By Michelle Seitzer
Elder abuse is a serious problem. The National Council on Aging (NCOA) estimates 1 in 10 Americans over the age of 60 have experienced some form of abuse; many experts believe nearly 5 million elders are abused each year. As if those numbers aren't alarming enough, underreporting is also an issue: per NCOA, one study revealed only 1 in 14 cases of abuse are reported to authorities.
While stories of elder financial exploitation and fraud often make the headlines, elder abuse encompasses sexual abuse, willful deprivation, passive neglect, physical abuse, emotional abuse, and confinement. All are inexcusable, and all elders—even celebrities like Mickey Rooney, abused by his own family—can be victims.
Every one of us has a responsibility to report elder abuse. We must change these statistics. And today, with a growing number of available tech tools, we have everything we need to do it.
Know the Signs
Elder abuse can happen anywhere, but NCOA estimates nearly 90 percent of abuse and neglect cases are perpetrated by a family member (two thirds of perpetrators are adult children or spouses).
At home, signs of elder abuse may include:
- Bruises, pressure marks, abrasions, broken bones
- A sudden change in alertness, unusual depression, or withdrawal from normal activities
- Sudden changes in financial situations
- Strained or tense relationships, frequent arguments between caregiver and caree(Source: US Department of Health Services, Administration on Aging)
In a nursing home, assisted living, or other residential care setting, there are four signs of elder abuse of which families should be aware, says Peter Anderson, a Washington, DC-based attorney who represents people abused and injured (sometimes fatally) in nursing homes:
- Pressure ulcers: Decubitus or pressure ulcers and skin issues are a telltale sign of elder abuse, and family members should be concerned at the first stage—a red mark on the skin in any of the following areas: heels, buttocks, elbows, back of the head/neck, and the lower back, just above the buttocks. When an elder is incontinent or immobile, they are at high risk for these sores, particularly if the facility is not meeting their obligation of turning or repositioning them every two hours. In the second stage of decubitus ulcers you will see surface blisters. In the third, the blisters invade the fat and muscle layers of the skin, and in the fourth, the bone—which can lead to permanent damage, the need for surgery, or even death.
- Dehydration/Malnutrition: If untreated, these conditions can lead to stroke, wounds that won't heal, and other serious health problems.
- Falls: There are a number of accidental yet preventable falls—an older adult trips over clutter in his room that staff have not cleared, or when she tries to get to the bathroom on her own after pressing her call button with no response. Some older adults may fall while getting dressed, or when being transferred from bed to wheelchair. If the elder cannot explain a bruise or injury, you should be concerned about an accidental fall or even an intentional drop.
- Cleanliness/Smell: Is the facility dark, dingy, and dirty? Is there a strong smell of urine when you enter the building? No place is perfect, but a poorly maintained community could be a sign that neglectful care or abuse is happening within its walls.
Take Action with Tech
If you see something, say something. Don't wait, hoping the issue will resolve itself. Report abuse—or concerns about it—immediately.
For an elder residing in a senior care facility, report your abuse concerns through its chain of command, says Anderson. Talk to the director of nursing and the nursing home/assisted living administrator, who will call a care plan meeting to discuss your concerns. Take thorough notes and document these meeting dates, as these records will be crucial should further legal action be required. If the facility's leadership team is not responsive/does not take timely action, determine what state agency is responsible for the community's licensing and regulations (nursing homes are federally licensed and regulated, assisted living communities are state licensed and regulated) and report your concerns for investigation. Some state agencies offer an anonymous, online complaint form for abuse concerns and reports.
Call the state ombudsman, who is charged with investigating quality concerns and reports of abuse, or the Adult Protective Services division of your local Area Agency on Aging.
Not sure who to call in your state? Use the Elder Care Locator, via ElderCare.gov or by calling 1-800-677-1116.
In cases of clear assault, call the police immediately.
Report elder financial abuse online via this report form on the Office of the Inspector General/Social Security Administration website.
Anderson recommends using your smart phone or tablet to take pictures of decubitus ulcers in various stages, bruises, or other visible signs of abuse. Document in your phone's notes function (or with paper and pen) your continuing concerns, and your efforts to bring them to the attention of the people in charge of your loved one's care. Conduct a video interview of your family member telling the details of the abuse (if the individual has dementia, try to capture as much information as possible when he or she is lucid). These photo, video, and written records are critical when building a case against the perpetrator, whether it's a family member who holds power of attorney, a nursing home employee, or home care worker.
Though it may be an extreme measure, you could also install a webcam in your loved one's house or senior care community room (though you should check with the facility first to get consent) and monitor its feed from your smartphone, says Peter Anderson.
Most importantly, stay involved. No matter where your elder loved one resides, no matter who is responsible for daily care, check in frequently. If possible, use Skype or FaceTime for these check-ins to get a visual—not just a voice report.
Need legal support or advice about an elder abuse situation? Read our latest post on Consulting An Elder Law Attorney.
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