World Elder Abuse Awareness Day June 15, 2009 Information from: Governor's Office of Elderly Affairs Elderly Protective Services

WHAT IS ELDER ABUSE? Louisiana law (R.S. 14:403:2) protects adults aged 60 or older from acts or omissions which result in physical or emotional abuse and neglect, inflicted by caregivers or others and from self-neglect by an individual. Louisiana law also protects seniors from acts of financial exploitation and extortion.

Types of Abuse: Physical Abuse Sexual exploitation Verbal Abuse Emotional Abuse Abandonment Caregiver Neglect Self Neglect Financial Exploitation Extortion or any violation of an elder person's privacy or other basic rights

Physical Abuse The use of physical force that may result in bodily injury, physical pain, or impairment. Examples: hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. Less Recognized Examples: inappropriate use of drugs and physical restraints, force-feeding and physical punishment of any kind. NCEA Website:

Physical Abuse; Signs to look for: Bruises, black eyes, welts, lacerations, and rope marks Bone fractures, broken bones, and skull fractures Open wounds, cuts, punctures, untreated injuries in various stages of healing Sprains, dislocations, and internal injuries/bleeding Burns Broken eyeglasses/frames, physical signs of being subjected to punishment, and signs of being restrained Laboratory findings of medication overdose or under utilization of prescribed drugs Statement of the client of being slapped, kicked, or mistreated. Sudden changes in the elder’s behavior Caregiver’s refusal to allow visitors to see an elder alone.* NCEA Website:

Sexual Abuse Non-consensual sexual contact of any kind with an elderly person. Sexual contact with any person incapable of giving consent is also considered sexual abuse. NCEA Website:

Sexual Abuse: Signs to look for Bruises around the breasts or genital area Unexplained venereal disease or genital infections Unexplained vaginal or anal bleeding Torn, strained, or bloody underclothing Statements made by the elder of being sexually assaulted or raped* NCEA Website:

Emotional Abuse The infliction of anguish, pain or distress through verbal or non-verbal acts. Examples: verbal assaults, insults, threats, intimidation, humiliation, and harassment. Less Obvious Examples: Treating an older person like a child, isolating an elderly person from his/her family and friends or regular activities, and giving the “silent treatment”. NCEA Website:

Emotional Abuse; Signs to look for Being emotionally upset or agitated Being extremely withdrawn and non- communicative or non-responsive Unusual behavior usually attributed to dementia (ie; sucking, biting, rocking)‏ Elders statements of being verbally or emotionally abused* NCEA Website:

Abandonment The desertion of an elderly person by an individual who has assumed responsibility for providing care for an elder, or by a person with physical custody of an elder. NCEA Website:

Abandonment; Signs to look for The desertion of an elder at a hospital, or nursing facility The desertion of an elder at a shopping mall An elder’s statement of being abandoned* NCEA Website:

Caregiver Neglect According to Louisiana law, a Caregiver is any person or persons, either temporarily or permanently, responsible for the care of an aged person or a physically or mentally disabled person. Caregiver Neglect: Is the failure, by a caregiver responsible for an adult’s care or by other parties, to provide the proper or necessary support or medical, surgical, or any other care necessary for the adult’s well-being. Typically, Neglect means the refusal or failure to provide an elderly person with such life necessities as food, water, clothing, shelter, personal hygiene, medicine, comfort, personal safety, and/or other essentials. NCEA Website: LA.R.S.14:403.2

Caregiver Neglect: Signs to look for Dehydration, malnutrition, untreated bed sores, and poor personal hygiene Unattended or untreated health problems Hazardous or unsafe living conditions (ie; improper wiring, no heat, or no running water)‏ Unsanitary and unclean living conditions (ie; dirt, fleas, lice on person, soiled bedding, fecal/urine smell, inadequate clothing)‏ An elder’s statement of being neglected* NCEA Website:

Self Neglect The behavior of an elderly person that threatens his/her own health or safety. Typically manifests itself in an elderly person who refuses or fails to provide himself/herself with adequate food, water, clothing, shelter, personal hygiene, medication, and/or safety precautions. Louisiana Law states: “Protective Services may not be provided in cases of self-neglect to any adult having the capacity to consent, who does not consent to such service or who, having consented, withdraws such consent.” NCEA Website: LA.R.S.14:403.2

Self Neglect; Signs to look for Dehydration, malnutrition, untreated bed sores, and poor personal hygiene Unattended or untreated health problems Hazardous or unsafe living conditions (ie; improper wiring, no heat, or no running water)‏ Unsanitary and unclean living conditions (ie; dirt, fleas, lice on person, soiled bedding, fecal/urine smell, inadequate clothing)‏ Lack of necessary medical aids (ie; dentures, hearing aids)‏ Is the client confused or disoriented* NCEA Website:

Financial Exploitation The illegal or improper use of an elder’s funds, property, or assets. Examples: cashing one’s check without authorization or permission; forging a signature; misusing or stealing one’s money or possessions; coercing or deceiving a person into signing any documents; improper use of a power of attorney or guardianship. NCEA Website:

