Department of Health and Human Services
Administration on Aging
Elder Rights & Resources
Elder Abuse
Information:
The International Network for the Prevention of Elder Abuse (INPEA) has produced the Community Guide to Raise World Awareness on Adult Abuse Tool Kit. The Toolkit provides sample ideas and templates for activities and examples of materials, resources, proclamations, and messages. The Toolkit is available for free download at http://www.inpea.net/.
For More Ideas or Information:
* International Network for the Prevention of Elder Abuse (http://www.inpea.net/) for more information on World Elder Abuse Awareness Day
* National Center on Elder Abuse (http://elderabusecenter.org) for data, fact sheets, and other information on elder abuse, neglect, and exploitation in the U.S.
* The National Clearinghouse on Abuse in Later Life (http://www.ncall.us/) for information on coordinating elder abuse prevention efforts with domestic violence and sexual assault programs
* Eldercare Locator (www.eldercare.gov) to contact your local area agency on agency about volunteering to call or visit an isolated senior
World Elder Abuse Awareness Day is an excellent opportunity to share information about abuse, neglect, and exploitation in later life. However, raising awareness of mistreatment of older persons is an ongoing effort, not limited to one day. AoA has a long-standing commitment to addressing elder mistreatment, and to protecting the dignity, rights, and financial security of older people. To that end, we are working to carry out the following objectives:
* Increase the awareness of elder abuse, neglect, and exploitation to guide programs that protect older people;
* Increase the ability of professionals, especially those of the aging network and community-based agencies who have access to frail seniors on a daily basis, to prevent elder abuse by encouraging the development and dissemination of timely and accurate information on best practices; and
* Foster the development of programs, models, and initiatives that measurably decrease the incidence of elder abuse, neglect, and exploitation.
Elder Abuse Is a Serious Problem
Each year hundreds of thousands of older persons are abused, neglected, and exploited by family members and others. Many victims are people who are older, frail, and vulnerable and cannot help themselves and depend on others to meet their most basic needs.
Legislatures in all 50 states have passed some form of elder abuse prevention laws. Laws and definitions of terms vary considerably from one state to another, but all states have set up reporting systems. Generally, adult protective services (APS) agencies receive and investigate reports of suspected elder abuse.
The 2004 Survey of State Adult Protective Services, funded by AoA, found the following:
* A 19.7 percent increase from 2000 – 2004 in the combined total of reports of elder and vulnerable adult abuse and neglect;
* A 15.6 percent increase from 2000 – 2004 in substantiated cases;
* In 20 of the states, more than two in five victims (42.8%) were age 80 or older;
* Most alleged perpetrators in 2003 were adult children (32.6%) or other family members (21.5%), and spouses/intimate partners accounted for 11.3% of the total (11 states responding).
Generally Accepted Definitions
Elder abuse is an umbrella term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult.
* Physical abuse is inflicting, or threatening to inflict, physical pain or injury on a vulnerable elder, or depriving them of a basic need.
* Sexual abuse is the infliction of non-consensual sexual contact of any kind.
* Emotional or psychological abuse is the infliction of mental or emotional anguish or distress on an elder person through verbal or nonverbal acts.
* Financial or material exploitation is the illegal taking, misuse, or concealment of funds, property, or assets of a vulnerable elder.
* Neglect is the refusal or failure by those responsible to provide food, shelter, health care, or protection for a vulnerable elder.
* Self-neglect is characterized as the behavior of an elderly person that threatens his/her own health or safety.
* Abandonment - The desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.
Reporting Elder Abuse
To report elder abuse, contact APS through your state’s hotline. The APS agency screens calls for potential seriousness, and it keeps the information it receives confidential. If the agency decides the situation possibly violates state elder abuse laws, it assigns a caseworker to conduct an investigation (in cases of an emergency, usually within 24 hours). If the victim needs crisis intervention, services are available. If elder abuse is not substantiated, most APS agencies will work as necessary with other community agencies to obtain any social and health services that the older person needs.
The older person has the right to refuse services offered by APS. The APS agency provides service only if the senior agrees or has been declared incapacitated by the court and a guardian has been appointed. The APS agency only takes such action as a last resort.
