Talk About It
Elder abuse and neglect happens far too often in Kentucky. Sadly, it is not always evident. Sometimes it’s not even intentional.
The Kentucky Cabinet for Health and Family Services has initiated a public awareness campaign to help seniors protect themselves and to teach the rest of us the warning signs of abuse and neglect.
We’re partnering with community groups in hopes that you and your members will use this material -- in at least one of your meetings – to spread the truth about elder abuse. Yes, it does happen. But we can do something about it.
The facts and statistics may surprise you. Use them to start your group’s initial discussion about elder abuse. Ask your newsletter editor to include some of the data in the next edition. Display the poster on your hallway bulletin board.
The case histories are true stories of elder abuse and neglect. Do they remind anyone in your group of a similar experience with an elderly person and his or her caregiver?
Sometimes a personal experience of pain provides the strongest incentive to work for change. It can be uncomfortable to relive such pain, but if someone in your group is able, consider asking them to share an instance of abuse or neglect that happened to one of their relatives or neighbors. Their story may bring home to members of your group the prevalence and tragedy of elder abuse and neglect in our communities.
Our goal and yours must be to stop even one more senior citizen from hurting. Because even one case is one too many.
Local Coordinating Councils on Elder Abuse
Currently in Kentucky, there are Local Coordinating Councils on Elder Abuse established in every Area Development District. The councils' goals are to:
- develop and build an effective communitywide system of prevention and intervention that is responsive to the need of victims, perpetrators, family members and formal or informal caretakers.
- identify and coordinate the roles and services of local agencies that work with elder abused, neglected or exploited victims and to investigate or prosecute elder abuse cases.
- monitor, evaluate, and promote the quality and effectiveness of services and protection in the community.
- promote a clear understanding of elder abuse, current laws, elder rights and resources available in the community.
- serve as a clearinghouse for information on elder issues.
Organized along regional or county lines, depending on the needs of each location, the local coordinating councils were formed under the joint leadership of the Area Agencies on Aging and local Adult Protective Services (APS) staff of the Kentucky Cabinet for Health and Family Services. Membership of each coordinating council includes APS staff, local law enforcement officers, judges, prosecutors, state police, bankers, care providers, long-term care ombudsmen and other advocates for the elderly.
Model Protocol for Local Coordination Councils on Elder Abuse
If you are interested in organizing a council in your community, the Model Protocol is a good starting point. It offers ideas, guidelines, resources, and tools to make it easier to start and operate a successful council that meets your community's needs.
The Model Protocol shows how to:
- set goals and strategies;
- identify current resources and needs;
- maximize available resources;
- identify the roles of professionals;
- adapt sample forms and documents, and
- evaluate the council's effectiveness.
The following are actual case histories of suspected elder abuse or neglect that were investigated by the Kentucky Cabinet for Health and Family Services, law enforcement authorities, or both. Names, dates and locations are omitted to preserve client confidentiality.
These cases might provoke discussion about who could have intervened, when, and how, to protect victims more effectively. You might also discuss cases of possible elder abuse or neglect.
When seniors are dependent on others for help, it’s easy for the people they trust most to take advantage of them. Financial exploitation is the illegal or improper use of an elder’s funds or resources. As with other types of elder abuse, the perpetrator is often a relative or acquaintance. But it may also be someone entirely unknown to the victim, such as a con artist who offers to perform home repairs or makes some other phony claim to extract money.
In one case described here, local bank staff recognized something was amiss with an elderly customer’s account. Together, the cabinet’s adult protective services staff and police investigated. In the second case, a trusted member of the victim’s community won her trust, then plundered her finances. The third case fits a common pattern of door-to-door scams directed at the elderly.
Non-willful Abuse and Neglect
Elder abuse can be non-willful when caregivers aren't able to or don't know how to properly look after someone. APS is commonly called in on cases that result from a family member's desire to keep a loved one at home at all costs, even when the care needs of the loved one exceed the knowledge and/or capabilities of the family. Even a caregiver with extensive education and nursing knowledge can be overwhelmed by the physical and financial demands of caring for a vulnerable adult with complex needs. In a situation like this, APS must take three basic steps:
- assess the safety of the vulnerable adult and determine his or her wishes;
- rule out abuse, neglect or exploitation by the caregiver; and
- get as much support as possible to assist the caregiver or assist with placing the vulnerable adult.
In one neglect case described here, family members caring for an elderly woman thought they were doing well, but malnutrition and other problems kept the woman in poor health and led a neighbor to suspect physical abuse. The family and cabinet staff formed a safety plan to restore her well-being. In a second case, a terminally ill man was being cared for in a home with no air conditioning, and APS helped his daughter and grandson make small alterations in the pattern of care that reduced the risk he would become overheated or dehydrated. In the third case, an elderly woman was physically no longer able to care for her mentally retarded son. APS arranged appropriate placement for both.
Non-willful Abuse and Neglect
Intentional Abuse and Neglect
Cases of flagrant, willful abuse of nursing home residents are apt to capture public attention. That's understandable, but it's somewhat misleading. The fact is that willful abuse, like other forms of elder abuse and neglect, is far more apt to occur outside institutional settings, in elders' own homes or in the homes of their relatives.
The vast majority of vulnerable elders live with relative caregivers, and relatives of elderly victims account for most cases of intentional abuse. When caregiver abuse occurs, it's likely to be persistent, rather than an isolated instance of "snapping" under the stress of providing constant care.
Due to feelings of shame, fear and misplaced loyalty, abused elders are unlikely to report that they are being abused or neglected by their family members. They derive some sense of security from living in familiar surroundings, and their fear of the unknown may outweigh their desire to escape from a terrible situation.
Reports of intentional abuse often come from neighbors who notice that something's amiss, or from home health providers or hospital workers who see clear signs of mistreatment. If APS workers substantiate intentional abuse, they notify law enforcement officials to get them involved. They also try to get the abused elder's consent to be moved to live elsewhere. If the victim is unable to give informed consent, workers can ask a court to order that he or she be moved to a safe setting.
In the cases described here, the perpetrators were all relatives of the abused or neglected victims. Intervention came too late for two of the victims, who died soon after APS workers became aware of their circumstances.
Intentional Abuse and Neglect
Sometimes a Happy Ending
Reporting any sign or suspicion of abuse, neglect or exploitation is always the best course — even when, as in this case, the explanation for what appear to be bruises turns out to be both innocent and delightful.
Sometimes a Happy Ending
All case histories in one document