Elder Abuse Investigation and Prevention Programs
It is estimated that between 700 thousand and 1.2 million elderly people residing in the United States suffer from mistreatment annually. Every year, 450 thousand new cases are observed. Elderly people are regarded as the ones responsible for uniting society owing to their wisdom. However, the elderly become subject to abuse, which led to the passing of The Old Americans Act in 1960. The act was followed by the introduction of the Elder Justice Act in 2003 by Senator John Breaux in the Senate, which was passed on March 2010 (Liederbach, Fritsch & Womack, 2011).
Provisions of the Elder Justice Act of 2010
The Elder Justice Act of 2010 provides for the Patient Protection and Affordable Care Act. The act gave permission to the government to spend $770 million on health care for the elderly between 2010 and 2014. Out of the $770 million, $500 million was used for carrying out services aimed at protection of the elderly. The Elder Justice Act of 2010 also provides for the formation of a council to coordinate offerings of justice to the elderly. The council is expected to involve members who are part of the government (Moore, January 01, 2012).
The council is meant to be a communication channel of the Department of Health and Human Services. It is expected to take recommendations from twenty-seven members selected from the public working in different fields. The Elder Justice Act of 2010 also stipulates the construction of forensics centers to help prevent and prosecute crimes affecting elderly people (Liederbach et al., 2011). The Elder Justice Act of 2010 also foresees introduction of programs that are aimed at facilitating durable care services for the elderly people in society.
The Elder Justice Act of 2010 led to the execution of Electronic Health Record Technology, which has helped people to report issues of elder mistreatment. The last provision by The Elder Justice Act of 2010 offers cover for inhabitants of care centers for the elderly. The inhabitants receive free training, which helps them conduct surveys on abuse of the elderly and efficiently evaluate the abuse complaints (Moore, 2012).
Methods Used to Identify whether an Elderly Person Is being Abused
The basic and most important method of identifying whether an elder person is being abused is through screening. However, screening should be done mainly by nurses and institutions offering health care. The reason for involving a health expert in screening is that a health expert can distinguish between signs of mistreatment and symptoms of normal aging. The Elder Justice Act of 2010 recommends that nursing facilities carry out screening for the elderly in line with the Medicare program.
When interviewing victims of abuse, it is important to ensure privacy. The victims who are suspected of abuse should be interviewed alone, in the absence of their caregiver. Privacy will help to ensure that circumstances are not misrepresented due to the fear of an individual suspected of being the perpetrator by the victim of abuse. It is also very important for health officials to consider different evidence, besides the reports by the victims since some sufferers may fear to disclose how they are abused even when their caregiver is not present (Liederbach et al., 2011).
The third method used to identify whether an elderly person is being abused by their caregiver is the comprehensive geriatric assessment (CGA). The geriatric form of assessment involves carrying out physical examination, administering cognitive screening, and assessing the mental health of the suspected abuse victim. Since the comprehensive geriatric assessment is a complicated process, it is advisable to involve a team of professionals to carry out the assessment.
Role of the Investigation Personnel
The role of the investigation personnel is aimed at prosecuting and arresting perpetrators of elder abuse. The investigation personnel is also responsible to ensure the safety of victims of abuse (Moore, 2012). The safety of victims can be achieved through issuing and enforcing of restraining orders to the perpetrators of elder abuse. It is also recommended to regularly check the well-being of the victims of elder abuse.
The personnel involved in the investigation is expected to give power to other professionals if they need to participate in the process. The investigative personnel is also expected to assist professionals in achieving their intended objective in order to inquire and intervene in an abuse situation. The investigative personnel also closely supervises the behavior of the suspected perpetrators of elder abuse. If the perpetrators are taken into custody, it is the role of the investigative personnel to cater for their needs (Moore, 2012).
How the Investigative Personnel Can Be Involved in Prevention of Abuse of Elderly People
The investigative personnel can prevent abuse of elderly people by participating in various teams involved in provision and execution of discipline. It is also important for the investigative personnel to be involved in forums within the communities they belong to in order to solve issues relating to abuse of elderly people (Moore, 2012). They can also play a big role in encouraging the organization of programs aimed at training people according to law enforcement system.
The programs of the investigative team training should mainly focus on teaching people about the special needs of the elderly and the disadvantaged. The investigative team should also educate people in order for them to recognize elements of elder abuse, as specified by the law. This team is also obliged to encourage adoption and implementation of policies that allow for prosecution and serious punishment of perpetrators of elder mistreatment. Accessibility of criminal justice by the elderly should be the primary aim of the investigative team (Liederbach et al., 2011).
Why Abuse of the Elderly People Occurs
In most cases, an incident of abuse of the elderly occurs due to a number of universal reasons. The first reason is that a caregiver of the older person may be undergoing stressful situations. Taking care of an old person is not an easy task, especially when he or she is either mentally challenged or physically impaired. Such a situation encourages a caregiver to be fully prepared both physically and mentally. When frustration increases, stress levels of a caregiver advance. Hence, they end up abusing an older person (Moore, 2012).
Another cause for elder abuse by caregivers is the existence of a cycle of violence in life of a caregiver. Some people are brought up in families where violence is an accepted norm. Violence is a behavior that is passed through generations. In such a family, children grow up, knowing that when they are faced with tension or end up being in conflict with someone, then the easiest way to respond is through violence. When such people become caregivers, they are usually abusive towards an elderly person (Twomey et al., 2010).