State Elder Abuse Hotlines (Off Site) http://www.elderabusecenter.org/default.cfm?p=statehotlines.cfm
If you suspect nursing home abuse, call your Long Term Care Ombudsman: http://www.ltcombudsman.org/static_pages/ombudsmen.cfm
National Citizen’s Coalition for Nursing Home Reform: State Directory (Off Site) http://www.nccnhr.org/static_pages/ombudsmen.cfm
The Role of the Administration on Aging
AoA has a strong commitment to protecting seniors from elder abuse. Our community-based long-term care programs allow millions of seniors to age in place with dignity. Older Americans Act programs such as congregate and home delivered meals reduce risk factors for elder abuse and exploitation such as isolation and depression. AoA also supports a range of activities at the state and local level to raise awareness about elder abuse. Our emphasis is on developing public-private partnerships that build the capacity of our providers and other professionals to prevent, identify, and respond to elder fraud, abuse, neglect, and exploitation.
AoA administers formula grants for state activities designed to protect seniors from abuse, neglect, and exploitation. These include efforts to train law enforcement personnel; develop and distribute educational materials to our providers and “gatekeepers,” such as mail carriers and bank tellers; conduct public awareness campaigns; and create community coalitions and multi-disciplinary teams. Our funding helps to support many elder abuse and exploitation prevention multi-disciplinary teams. The characteristics of these teams vary, but most meet regularly to discuss specific cases, provide cross-training and community education, and identify and fill gaps in the service system. They often include a wide range of public and private professionals, including law enforcement personnel, medical professionals, APS workers, social service providers, and representatives from banks.
For example, AoA helps to support:
* Orange County, California’s Fiduciary Abuse Specialist Team: In the 2005 state fiscal year, this team of 50 multi-disciplinary public and private professionals met monthly to discuss exploitation cases and the program coordinator provided 63 community and professional education sessions to over 2,000 people.
* Sonoma County, CA Elder Abuse Prevention Council, created a Court Advocacy Workgroup made up of senior volunteers. The workgroup follows cases of elder abuse and exploitation to help raise their visibility within the judicial system. When the workgroup began in 2000, they were following about 5 cases a year. They are now following nearly 30 each year, 80% of which are financial exploitation cases.
* The Florida Department of Elder Affairs’ Senior Companion Program trains volunteers and local Adult Protective Services staff in abuse, neglect, and exploitation to work with self-neglecting elders to improve their outcomes.
* The Area Agency on Aging of Cape Fear, North Carolina Council of Governments provides annual training that addresses a variety of topics impacting the quality care for older adults to nursing assistants, volunteers, and staff from assisted living facilities, nursing homes, Home Health Services, Department of Aging, Adult Day Care, Department of Social Services, law enforcement, and mental health agencies. The training methods portray elder mistreatment, reporting, and intervention that includes a short play and audience reaction. The Cape Fear Council of Governments also hosts two-day training sessions with agencies that provide services to seniors in New Hanover County with the goal of implementing local planning processes for building an effective elder rights system that examines issues impacting seniors and addresses service gaps.
* The Ohio Department of Aging began a Public Awareness Campaign where the State Unit on Aging Director taped TV and radio segments, 30-60 seconds in length, about the State Long Term Care Ombudsman and the Long Term Care Consumer guide. Since implementation, calls and website visits have increased.
* The Washington, D.C. Office on Aging supports an Adult Abuse Prevention Committee, which develops work plans each year including initiatives such as consumer fraud prevention conferences, roundtables with different agencies and organizations to collaborate efforts, and training for bank security personnel to identify financial exploitation.
AoA and the HHS Office of Women’s Health developed the curriculum Building a Coalition to Address Domestic Abuse in Later Life to include information on working with traditionally under-served populations, including Native and African Americans, Hispanics, and Asian and Pacific Islanders. Domestic violence shelters and programs primarily serve younger women, and adult protective services programs may not offer traditional domestic violence services to senior victims, such as support groups. The curriculum provides a model for how these professionals can work together. A number of communities have received training based on this curriculum and launched their own coalition, such as the Pikes Peak Region Coalition to Address Abuse in Later Life in Colorado Springs, CO.
AoA also funds the National Center on Elder Abuse (NCEA) to serve as a resource for the public and for professionals. NCEA provides elder abuse information to the public and to professionals; offers technical assistance and training to elder abuse agencies and related professionals; conducts short-term elder abuse research; and assists with elder abuse program and policy development. It manages an elder abuse list serve for professionals in the field, and it produces a monthly newsletter.
