexual. Neglect can be self-neglect or neglect by a caregiver. A caregiver may be a family member, an in-home paid worker, a staff person of a program such as an adult day care center or of a facility such as a nursing home, or another person. Exploitation means that a person in a position of trust knowingly, by deception and intimidation, obtains and uses or tries to obtain and use a vulnerable person's funds, assets, or property. This includes failure to use the vulnerable person's income and assets to provide for the necessities required for that person's care.
When you call the Abuse Hotline to make a report, have this information ready:
Victim's name, address or location, approximate age, race, and sex.
A brief description of the adult victim's disability or infirmity.
Signs or indications of harm or injury, including a physical description if possible.
Name, address, and telephone number of any possibly responsible person/ perpetrator.
Relationship of the possibly responsible person/perpetrator to the victim, if possible. If the relationship is unknown, a report may still meet requirements for investigation.
As the reporter, your name, address, and telephone number. This information is never given out. The reporter may choose to remain anonymous.
The Florida Department of Children and Families (DCF) is responsible for providing services to detect and correct abuse, neglect, and exploitation of adults. This must be done so as to place the fewest possible restrictions on personal liberty and constitutional rights. In other words, DCF cannot forcibly remove a competent adult from a situation he or she refuses to leave. Some elders are unwilling to leave an abusive situation or to press charges against family members. Only if the person is found to be mentally impaired enough that judgment and decision making are impaired can the worker intervene to protect the person against his or her will. Law enforcement takes the lead in all criminal investigations and prosecutions for abuse, neglect, or exploitation of a vulnerable adult by another person.
Groups most at risk for elder abuse include:
Older women are most commonly reported. Older men may be just as much or even more at risk but are less frequently reported.
The higher the age, the greater the risk.
Those who live with a caregiver or depend on someone for care and assistance.
Physically frail or disabled.
Confused, disoriented, or mentally impaired.
Individual characteristics include:
Very loyal to the caregiver. Willing to accept blame.
Socially isolated and history of poor relationship with caregiver.
Alcohol, medication, or drug abuse.
Has illness that causes behavior that is stressful for caregiver (verbal outbursts, incontinence, wandering, agitation).
Displays behavior that provokes caregiver (ungrateful, overly-demanding, unpleasant).
The more of the following observable indicators are present, the greater the risk:
Physical indicators such as bruises, burns, unexplained fractures, bedsores, being dirty and unkempt, inadequate clothing, showing evidence of malnutrition.
Behavioral indicators such as being nervous or agitated, avoiding eye contract, hesitant to talk openly, depressed or despairing, feeling hopeless, withdrawn, denying problems, covering up for caregiver, confused or disoriented, suspicious.
Environmental indicators such as dirty, cramped, unsanitary living space with inadequate light, heat, or cooling; health and safety hazards such as doors with no locks, rodents or insects, open space heaters, broken plumbing, no water or electricity, fire hazards, repairs needed to roof, stairs, railing; and questionable care as evidenced by lack of food, medicine not managed, soiled bedding, or patient is restrained.
Many times the abuser is a family member who is providing unpaid care to the vulnerable person.
A caregiver is more at risk of being an abuser if he or she:
Has personal problems such as alcohol or medication abuse, mental or emotional illness, physical health problems, or low self-esteem.
Was abused as a child, grew up in a household where violence was used to resolve disputes, or has a history of conflict with the older person.
Is experiencing stresses such as marital conflict, unemployment, economic problems, lack of activities outside the home, or caring for both parents and children.
Lacks experience and skills as a caregiver, does not understand the older person's disease, has little support from other family members, or has unrealistic expectations for being a caregiver.
Observable factors that could indicate that abuse by a caregiver is happening include:
Not letting the older person speak for himself/herself or have a conversation without the caregiver present.
Family members blaming the older person for being a burden or perceiving symptoms of a disease as intentional behavior.
Conflicting accounts of an incident by family members and the victim.
Caregiver is financially dependent on the older person.
Older person lives in overcrowded environment with caregiver and is socially isolated outside the family.
Some of the risk factors for abuse by caregivers can be changed through caregiver education and support. The Area Agency on Aging of Pasco-Pinellas, Inc. (AAAPP) offers two caregiver programs, but caregivers most in need of this help may be the ones least likely to hear about and accept assistance. It is up to all of us to inform caregivers we know and to encourage them to ask for support to preserve their own health and allow them to provide care longer with less risk of abuse or neglect.
The Caregivers REST Project (Caregivers of Seniors Resources, Education, Services and Training Project) serves caregivers of persons sixty and older in Pinellas County. This program, which focuses on caregiver education, is developing the web site you are using now, www.AgingCareFL.org. Ask for the Caregivers REST Project if you want to learn more about what to expect and how to find help. For referral, call the Senior Helpline at 727-217-8111.
The second program is the National Family Caregiver Support Program, which serves caregivers of persons sixty and over. Services such as respite care, counseling, and chore services are available. Grandparents sixty and over caring for children eighteen and younger are eligible for similar services. This program is available in other areas of Florida and the U.S. For referral in Pinellas and Pasco County, Florida, call the Senior Helpline at 727-217-8111 (Pinellas) or 1-800-861-8111 (Pasco). In other Florida counties call the toll-free state Elder Helpline number, 1-800-96ELDER or 1-800-963-5337. Nationally, use the Eldercare Locator's toll-free number, 1-800-677-1116 or use the Eldercare Locator web site, www.eldercare.gov.
For information on how to prevent caregiver burnout that can lead to abuse if there is no relief, see The Four Stages of Caregiving, Stage Three, section 1. Recognize and prevent caregiver burnout. For ways to cool down immediately and the numbers of several crisis counseling or prayer lines available 24 hours a day that is described in The Four Stages of Caregiving, click here
There are additional resources to help victims of spouse abuse. The Center Against Spouse Abuse (CASA) in St. Petersburg, Florida, has a 24-hour crisis line, 727-895-4912. This organization provides support, advocacy, safety planning, shelter, etc. For more information, call the Senior Helpline at 1-800-861-8111 in Florida. The Florida Domestic Violence Hotline may be called toll-free at 1-800-500-1119.
In October of 2003 the Area Agency of Pasco-Pinellas, Inc. joined with the Pasco Aging Network to sponsor a conference on caregiving. One of the presentations addressed the topic of elder abuse and was given by Teresa Hays, M.P.A., Health and Wellness Trainer, Florida Department of Elder Affairs. The Powerpoint presentation that was displayed that day is attached. Click on the title to download the presentation. DOEA Abuse Presentation 2003 (This may take a few minutes to download.)

