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Domestic Violence in Later Life Online Training Florida Coalition Against Domestic Violence Contact Information: Maggie Cveticanin Disability Compliance and Later in Life Specialist firstname.lastname@example.org
ObjectivesBy the end of this online course, you should be able to: Identify three types of abuse in later in life. Recognize the role of family in elder abuse List three consequences of abuse and neglect for: the older adult, the abuser, and society Identify risk factors for perpetration
Vulnerable Adult Legal Definition Person(s) 18 + whose ability to perform the normal activities of daily living, and/or to provide for his or her own care or protection, is impaired due to a mental, emotional, long-term physical, or developmental disability or dysfunctioning, or brain damage, or due to the infirmities of aging.3 Florida Statute Section 415.102(26)
Distinction Between Intentional and Unintentional Abuse Intentional abuse is a Unintentional abuse is an conscious and deliberate inadvertent action attempt to inflict physical, resulting in physical, emotional, or financial emotional, or financial harm. This type of abuse harm. This type of abuse is most often due to the is usually due to abuser’s desire to ignorance, inexperience, maintain power and lack of desire, or inability control over the survivor. to provide proper care.
Intentional AbuseThis training will focus solely on intentional abuse, some examples of this type of abuse are: Harm to pets Name calling Hiding necessary medications Hitting, punching, pushing Rape Destroying assistive technology
Dynamics of Elder Abuse and NeglectThe reasons are complex and multifaceted. Family dynamics often play a role. Some older adults may rely on their children or other family members for their physical care. In other cases, family members may depend on the older adult for housing or financial support.
Dynamics of Elder Abuse Elder abuse, neglect, and exploitation often go unrecognized and unreported for many reasons: Isolation caused by the perpetrator. The victim may have valid fears that they will have to go to a nursing home if they report the abuse. An age related illness such as dementia may make it difficult for law enforcement to build a strong case and successfully prosecute the perpetrator.
Trust Is a Necessary Factor in Elder AbuseUnlike random acts of violence, elder abuse implies thepresence of a personal relationship, usually with someonein a position of trust, such as a caregiver, lawyer, or familymember who has caused injury or harm and could be;Intentional, orUnintentionalIn these relationships of trust, the elder person andperpetrator often have strong emotional ties.
Types of Elder Abuse in Intimate Partner Violence Situations Physical abuse is the use of Sexual abuse is nonconsensual physical force that may result sexual contact of any kind with in bodily injury, physical pain, an elderly person. It includes, or impairment. Physical abuse but is not limited to: may include, but is not limited Unwanted touching to, such acts of violence as: All types of sexual assault or Striking (with or without an battery such as rape, object) sodomy, and coerced nudity Hitting, beating, pushing, Sexual harassment shaking, slapping, kicking, and burning Unwarranted administration of drugs and physical restraints or force-feeding Physical punishment
Types of Elder Abuse in Intimate Partner Violence Situations Emotional or Financial exploitation is psychological abuse the illegal or improper use involves inflicting anguish, of an elders funds, emotional pain, or property, or assets. distress. Examples Examples include, but are include, but are not not limited to: limited to: Cashing checks without authorization or permission Verbal assaults, insults, and threats Forging an older persons signature Intimidation, humiliation, and Misusing or stealing an older persons harassment money or possessions Physically or socially isolating an Coercing or deceiving an older person elderly person from family, friends, or regular activities into signing a document (e.g., contracts or a will). Giving an older person the "silent treatment"
Types of Elder Abuse in Intimate Partner Violence Situations Medication abuse can Violation of rights refers include: to denial of an elderly Misuse of an older adults persons fundamental medication and rights, such as: prescriptions, such as Withholding information withholding medication or overmedicating Denying privacy (personal or Theft or illegal use of an financial) older persons medications Denying visitors Censoring mail
Most Common Perpetrators in Later Life1.Spouses2.Adult children3.Grandchildren4.Other family members5.Siblings*In order of incidence rates, spouses and adultchildren being the most common perpetrators. 2005 National Center on Elder Abuse, Washington D.C.
Elder Abuse: Who is Most at Risk?Female andmale olderadultsSeniors 85and olderSeniors whohave aphysical orcognitivedisabilityNational Center on Elder Abuse
Some Signs of Elder Abuse•Withdrawalfrom routineactivities•Suddenchanges inbehavior•Bruises•Difficultywalking orsitting•Appearsafraid•Depression
Age-Related Vulnerabilities Medical knowledge regarding elder abuse and neglect is years behind that of child abuse and intimate partner violence. Many health practitioners have difficulty distinguishing between changes related to aging and signs of abuse or neglect. For example, bruises on an older patient could be the result of an accident or an act of abuse.
Age-Related Vulnerabilities Older people are subject to psychological and physical challenges inherent in aging as well as "ageist" attitudes that discount the value or ability of older adults to contribute to society. Due to this attitude elders are not always believed by law enforcement or family.
Age Related VulnerabilitiesThe living situations of many older adults can make themvulnerable to abuse and create barriers for intervention.An abusive family member may be one of the few peoplewho come in contact with an older victim, creating feweropportunities for outsiders to witness the abuse andintervene. This can make it difficult to detect physical oremotional abuse, medication misuse, or neglect.
