Elder Abuse Part I
Abuse and neglect is a widespread problem in societies of the 21st century. In the prior century, elderly abuse remained somewhat of a private matter well hidden from the public view. Today it is increasing becoming a critical issue, and affecting people of all races, ethnic backgrounds, and social statuses. In the U.S., the Federal government and the states have enacted laws to protect and provide services to older adults. Within the states and communities, agencies are assigned to implement the laws concerning abuse and neglect by providing protective services to those in need.
The purpose of Adult Protective Services, a division of the Florida Department of Children and Families (DCF), is to protect vulnerable adults from being harmed; adults who cannot physically or mentally protect themselves and who are harmed or threatened with harm through action or inaction by themselves or individuals responsible for their care or by other persons. It is startling to think that such abuse is taking place!
Florida law (Chapter 475) requires that persons who know or have reasonable cause to suspect, that an adult has been neglected or abused report such knowledge to the Florida Abuse Hotline at 1-800-962-ABUSE (1-800-962-2873). Adults determined to be vulnerable are those persons 18 and over (including senior adults sixty and older), who because of age or circumstances cannot care for themselves or they may be abused physically, mentally, emotionally, or sexually by another. Everybody in the State of Florida is a “mandatory reporter” according to the laws of the state.
Elder Abuse can be an act or omission, which results in serious physical or emotional injury to an older person; financial exploitation or failure to provide one or more essentials for physical, or emotional well being to themselves or by a caregiver. Although the DFC is responsible for providing services to detect and correct abuse, it is also necessary that this be done with placing the fewest possible restrictions on a person’s constitutional rights and liberties. If older adults are unwilling to leave an abusive situation or to press charges against family members or others and they are competent, the DFC cannot forcibly remove them.
If the abused is found to be impaired mentally and it is determined that their decision-making is impaired only then can the DFC intervene protecting the person against his or her will. All criminal investigations and prosecutions for neglect, abuse or exploitation of a vulnerable adult are handled by law enforcement after initially being investigated by the FSFN.
The FSFN has a sophisticated case management system that has been operational since 2007 according to Pamela Blumenthal, regional program administrator for the SunCoast chapter of Adult Protective Services. After a call to the Hotline is accepted as an intake and forwarded to the Criminal Investigations Unit for a criminal background records check, it is either called out as an “Immediate” to the investigator, or “forwarded” to the appropriate receiving unit. The investigators conduct an investigation and enter the following information into the system said Ms. Blumenthal: Information about allegations of maltreatment, identification, interview, and observation of participants in the intake, identification of other relevant people and additional investigative information, an analysis of the intake participants’ background history (criminal, prior involvement with the Dept etc); documentation of investigative activities and assessment of risk/safety, and documentation of the results and findings of the investigationbefore a dispositional recommendation is made.
Adult Protective Services intervenes when a report of non-accidental infliction of serious injury is made. These injuries can be caused by pushing, grabbing or physically restraining an older adult. Emotional abuse is the deliberate use of language or behavior that causes severe pain, fear, depression or other extreme reaction. The failure or refusal of a caretaker to provide the essential necessities such as food, clothing, shelter, personal or medical care constitutes neglect. Financial exploitation is illegally taking, misusing or concealing funds and property of a vulnerable adult with failure to provide necessities required for the individuals care.
Self-neglect accounts for the majority of cases reported to the APS. Often times the problem is paired with declining health, isolation, Alzheimer’s disease, dementia or drug and alcohol dependency. Self neglect can include behaviors of hoarding, failure to take essential medications, leaving a burning stove unattended, poor hygiene, not wearing suitable clothing for the weather, confusion, inability to attend to housekeeping, and dehydration.
Social isolation and cognitive impairments are factors that may make an older person more vulnerable to abuse as well. The National Center for Elder Abuse studies also show that living with a caregiver or a friend may increase the chances of abuse to an older adult. Abusers are both women and men. Family members often are abusers over any other group. It is very clear that elder abuse is a family issue.
Statewide from January 1, 2010 through September 30, o f this year, 33, 812 adult reports of abuse, neglect and exploitation were received. This is staggering! It appears that reports peak from October through Easter as does our typical tourist season. As family members and visitors come from the north to Florida, they visit or see their families and neighbors more often and this is when they may find them in distress or stumble upon unusual circumstances. In the summer months older adults may not get out as much as others or are not seen and their abuse, whatever type could go unnoticed for long periods of time.
Florida was the first state to implement an automated database hotline which originally dates back to the 1970’s, and over the past 30 years or more the state has been continuing to improve on its technology. The current state-of-the art tracking mechanisms in place now include child welfare systems and protective services for adults and children in one database.
With mandatory reporting to 24-hour investigators on-call, Florida is committed to the detection and correction of abuse, neglect and exploitation and has demonstrated this through the division of the DFC.
Throughout the State of Florida, the office of Elder Affairs has established several designated Protective Services offices to respond to the report of Elder Abuse as well as the statewide Elder Abuse Hotline. The Florida Association of Areas Agencies on Aging work closely with the Department of Elder Affairs to develop effective projects to over 4.5 million older adults. In our local area, you can contact Elder Helpline in Collier County at 332-3049 for assistance with general needs or call the Florida Abuse Hotline at 1-800-962-2873 to report a suspicion of neglect or abuse. The safety and care of our older adults is paramount. Let us do our part!!
Paula Camposano Robinson, RN, is co-founder and owner of Sanitasole Senior Health Services. This is an information-only column and is not intended to replace medical advice from a physician. Email firstname.lastname@example.org or visit Sanitasole.net, for more information. Phone: 239.394.9931.