Financial Exploitation; Signs to look for Sudden changes in bank account or banking practices New names added to the client’s bank account and signature card Unauthorized ATM withdrawals Abrupt changes in the elder’s Will Unexplained disappearance of money of possessions Bills going unpaid when resources should be adequate Signatures being forged Previously uninvolved relatives start to appear, claiming their rights to an elder’s funds or assets Unexplained sudden transfer of assets to a family member or someone outside of the family The elder’s statements of being financially exploited* NCEA Website:

Extortion The acquisition of a thing of value from an unwilling or reluctant adult by physical force, intimidation, or abuse of legal or official authority. LA.R.S.14:403.2

Extortion; Signs to look for Same basic signs as financial exploitation May have physical signs (ie; bruising, etc)‏ May verbalize fears of being alone. Statements of the elder of being extorted.*

ACCORDING TO LOUISIAN LAW, WHO REPORTS?

According to Louisiana Law: Physicians, medical interns, dentists, nurses, social workers, family counselors, police officers, licensed psychologists, coroners, registered podiatrists, occupational therapists, osteopaths, probation officers, staff of home health agencies or nursing facilities, financial directors, bank tellers, family members, friends…anyone who has reasonable cause to believe an adult, aged 60 or older is being abused or neglected by a caregiver or by self-inflicted acts, should contact the EPS office.

To Whom Do You Report? ELDERLY PROTECTIVE SERVICES

What Should Be Reported? Simply use your eyes and ears to note any unusual occurrences, such as burns, bruises, black or swollen eyes, broken bones, dilated pupils, evidence of restraints, bedsores, lack of clothing or dirty clothing, body odor, dehydrated or malnourished appearance, no utilities in the home, disappearance of personal property, absence of food or medication, frequent changes in doctors, discontinuation of visitor privileges, no visitors allowed individual expressions of shame, embarrassment or fear.

What Is My Responsibility? The persons reporting incidents of abuse or neglect are immune from civil and criminal liability if they acted in good faith. Further, a person who knowingly fails to report abuse may be liable for fines and/or imprisonment. It is everyone's responsibility to report abuse or neglect of an elder..

Elderly Protective Services: The purpose of Elderly Protective Services (EPS) is to protect adults who cannot physically or mentally protect themselves and who are harmed or threatened with harm through action or inaction by themselves or by the individuals responsible for their care or by other persons. EPS acts to prevent, remedy, halt or hinder acts of abuse or neglect against persons aged 60 and older, while promoting the maximum possible degree of personal freedom, dignity and self-determination. Only when other efforts fail, will EPS recommend referral or admission to an appropriate care facility for the elder adult or seek judicial remedy to the situation.

What EPS Does: Locate and refer individuals to community agencies and facilities that offer the services they need. When necessary, advocate ( that is recommend, support and /or defend their rights.)‏ Provide short-term, limited, case management services. That is monitor the case for stability Work with law enforcement to provide protection Work with the judiciary system to remedy problems that require legal action from the D.A. or Judge when legal intervention is warranted. Methods of Legal intervention are

What EPS Does: Order to Enter Home Interdiction - full/limited Order for Injunctive Relief- Restraining Order Order for Mandatory Counseling Order for Medical/Psychiatric/Psychological Evaluation Power of Attorney

What EPS Does: Admission by Emergency Certificate Order for Protective Custody Judicial Commitment Protective Service Order- temporary custody by EPS to place elder in a protected environment until a more permanent solution can be arranged Provide information and referral service to individuals who do not meet the criteria for elderly protective services.

EPS DISPOSITIONAL OUTCOMES Case Management/Social Services Nursing Home Placement Legal Referrals (Civil)‏ Legal Referrals (Criminal)‏ Family Intervention

EPS DISPOSITIONAL OUTCOMES Psychiatric/Mental Health Referral Health Care Referral Housing Transportation Utilities

What EPS does not do: They do not remove elders from their homes against their will unless it is determined that they are a danger to themselves or others. If this is determined, EPS requests an Order for Protective Custody from the Coroner or a District Judge and if granted, the elder is transported by a law enforcement officer to a facility for evaluation and/or treatment. They do not force nursing home placement unless a doctor/psychiatrist determines that the elder is no longer mentally capable of making decisions, there is no family member/s available or willing or capable of caring for the elder and a court of law deems the elder incapable of caring for themselves or having the mental capacity to know. They do not provide discharge planning for medical or other facilities. They do not provide crisis intervention on an emergency basis. They are not on 24 hour call.

ELDERLY PROTECTIVE SERVICES STATE OFFICE: 412 North Fourth Street Baton Rouge, LA Telephone # (225) Toll Free # (800)254990(Statewide)‏ Fax # (225) Nationwide Toll-Free Elder Care Locator Number 1 –

Felicity Cole, LCSW Director, Volunteer Department and h2u