source: http://www.agingcarefl.org/aging/elderAbuse

Elder abuse is a serious problem in our society, and must be reported, under California law, by therapists.  California Laws Chapter 769, Statutes of 1986, Chapter 637, Statutes of 1987, and Chapter 1396, Statutes of 1987 provides for mandatory reporting of physical abuse when:

the victim reports that abuse has occurred or if you observe the incident when an injury or condition reasonably leads one to suspect that abuse has occurred.

The law requires mandated reporters to make a verbal report immediately, or as soon as possible, followed by a written report within two (2) working days." For a listing of phone numbers to report for each state, please go to: http://www.elderabusecenter.org/report/index.html

Elder Abuse

Elder Abuse is under a provision of mandatory reporting. The following is from http://www.oaktrees.org/elder/recog.shtml

"The following indicators, by themselves, do not necessarily signify abuse or neglect. They may be clues, however, and thus helpful in assessment of abuse.

* Possible indicators of Physical Abuse
o Cuts, lacerations, puncture wounds
o Bruises, welts, discoloration
o Any injury incompatible with history
o Any injury which has not been properly cared for (injuries are sometimes hidden on areas of the body normally covered by clothing)
o Poor skin condition or poor skin hygiene
o Absence of hair and/or hemorrhaging below scalp
o Dehydration and/or malnourished without illness-related cause
o Loss of weight
o Burns: may be caused by cigarettes, caustics, acids, friction from ropes or chains, or contact with other objects o Soiled clothing or bed

* Possible indicators of Psychological/Emotional Abuse
Helplessness
Fear
Hesitation to talk openly
Withdrawal
Implausible stories
Depression
Confusion or disorientation
Denial Anger Agitation

* Possible indicators of Financial Abuse
o Unusual or inappropriate activity in bank accounts
o Signatures on checks, etc., that do not resemble the older person's signature, or signed when older person cannot write
o Power of attorney given, or recent changes or creation of will, when the person is incapable of making such decisions
o Unusual concern by caregiver that an excessive amount of money is being expended on the care of the older person
o Numerous unpaid bills, overdue rent, when someone is supposed to be paying the bills for a dependent elder
o Placement in nursing home or residential care facility which is not commensurate with alleged size of estate
o Lack of amenities, such as TV, personal grooming items, appropriate clothing, that the estate can well afford
o Missing personal belongings such as art, silverware, or jewelry
o Deliberate isolation, by a housekeeper, of an older adult from friends and family, resulting in the caregiver alone having total control

* Possible indicators of Neglect by Caregiver
o Dirt, fecal/urine smell, or other health and safety hazards in elder's living environment.
o Rashes, sores, lice on elder o Elder is inadequately clothed
o Elder is malnourished or dehydrated
o Elder has an untreated medical condition

* Possible indicators of Self-Neglect
o Inability to manage personal finances, e.g. hoarding, squandering, giving money away or failure to pay bills
o Inability to manage activities of daily living, including personal care, shopping, meal preparation, housework, etc.
o Suicidal acts, wanderings, refusing medical attention, isolation, substance abuse
o Lack of toilet facilities, utilities or animal infested living quarters (dangerous conditions)
o Rashes, sores, fecal/urine smell, inadequate clothing, malnourished, dehydration, etc.
o Changes in intellectual functioning, e.g. confusion, inappropriate or no response, disorientation to time and place, memory failure, incoherence, etc.
o Not keeping medical appoints for serious illness

* Possible indicators of Abuse from the Caregiver
o The elder may not be given the opportunity to speak for him or herself, or see others, without the presence of the caregiver (suspected abuser)
o Attitudes of indifference or anger toward the dependent person, or the obvious absence of assistance
o Family member or caregiver blames the elder (e.g. accusation that incontinence is a deliberate act)
o Aggressive behavior (threats, insults, harassment) by caregiver toward the elder
o Previous history of abuse of others
o Problems with alcohol or drugs
o Inappropriate display of affection by the caregiver
o Flirtations, coyness, etc. as possible indicators of inappropriate sexual relationship
o Social isolation of family, or isolation or restriction of activity of the older adult within the family unit by he caregiver
o Conflicting accounts of incidents by family, supporters, or victim
o Unwillingness or reluctance by he caregiver to comply with service providers in planning for care an implementation
o Inappropriate or unwarranted defensiveness by caregiver

California Laws Chapter 769, Statutes of 1986, Chapter 637, Statutes of 1987, and Chapter 1396, Statutes of 1987 provides for mandatory reporting of physical abuse when: the victim reports that abuse has occurred or if you observe the incident when an injury or condition reasonably leads one to suspect that abuse has occurred. The law requires mandated reporters to make a verbal report immediately, or as soon as possible, followed by a written report within two (2) working days. For a listing of phone numbers to report for each state, please go to: http://www.elderabusecenter.org/report/index.html

(excerpted from TLC: Tender Loving Care for our Elders )