NCEA has undertaken a number of efforts to promote the development and effectiveness of multi-disciplinary teams and other collaborative efforts. They have completed a national survey of multi-disciplinary teams and developed a manual for those wishing to start or revitalize their own team. Through NCEA, AoA recently funded six new community initiatives designed to develop and test interventions to reach underserved and isolated elders who are victims of, or at-risk of, elder abuse. NCEA is also supporting the development of elder abuse fatality review teams. These multidisciplinary, multi-agency teams examine deaths resulting from elder abuse to prevent similar deaths in the future.NCEA's website contains many resources, including a list of the state elder abuse hotlines and information on publications, community coalitions, and upcoming conferences. You can contact NCEA in a number of ways:
* National Center on Elder Abuse (NCEA) (Off Site)
Six partner organizations that make up NCEA:
o National Association of State Units on Aging (Off Site)
o ABA Commission on Law and Aging (Off Site)
o The Clearinghouse on Abuse and Neglect of the Elderly (Off Site)
o The National Committee for the Prevention of Elder Abuse (Off Site)
o National Association of Adult Protective Services Administrators (Off Site)
(Additional information and resources can be found on the following articles here on Love Me -- Or ELSE, relative to ELDERLY ABUSE)
Disclaimer: References from this web page or from any of the information services sponsored by AoA to any non-governmental entity, product, service or information does not constitute an endorsement or recommendation by the Administration on Aging or any of its employees. AoA is not responsible for the contents of any "off-site" web pages referenced from this server. Although our page includes links to sites including or referencing good collections of information, AoA does not endorse ANY specific products or services provided by public or private organizations. By using this site, the user takes full responsibility for any use of these links.
The State Health Insurance Assistance Program, or SHIP, is a national program that offers one-on-one counseling and assistance to people with Medicare and their families. Through grants to states, SHIPs provide free counseling and assistance via telephone and face-to-face interactive sessions, public education presentations and programs, and media activities.
Trained counselors offer information, counseling and assistance to Medicare beneficiaries on a wide range of Medicare and Medicaid, and Medigap matters, including, Medicare+Choice health plan options, long-term care insurance, claims and billing problem resolution, information and referral on public benefit programs for those with limited income and assets, and other health insurance benefit information.
To locate a SHIP program in your area click here (hyperlink to http://www.medicare.gov/contacts/static/allStateContacts.asp} and you will be taken to the SHIP listing on Medicare.gov.
In addition, you can be referred to your SHIP by contacting 1-800-Medicare and asking for health insurance counseling.
Long-term care ombudsmen are advocates for residents of nursing homes, board and care homes, assisted living facilities and similar adult care facilities. Since the program began 30 years ago, thousands of paid and volunteer ombudsmen working in every state and three other jurisdictions have made a dramatic difference in the lives of long-term care residents. LTC Ombudsmen advocate on behalf of individuals and groups of residents, provide information to residents and their families about the long-term care system, and work to effect systems changes on a local, state and national level. They provide an on-going presence in long-term care facilities, monitoring care and conditions and providing a voice for those who are unable to speak for themselves.
Begun in 1972 as a demonstration program, the Ombudsman Program today is established in all states under the Older Americans Act, which is administered by the Administration on Aging (AoA). Local ombudsmen work on behalf of residents in hundreds of communities throughout the country.
One thousand paid and 14,000 volunteer staff (8,000 certified) investigate over 260,000 complaints each year. They provide information to more than 280,000 people on a myriad of topics including how to select and pay for a long-term care facility.
Ombudsman Responsibilities
Ombudsman responsibilities outlined in the Older Americans Act include:
* identify, investigate and resolve complaints made by or on behalf of residents;
* provide information to residents about long-term care services;
* represent the interests of residents before governmental agencies and seek administrative, legal and other remedies to protect residents;
* analyze, comment on and recommend changes in laws and regulations pertaining to the health, safety, welfare and rights of residents;
* educate and inform consumers and the general public regarding issues and concerns related to long-term care and facilitate public comment on laws, regulations, policies and actions;
* promote the development of citizen organizations to participate in the program;
* provide technical support for the development of resident and family councils to protect the well-being and rights of residents; and
* advocate for changes to improve residents’ quality of life and care.
Resident’s Rights
Ombudsmen help residents and their families and friends understand and exercise rights that are guaranteed by law, both at the federal level and in many states. Residents have the right to:
· be treated with respect and dignity;
* be free from chemical and physical restraints;
* manage their own finances;
* voice grievances without fear of retaliation;
* associate and communicate privately with any person of their choice;
* send and receive personal mail;
* have personal and medical records kept confidential;
* apply for state and federal assistance without discrimination;
* be fully informed prior to admission of their rights, services available and all charges; and
* be given advance notice of transfer or discharge.
For more information on the LTC Ombudsman program, please go to AoA's Professionals section of the web site.
