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How to spot signs of, report elder abuse

THE BIRMINGHAM TIMES — Approximately one in 10 older people living in the United States has experienced physical, sexual, psychological or financial abuse or neglect, according to the National Center on Elder Abuse.

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By Holly Gainer

Approximately one in 10 older people living in the United States has experienced physical, sexual, psychological or financial abuse or neglect, according to the National Center on Elder Abuse.

To understand how to keep your elderly loved ones safe, whether in your care or in the care of others, Patricia Speck, DNSc, a board-certified family nurse practitioner who specializes in forensic nursing, family and sexual violence at the University of Alabama at Birmingham School of Nursing, explains the different types of elder abuse and how to spot signs of and report suspected abuse.

Physical and sexual abuse

Physical abuse is defined as the intentional use of physical force that results in illness, injury, pain or functional impairment.

“Unexplained bruises, cuts, burns and bedsores are signs of physical abuse,” Speck explained. “If you notice sudden changes in behavior, particularly when the suspected abuser is around, that is a sign that you should seek help for your loved one.”

Speck says health care providers should suspect abuse if they see subdural hemorrhages (or bleeding that occurs outside the brain as a result of a head injury) and eye, nose and mouth injuries.

“Nurses should particularly look for signs of intentional injuries, such as contusions of lips, cheeks, soft palate, facial fractures, missing hair, particularly in odd places and not where you would expect to see balding,” Speck said. “Bruising and skin tears in odd places, like the abdomen or under the arm or in the crotch, are also common signs.”

Another common indication of abuse is for people who spend most of their time in wheelchairs.

“If there is injury to an older person who is being restrained in a wheelchair, you would look for friction burns on the abdomen or wrists, different patterns in bruising and skin tears,” Speck said.

The majority of sexual assault cases to older adults are in the community; but many are reported from institutions, and in most cases the perpetrator is known by the victim.

Speck says signs of sexual abuse include unexplained venereal diseases, genital infections, and bleeding and tearing in the genital area. They also include bruises to the buttocks and around the inner and outer thighs.

Psychological abuse

Psychological abuse is one of the most common types of abuse. Suspected signs include unusual changes in behavior or sleep, fear or anxiety, sadness, and isolation.

“Isolation is one of the worst symptoms of psychological abuse,” Speck said. “Many older people who are being abused by a loved one don’t want to tell other people what their son or daughter is doing to them because it is their child. This leaves the victim feeling very alone and depressed.”

Speck says control is a major issue in psychological abuse.

“The abuse could come in the form of scolding, insults and degradation; but it could also be less obvious to see,” Speck said. “For example, if a loved one or caretaker keeps a walker or wheelchair just out of reach of the person so they can’t get up and around. Another example might be withholding glasses or dentures from the patient so they can’t eat or see.”

Common signs of abuse may occur when one notices that the patient is unwilling to communicate when a certain person is in the room or nearby.

“If you suspect abuse and are speaking to the patient as part of an investigation or as a friend or relative who is concerned, and you notice the older person’s behavior changes, that should be a major indicator of abuse,” Speck said. “The problem is that moving an older person from their living environment may be disorienting. It takes time to figure out what happened.”

Financial abuse

Financial abuse is defined as the illegal or impromptu use of an elder’s funds, property or assets. Examples include forging an older person’s signature, coercing an older person into signing documents, such as a contract or will, and the improper use of power of attorney.

Speck says financial abuse is common among seniors, especially those with dementia or cognitive impairment; but despite their mental state, the best thing to do is believe them when they complain of missing funds.

“When an older person complains, believe them and listen to them,” she said. “If a loved one is in an assisted-living facility and complains that things are missing, pay attention to that. It is important to do this until you have evidence to prove otherwise.”

Not listening or disregarding complaints about financial abuse will cause the victim to feel shame for not being believed and will also create fear and skepticism when it comes to reporting future instances of abuse. Providers want to create a trauma-informed safe environment.

Neglect

According to Speck, there are three types of neglect — physical, emotional and self.

“Physical neglect is defined as failing to attend to a person’s medical hygiene, nutrition and dietary needs,” she said. “It may also involve not giving them the medications they’ve been prescribed or not changing their bandages on time.”

Emotional neglect also causes pain and distress.

“We often see emotional neglect when an older person is infantilized by their caregivers,” she said. “Abandonment is also a common problem, where someone is left at an emergency department or the hospital.”

