Health Article

June 15th is Elder Abuse Awareness Day

Pam Koenig, FNP

EHC Post Date: Fri, Jun 13th, 2014

On June 1st Governor Paul R. LePage signed a Proclamation recognizing June 15, 2014 as Elder Abuse Awareness Day.  All citizens and organizations are asked to recognize this observance.

Elder abuse is an ever increasing problem in Maine as the senior population swells. Seniors are often targeted and, like domestic violence, elder abuse knows no socio-economic boundaries and occurs in all communities. Physical, psychological, and sexual abuse are perpetrated against senior citizens as well as neglect, abandonment and financial exploitation.  The Governor's Proclamation aims to raise awareness of elder abuse and financial exploitation while seeking commitment to protecting seniors in all Maine communities.

The U.S. Census Bureau reports the percentage of Maine's 65 and older population is currently above that of New England and the nation.  By 2020 Maine is projected to have nearly 294,000 senior citizens, nearly 21% of the state's total population.  The increase in the number of frail and vulnerable elders, makes Washington County the 2nd oldest in Maine.

Domestic violence reports are published almost daily in the Bangor Daily News, but unfortunately, elder abuse is vastly underreported across the state with estimates of 1 in 5 cases or fewer reported to authorities. Abuse, neglect, and exploitation are a reality for thousands of adults in Maine each year. The typical victim of elder abuse in Maine is female, over 60 years of age, and dependent on someone else for part of their daily living activities. The majority of abused elders live alone or with family, however, they also reside in nursing homes and assisted living facilities.

Maine law defines abuse as the infliction of injury, unreasonable confinement, intimidation or cruel punishment that causes or is likely to cause physical harm or pain or mental anguish; sexual abuse or sexual exploitation; or intentional, knowing or reckless acts of omission or deprivation of essential needs (22 MRSA §3472).

While one may not witness abuse directly, there are observable signs of abuse, neglect or exploitation once awareness, skill and sensitivity is heightened. Indicators of physical abuse include broken bones, pain/inability to move a limb, burns/blistering skin, cuts/scratches, slap marks, bruises or scars.  Abuse also includes cruel forms of discipline such as isolation, and excessive use of physical or chemical (medication) restraints.

Maine defines sexual abuse as contact or interaction of a sexual nature involving an incapacitated or dependent adult without that adult's informed consent (22 MRSA §3472).

A recent news story reported a 22 year old female aide charged with the sexual assault of an incapacitated dependent adult in a nursing home.  Sexual assault in long-term care facilities may be perpetrated by staff, family members, visitors or other residents.  Indicators of sexual abuse include lingering seductive affectionate gestures, injuries sustained during sexual contact, and exposing oneself in a sexual manner.

Maine law defines exploitation as the illegal or improper use of an incapacitated or dependent adult or that adult's resources for another's profit or advantage (22 MRSA §3472).  Indicators of exploitation may include manipulation of an elder into giving money or personal property (such as jewelry), abuse of power of attorney or bank account co-signer privileges, cashing social security checks or withdrawing money from an elder's savings and using the money for personal purchases. Disappearance or transfer of personal property, savings, or insurance, unexplained change in cash flow, change in a will, or depleted bank accounts are suspicious of financial exploitation.

Financial exploitation is not uncommon in Maine. In the month of May the Bangor Daily News reported two such cases. One involved a woman who ran errands for an elderly man who then stole his identity and opened three credit cards in his name, racking up debt and breaching his bank account to pay the bills. The other involved a former police officer who stole nearly $160,000 when he served as power of attorney for a female relative.

A few weeks ago a Washington County health care provider was informed by an Adult Protective Services (APS) case worker that her patient, Mrs. A., had been a victim of financial exploitation.  Mrs. A is a 75 year old widow who lives alone on a back road in a very small Washington County town.  Over the past few years her memory and health have declined and she has had to rely on others for transportation.  Apparently, two local community members whom she calls "friends" have been giving her rides to the store, bank and medical appointments in exchange for money.  Her only son lives in New Jersey, and, although he would like her to move closer to him, she will only visit him for a few months at a time, preferring to return to her own home.  The local police have been involved and while APS maintains an open case file on Mrs. A., she remains a vulnerable elder in this community.

The  definition of neglect means a threat to another's health or welfare by physical or mental injury or impairment, deprivation of essential needs or lack of protection from these (22 MRSA §3472).  Self neglect/abuse refers to persons who do not have the capacity to care for themselves due to physical or mental impairment. Indicators of neglect include ignoring or isolating someone, unusual fear or silence when a perpetrator is in the same room as the abused elder, unattended health problems, and purposefully ignoring calls for assistance.

Maine's reporting law mandates health care providers, law enforcement officers, caregivers, church personnel, and volunteer ride services/drivers to report suspected abuse, neglect or exploitation to Adult Protective Services. However, anyone may make a report if that person knows or has reasonable cause to suspect abuse, neglect or exploitation of a dependent or incapacitated adult.

Reports are made by telephone to the Department of Health and Human Services, Adult Protective Services and Division of Regulatory Services and are kept confidential on request. Elder abuse is a community problem with a community solution: The involvement of concerned citizens will help prevent the devastating and at times life-threatening problem of elder abuse.

For more information:

Office of Elder Services Maine: http://www.maine.gov/dhhs/elderly.shtml

Adult Protective Services; Abuse/Neglect reports: 532-5047; 24 hour hotline   1-800-624-8404

The Eastern Area Agency on Aging: 941-2865; 1-800-432-7812.  http://eaaa.org/