1. NOTE: To change the image on this slide, select the picture and delete it. Then click the Pictures icon in the placeholder to insert your own image. ELDERLY WITH MENTAL ILLNESS: CIT TEAMS NEED FOR EDUCATION- REAL ADULT PROTECTION Kim Jardine-Dickerson, RN, MSN, BC, CADC Idaho State University, School of Nursing jardsusa@isu.edujardsusa@isu.edu 208-589-76667

2. And Here We Have Idaho  Home of the Jeff D Law Suit  Established Specialty Courts /Drug Courts  ACT Teams  NAMI Idaho  SPAN Idaho  24 Hour Suicide Hotline  1 st Community Crisis Center  Nov 2014

3. IDAHO IS CIT 7 YEARS It Is More Than Training

6. Law Enforcement Adult Protection Case Management Community Resources Advocacy Mental Health Professionals What can CIT do in Partnership with Adult Protection?

11. Case in Point  Married couple living in a rural community everyone knows  Female 85 male 89 living in their own home  She has dementia. He is a WWII Veteran, uses oxygen, and drinks at night.  2 cats 1 dog  Daughter living out of state (California)  She is confused most days most of the day  He still drives and is confused most days especially at hours of darkness)  Neighbors hear loud banging noises and dog barking: calls 911  Sherriff Officers and City Police know this couple  Nice people that are getting worse, daughter lives in California, church people are getting worn out

13. Case in Point  82 year old female in assistant living  Becomes agitated acutely and started biting, scratching, and hitting staff

14. Adult Protection  Under Idaho Law Adult Protection is responsible for investigating allegations of Abuse, Neglect and Exploitation against Idaho's vulnerable disabled and senior populations and working with other agencies toward resolution (39-5301A(3)  Adult Protection seeks to preserve individual rights in the least restrictive manner while offering protection from further harm and solutions to problems (39-5301A(3 )

16. Self Neglect  vulnerable adult, not living in a care facility, cannot provide for him-or herself the goods and services needed for his/her physical or mental health, and this hurts or threatens the vulnerable adult's well-being

17. Neglect  when a person or agency with a duty to care for a vulnerable adult acts (or fails to act) in a way that results in the vulnerable adult not getting care needed to maintain his/her physical or mental health

18. Exploitation  an abuser illegally or improperly uses a vulnerable adult or the vulnerable adult’s income /resources, including trust funds or bank accounts, for the abuser’s profit or advantage

19. Abandonment  when a person or agency with a duty to care for a vulnerable adult acts (or fails to act) in a way that leaves the vulnerable adult unable to get needed food, clothing, shelter, or health care

20. Considerations of Disability  Any person who is 18 years of age or older who is:  Frail or suffers a chronic physical or mental impairment  Socially isolated  Dependent upon others for their basic needs  Unable to protect themselves in an abusive situation  Fearful of retaliation or ashamed to take action  Judgment or behavior is affected to the point the person is unable to make, communicate or implement decisions in his best interest

21. Adult Developmental Disabled Population in Assisted Living  Since deinstitutionalization  Significant percentages of men with Schizophrenia  Co occurring medical disorders  Prescribed psychotropic medications  Significant percentages non compliant with psychotropic medications  Often escalates quickly when they are medically ill and  Staff in assisted living facilities are not trained in de escalation skills  Staff in assisted living facilities are not trained in medical assessment

22. Case in Point  65 year old developmentally disabled male living in rural community assisted living  Law enforcement knows this man from recurring calls to assistant living  This resident escalates quickly to the point staff are afraid of him  He is on psychotropic medications for schizophrenia

23. Team Approach For All Advocacy Law Enforcement Mental Health Professionals

24. What Can We Do For Adult Protection?  Listen to their cases  Advocate for them  Bring training to them  SEE what they need

25. What Nursing Can Bring To The Team  Assessment  Intervention  Planning  Evaluation  Outcome  Education to team members

26. CIT: It’s More Than Training  Stakeholder Meetings  Law Enforcement  911 Dispatch  EMS Fire and Paramedics  Adult Protection  Health and Welfare  Housing  Advocacy  Case Management  ED Nursing  Community Resources

27. History and Development  Not what Law Enforcement can do for us nut We can do for Law Enforcement  Academies  Consistent meetings  Recognition of Law Enforcement (Banquets, Letters to Editor, Training)  Recognition of 911 Dispatch  Recognition of EMS  Incorporating Adult Protection