Self-neglect is a growing concern and appears when a person chooses not to be treated by a health care provider. Signs of self-neglect include attempted suicide, withdrawal, anxiety, psychosomatic ailments such as stomachaches and headaches, and difficulty sleeping. The older person may desire to be alone, but social support is so important to the older person’s health.

What to do if you see signs of abuse

As the elderly population continues to grow, understanding the signs and symptoms of abuse is an important way to care for your loved ones. Speck says the best thing to do is to be gentle and listen.

“Older people need you to be patient with them, so be patient and listen twice as long as you speak,” she said.

When communicating with an older person whom you suspect has been abused, make sure the person knows what you are saying. If a document or something they need to read is involved, make sure the letters are large enough so they can read the print.

Also, use trauma-informed care principles of safety and transparency to communicate with them in a place where they feel comfortable, and ask them about their hearing and vision preferences.

“They may not be able to see well in a bright room, or they may be sensitive to loud speech and need you to speak in a slow, calm manner using their language,” Speck said. “Avoid medical-ese. Ask them if they have any difficulties, and offer to help them make the environment safer for them. They will be more cooperative and trust you if you show that you are putting their needs first.”

If you suspect abuse, talk with them when the two of you are alone. Offer to take that person to get help and let them know you are worried about their safety and well-being. Many communities have Coordinated Community Responses to Elder Abuse, with a variety of services for the older person. Be proactive, identify older persons at risk, and participate in the development of Coordinated Community Responses to elder maltreatment. In Alabama, Adult Protective Services supports and enables county departments to protect elderly and disabled adults from abuse, neglect and exploitation and to prevent unnecessary institutionalization.

In Alabama, to report abuse, neglect and exploitation of elders or vulnerable adults:

  • IMMEDIATE DANGER? Call 911 if that person is in immediate, life-threatening danger.
  • Call the HOTLINE at 1-800-458-7214 to report abuse, neglect and exploitation of elders or vulnerable adults when suspicious.
  • For services to support elder persons in your community, call 1-800-677-1116 TO PREVENT, the Eldercare Locator (a public service of the U.S. Administration on Aging), to speak with someone who will connect you to services for older adults and their families and prevent abuse, neglect and exploitation of elders or vulnerable adults.

This article originally appeared in The Birmingham Times

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Business

Groups Unite to Oppose Landmark California Mental Health Legislation

“With broad support from California’s state Senate, CARE Court is one step closer to becoming a reality in California,” said Gov. Gavin Newsom, “I am also grateful to have the California Chamber of Commerce, the California Downtown Association, and 21 local chambers of commerce join our ever-expanding CARE Court coalition, which includes a diverse group of supporters focused on tackling the challenge of severe mental illness that too often leaves individuals on our streets without hope.”

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The proposal, introduced in February by Senators Tom Umberg (D-Santa Ana) and Susan Talamantes Eggman (D-Stockton), would create a supportive alternative to the criminal justice system in California for people who are mentally ill or suffering from Substance Abuse Disorder.
The proposal, introduced in February by Senators Tom Umberg (D-Santa Ana) and Susan Talamantes Eggman (D-Stockton), would create a supportive alternative to the criminal justice system in California for people who are mentally ill or suffering from Substance Abuse Disorder.

By Aldon Thomas Stiles, California Black Media

Senate Bill (SB) 1338, also known as the CARE Court Program, is attracting growing resistance as it makes its way through the legislative process. Some legal advocacy and civil rights groups say the law would negatively African Americans and other minorities.

The proposal, introduced in February by Senators Tom Umberg (D-Santa Ana) and Susan Talamantes Eggman (D-Stockton), would create a supportive alternative to the criminal justice system in California for people who are mentally ill or suffering from Substance Abuse Disorder.

Focused on the state’s unhoused population, SB 1338, would mandate treatment for people diagnosed with mental illnesses. About 40% of homeless adults and children in California are Black, a number nearly seven times higher than the total percentage of Blacks (5.6%) in a state with about 40 million people.

Opponents of the legislation say SB 1338 dangerously expands judicial power and empowers the criminal justice system to commit people to mental health treatment that is sub-par – and often against their will. There is also the potential for misdiagnosis, they warn.

“CARE Court promotes a system of involuntary, coerced treatment, enforced by an expanded judicial infrastructure, that will, in practice, simply remove unhoused people with perceived mental health conditions from the public eye without effectively addressing those mental health conditions and without meeting the urgent need for housing,” read the Human Rights Watch’s (HRW) opposition letter.

“We urge you to reject this bill and instead to take a more holistic, rights-respecting approach to address the lack of resources for autonomy-affirming treatment options and affordable housing,” the letter said.

