Aging well: Awareness key to stopping elder abuse

June is Elder Abuse Awareness Month

Sherry Bray, long-term care ombudsman for Moffat County, will speak about elder abuse issues at noon Wednesday at the American Legion during Wellness Wednesdays in Craig. For more information, call 871-7676.

To report abuse locally (referrals are confidential and can be anonymous):

• Moffat County Social Services: 824-8282

• Routt County Human Services: 879-1540

The Colorado Long-term Care Ombudsman Program assists residents of licensed long-term care facilities in protecting their health, safety and welfare. To speak with an ombudsman, call 879-0633 in Routt County or 871-7659 in Moffat County.

Editor's Note: This article first was published Aug. 8, 2008. Information has been updated for accuracy.

When Vickie Clark became director of the Routt County Department of Human Services last year, she was surprised to learn that only six referrals regarding possible abuse of at-risk adults were made in the county in the previous year.

"When people ask me why : I'm going to guess that part of it is a lack of awareness to what the issues are and the resources that are available," she said.

Clark, a former supervisor of adult protective services in Mesa County, noted that all the reports turned out to be situations of self-neglect. However, she suspects there are more possible adult abuse cases in Routt County that are not being reported.

Her experience has shown that referrals typically increase as the public becomes more conscious of elder abuse problems.

Who is at risk

Elder abuse is any knowing, intended or careless act that causes harm or serious risk of harm to an older person. It includes physical, mental and sexual abuse, financial exploitation, neglect, abandonment and self-neglect, according to the National Center on Elder Abuse.

Between 2002 and 2004, more than 50 percent of clients of Adult Protective Services programs in Colorado were 75 or older.

In 2006, more than half of Colorado APS cases involved situations of self-neglect. About 22 percent involved caregiver neglect, while financial exploitation accounted for about 16 percent of cases and other abuse about 9 percent, according to data from Colorado Adult Protective Services.

Elder abuse can happen to anyone, though certain factors can make a person more vulnerable. These include illness, frailty, physical disability, mental impairment and living with or depending on a person with a history of mental illness, hostility or alcohol or drug abuse.

While some abuse occurs in long-term living facilities, the vast majority of cases involve abuse in the home by family members, old or "new" friends or service providers in a position of trust, according to the American Psychological Association.

Although there are extreme cases of elder abuse, most situations are more subtle, making the difference between interpersonal stress and abuse sometimes difficult to discern.

Some elder abuse may be a continuation of marital or family violence that has taken place during many years or the result of stress triggered by lifestyle adjustments and the difficulty of caring for an increasingly dependent older person, the association notes.

Reporting abuse

Referrals of possible elder abuse to APS typically come from medical staff and community groups, concerned individuals and members of the criminal justice or government communities.

There are many warning signs of elder abuse, such as slap or pressure marks or certain kinds of burns or blisters which may indicate physical abuse. Untreated bed sores, the need for medical or dental care, dirty clothing, poor hygiene and grooming and unusual weight loss are possible signs of self-neglect or neglect by a caregiver.

Emotional abuse or neglect may cause a person to withdraw from normal activities, be less alert or behave unusually. Exploitation may be signified by sudden changes in a person's finances and accounts, altered wills and trusts, unusual bank withdrawals or loss of property, according to the National Center on Elder Abuse.

A person may be abusive if they seem to control an elder's actions, isolate the elder from family and friends and be emotionally or financially dependent on the elder. Abusers also may appear indifferent to the elder, seeming apathetic or hostile, call the elder names or threaten the elder's pet.

Although it's been difficult to pinpoint how many older adults are abused, research suggests only one in 14 elder abuse incidents in the home are reported to authorities.

Several factors that may contribute to the lack of reporting elder abuse incidents include isolation of older adults in rural areas, as well as cultural and societal attitudes emphasizing autonomy and privacy.

Kathy Rickart, former coordinator of Colorado Coalition for Elder Rights and Adult Protection, which provides education and resources about elder rights issues, said these attitudes can be common in ethnic and immigrant populations.

Abuse awareness among friends and family can be particularly important in rural areas where they can be a support and resource to victims in place of lacking programs and services, she said.

"The skill of the professional is key along with creating abuse awareness among the general public," Rickart said. "Mental illness used to be hid in the closet, but with education, more and more people no longer feel stigmatized if they have a mental illness. Abuse will have to travel the same educational path."

Once a county department of social/human services (some have adult protection teams) receive a referral about possible abuse, staff access the situation and determine what kind of services in the community, such as medical care, counseling, home health or other programs, will help the person in their situation. More dire or extreme circumstances may require the help of law enforcement or other agencies.

"Basically our job is to go out and advocate for the rights of that person a lot of times," said Clark in Routt County.

She emphasized that competent adults have the right to refuse some or all help offered to them by APS, even if staff feel it is not in the person's best interest. Finding the least restrictive help or intervention is among APS priorities.

Preventing abuse

Competent older adults can take a number of steps to prevent themselves from being mistreated. These include staying busy and engaged in life, cultivating a strong network of family and friends and taking care of themselves to stay as independent as possible.

Older adults also should refuse to allow anyone to add their name to the person's bank account without their consent and should never make financial decisions under pressure or sign over money or property to anyone without getting legal advice, according to recommendations from the National Center on Elder Abuse.

Elder abuse within the home can be averted by proactive family choices, such as seeking counseling or help change long-time patterns of behavior, conflict or addictions or deal with current stresses, recommends the American Psychological Association.

Concerned citizens can prevent or end abuse by reaching out to vulnerable neighbors, friends or family members, especially those isolated because of physical, cultural or geographical circumstances. They also may volunteer with community programs that provide older adults companionship and help in their homes.

Finally, if they suspect someone is being abused or are neglecting themselves, they should report the situation to the county department of social/human services where that person lives. Referral sources are kept confidential and may be anonymous.

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