Other Resources:
* Directory of State Long Term Care Ombudsman - Will help you locate the ombudsman nearest you.(Off Site)
* National Long Term Care Ombudsman Resource Center - Provides training and assistance to ombudsman (Off Site)
* For information about choosing a nursing home, you can call the Center for Medicare and Medicaid Services toll free number 1-800-633-4227 or view information on the web at: http://www.medicare.gov.
Legal Assistance
Protecting the rights of older people and preventing their exploitation, abuse, and neglect continue to be our most important goals and that of the national aging network. Predatory lending, home repair scams, and other types of financial exploitation can have tragic consequences for seniors. AoA provides critical consumer information, training, and technical assistance and funding for programs that protect the rights of vulnerable, at-risk older persons.
Legal Assistance Sub Navigation:
* Legal Hotline
* Legal Services
Disclaimer: References from this web page or from any of the information services sponsored by AoA to any non-governmental entity, product, service or information does not constitute an endorsement or recommendation by the Administration on Aging or any of its employees. AoA is not responsible for the contents of any "off-site" web pages referenced from this server. Although our page includes links to sites including or referencing good collections of information, AoA does not endorse ANY specific products or services provided by public or private organizations. By using this site, the user takes full responsibility for any use of these links.
(This concludes the series on Elderly Abuse in the USA. I have found Canadian circumstances and laws by googling elderly abuse in Canada, if that fits your needs.)
Department of Health and Human Services
Administration on Aging
Elder Rights
Preventing Fraud & Abuse
The Administration on Aging (AoA) is dedicated to promoting consumer awareness, preventing elder victimization, and working to implement community partnerships to prevent Medicare and Medicaid fraud, error, and abuse. By informing and training senior volunteers, aging network personnel, and health care providers, AoA wants to make older Americans and their advocates better health care consumers.
Our efforts to keep seniors living in their own homes and participating fully in community life are undermined by financial exploitation and consumer fraud. We can encourage seniors to plan for their disability and make lifestyle changes that will delay or prevent it, but these efforts will not be fully realized for those seniors who lose their savings or their homes due to scams or financial exploitation. Fraud and financial exploitation are major threats to the well-being and independence of seniors. According to the National Elder Abuse Incidence Study, Adult Protective Services (APS) agencies substantiate more cases of financial abuse than physical abuse each year.
The mission of AoA's Anti Fraud and Abuse Team is to serve as the agency's focal point for coordinating, implementing, monitoring, expanding, evaluating, and promoting efforts to provide consumer information and protection designed to detect, prevent, and report error, fraud and abuse in the Medicare and Medicaid programs.
BITS Financial Services Roundtable Fraud Prevention Toolkit:
Financial institutions are often the first to recognize abuse, fraud, and exploitation against elderly and vulnerable adults, which is often perpetrated by a relative or trusted caregiver. The immediate, and often regular contact, financial institutions have with their older customers puts financial institutions in a unique position to report suspected fraud to APS for further investigation.
Recognizing this, the Philadelphia Corporation for Aging APS office used AoA funding to hire and train a financial exploitation investigator with experience in fraud and financial crimes. The APS office then developed a partnership with Wachovia Bank for cross-training of bank personnel and increased sharing of records to stop financial exploitation of seniors. This partnership had remarkable results and was later shared as a successful practice with the fraud reduction committee of a national bank consortium, known as the BITS Financial Services Roundtable. The bankers responded with enthusiasm and committed to expanding upon this model for national dissemination within the banking community.
Over 100 financial institutions are represented on the BITS Roundtable, including Wachovia, Bank of America, Citigroup, and JP Morgan Chase. U nder the auspices of the BITS Fraud Reduction Steering Committee, and with technical assistance from AoA and other members of the aging network, such as the National APS Association, and AARP, the BITS Vulnerable Adult Project Team developed and distributed the BITS Fraud Prevention Toolkit: Protecting the Elderly and Vulnerable from Financial Fraud and Exploitation, designed to address special needs for which financial institutions are uniquely suited to assist. The Toolkit provides information to support the implementation or improvement of a financial institution’s internal program for education and awareness about abuse, fraud, and exploitation against the elderly and vulnerable adults.
The Toolkit and PowerPoint slides for training are available for free download.
Stetson University School of Law Senior Fraud Project
AoA also funded the development of the Stetson University Consumer Protection Education Project, a statewide effort to educate elder consumers, their families, and professionals about consumer fraud. As part of this project, Stetson produced 15 consumer scam videos targeted to seniors. These are designed to show how a scam works, how easy it is to become a victim, and include information on what to do to protect yourself or if you are a victim. Stetson also created four Public Service Announcements (PSA) and two additional public information videos on consumer protection and telemarketing, featuring General Norman Schwarzkopf; Marie Smith, AARP President; Senator Max Cleland; and H. Douglas Lee, president of Stetson University.