Possible Risk Factors for Perpetration Lack of family support Caregivers who feel forced to provide care Too many people in a crowded home co-habitation of multi-generations Economic issues/financial problems Marital conflict Medical issues Negative beliefs about aging and elders in society National Clearing on Elder Abuse and the CDC
Consequences of Elder AbusePsychical Effects: Psychological Effects: Broken bones Distress Sleep disturbances Depression Increased risk for Post Traumatic Stress premature death Syndrome Nutrition and hydration Increased risks for issues developing fear/anxiety Death reactionsCenter for Disease Control 2008
Consequences of Abuse and NeglectAbuse, neglect, and exploitation have consequencesbeyond bruises and other physical manifestations. Theconsequences also extend to unnecessary suffering, pain,injury, decreased quality of life, and an overall violation ofone’s human rights.
Who is Effected by Elder Abuse?Elder abuse impacts people from all ethnic backgrounds,religions, and socio-economic statuses, it affects oldermen as well as women. Although older people who areinfirmed or impaired are at a higher risk, healthy olderpeople also may be in an abusive situation or relationship.Due to the high percentage of underreported cases ofelder abuse, the patterns and profiles of victims andabusers are derived from the smaller number of reportedcases.
Where Can Elder Abuse Occur? A common misperception about elder abuse is that the abuse occurs primarily in institutions, such as nursing homes and other long-term care facilities. Although nursing homes are not immune to elder abuse, abuse rates for in home care patients are larger because only 4% of all adults over 65 live in institutions due to their care needs. 51% of care recipients live in their own home, 29% live with their family caregiver, and 4% live in nursing homes and assisted living. Caregiving in the United States; National Alliance for Caregiving in collaboration with AARP. November 2009
National and State Statistics For every one elder abuse report filed there are five that are unreported. Every five seconds an elderly person is abused. California, Florida, New York, Texas and Pennsylvania have the most cases of elder abuse annually. Spouses and adult children are the most common family member perpetrators of elder abuse.Elder Assistance Daily
Social Consequences of Abuse for Elder PeopleVirtually all forms of abuse can have social consequences,including increased isolation, visits to the emergencyroom, and hospital admissions. However, financial abuseand neglect can also lead to the loss of assets, the inabilityto maintain a home, and other limitations on quality of lifeand independence.
Summary Elder abuse includes physical, sexual, and emotional abuse as well as financial exploitation, neglect or abandonment, self-neglect, medication misuse, and violation of rights. Elder abuse implies the presence of a relationship between the survivor and the abuser. Family members perpetrate most elder abuse. The typical perpetrator is an adult child or spouse in a family setting. Physical and psychological consequences of elder abuse are long lasting.
Case Study Mr. and Mrs. D are a retired couple living in a largehouse in an affluent neighborhood. Mr. B, 81, is a retiredmail carrier who is orderly, controlling, and very “set in hisways.” He suffers from hearing loss and severe back pain,for which he takes strong pain medication. Mrs. D., 79, hasalways been a housewife and caregiver for the family.When Mrs. D was 72 she had breast cancer which has lefther weakened and frail. Though quite well off financially,they always lived a very private and isolated life, with noreal support network. They have had a long-standingdispute with their immediate neighbor and there are fewfriends willing to visit anymore.
Case Study When Mr. D’s needs increased, they hired an in-home caregiver.The caregiver quit after a few weeks, overwhelmed with the dailydemands of the job. Mr. D refused to hire anyone and said that iswhat a wife was for. All of the chores and caretaking of Mr. D fell onMrs. D and she started to become physically weaker and depressed.Mrs. D had only one friend left in the neighborhood, Thelma. Mrs. D ishappy to have a woman her age living across the street that she cantalk to on occasion. One night Mrs. D had a sleepless and difficultnight taking care of her husband. Mrs. D only slept for two hours thatevening. In the morning, Mr. D grabbed her arm and twisted it tellingher she didn’t take care of him the right way the night before becauseshe slept too long. Mrs. D cried and walked away into the living roomto escape his violent mood. The doorbell rang and it was her neighborThelma from across the street with muffins.
Case Study The neighbor noticed the red marks on Mrs. D’s arm andalso saw the drying tears. Mr. D yelled “who is at the door, tellthem to go away, come here and help me get dressed, I amhungry.” Mrs. D whispered something to the neighbor, grabbedthe plate of muffins and closed the door. The next time theneighbor saw Mrs. D, she was on a stretcher with EMT’s andpolice all around her. There was a sheet covering her body andthe police were speaking with Mr. D. Later in the week theperceived details were discussed between all the neighbors onthe block. The neighbors shared that Mrs. D tripped on thestairs in the night and broke her neck. Mr. D was going to anursing home so he could be taken care of since his wife died ina tragic accident. The truth is that the night before, Mr. Dpushed her down the stairs when she forgot to bring him anextra blanket.
Maggie CveticaninFlorida Coalition Against Domestic Violence 425 Office Plaza Drive Tallahassee, Florida 32301 (850) 425-2749 www.fcadv.org The Florida Abuse Hotline: (800) 962-2873