 |
|
|
|
|
Abuse of the elderly is now a problem taken seriously
By Rita Baum
The old grandmother scavenged for food left from the family's sparse meals--cheese rinds, bread crusts--whatever she could forage to keep from starving. The poverty-stricken Georgia family resented the old woman for living so long and believed she had no right to expect more. The few available resources were needed for the young.
Her misery eventually ended when her 16-year-old grandson hit her while backing up the battered car. The grandmother is a memorable character in Tobacco Road, the Depression-era novel by Erskine Caldwell that described the poverty and ignorance of rural America, while introducing Americans to the topic of elder abuse. Readers still shudder in horror at the heartless treatment of the old woman. But then, this is fiction--isn't it?
In fact, nearly 1 million older Americans are abused or neglected yearly, according to studies commissioned by Congress and various organizations. And those numbers reflect only the reported cases. Closer to home, Jamie Buckmaster, program manager of Santa Clara County's Adult Protective Services (APS), estimates they receive about 2,000 cases of domestic elder and dependent adult abuse reports each year in this county alone.
Elder abuse takes many forms: physical, financial, psychological, passive or active neglect, self-abuse and abandonment.
Passive neglect is described as the unintentional failure to fulfill a caretaking obligation, or the infliction of distress without conscious or willful intent. The caregiver, perhaps an elderly frail spouse or sibling, may not be aware of the victim's needs, or may be physically or mentally incapable of providing them. Active neglect involves the intentional failure to fulfill caregiving obligations by inflicting emotional or physical stress or injury, abandonment, or the denial of medical attention, food, medication, or personal care, often for personal gain.
Less frequently reported is psychological abuse that includes the infliction of mental anguish by demeaning, name-calling, insulting, ignoring, humiliating, frightening or threatening.
Physical abuse is described as actual infliction of pain or injury, physical coercion, confinement, slapping, bruising, burning, sexual molestation and similar oppressive behavior.
Financial abuse, which includes the illegal or unethical exploitation of the funds, property or other assets of an older person for personal gain, is rampant in Santa County, according to Buckmaster. Some 500 cases of financial abuse were reported to APS last year, not including scams directed at older people, and only one in 100 incidents of financial abuse are actually reported. In this county almost 90 percent of financial abuse situations involve family members or paid caregivers, says Buckmaster.
Often financial abuse is accompanied by emotional and physical abuse. Since Americans over age 50 control 70 percent of the net worth in the United States, it is no wonder that older people--especially dependent, disabled and trusting elders--are prey for exploitation.
Self-abuse, generally reported by neighbors, service providers and friends is not uncommon. Self-abuse generally occurs among older people who are unable to protect their own interests or safety as a result of ignorance, illiteracy, incompetence, mental limitations, substances abuse, poor health, or lack of adequate food, shelter or clothing. In cases of self-abuse, APS investigators are able to provide remedial activities and link people to services.
Take A Stand: Telephone numbers to call to report elder abuse.
The good news is that steps have been taken to curtail elder abuse substantially since the days of Tobacco Road. In the 1960s, with the advent of the Older Americans Act, elder abuse was recognized as a real, serious and growing problem. Many laws were passed in an effort to protect elders from what was earlier called parent battering. Payments to states were authorized to establish protective services for persons with physical or mental limitations who were neglected, exploited, or unable to manage their own affairs.
In the mid-'70s, Adult Protective Services became a state-mandated program. Since that time, elder rights have gained momentum. California made a giant step forward in protecting our older citizens from abuse and exploitation in May 1999, with the passage of California Senate Bill 2199 (Elder and Dependent Adult Abuse legislation). The legislation standardized APS from county to county, broadened and redefined terms, and set forth provisions for the reporting of actual or suspected abuse.
The bill also increased the funding allotted to APS workers, enabling the purchase of services and medications to keep older people in their own homes. And it mandated a 24-hour abuse-reporting hotline, increased staff sizes, and provided for a multidisciplinary investigative team, all of the provisions that empower abuse investigators to provide greater protection for older people.
For example, last year Department of Aging and Adult Services Director Betty Malks created the award-winning Financial Abuse Specialist Team (FAST) to respond immediately to incidents of financial abuse and to freeze assets within hours of a report. The team recovered or prevented the loss of $56 million in assets and property for Santa Clara County seniors and dependent adults in its first year. In the future, California may follow Oregon and Massachusetts, the first states to give protection from liability to banks and credit unions for releasing private and confidential financial records in cases of suspected fraud, forgery or other crimes.
There is little data on abuse in institutional settings, in spite of well-documented reports of elder abuse by state health agencies, ombudsman programs and personal histories. But it is suspected that the incidence is greater in these settings.
A report in the Older Americans Report estimates that 400,000 residents a year suffer from actual harm in nursing homes, and care is worse in for-profit homes than nonprofit facilities. Donna Di Minico, director of the Long Term Care Ombudsman Program of Santa Clara County, reports there were 465 elder abuse complaints last year. National studies show that 80 percent of facility staff report having observed abuse in the institutional setting.
The behaviors most often reported are neglect, yelling, swearing, insulting, rough- handling, and improper use of restraints. Solutions include the frequent and ongoing presence of ombudsman, family members, and volunteer visitors, training of nursing aides, and stricter enforcement of regulations and staffing requirements. Some groups are endorsing the use of video cameras in nursing home rooms to monitor the care provided.
Financial abuse remains pervasive, as con artists consider older people easy targets for exploitation. Almost every APS agency staff has investigated a case in which an elder agreed to deed his or her house to a relative or hired caregiver in exchange for care in declining years, only to be evicted and have the house sold from under them.
In many cases, watchful families can prevent elder abuse. Even if the older relative has a history of high competency in managing his or her own affairs, recent widowhood, age-related changes, or other factors, might make it difficult to handle new challenges or unexpected developments. Family members should watch for changes that signal an inability to manage affairs as previously, and be alert for bruises or changes in personality, such as increased depression, anxiety or timidity.
On the financial front, families should pay attention to sudden, large checking account withdrawals or unexplained financial losses, and they should always assist with the hiring and monitoring of individuals for checkbook balancing, personal care, home repairs and other needs. Make sure that emergency phone numbers are accessible.
Fortunately, most older people do not experience abusive treatment, but 4 percent of older Americans do experience abuse of some type. Whether handled roughly or robbed of their assets, elders deserve to be protected.
|
|
|
|
Willow Glen, California Since 1992
