1. Welcome to….. The Flaw in our Current Approach to Addressing Elder Abuse and Neglect March 9, 2016

2. What Are We Talking About? Abuse Physical, Emotional/Psychological, Sexual Altercations/Aggression between residents Neglect Misappropriation of Funds/Property

3. Prevalence of Abuse 1 in 10 elders are victims of Abuse, Neglect and Exploitation Estimated that for every 1 reported case…23 cases are unreported Estimated that 50% of all elders living with dementia suffer some form of abuse 70-90% of all abuse happens at the hands of family members

4. Types of Abuse Physical Sexual Neglect Emotional/Psychological Financial Exploitation

5. Abuse in LTCF’s NATIONALOKLAHOMA Physical – 27%Physical – 20% Sexual – 8% Psychological/Verbal Abuse – 19%Psychological/Verbal Abuse – 39% Financial Exploitation – 8%Financial Exploitation – 16% Gross Neglect – 15%Gross Neglect – 7% Resident to Resident – 22%Resident to Resident – 11% (NORS data – 2013) Oklahoma had 76 cases of Abuse, Neglect and Exploitation in 2013

6. Oklahoma Definitions ABUSE – The causing or allowing to be caused the infliction of physical pain, injury or mental anguish. Abuse includes unreasonable restraint or confinement, verbal abuse and sexual abuse. OKLA.STAT.tit.43A § 10-103(A)(8)(2001) NEGLECT - A failure to provide protection, adequate shelter, clothing, nutrition, health care, or causing or permitting harm or risk of harm through the action, inaction or lack off supervision by another individual. OKLA. STAT.tit.43A§10-103(A)(10)(2001) FINANCIAL EXPLOITATION – The improper use of a vulnerable adult’s financial, real or personal resources for the benefit of another person, through the use of undue influence, coercion, harassment, duress, deception, false representation or false pretense. OKLA. STAT.tit.43A§10-103(A)(9)(2001)

7. Impact of Elder Abuse  Higher risk of death  Higher level of psychological distress  Physical injuries  Pain and suffering  Loss of dignity  Loss of property and items of value  Profound financial cost

8. Why Elders Don’t Report  Fear of repercussions  Fear of loss of independence  Embarrassment for not being able to protect themselves or being duped  Doesn’t want to get the perpetrator in trouble  Incapacitated or unable to report  Elder doesn’t recognize abuse is happening

9. Elder Demographics

10. When Abuse or Neglect Occurs: Facility Responsibilities Stop the abuse right away Attend to the resident's immediate physical or emotional needs Report as required by facility policies and/or state law

11. Your Responsibility as a Leader What is the relationship between abuse and.. the working conditions in your home? your staffing levels? staff training? What staff characteristics and attitudes are most impervious to abuse? What are the risk factors for staff members?

12. Focus on Prevention Evaluate the impact of……  Facility management style  Physical environmental  Screening & hiring practices  Consistency of the staffing model  Staffing patterns & ratios  Staff training on Abuse Prevention  Staff empowerment  Relationship-based culture change models

13. Michigan Abuse Prevention AANP - Adult Abuse & Neglect Prevention Initially funded by CMS in 2005 Demonstration Project leaders: Michigan Office on Aging MSU – College of Human Medicine BEAM Trained 7,800 LTSS direct access staff members

14. AANP Research Results 91% improved ability to recognize abuse 48% reported abuse more often 91% believe training improved abilities to prevent abuse from developing 60% had used the prevention techniques 96% believe the used techniques helped prevent abusive situations http://phinational.org/training/adult-abuse-neglect-prevention-aanp-training

15. TPAAN The Training to Prevent Adult Abuse and Neglect 1-Day Workshop For all eldercare workers Taught in Train the Trainer format Based on idea that anyone of us could be an abuser given the right circumstance Increases self-awareness about abuse and our own stress triggers Provides skills and strategies to avoid abusing http://phinational.org/consulting/services/training- prevent-abuse-and-neglect-tpaan http://phinational.org/consulting/services/training- prevent-abuse-and-neglect-tpaan

16. QUESTIONS??

17. Thank You for Joining Me! Cean Eppelheimer 517.927.1875 ceppelheimer@phinational.org ceppelheimer@phinational.org