With these tools, they have conducted over 300 education sessions on consumer fraud at such places as senior centers and churches to more than 9,000 Florida seniors. They have also trained professionals by providing over 61 regional law enforcement trainings, 18 legal aid and private attorney continuing law education credits, and distributing their replication manual to 31 law schools.
For more information and to view the videos, visit:
http://elder.law.stetson.edu/index.php
Senior Medicare Patrols
Since 1997, the U.S. Administration on Aging (AoA) has worked in partnership with the Department of Health and Human Services’ Office of Inspector General, the Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration), the Department of Justice, community-based grantees, retired professionals, service and health care providers, AARP, and other interested individuals and organizations to address this serious national problem.
In the initial phase of this initiative, known as ORT, $23 was returned in improper payments, fines and settlements for every dollar spent on the effort.
Today, AoA provides grants to community-based agencies in nearly every state to train volunteers how to educate Medicare and Medicaid beneficiaries and their families how to protect their Medicare number as they would their credit card, how to take a more active role in protecting their health care programs, and how to detect and report potential instances of error, fraud, and abuse.
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While doing some googling to finalize this treatise on therapists and counselors that we seek for aid in cases of various types of abuse by control freaks, arsonists, serial criminalists and a host of other illnesses catalogued on "Love Me - Or ELSE!", I ran across this fine article done by SEATTLE TIMES. It deals in depth with one of the biggest problems (as their investigations into the matter reveal) facing their state--licensed professionals that use their license to harm their clients. It deals with everything from financial to sexual abuse of those that are entrusted to their care. Don't forget to click on the chart where the numbers of offenders are listed by their profession. It is an eye opener, believe me!
By clicking on the link above, you can delve deeper into the problem as a whole, and also into the individual cases listed below.
The case of Dr. Huong Luu, family practice doctor
JOHN LOK / THE SEATTLE TIMES
Dr. Huong Luu, of Vancouver, Wash., was allowed to keep his license despite secretly taking pictures of dozens of female patients' genitalia.
Weak regulation fosters more abuse
The state allows hundreds of doctors, counselors, others to keep practicing despite their sexual misconduct.
* Probe prompts changes by state
* How sexual misconduct complaints move through the system
* Who does the most harm
* The state's role in the flawed system
* The case of Keith Fair, Chehalis chiropractor
The case of Dr. Richard Toby Sutcliffe, eye surgeon
Doctor convicted, loses license
One of this Seattle surgeon's 10 victims describes her inner battle about coming forward and filing a complaint.
The case of Dr. Eugene Kester, psychiatrist
An abuser's road to remorse
This psychiatrist, who admitted having sex with at least six female patients, expresses regret for the harm he caused.
The case of Anthony W. Grant, registered counselor
JOHN LOK / THE SEATTLE TIMES
Anthony W. Grant pleaded guilty last year to a charge that grew out of his actions while a counselor at Washington's only state-run psychiatric hospital for children.
State's troublesome catchall category
The state licenses 17,000 "registered counselors." The category accounts for the largest number of sex offenders in health care.
* No. 1 offender
* What it takes to be a counselor
* Excerpt from complaint about counselor Thomas E. "Gene" McDonald Jr. by Codie Deyo's sister [PDF]
PREDATORS IN THE SYSTEM
The case of Raymond Hughes, registered nurse
Registered nurse Raymond C. Hughes, left, was sentenced to eight years in prison for sexually assaulting Sara Hendershott, above, at her Spokane home.
Anemic oversight lets predators prey on weak
Paralyzed girl, woman with dementia among the victims of health-care providers by the state.
* Prison letter from Raymond Hughes [PDF]
* Series prompts state to make major reforms
State oversight easy for felons to foil
State regulators search only for in-state convictions when screening applicants for health-care licenses.
* A timeline of a man on the run — and regulators left behind
Mike Fancher
Series reveals a regulatory system in disarray
Washington state health-care regulators surprised us when confronted with the findings in today's Seattle Times special report. They thanked us.
Not every licensed practioner is, of course, a predator--no more than all policemen, lawyers, firemen, etc. But some of every walk in life ARE, and sometimes just having a LICENSE hanging on a wall, dulls our usual self-protective thought processes just enough to make us a victim. After all, bullies and control freaks and every other type of personality disorder can be found everywhere. That is why I thought it a good idea to address this problem, before going on with more instances of "Love Me - or ELSE!"
Again, these are just snips from the article which you can view in full at SEATTLE TIMES.
