In part one of our series on elder abuse, we discussed what elder abuse entailed and the five different types. In part 2 of our series, will go into detail on identifying elder abuse warning signs by type, how to properly report it, and how to prevent it.
Elder Abuse Warning Signs
Warning signs of elder abuse often go unnoticed. Observing signs of abuse does not always confirm abuse but can indicate a possible problem that requires a heightened awareness.
Sexual abuse warning signs include sudden and unexplained sexually transmitted diseases, bruising, cuts and sores in or around the breasts, genitalia, inner thighs, and buttocks. Additionally, the elder person may have torn, bloody or stained undergarments, difficulty walking or sitting, and/or engage in unusual or inappropriate sex roles or activities.
Physical abuse warning signs can include unexplained injuries such as bruises, fractures, cuts, sores, burns, and pressure marks. Victims may also experience weight loss, anxiety, depression, or confusion and become withdrawn from family and friends.
Emotional abuse may present as unexplained or uncharacteristic changes in mood and behavior, self-isolation, and withdrawal from previously engaged activities. Victims may exhibit behavior that mimics dementia, such as rocking, sucking, or mumbling to themselves.
Financial abuse warning signs include a sudden or slow onset of an inability to afford amenities. The person may be excessively gifting money to an organization, a friend, a family member, or companion. A caregiver, family member or Power of Attorney may have control of the person’s finances, and still the needs of the elder person are not being met. Financial abuse also occurs when the person has signed away property, money, or assets but is unable to comprehend what the transaction means. (U.S. Department of Health and Human Services)
Neglect warning signs include lack of basic hygiene, appropriate clothing, food, and medical care. The elder person may be unkempt, have an odor, bedsores, sudden unexplained weight loss, or dehydration. The person may also be left unattended or in bed without proper care. Their home or environment may be dirty, cluttered, in disrepair, lack heating, water, electricity, and appropriate appliances.
With any type of abuse there are also some warming signs not directly related to the victim. These may include actions of the caregiver such as isolating the victim, being verbally or physically aggressive, or frequenting financial institutions.
Elder Abuse Reporting
Anyone who suspects an elder person is being abused should report their suspicion. When reporting abuse, the person making the report does not need to prove or have proof that abuse has actually taken place. If the person is in immediate danger, 911 should be contacted. When the situation is not life-threatening, the local Adult Protective Service agencies should be notified. The identity of the person making the report cannot be provided to the abuser or the alleged victim.
There are specific guidelines and regulations for the reporting of suspected abuse within nursing homes. Under federal regulations set forth by the Centers for Medicare and Medicaid Services, persons such as physicians, caregivers, persons responsible for the care or custody of the elder, licensed staff, clergy, and ombudsman are required to report any suspicions of elder abuse.
According to the Code of Federal Regulations, the resident has the right to be free from abuse, neglect, misappropriation of resident property, and exploitation. This includes but is not limited to freedom from corporal punishment, involuntary seclusion and any physical or chemical restraint not required to treat the resident’s medical symptoms. The facility, in which the elder person resides, must develop and implement written policies and procedures prohibiting the mistreatment, neglect, abuse, and misappropriation of resident property. (Resident Behavior & Facility Practices Code of Regulations) While each state maintains its own requirements related to reporting, investigating, and preventing elder abuse, the federal regulations requires all alleged violations involving abuse be reported immediately, but not later than 2 hours after the allegation is made. (Electric Code of Federal Regulations)
Elder Abuse Prevention in Nursing Homes
The best way to decrease the elder abuse by caregivers in nursing homes is to focus on preventing the abuse before it occurs. In order to do this, the facility should focus on screening, training and reducing the stress of staff and volunteers. All staff and volunteers within a facility must undergo a screening process prior to the start of employment or volunteering in the facility. These screenings include criminal background checks, national background checks, abuse clearances and license verifications. Annually, the employer is required to verify that all nursing personnel, Certified Nursing Assistants, Licensed Practical Nurses, and Registered Nurses licenses are in “good-standing” and without disciplinary action.
Abuse training is required annually for all employees of the nursing home. This training may include definitions and explanation of the types of abuse (including examples), signs of possible abuse, requirements for reporting abuse, intervention methods related to dealing with aggressive and/or inappropriate behaviors of residents, and stress reduction. The facility can assist in decreasing the potential for abuse by maintaining sufficient staffing levels, supervising staff/volunteers to identify burnout and inappropriate behaviors, and offering programs focusing on stress reduction techniques. Through proper and effective development of screening processes and training, nursing homes can help to decrease the prevalence of elder abuse within facilities.
As we’ve established, elder abuse may be difficult to identify. Depending on the type, there may or may not be outward signs and symptoms of abuse. An expert in nursing home care has the education, training and experience to assist in determining whether elder abuse occurred and if the facility staff followed the established standards of care and regulations.
Contact us today if you would like to reach an expert who specializes in nursing home abuse.