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Hiding in plain sight recognizing and responding to abuse later in life

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Hiding in plain sight recognizing and responding to abuse later in life

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Hiding in plain sight recognizing and responding to abuse later in life

  1. 1. Hiding in Plain Sight: Recognizing & Responding to Abuse in Later Life
 May 2, 2016 Courtney O’Hara Program Manager Central VA Task Force On DV in Later Life Virginia Center on Aging Virginia Commonwealth University cdohara@vcu.edu 804.828.1650
  2. 2. OBJECTIVES To identify domestic and sexual violence in later life. To identify appropriate resources and community collaborations. To identify issues for allied professionals.
  3. 3. These are handled by Adult Protective Services.
 WHAT IS ELDER ABUSE?
 Abuse, Neglect, and/or Exploitation of an Elder or Vulnerable Adult Includes Self-Neglect Age 60 and Older
  4. 4. What’s Domestic Violence? Domestic violence is a pattern of abusive behaviors used by one individual intended to exert power and control over another individual in the context of an intimate or family relationship.
  5. 5. 
 SCENARIOS OF FAMILY VIOLENCE 
 IN LATER LIFE Partner/ Spouse/ Adult Child Domestic Violence Grown Old New Relationship Late Onset Domestic Violence “Reverse” Domestic Violence
  6. 6. Family Violence National Association of Adult Protective Services Administrators- National Center on Elder Abuse- 2001 Adult Children, Relatives/ Intimate Caregivers “Domestic elder abuse is a family problem- almost 90% of abusers were family members” “In the last decade domestic elder abuse reports investigated by APS have increased by more than 150%”
  7. 7. Why should we care? ! Higher risk of death when compared to those who had not been abused. ! Victims of elder abuse have had significantly higher levels of psychological distress and lower perceived self-efficacy than older adults who have not been victimized. ! Older adults who are victims of violence have additional health care problems than other older adults, ! The impact of abuse, neglect, and exploitation also has a profound fiscal cost. www.NCPEA.org
  8. 8. Symptoms? Fragility Isolation Bruising Increased worries Lack of coordination Startle Response
  9. 9. Family Abuse in Later Life Created by the National Clearinghouse on Abuse in Later Life (NCALL) used with permission www.ncall.us www.wcadv.org This diagram adapted from the Power and Control/Equality wheels developed by the Domestic Abuse Intervention Project, Duluth, MN
  10. 10. Power and Control Wheel: 
 The Inner Spokes These are behaviors that go on all the time. They make the victim feel trapped. Most of the abuser’s acts are non-criminal (emotional abuse, control, ridiculing values) Only when you understand the victim’s history (why she/ he stays, why she/he minimizes) can you develop a rapport
  11. 11. THE OUTER WHEEL:
 PHYSICAL ABUSE These behaviors of physical abuse are how the abuser enforces control – they instill fearThese behaviors may be intermittent because the abuser is using subtle threats which are less
  12. 12. 
 Pat’s Story ! Domestic Violence in Later Life
  13. 13. Case Study Pat What scenari o is present ed here? What are the sympto ms? Controlli ng behavio rs? Referrals ?
  14. 14. Family Violence Code of Virginia 
 § 16.1-228 ! "Family abuse" means any act involving violence, force, or threat including, but not limited to, any forceful detention, which results in bodily injury or places one in reasonable apprehension of bodily injury and which is committed by a person against such person's family or household member. ! "Family or household member" means (i) the person's spouse, whether or not he or she resides in the same home with the person, (ii) the person's former spouse, whether or not he or she resides in the same home with the person, (iii) the person's parents, stepparents, children, stepchildren, brothers, sisters, half-brothers, half-sisters, grandparents and grandchildren, regardless of whether such persons reside in the same home with the person, (iv) the person's mother-in-law, father-in-law, sons-in-law, daughters-in-law, brothers-in-law and sisters-in-law who reside in the same home with the person, (v) any individual who has a child in common with the person, whether or not the person and that individual have been married or have resided together at any time, or (vi) any individual who cohabits or who, within the previous 12 months, cohabited with the person, and any children of either of them then residing in the same home with the person.
  15. 15. Issues with Assault in the Family Older IPV victims socialized differently Many have suffered years of abuse, disempowerment high Complex, ambivalent feelings for offender normal Dependency upon offenders Desire to protect offspring inhibits self-protection Fear that kin will be prosecuted
  16. 16. Victims Overlooked Victim conditions that prohibit reporting (dementia, aphasia) Some reporting discounted as psychotic or demented Forensic indicators often missed or misinterpreted on an older body Professional training insufficient Response to allegations often insufficient
