Sam Bauman: Elder abuse a big, complicated subject

A while back I wrote about a seminar the Retired Senior Volunteer Program held for seniors who handle respite care and transportation for the Carson City senior community. This was held at the Western Nevada College campus and included 40 RSVP volunteers on hand, plus others at outposts such as Fallon which were involved via a television setup. Here are some more details from that seminar, from a two-hour presentation on elder abuse training given by Maria Coe of Nevada Aging and Disability Services. The ADS is the only agency in the state, other than law enforcement, that investigates elder abuse.Elder abuse is not a subject most citizens come in contact with. The Elder Protection Services program is “to assist older persons, 60 and over, who are abused, neglected, isolated or exploited,“ Coe explained, adding that the goal is to arrange for help to alleviate and prevent maltreatment while safeguarding their civil liberties.For purposes of the seminar, Coe defined “abuse” as willful and unjustified infliction of pain, injury or mental anguish on an older or vulnerable person, including depriving such persons of food, shelter, clothing or services. She listed three types: physical, psychological-mental and sexual. Nevada has imposed sentencing enhancements or increased penalties when the victim is elderly. In this state “an offender who commits a crime against a person over 60 is subject to a prison term twice as long as that normally allowed for the same offense,” Coe said.Coe defined physical abuse as serious or unexplained injury, inappropriate physical or chemical restraint and over-medicating or under-medicating a senior.She mentioned a case where a son was tying his mother to her chair because she was at risk of falling and wandering alone. “We showed the son that there were better ways to deal with fall risk and wandering,” she said.Psychological or mental abuse includes assaults, threats or harassment, humiliation of intimidation and demeaning name-calling.Sexual assault is when an older person is forced, tricked or manipulated into any unwanted sexual contact. This includes sexual contact with anyone who is unable to give informed consent and includes rape, unwanted touching or explicit photography. “People don’t like to talk about sexual abuse because they don’t think it happens to elderly people,” Coe said. “But it does. We had a case where a client with significant dementia in a nursing home thought she was having sex with her husband, but it was really her brother-in-law.”If sexual abuse is alleged, law enforcement needs to be contacted so that a physical exam can be arranged and action taken to protect the elderly person from further abuse.Elder neglect is the failure to provide food, clothing, shelter and services such as medical care and personal hygiene. If someone has assumed personal responsibility to provide necessary supervision of the senior and then fails to do so, it is neglect. “We had a case where a daughter was taking care of her mother but tired of it and quit. She stopped seeing her mother,” Coe said. “After a few days a neighbor noticed that the daughter was no long coming to the house and contacted our office. The senior was severely dehydrated and needed hospitalization.”Self-neglect is when a senior fails to provide for his or her own needs because of an inability to do so. It is not a crime as an older person has the right to make choices unless a judge has declared the individual incompetent. But problems result when an elderly person makes poor choices. Exploitation is a violation of a relationship based on trust and involves deception, intimidation or undue influence in an attempt to gain control of money, assets or property to deprive the senior of the assets. “It is our fastest-growing elder abuse,” Coe said.A national study by MetLife revealed 107 cases where seniors lost more than $145,000 from fraud by family, friends or neighbors. An average of $95,000 was lost in fraud cases involving strangers through schemes such as Internet scams.Isolation occurs when someone willfully, maliciously and intentionally prevents seniors from receiving phone calls, mail or visitors or physically retrains a senior to prevent visitation. Here are some signs of possible elder abuse: Unexplained cuts, bruises or burns; dehydration or malnutrition; over-medication or unusual confinement or lack of cleanliness and grooming; the senior is afraid to speak up in the presence of a caretaker, is overly anxious to please, shows signs of anxiety and confusion, is withdrawn, depressed, or shows signs of shame, fear or embarrassment; and a sudden change in financial activity, such as unusual cash withdrawals from the senior’s account in a short period of time.There’s the other side of the coin of elder abuse: abusive caretakers. Clues to such cases include caretakers who make threatening remarks, offer conflicting reports about accidents, display insulting or aggressive behavior and withhold attention, security and affection. Some abusers may be well-intentioned persons doing their best in difficult situations.Those 80 and older are two or three times likely to be abused. Most victims are suffering from dementia. Two-thirds of victims are women. Often the client lives with the abuser and depends on the abuser to meet some daily care needs. Most often the senior is living with a son or daughter.Stopping elder abuse starts with a report which is reviewed by Elder Protection Services personnel. A case investigation is opened. EPS social workers take intervention steps to assist seniors. EPS social workers may refer cases to law enforcement based on investigations. Law enforcement may refer a case to the district attorney.Mandatory reporters are those who are required by Nevada law to inform the district attorney when they believe that a person 60 or older is being abused, neglected or isolated. Almost all who come in contact with a suspected case of abuse must report a case. Only lawyers are exempt because of client-attorney relations.Any report of life-threatening elder abuse must be made to law enforcement at once. After making the report, the person doing so should also report to the Elder Rights Unit by phone, writing or in person. Those making reports are protected by Nevada law.Where to report elder abuse: Elder Rights Intake Unit, 1-888-729-0571. For more detailed information, check www.nvaging.net.Elder abuse is not a pretty subject, but to reduce it all of us must stay alert to the evidence and do our part. • Sam Bauman writes about senior affairs, among other things, for the Nevada Appeal.