NOTE: To change the image on this slide, select the picture and delete it. Then click the Pictures icon in the placeholder to insert your own image. ELDERLY WITH MENTAL ILLNESS: CIT TEAMS NEED FOR EDUCATION- REAL ADULT PROTECTION Kim Jardine-Dickerson, RN, MSN, BC, CADC Idaho State University, School of Nursing

And Here We Have Idaho  Home of the Jeff D Law Suit  Established Specialty Courts /Drug Courts  ACT Teams  NAMI Idaho  SPAN Idaho  24 Hour Suicide Hotline  1 st Community Crisis Center  Nov 2014

IDAHO IS CIT 7 YEARS It Is More Than Training

Law Enforcement Adult Protection Case Management Community Resources Advocacy Mental Health Professionals What can CIT do in Partnership with Adult Protection?

Case in Point  Married couple living in a rural community everyone knows  Female 85 male 89 living in their own home  She has dementia. He is a WWII Veteran, uses oxygen, and drinks at night.  2 cats 1 dog  Daughter living out of state (California)  She is confused most days most of the day  He still drives and is confused most days especially at hours of darkness)  Neighbors hear loud banging noises and dog barking: calls 911  Sherriff Officers and City Police know this couple  Nice people that are getting worse, daughter lives in California, church people are getting worn out

Case in Point  82 year old female in assistant living  Becomes agitated acutely and started biting, scratching, and hitting staff

Adult Protection  Under Idaho Law Adult Protection is responsible for investigating allegations of Abuse, Neglect and Exploitation against Idaho's vulnerable disabled and senior populations and working with other agencies toward resolution ( A(3)  Adult Protection seeks to preserve individual rights in the least restrictive manner while offering protection from further harm and solutions to problems ( A(3 )

Self Neglect  vulnerable adult, not living in a care facility, cannot provide for him-or herself the goods and services needed for his/her physical or mental health, and this hurts or threatens the vulnerable adult's well-being

Neglect  when a person or agency with a duty to care for a vulnerable adult acts (or fails to act) in a way that results in the vulnerable adult not getting care needed to maintain his/her physical or mental health

Exploitation  an abuser illegally or improperly uses a vulnerable adult or the vulnerable adult’s income /resources, including trust funds or bank accounts, for the abuser’s profit or advantage

Abandonment  when a person or agency with a duty to care for a vulnerable adult acts (or fails to act) in a way that leaves the vulnerable adult unable to get needed food, clothing, shelter, or health care

Considerations of Disability  Any person who is 18 years of age or older who is:  Frail or suffers a chronic physical or mental impairment  Socially isolated  Dependent upon others for their basic needs  Unable to protect themselves in an abusive situation  Fearful of retaliation or ashamed to take action  Judgment or behavior is affected to the point the person is unable to make, communicate or implement decisions in his best interest

Adult Developmental Disabled Population in Assisted Living  Since deinstitutionalization  Significant percentages of men with Schizophrenia  Co occurring medical disorders  Prescribed psychotropic medications  Significant percentages non compliant with psychotropic medications  Often escalates quickly when they are medically ill and  Staff in assisted living facilities are not trained in de escalation skills  Staff in assisted living facilities are not trained in medical assessment

Case in Point  65 year old developmentally disabled male living in rural community assisted living  Law enforcement knows this man from recurring calls to assistant living  This resident escalates quickly to the point staff are afraid of him  He is on psychotropic medications for schizophrenia

Team Approach For All Advocacy Law Enforcement Mental Health Professionals

What Can We Do For Adult Protection?  Listen to their cases  Advocate for them  Bring training to them  SEE what they need

What Nursing Can Bring To The Team  Assessment  Intervention  Planning  Evaluation  Outcome  Education to team members

CIT: It’s More Than Training  Stakeholder Meetings  Law Enforcement  911 Dispatch  EMS Fire and Paramedics  Adult Protection  Health and Welfare  Housing  Advocacy  Case Management  ED Nursing  Community Resources

History and Development  Not what Law Enforcement can do for us nut We can do for Law Enforcement  Academies  Consistent meetings  Recognition of Law Enforcement (Banquets, Letters to Editor, Training)  Recognition of 911 Dispatch  Recognition of EMS  Incorporating Adult Protection