  17. 17. Who Abuses? Relationship of Identified Perpetrator to Victim 14% 20% 26% 40% Adult Child Other Family Member Unknown Spouse/Intimate Partner The 2004 Survey of State Adult Protective Services: Abuse of Adults 60 Years of Age and Older
  18. 18. Perpetrators Who Abuses? Spouses/ partners Adult Children “Quasi- Relatives ” Care providers Other Residents of Facility Strangers
  19. 19. Virginia Adult Abuse Statistics VA DSS State Fiscal Year 2014 Report http://www.dars.virginia.gov/downloads/publications/APS2014AnnualReport.pdf
  20. 20. What Are Mandated Reporters? Mandated reporters are required to report suspected abuse, neglect, or exploitation of elders or incapacitated adults. Reporters should provide the name, age and address or location of the person who is suspected of being abused, and as much information about the abusive situation as possible. Mandated reporters include * Any person licensed, certified, or registered by health regulatory boards listed in § 54.1-2503: including: * Board of Social Work: Registered Social Workers; Associate Social Workers; Licensed Social Workers; Licensed Clinical Social Workers * Any mental health services provider as defined in § 54.1-2400.1 * Any emergency medical services personnel certified by the Board of Health, unless such personnel immediately reports the suspected abuse, neglect or exploitation directly to the attending physician at the hospital to which the adult is transported, who shall make such report forthwith * Any guardian or conservator of an adult * Any person employed by or contracted with a public or private agency or facility and working with adults in an administrative, supportive, or direct care capacity *Any person providing full, intermittent or occasional care to an adult for compensation, including but not limited to companion, chore, home
  21. 21. How Do I Report? ● All mandated reporters must make a report to the local department of social services or to the Virginia toll-free 24- hour APS Hotline at 1 (888) 832-3858. When sexual abuse, serious bodily injury, disease or death believed to be caused by abuse or neglect, and any criminal activity involving abuse or neglect that places the adult in imminent danger of death or serious bodily harm are suspected, mandated reporters are required to report to both local departments of social services and local law enforcement. Suspicious deaths must be reported to the local medical examiner and law enforcement.
  22. 22. What can you do those experiencing Domestic Violence in Later Life? Take time to listen Respect the individual Understand how difficult this is Support the victim’s decisions Tell the person help is available Based on materials from NATIONAL CLEARINGHOUSE ON ABUSE IN LATER LIFE WISCONSIN COALITION AGAINST DOMESTIC VIOLENCE
  23. 23. Coordinated Community Response Religious Leaders Advocates Police Adult Protective Agencies Health Professionals Educators Friends Policy Makers Judges & Legal Professionals Source: CANDACE HEISLER CONSULTING ATTORNEY
  24. 24. Resources: ! NCALL- National Coalition On Abuse in Later Life- Wisconsin State coalition www.ncall.us ! Clearinghouse on Abuse and Neglect of the Elderly (CANE) This site contains many resources to help you find assistance, publications, data, information, and answers about elder abuse.
 www.elderabusecenter.org/clearing/index.html ! National Association of Adult Protective Services Administrators (NAPSA) This site contains many resources to help you find assistance, publications, data, information, and answers about elder abuse. http://www.apsnetwork.org/
  25. 25. Resources Con’t ● NSVRC- National Sexual Violence Resource Center- Sexual violence can affect individuals across the life span, including people in later life. The NSVRC has created a series of new resources related to sexual violence in later life. The Sexual Violence in Later Life Information Packet was developed by Holly Ramsey-Klawsnik, Phd, in conjunction with the National Sexual Violence Resource Center. The packet includes the following:
 fact sheet, technical assistance bulletin, technical assistance guide, resource list, annotated bibliography, research brief, and an online collection. http://www.nsvrc.org/publications/sexual-violence-later-life-information-packet ● The National Committee for the Prevention of Elder Abuse (NCPEA) is an association of researchers, practitioners, educators, and advocates dedicated to protecting the safety, security, and dignity of America's most vulnerable citizens. It was established in 1988 to achieve a clearer understanding of abuse and provide direction and leadership to prevent it. Since 1998.  www.NCPEA.org
  26. 26. • A regional collaboration of aging, domestic violence, law enforcement, and criminal justice organizations founded in 1998 to raise awareness and improve the community response to older women who experience domestic violence and sexual assault. • Serves the City of Richmond and Henrico, Hanover, and Chesterfield Counties- also provides technical assistance statewide. OUR MISSION Central Virginia Task Force on Domestic Violence in Later Life

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