SB 1338 unanimously passed in three Senate committees before the full State Senate approved it in May.

The legislation is currently making its way through the Assembly, where the Committee on Judiciary is reviewing it.

“Given the racial demographics of California’s homeless population, and the historic over-diagnosing of Black and Latino people with schizophrenia, this plan is likely to place many, disproportionately Black and Brown, people under state control,” HRW’s letter continued.

Some members of the California Association of Mental Health Peer Run Organizations share HRW’s opinion, claiming that the program would “disproportionately affect people of color by imposing another unnecessary court process on an already overloaded and biased system.”

SB 1338 does, however, have support from various California-based organizations.

“With broad support from California’s state Senate, CARE Court is one step closer to becoming a reality in California,” said Gov. Gavin Newsom, “I am also grateful to have the California Chamber of Commerce, the California Downtown Association, and 21 local chambers of commerce join our ever-expanding CARE Court coalition, which includes a diverse group of supporters focused on tackling the challenge of severe mental illness that too often leaves individuals on our streets without hope.”

Jennifer Barrera, president and CEO of the California Chamber of Commerce, expressed her support for the bill.

“The California Chamber of Commerce and our colleagues from throughout the state are pleased to support Governor Newsom and his vision to provide support for those suffering from severe mental illness and substance use disorders through the newly proposed CARE Court plan,” she explained.

Barrera says that CARE Court is a thoughtful, measured response to the tragedy of untreated mental illness impacting thousands of individuals. California employers have a clear stake in seeing the success of CARE Court as many business owners and their employees experience, first-hand, the impacts of inadequate policies that fail to address the needs of those individuals suffering on our streets and in our communities.

Disability Rights California (DRC) is also voicing its opposition to SB 1338.

“CARE Court is antithetical to recovery principles, which are based on self-determination and self-direction,” read the DRC’s opposition letter. “The CARE Court proposal is based on the stigma and stereotypes of people living with mental health disabilities and experiencing homelessness.”

DRC proposes an alternative solution to the problems CARE Court is attempting to address.

“The right framework allows people with disabilities to retain autonomy over their own lives by providing them with meaningful and reliable access to affordable, accessible, integrated housing combined with voluntary service,” read the letter.

The HRW expressed concern about how the program might impact personal rights.

“In fact, the bill creates a new pathway for government officials and family members to place people under state control and take away their autonomy and liberty,” HRW warns.

About a month before Umberg and Eggman introduced SB 1338, Gov. Newsom foreshadowed the bill’s arrival in his January budget proposal.

“We are leaning into conservatorships this year,” the governor said. “What’s happening on the streets and sidewalks in our state is unacceptable. I don’t want to see any more people die on the streets and call that compassion.”

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Activism

COMMENTARY: The Plan for Transforming Public Safety and Policing in the U.S.

One transformative public safety plan is currently moving forward in Ithaca, New York. It will replace the current police department with a new public safety department that will include armed officers and unarmed crisis intervention specialists. It would allow police officers to be more focused and effective while minimizing the chances that police-civilian interactions will spiral unnecessarily into violence. 

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Ben Jealous serves as president of People For the American Way and Professor of the Practice at the University of Pennsylvania.

By Ben Jealous, President of People For the American Way

Communities all across the country are facing public safety crises.

Crime is rising in ways that leave many people feeling unsafe. At the same time, police violence and killings of unarmed civilians demonstrate that pouring more money into more-of-the-same policing is not the answer.

Here’s some good news. There is a new road map for public officials who are eager for solutions. And there is a growing network of mayors and other officials who are ready to do what it takes.

“All Safe: Transforming Public Safety” is a game plan for transformative change. This massive policy blueprint just published by People For the American Way is grounded in real-world data and the expertise of local elected officials, law enforcement experts, clergy, and other community activists.

There are two truths about authoritarian policing. They do not contradict each other. In fact, they point us toward the possibility of building coalitions that are broad enough to make change happen.

One truth is that Black Americans, Native Americans, and other people of color pay a disproportionate price. Black Americans are more than twice as likely as white people to be shot and killed by police officers. Racial profiling is experienced by communities of color throughout the U.S.

A second truth is that people of color are not the only victims of authoritarian policing. As with so many other issues, Black and Brown communities are the canaries in a much larger American coal mine. White people make up the second-largest group in our prisons, disproportionately low-income white men, and they make up a majority of people killed by police each year.