If caregivers face problems with finances, family or at their workplace, then they are most likely to abuse the old people they are taking care of. Some caregivers deal with harmful habits such as alcoholism while others have health problems. For such people, taking care of an elderly person brings much frustration, hence making them abusive. In this case, caregivers feel like they are sharing the burden of stress with their victims.
Types of Abuse of Elderly People
The abuse of elderly people occurs in different forms. One major form of abuse is physical abuse, which occurs when a caregiver intentionally uses force against an elderly person, which results in injuries. Physical abuse also involves confinement of the elderly people in rooms or specific seats. Some caregivers abuse the elderly by inappropriately administering the use of various drugs. Some of the elderly people are abused by being commanded by their caregivers (Moore, 2012).
The other form of abuse is emotional. It occurs when a caregiver talks to an elderly person in a way that causes them distress. This may come about through yelling at the elderly, as well as using intimidation or threats. Elderly people also hate being ridiculed and humiliated whether in the presence of third parties or privately. When a caregiver has a habit of blaming an older individual for his faults, it results in emotional problems or chronic stress.
Most of the elderly people hate being ignored. When an older person is constantly ignored, it leads to emotional trauma. Most caregivers make a mistake of isolating an elderly person from the rest of the family, especially when they are visited by their close friends. Isolation makes an elderly person feel unwanted and bothersome. When a person feels unwanted, she gradually becomes emotionally strained (Moore, 2012).
Some caregivers abuse the elderly by neglecting them, sometimes intentionally or circumstantially. Hence, caregivers ignore the needs of the elderly. However, sometimes they deny that the elderly actually require their attention. Another form of abuse, though not a common one, is sexual abuse. Sexual abuse occurs when caregivers force the elderly to watch pornographic images, to undress, or, in some cases, to have sex with them (Liederbach et al., 2011).
Some elderly people are abused by being exploited financially. Their caregivers may misuse their personal checks. Other caregivers withdraw money from personal accounts of the elderly, using their credit cards. In few cases, household goods and cash of the elderly are stolen from them by their caregivers. Caregivers might undertake an investment fraud in order to steal from the elderly (Nerenberg, 2008). Other caregivers lie about their involvement in charities in order to embezzle the elderly people’s money.
Older people might sometimes be abused by healthcare givers through frauds in healthcare. Some doctors in charge of offering healthcare services for the elderly fail to provide it. Other doctors deceive the elderly by overcharging them for the services they offer. Thus, some elderly people end up being overmedicated or receive insufficient medication (Moore, 2012). There are also physicians who give referrals for the elderly, or prescribe drugs found in specific chemists in order to cleverly obtain money from the patients.
Signs of Abuse
An elderly person with the signs of injury that cannot be explained, or bruises and scars that appear in a systematic way, is most likely to be a victim of physical abuse. Other elderly people who are victims of physical abuse show signs of dislocation, sprains and broken bones. It is likely to see elderly persons’ wrists with marks of ropes if they are victims of restraint by their caregivers. The most common sign of elder abuse is when a caregiver refuses to see an elderly person alone (Moore, 2012).
When a caregiver threatens, belittles and controls the elderly, these are evident signs of emotional mistreatment. Sometimes, the elderly clearly allude that they are being mistreated emotionally (Nerenberg, 2008). In this case, some of them remain speechless, while others show signs of body rocking. Elderly people who are victims of sexual abuse have bruises around their breasts or their genital areas. Some victims of sexual abuse have unexplained bleeding in their vagina or their anus.
In some cases, the elderly are abused by their caregivers through neglect. A neglected elderly person can be identified through abrupt loss of weight, signs of malnutrition and signs of dehydration. Some of the neglected elderly people have other physical signs, such as untreated bedsores (Twomey et al., 2010). The most common sign of a neglected elderly person is when a caregiver does not help him to manage a personal hygiene.
Financial exploitation can be identified by rapid adjustments in the financial state of the elderly person. An elderly person can also complain that some personal belongings are missing from the house. You might also notice that names have been added to the senior’s signature card of an elderly person. When it comes to identifying an elderly person who is abused through fraud in health care, you will notice billings that are duplicated that serve an equivalent medical examination (Nerenberg, 2008).
It is not difficult to identify elderly people who have been overmedicated and those who have received insufficient medication. It is also easy to identify bills that were paid in full for medication a patient did not receive. Some of the medical caregivers are not fully trained and equipped. Moreover, some care giving centers have inadequate facilities and deficient staff, which means that their services are not provided according to healthcare standards. You might also notice that an elderly person is given unnecessary services; some are given unnecessary prescriptions (Twomey et al., 2010).
How to Manage Abuse of the Elderly People
Since the elderly people cannot report about their abuse to the authorities, it is then the responsibility of health care providers to report any suspected cases of abuse of their elderly patients. The health providers should then inform adult protective services in the country. A professional team should be involved in monitoring elderly patients suspected of abuse. The team should consist of physicians able to carry out tests, nurses to monitor the progress of patients, as well as office-based social workers and community-based social workers to help the elderly (Twomey et al., 2010).
Immediate care should involve admission of the elderly to an equipped hospital, as well as obtainment of a court order to protect them from their abusive caregivers. Moreover, victims should be placed in safe accommodation after being taken away from their homes. A permission to the elderly patients to go back to their homes should be given only in case they are perceived as being able to make informed decisions (Moore, 2012). After that, social workers should be responsible for comfort and safety of the elderly. It is also important for physicians to learn laws concerning elder abuse.