If not you, then who?

This blog post is dedicated to raising awareness about elder abuse. It is a difficult and painful subject to discuss, but an important one to acknowledge. As professionals that work closely with seniors and their families, it is our responsibility to report elder abuse when it is suspected. Do not assume someone else will address the situation, if not you, then who? Please read below to educate yourself and learn the signs.

Elder abuse is more likely when:

• The older adult is socially isolated

• There is dementia or cognitive impairment

• The caregiver is under high stress

• There is dependency for daily care or finances

Following up from a previous post about fraud and scams that target seniors, Detective Chris Seiler from the Swatara Township Police Department, has graciously agreed to answer some questions about elder abuse and neglect.

1. Can you explain the difference between elder abuse and elder neglect?

   The PA Crimes Codes defines the crimes as follows:

   2713.  Neglect of care-dependent person.

   (a)  Offense defined.--A caretaker is guilty of neglect of a care-dependent person if

   he:

   (1)  Intentionally, knowingly or recklessly causes bodily injury, serious bodily injury

   or death by failing to provide treatment, care, goods or services necessary to preserve

   the health, safety or welfare of a care-dependent person for whom he is responsible to

   provide care.

   (2)  Intentionally or knowingly uses a physical restraint or chemical restraint or

   medication on a care-dependent person or isolates a care-dependent person contrary to

   law or regulation, such that bodily injury, serious bodily injury or death results.

   
   

   (3)  Intentionally, knowingly or recklessly endangers the welfare of a care-

   dependent person for whom he is responsible by failing to provide treatment, care,

   goods or services necessary to preserve the health, safety or welfare of the care-

   dependent person.

   2713.1.  Abuse of care-dependent person.

   (a)  Offense defined.--A caretaker is guilty of abuse of a care-dependent person if

   the caretaker:

   (1)  With the intent to harass, annoy or alarm a care-dependent person:

   (i)  strikes, shoves, kicks or otherwise subjects or attempts to subject a care-

   dependent person to or threatens a care-dependent person with physical contact;

   (ii)  engages in a course of conduct or repeatedly commits acts that serve no

   legitimate purpose;

   (iii)  communicates to a care-dependent person any lewd, lascivious, threatening

   or obscene words, language, drawings or caricatures; or

   (iv)  communicates repeatedly with the care-dependent person at extremely

   inconvenient hours.

   (2)  Commits an offense under section 2709.1 (relating to stalking) against a care-

   dependent person.

   (3)  With the intent to ridicule or demean a care-dependent person, uses any

   audio, video or still image of the care-dependent person in any format or medium on or

   through any electronic service, wireless communication or any form of electronic service

   or wireless communication as pertaining to communication.

   
   

2. Where is abuse/neglect most likely to happen?

   Abuse and neglect can happen anywhere, we get allegations reported from care homes

   such as nursing, assisted living and personal care homes. We also see in-

   home/residence-based care allegations against home care providers and family

   members of care dependent people. It is believed that elder abuse and neglect

   incidents have been and are still underreported, however over the past several years

   there has been more awareness, and we have seen an increase in reported allegations.

   To identify where it is most likely to occur is difficult as we see a broad range from all of

   the above noted areas.

   
   

3. How do we report suspected elder abuse and neglect?

To report an incident/allegation of suspected elder/care dependent abuse or neglect you

should call the PA Dept of Aging hotline 1-800-490-8505; if in Dauphin County call the

Dauphin County Area Agency on Aging hotline at (717)780-6130; you can contact

the PA Attorney General’s Office 1-866-623-2137 or contact your local police

department.

4. Do seniors typically report the elder-abuse crimes or do their loved ones?

   We receive reports from a variety of sources, but generally older people do not

   report incidents themselves. Most often we receive complaints/allegations from family

   members calling on behalf of their loved ones. Again, elder abuse, neglect and financial

   exploitation incidents go widely underreported.

   
   

   Other places we receive reports from are:

   *Police responding to calls for service

   *Other first responders such as Fire or EMS

   *Local Hospitals or other Medical Facilities

   *Care Facilities (who are required by statute to report such incidents)

   *Dauphin County Area Agency on Aging

   *Financial Institutions

   *In home care provider agencies

   
   

   I should note that Mandatory Reporting requirements for Elder Abuse/Neglect are not as

   widespread nor as inclusive as compared to the requirements for Mandatory Reporting

   regarding Child Abuse. This has been an issue (among several others) that we are

   hopeful will be addressed within the PA Legislature soon.

   
   

5. How can the police be a community resource to help keep seniors safe from

   these crimes?

   In Dauphin County, we formulated a Multi-Disciplinary Investigative Team (MDIT) as has become the nationally recognized standard for investigating elder abuse and neglect allegations. The team is coordinated by the Dauphin County DA’s Office and its members consist of at least one representative from every police agency in the county, DC Area Agency on Aging investigators, DC Ombudsman, DC Coroner’s Office, PA Attorney General’s office, PA State Dept of Health, Liberty/Adult Protective Services, PA Dept of Human Services and several others. We realized that each one of these entities took on or had information regarding allegations of elder/care dependent abuse, neglect or financial exploitation but were not communicating with each other. Now we are better able to provide a more accurate, more thorough investigative effort, which enables us to better serve our community members as well as ensure that incidents are not overlooked.

   
   

   Lastly, we want to encourage our community seniors and their families to contact their

   local police departments if they are concerned that someone is being abused or neglected. The earlier that we can get involved the more quickly we can make sure everyone is safe and being treated appropriately. We want our community members to know that we are

   here to help navigate an investigation as needed.

COMMON SIGNS OF ELDER ABUSE AND NEGLECT:

Common signs of elder abuse and neglect can be physical, emotional, financial, or behavioral. A single sign does not always mean abuse or neglect, but patterns or multiple warning signs should be taken seriously.

Physical abuse

• Unexplained bruises, burns, cuts, fractures, or sprains

• Injuries at different stages of healing

• Frequent emergency room visits or repeated “accidents”

• Signs of restraint, such as marks on wrists or ankles

• Fearfulness around a caregiver

Neglect

• Poor hygiene, dirty clothing, or strong odors

• Bedsores or untreated medical conditions

• Malnutrition, dehydration, or sudden weight loss

• Unsafe or unsanitary living conditions

• Lack of needed medications, glasses, hearing aids, or mobility devices

• Being left alone for long periods when assistance is needed

Emotional or psychological abuse

• Withdrawal from normal activities

• Depression, anxiety, confusion, or sudden mood changes

• Fear, agitation, or unusual silence around certain people

• Caregiver insulting, threatening, humiliating, or isolating the older adult

Financial exploitation

• Sudden changes in bank accounts or spending patterns

• Missing cash, valuables, or property

• Unexplained withdrawals or transfers

• Changes to wills, powers of attorney, or beneficiaries under pressure

• Unpaid bills despite adequate financial resources

Sexual abuse

• Bruising around breasts or genital areas

• Torn or bloody underclothing

• Sexually transmitted infections

• Panic or distress related to personal care

Caregiver-related warning signs

• Caregiver appears controlling, angry, or indifferent

• Prevents private conversations with the older adult

• Gives conflicting explanations for injuries

• Appears overwhelmed, intoxicated, or financially dependent on the elder