MAKING APPROPRIATE ELDER ABUSE REFERRALS Kaye Mason- Inoshita, R.N. Ombudsman Director Area Agency on Aging District 7, Inc

Domestic Elder Abuse Verses Institutional Abuse  Domestic Abuse occurs in the community setting.  Institutional Abuse occurs in a long- term care facility such as a Nursing Home or Assisted Living Facility.

Domestic Abuse Facts…  Is Not rare  Is Typically a family affair  Not all elder abuse situations can be effectively resolved.  Takes many forms  Majority of victims are female  Is considered this nation’s hidden problem

Domestic Elder Abuse Facts Continued  Reporting is more common in urban areas compared to a rural setting.  Reporting of elder abuse is more common by health and social service workers than by family members.  Neglect is the most common form of domestic elder abuse.

What is Elder Abuse? Ohio Revised Code (APS Law) Abuse: The infliction upon an older adult, by self or by others, of injury, unreasonable confinement, intimidation, cruel punishment with resulting physical harm, pain or mental anguish.  Neglect: The failure of an older adult to provide for himself or herself the goods or services necessary to avoid physical harm, mental anguish, or mental illness, or the failure of a caretaker to provide such services.

What is Elder Abuse?  Exploitation: The unlawful or improper act of a caretaker who uses an older adult’s resources for monetary benefit, personal benefit, profit or gain.

CBS Evening News Clip 11/15/2006 “Aging in the Shadows”

Institutional Elder Abuse Facts  Nursing Homes are required, by law, to ensure that all allegations of abuse are reported immediately to the administrator of the facility and are thoroughly investigated with results reported to the Ohio Department of Health within five working days of the incident.  Nursing Homes are required, by law, to develop abuse policies and procedures that prohibit abuse, neglect and exploitation of residents.

Institutional Abuse Facts Continued  Many factors contribute to abuse of residents by nursing home staff.  Characteristics of residents at risk of being abused include residents who are demented, more seriously ill, combative, and have few or no visitors.  Abuse of nursing home residents is Not Rare.

Elder Abuse Definitions Ohio Revised Code /Nursing Home Licensure Law  Abuse: Knowingly causing physical harm or Recklessly causing serious physical harm to a resident by physical contact or by use of physical or chemical restraint, medication, or isolation as punishment.

Elder Abuse Definitions/NH Licensure Law  Neglect: Means Recklessly failing to provide a resident with any treatment, care, goods, or service necessary to maintain the health or safety of the resident when the failure results in serious physical harm to the resident.  Misappropriation: Means depriving, defrauding, or otherwise obtaining the real or personal property of a resident by any means prohibited by the Revised Code.

CBS Evening News 11/15/2006 “Aging in the Shadows”

Indicators of Physical Abuse  Unexplained Bruises and Welts  Unexplained Burns  Traumatic Alopecia  Unexplained fractures, lacerations, abrasions, or punctures  Proximal Trauma  Defensive Posturing  Inappropriate administration of medication  Signs of Sexual Abuse

Indicators of Neglect and Self- Neglect  Dehydration and/or malnourishment  Pressure Ulcers  Memory Problems/Confusion  Unattended or Untreated health problems  Unsafe or Unhealthy living conditions  Poor personal hygiene  Lack of functional aides

Indicators of Exploitation  Lack of necessary functional aides, personal care items and medications.  Changes in assets or sudden poverty  Belongings that are missing, lost or loaned  Unpaid or overdue bills  Sudden appearance of previously uninvolved relatives claiming their rights to an elder’s affairs and possessions.  An elder’s report of financial exploitation.

Ohio’s Mandated Reporters Ohio’s APS law mandates the following categories of professionals to report immediately to the County Department of Jobs and Family Services/Adult Protective Services any suspected cases of elder abuse, neglect, or exploitation. Physicians, Podiatrists, Psychologists, Hospital Employees, Nurses, Home Health Employees, Social Workers, Dentists, Clergy, Attorneys, Chiropractors, Coroners, and more

Who Do You Call? For Domestic Abuse: The County Department of Jobs and Family Services/Adult Protective Services Scioto County APS: /Herman Patrick For Institutional Abuse: 1.The AAA-7 Regional Long Term Care Ombudsman Program: The Ohio Department of Health: The AG’s Office: A-BUSE

Role of the AAA-7 Ombudsman Program  Primary Role: To investigate and resolve complaints concerning long term care facilities and service providers in an effort to improve the quality of life and quality of care for long term care consumers. Complaints may encompass concerns about nursing care, rights violations, as well as abuse, neglect and exploitation.

Ombudsman Role Cont’  Victims Assistance: The Victims of Crime Act of 1984 provides for assistance and compensation to victims of crime. The AAA-7 Ombudsman Program received a grant from the Ohio Attorney General’s Office to provide advocacy and direct assistance to victims of crime, helping clients through the criminal justice maze.

Ombudsman Role Cont’  Ombudsmen are Negotiators, Educators, Advocates, Mediators, and Brokers.  Ombudsmen are Not the Enforcement Power or the Nursing Home “Police.”

The 3 “Cs” of Ombudsmen  Consent is a must!  Client-Driven  Confidential From Client, Legal Representative or from State Ombudsman. What is the goal of the client? Must maintain confidentiality of client, complainant and witnesses.

Ombudsman Role in Elder Abuse Cases The Ombudsman is a/an:  Investigator  Advocate  Educator  Broker/Making Referrals to appropriate state agencies.

Referral Numbers  Ohio Department of Health’s Complaint Hotline:  Ohio Attorney General’s Abuse Line: A-BUSE

How You Can Become Involved/Community Resources  The Scioto County Adult Protective Services Task Force and Interdisciplinary Team.  Established in 1993 to bridge the service gaps for Scioto County’s abused elders.  Members include representatives from various county agencies including SCDJFs/APS, AAA-7, MRDD, Probate Court, the Prosecutor’s Office, Sheriff’s Department, Police Department, Southern Ohio Medical Center, and more.

Scioto County APS Task Force  Developed an Elder Abuse Cluster/Interdisciplinary Team to review difficult Adult Protective Services Cases.

Scioto County APS Task Force  Participate in community elder abuse awareness and educational activities.  For More Information on how to become a member, contact: Kaye Inoshita at

Elder Abuse Educational Event

Thank You & Happy New Year!!