Four years before George Floyd died under the knee of Minneapolis police officer Derek Chauvin, a white man named Tony Timpa called Dallas police to ask for help during a mental health crisis. He was handcuffed and zip-tied and killed by an officer who pressed his knee into Timpa’s back for 14 minutes while Timpa cried, “You’re gonna kill me!”

Every community is put at risk by systems that resist accountability for those who abuse their power.

Every community is put at risk by a police culture that promotes and tolerates an aggressive “warrior” mentality among law enforcement officers.

Those problems are compounded by communities’ over-reliance on police. Over the decades, we have added additional burdens to police officers that distract them from their primary purpose. That leaves all of us underserved and less safe.

Transforming public safety requires policy change in four major areas: restructuring public safety systems to ensure communities’ underlying safety and social needs are met; holding unfit officers responsible and accountable for their actions; removing unfit officers, particularly those with a demonstrated history of violence, aggression, or other misconduct from police departments; and recruiting well-trained public safety personnel committed to serving and protecting their communities.

One transformative public safety plan is currently moving forward in Ithaca, New York. It will replace the current police department with a new public safety department that will include armed officers and unarmed crisis intervention specialists. It would allow police officers to be more focused and effective while minimizing the chances that police-civilian interactions will spiral unnecessarily into violence.

The “All Safe” roadmap for transforming public safety demolishes the false narrative often promoted by police unions and their political allies to resist change and accountability. They claim that public safety reform is incompatible with effective crime fighting. In reality, the opposite is true.

The system of authoritarian policing that we have inherited from our past is not aligned with our national ideals of equality and justice for all. It is a threat to our people, our communities, and even our democracy. And it is not working to keep us safe.

Making America safer and more just requires a commitment to address root causes of criminal activity and violence, including unjust laws, discriminatory enforcement, and insufficient effective investments in individual and community wellbeing. And it requires a lasting transformation in the U.S. public safety system, including mechanisms to hold officers accountable for excessive use of force.

We know what kind of change is necessary. Let’s make it happen.

Ben Jealous serves as president of People For the American Way and Professor of the Practice at the University of Pennsylvania.

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Bay Area

De La Fuente Runs for Mayor

De La Fuente said he “will not tolerate homeless encampments where violence and drug abuse are rampant.” These encroachers are disrespecting our neighborhoods, our schools, our businesses, our residents, taking over our parks and defacing our city. He said the residents and businesses in our low-income flatland neighborhoods have been disproportionately affected by these encampments, and they deserve better. In collaboration with the county, we will serve our homeless residents who need it most, but not at the expense of other residents and businesses in our city.”

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Photo Caption: Ignacio De La Fuente

By Paul Cobb and news services

Ignacio De La Fuente, the former President of the Oakland City Council for 11 years, says he will run for mayor to rescue the city from its deep troubles.

He said he is returning to political leadership after a 10-year absence. Claiming that he is “sick and tired of what’s happening to our city,” and he can’t just stand by and witness “the city that I love become a place where people are afraid to walk the streets, to take their children to parks, to go out to dinner with their families or to park their cars on the street. I cannot let our city continue [to] be a place where seniors are assaulted and robbed in broad daylight, a place where illegal side-shows are constant throughout the city and a place where children are being shot and killed! ENOUGH IS ENOUGH! Oakland is not a dumping ground, and it is time to take action!”

He, along with the support of his former council colleague Nate Miley, who is now serving as an Alameda County Supervisor, and who is sponsoring a fundraiser for De La Fuente, has boldly declared that he will “do whatever it takes to increase the number of police officers, but I will give them the resources that they need to help them do their job, but above all, I will provide them the back up and political support that they need and deserve to perform their job for our residents and for our businesses.”

He said he “will not tolerate homeless encampments where violence and drug abuse are rampant.” These encroachers are disrespecting our neighborhoods, our schools, our businesses, our residents, taking over our parks and defacing our city. De La Fuente said the residents and businesses in our low-income flatland neighborhoods have been disproportionately affected by these encampments, and they deserve better. In collaboration with the county, we will serve our homeless residents who need it most, but not at the expense of other residents and businesses in our city.”

He wants to change the focus and emphasis of how the city spends its infrastructure money on what is truly needed by “repairing potholes, taking back and beautifying our parks, fixing our sewers and providing robust programming for our recreation centers and libraries to enrich the lives of our kids and seniors.”

In a characteristic fearless, colorful style that he achieved a no-nonsense reputation De La Fuente announced “The job of mayor is not for the faint of heart! Oakland is a great city that needs a mayor with the political backbone and experience to make the tough decisions to get this city back on track!

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