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How to Identify Elder Abuse

Identifying Abusive Behavior by Home Care Staff

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How to Identify Elder Abuse
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The home care industry is literally exploding as consumers, government and payers look to "aging in place" (aging in home) as a more desirable and less costly alternative to long-term care in assisted and nursing facilities. Whether you are contemplating starting a home care company or looking to staff up to meet demand, it will come as no surprise that your client facing employees are your number one asset and the face of your brand. That brand, your reputation, and your business can quickly be ruined with allegations of abusive behavior by staff. Here is what you can do to identify elder abuse.

After reading this you may want to read this article that delves into related topics around the issue such as hiring right, monitoring and preventing abuse.

Identifying Abusive Behavior

Here are the types and symptoms of elder abuse in the home.

Physical abuse is the use of physical force that may result in bodily harm.

Physical abuse may include striking, hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. The use of drugs, physical restraints, force-feeding, and physical punishment are abuse.

Here's how can you tell if the home-care patient might be a victim.

  • bruises, black eyes, welts, lacerations, and rope marks
  • bone fractures, broken bones, and skull fractures
  • open wounds, cuts, punctures, untreated injuries
  • sprains, dislocations
  • broken eyeglasses/frames
  • laboratory findings of medication overdose or under utilization of prescribed drugs
  • what a person reports to you in terms of the above
  • a person's sudden change in behavior
  • the worker's refusal to allow visitors to see their patient alone
Sexual abuse is non-consensual sexual contact of any kind.

Sexual contact with any person incapable of giving consent is sexual abuse. It includes unwanted touching, sexual assault such as rape, sodomy, coerced nudity, and sexually explicit photographing.

Here's how can you tell if the home-care patient might be a victim.

  • bruises around the breasts or genital area
  • unexplained venereal disease or genital infections
  • unexplained vaginal or anal bleeding
  • torn, stained, or bloody underclothing
  • a person's report of being sexually assaulted or raped
Emotional abuse is the infliction of pain or distress through verbal or nonverbal acts.

Emotional/psychological abuse includes verbal assaults, insults, threats, intimidation, humiliation, and harassment. In addition, treating a person like an infant; isolating a person from his/her family, friends, or regular activities; giving an person the "silent treatment;" and enforced isolation are other examples.

Here's how can you tell if the home-care patient might be a victim.

  • being emotionally upset or agitated
  • being extremely withdrawn and non communicative
  • unusual behavior usually attributed to dementia (e.g., sucking, biting, rocking)
  • their own report of being verbally or emotionally mistreated
Neglect is defined as the refusal or failure to fulfill a person's obligations or duties to an elder.

Neglect typically means the failure to provide a person with such life necessities as food, water, clothing, shelter, personal hygiene, medicine, comfort, personal safety, and other essentials.

Here's how can you tell if the home-care patient might be a victim.

  • dehydration, malnutrition, untreated bed sores, and poor personal hygiene
  • unattended or untreated health problems
  • hazardous or unsafe living condition/arrangements
  • unsanitary and unclean living conditions
Abandonment is the desertion of a person by a someone with responsibility for providing care or who has physical custody of the person.

Here's how can you tell if the home-care patient might be a victim.

  • the desertion of a person at a hospital, a nursing facility, a shopping center or other public location
Financial or material exploitation is defined as illegal or improper use of funds, property, or assets.

This includes cashing an elderly person's checks without authorization; forging an older person's signature; misusing or stealing an older person's money or possessions; coercing or deceiving an older person into signing any document and the improper use of conservatorship, guardianship, or power of attorney.

Here's how can you tell if the home-care patient might be a victim.

  • sudden changes in bank account
  • the inclusion of additional names on a bank signature card
  • unauthorized withdrawal of funds
  • abrupt changes in a will
  • unexplained disappearance of funds or valuables
  • bills unpaid despite the availability of adequate financial resources
  • sudden appearance of previously uninvolved relatives claiming rights
  • unexplained sudden transfer of assets to a family member or someone else
  • provision of services that are not necessary
  • a person's report of financial exploitation
Self-neglect is characterized as the behavior of a person that threatens his/her own health or safety.

Self-neglect includes a refusal to provide oneself with adequate food, water, clothing, shelter, personal hygiene, medication (when indicated), and safety precautions unless that person of sound mind has made a voluntary decision to engage in acts that threaten health or safety as a matter of personal choice.

Here's how can you tell if the home-care patient might be a victim.

  • dehydration, malnutrition, untreated or improperly attended medical conditions, and poor personal hygiene
  • hazardous or unsafe living conditions
  • unsanitary or unclean living quarters
  • inappropriate and/or inadequate clothing
  • lack of the necessary medical aids (e.g., eyeglasses, hearing aids, dentures)
  • grossly inadequate housing or homelessness

Abuse is a serious issue and can never be tolerated. In fact if you conduct work in assisted living facilities, new regulations require them to report abuse within two hours to authorities or face steep fines. By extension that could affect your services too.

By knowing what to look for you can protect your clients and your business, your brand and your reputation.

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