1. Presenter: ___________________ County: ____________________ Date: _____________________ Faith Leaders Respond to Elder Abuse 1 “Honor Thy Father and Thy Mother”

2. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 2 The elderly are not valued in America. Yet, they are our parents and grandparents, the soldiers who landed at Normandy, the women who taught us to read. The helped make this country what it is today. They are my heroes…

3. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 3  Why Learn About Elder Abuse?  What is Elder Abuse?  Who Must Report Elder Abuse?  What is Adult Protective Services?  When Should I Report?  How Do I Make a Report?  What Can I Do In My Congregation? Overview Overview

4. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 4 Why Learn About Elder Abuse? Faith leaders:  Are often the first stop for help;  May be the only other person (except the abuser) in the victim’s life;  Will be better prepared to help congregants;  May be required (by state law) to report. Knowing the warning signs… may save a life.

5. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 5 What Is Elder Abuse What Is Elder Abuse? Elder Abuse:  any knowing, intentional, or negligent act  by a caregiver or any other person  that causes harm or a serious risk of harm to a vulnerable older person.* Types of abuse  physical, emotional, sexual abuse, financial exploitation, abandonment, and neglect *General definition used by the National Center on Elder Abuse. For more information see NCEA Web site: http://www.elderabusecenter.org

6. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 6  A large problem—2-10% of older American population may be victims  A hidden problem—Only 1 in 5 victims are identified  A family problem—Perpetrators are often family members and people known to the elder  A serious problem—Abused elders four times more likely to die prematurely What Is Elder Abuse?

7. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 7 In (your state), the following categories of abuse are defined in law: What Is Elder Abuse?

8. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 8 Occurs wherever older Americans live  Own home  Apartment  Public housing  Nursing home  Board and care  Assisted living  Relative’s home Where Does Elder Abuse Occur?

9. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 9 Who Are the Victims?  Men and women. Women more likely to be identified and reported  Socially isolated  Have dementia (stroke, Alzheimer’s disease)  Have mental illness or physical infirmities  Are trusting of others  Many are over 80 years old

10. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 10 4 –10 times higher risk of becoming a victim of crime 10 times more likely to be sexually assaulted Less likely to report abuse Lower rates of police follow-up, prosecution, conviction What About Adults with Disabilities?

11. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 11  Have alcohol or substance abuse problems  Have mental health issues  Dependent on the older person, unemployed – no personal income  Family members, friends, neighbors, new “best friend”  Provider of care (paid or unpaid) What are Red Flags? Potential Abusers

12. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 12  Spouses  Adult Children  Other Relatives (grandchildren, nieces, nephews)  Friends, Neighbors  Caregivers  Others Who are the Abusers?

13. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 13 Facts and Figures in Our Area  In (state/county), the data shows that: 

14. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 14 More Facts and Figures…

15. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 15 Why Abuse Is Not Reported  Ageism—Unfavorable attitude towards older people  Disbelief—“They’re such an upstanding family”  Lack of knowledge of signs of abuse  Lack of knowledge of reporting procedures  Reluctance or fear of confronting the offender  Fear of jeopardizing relationship with elder or elder’s family  Mistreated person requests it not be reported

16. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 16 SIGNS OF ELDER ABUSE

17. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 17 What are some Warning Signs of Neglect?  Elder's report of being mistreated  Dehydration, malnutrition, untreated bed sores, poor personal hygiene  Unattended/untreated health problems  Hazardous or unsafe living conditions: improper wiring, no heat, no running water  Unsanitary living conditions—dirt, fleas, lice, soiled bedding, fecal/urine odors, inadequate clothing

18. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 18 Warning Signs Abandonment  Elder's own report of being abandoned  Desertion of an elder at a  nursing facility or other similar institution  shopping center  other public location What are some Warning Signs of Abandonment?

19. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 19 Physical Abuse Warning Signs  Elder’s report of being hit, slapped, kicked, etc..  Findings of medication over- or under-utilization  Signs of being punished or restrained  Elder's sudden change in behavior  Caregiver's refusal to allow visitors to see an elder alone What are some Warning Signs of Physical Abuse?

20. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 20 What are some Warning Signs of Physical Abuse?  Bruises, black eyes, welts, lacerations, rope marks  Broken or fractured bones, skull fractures  Open wounds, cuts, punctures, untreated injuries in various stages of healing  Sprains, dislocations, bleeding  Broken eyeglasses or frames

21. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 21  Sudden changes in bank account or banking practice  Inclusion of additional names on bank signature card  Unauthorized withdrawal using elder's ATM  Abrupt changes in will or other financial documents  Unexplained disappearance of funds or valuable possessions What are some Warning Signs of Financial Abuse?

22. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 22 Warning Signs Financial Abuse  Disparity between assets and living conditions  Forged signature on financial transactions or titles of possessions  Sudden appearance of previously uninvolved relatives claiming rights to elder's affairs and possessions  Unexplained sudden transfer of assets to a family member or someone outside the family  Elder's report of financial exploitation What are some Warning Signs of Financial Abuse?

23. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 23 Warning Signs Emotional Abuse  Elder's report of being verbally or emotionally mistreated.  Emotionally upset or agitated  Extremely withdrawn, non-communicative, non- responsive  Unusual behavior usually attributed to dementia— sucking, biting, rocking What are some Warning Signs of Emotional Abuse?

24. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 24 Warning Signs Sexual Abuse Bruises around the breasts or genital area Unexplained venereal disease or genital infections Torn, stained, or bloody underclothing Elder's report of being sexually assaulted or raped  Elder's report of being sexually assaulted or raped  Bruises around the breasts or genital area  Unexplained venereal disease or genital infections  Torn, stained, or bloody underclothing What are some Warning Signs of Sexual Abuse?

25. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 25  When the person because of depression, confusion, dementia or alcoholism does not take care of him or herself.  Dehydration, malnutrition, untreated or improperly attended medical conditions, poor personal hygiene  Hazardous or unsanitary living conditions  Inappropriate or inadequate clothing  Lack of the necessary medical aids—eyeglasses, hearing aids, dentures  Homelessness What are some Warning Signs of Self Neglect?

26. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 26 Is Elder Abuse a Crime?  Penal Code Section ____ provides that:

27. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 27 If I Suspect Abuse… What Should I Do?  You play an important role as a “sentinel” or “gatekeeper” for an abused person in your community  If you suspect that something is amiss, call your local Adult Protective Services Program. It is not your responsibility to investigate abuse  APS will consult with you about the case. If they believe a report needs to be made, they will take the necessary information from you

28. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 28 Are Clergy Required to Report? In (your state) the reporting policy:

29. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 29 An essential part of our community safety net.  Helps vulnerable adults who are in danger of being mistreated or neglected  Helps those unable to protect themselves Adult Protective Services (APS Adult Protective Services (APS)

30. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 30 What Does APS Do?  Prevents and alleviates harm resulting from abuse, neglect or exploitation:  Receives reports  Investigates needs and risks  Develops case plans  Provides and monitors services  Offers needed services  Competent adults may refuse APS help  Collaborates with other services to meet elders’ needs

31. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 31 Our (state/area) APS program includes: What Does APS Do?

32. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 32 To report abuse that occurs in the Community (i.e. private home, hotel, senior center) Call: Who Should I Call?

33. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 33 Adult Protective Services (APS) LTCO is a unique, nationwide program  Provides advocacy for residents of nursing homes, board and care, and other long term care facilities. Long Term Care Ombudsman (LTCO Long Term Care Ombudsman (LTCO)

34. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 34 What Does the LTCO Do? Advocate for Residents complaints  Receives and resolves complaints about resident care  Educates  Educates residents, families and communities on  Resident Rights  Quality Care  Collaborates  Collaborates on policy change to meet resident needs

35. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 35 What Does the LTCO Do? Our LTCO program includes:

36. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 36 To report abuse that occurs in a Long Term Care Facility (e.g., nursing home, assisted living facility) Call: Who Should I Call?

37. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 37  Be patient  Do not act shocked, keep your demeanor calm  Reassure the person that he or she is not to blame  Let him or her know that he or she is not alone. If someone tells me about abuse… What Should I Do?

38. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 38 I have never reported before… What is Involved? In (state/area), the protocol for reporting elder abuse includes:

39. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 39 What information do I give?  Your name  Victim’s name  Victims address/location  Your observations and concerns  Who is the suspected abuser?  Can the victim walk, hear, see, etc.?  Anyone else who should be contacted.  Contact information.

40. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 40  In (state/area) the policy includes: Do I have to make a written report?

41. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 41 What happens after I report?  You can expect a professional & confidential response: What happens after I report?

42. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 42 I am not a trained investigator… How can I recognize abuse? I am not a trained investigator… How can I recognize abuse?  No one expects you to be the experts on abuse or to know all the warning signs  Sometimes abuse is so obvious that there is no question whether to report it  If you are concerned and you think something is going on, call the professionals at APS. They are trained to investigate and make that decision

43. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 43 What if I don’t report? In (your state), if a mandated reporter fails to report abuse:

44. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 44 Are there times when… I should not report?  The short answer is, no:  Some Faith Leaders believe that they can assist an elder or a family without reporting abuse  If you have been told, or reasonably believe that abuse is taking place, very important it is very important that you report it  Let the experts assist the elder and the family.

45. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 45 What about my relationship with my congregation member? Abused persons will often drop hints or tell someone about the abuse because they know they need help  If, having been told about the abuse, you do not report it, you may be sending a message to the older person that what is happening to them is not serious  In addition, in (your state), if you do not report reasonable suspicions, there are/are not legal consequences

46. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 46 You can help prevent it before it gets serious:  Take time to meet alone with the older person. Tell him or her what you know about some of the risk factors of elder abuse (e.g., adult child who is financially dependent).  Tell him/her of your concern.  Explain the role of APS. Encourage him/her to seek help before abuse occurs or worsens. What if I see early warning signs of abuse?

47. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 47 What if the elder wants help but… The elder may want help but doesn’t want to get the alleged abuser in trouble.  This is a very common response of older abused people, especially when the abuser is a family member  Remind the abused person that help is available to him or her and that it is better to seek help than to try to handle a difficult situation alone.  Encourage them to talk with APS  APS may be able to refer the alleged abuser to services (e.g., drug or alcohol treatment), however, these are also voluntary and may be rejected by the abuser

48. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 48 The elder may seem confused. It’s not clear that he/she understands the situation.  Sometimes dementia, mental illness, or other factors may hamper an older person’s cognition  An assessment may indicate that the elder does not have the capacity to make informed judgments about his or her care.  Adult Protective Services, may, on an emergency basis, or with court approval, act on behalf of the elder’s best interest, even without his or her consent.  The procedure for such actions varies from state to state What if the elder seems confused…

49. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 49 What about “caregiver stress” and elder abuse? The abuser says that “caregiver stress” is causing the abuse, how can I help?  Caregiving is, without question, a stressful endeavor. However, research shows that stress related to caregiving is not the cause of elder abuse. Some people should not be entrusted with care of an elder. If these people become caregivers, they may abuse and blame the stress for the abuse.  Be careful not to come to the support of the caregiver without also seriously considering the safety of the older person. The safety of the older person should be your foremost concern.

50. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 50 What about forgiveness? What about forgiveness? Shouldn’t the abusers be forgiven?  Forgiveness does not mean returning to an abusive situation.  An abused person may one day find that forgiveness is possible.  However, no one should be told to put up with an abusive situation because their faith calls on them to forgive the abuser’s transgressions.

51. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 51 What Can Faith Leaders Do?  Educate yourself and other Faith Leaders about elder abuse  Create a Safe Place for Elders by making your place of worship a place where elderly victims can come forward for help.  Educate the Congregation on the subject of violence against and fraud and abuse of elders.  Talk with other Faith Leaders about a regular meeting on issues of family violence.

52. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 52  Establish a Friendly Visitor Program  Create a Nurse Program for homebound elders  Break the silence about abuse  Give a sermon that mentions abuse in vulnerable populations  Make it clear that this type of behavior is not condoned  Intervene  Do not turn a blind eye or a deaf ear to the clues of abuse What Can Faith Leaders Do?

53. Faith Leaders Respond to Elder Abuse NCEA, 2005 Grant #90 AM 2457 53 An Elder A person whose life continues to have promise for and connection to the future: …still growing, …still growing, …still a learner, …still a learner, …still with potential …still with potential