What to Do if You Suspect Elder Abuse

We love to read heartwarming stories about devoted caregivers and thriving seniors. When we look at seniors who are well cared for, we think, “Of course – that’s the way it should be.”

Unfortunately, the good stories don’t tell the whole tale of senior care in the United States. According to the National Center on Elder Abuse (NCEA), 1 out of 10 seniors is a victim of abuse. What’s more, elder abuse is typically underreported. The National Elder Abuse Incidence Study estimates that only 1 in 14 cases of elder abuse ever comes to the attention of authorities.
Here, NCEA Deputy Director Julie Schoen offers tips on how to intervene in cases of suspected elder abuse.

What Is Elder Abuse?

“Elder abuse takes many forms,” says Schoen. The major categories of mistreatment include physical abuse, emotional abuse, sexual abuse, exploitation, neglect, and abandonment. Elder abuse can happen at the hands of a trusted friend or family member (domestic abuse), or it can be perpetrated by caregivers at a senior care facility (institutional abuse).

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Bullying: A problem in Healthcare?

Like schoolyard bullying, workplace bullying involves a real or perceived imbalance of power and repetition of negative behavior. The behavior can be overt, such as yelling or threatening, or it can be more insidious and passive, like refusing to cooperate or perform necessary tasks. The American Nurses Association (ANA) reports that between 18 and 31% of nurses have experienced bullying behavior at work (ANA, 2012).

Whatever forms it takes, bullying is a serious, complex and ongoing problem in the health care workplace, which can lead to demoralization and decreased job satisfaction, as well as feelings of isolation, anxiety, sadness and depression.

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4 Things That Increase Risk for Falls

Younger people can spring back from a fall. But for elders, taking a spill can lead to broken bones and trigger a domino effect of health problems and decline.

According to the National Conference of State Legislatures (NCSL), every 18 seconds, an older adult is treated in an emergency room for a fall, and more than 95 percent of hip fractures are caused by falls.

Since falls can be a major setback, elders—and caregivers—must stay mindful of the specific risk factors that can lead to a big spill.

Here are four key factors that contribute to falls when you're older, and what you can do to prevent them.

1. Household and environment hazards. "Throw rugs, jutting furniture, and grandkids' toys on floor can create household dangers for older people challenged by sight and balance," says Rebecca S. Boxer, geriatric heart failure specialist and assistant professor of medicine. "Outside the home, getting out of the car, stepping up and down from curbs, and slipping on ice are common reasons older people fall."

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Common Causes of Family Tensions and Disagreements

It shouldn't surprise anyone that sensitive family dynamics can be one of the most challenging aspects of care giving for an elder, given the tremendous financial, physical, and emotional demands involved.

This doesn't mean that family squabbles are inevitable. In fact, if managed well, the experience of caring for an older family member has the potential to bring relatives closer as you help this person through this final stage of life. Here's how to avoid conflicts with family members and work through them when they occur.

Typically, disagreements arise because of:

• Roles and rivalries dating back to childhood. Mature adults often find that they're back in the sandbox when their family gets together. This tendency can grow even more pronounced under the strain of caregiving.If your sister was the favored child, for example, you may find that -- no matter how successful and capable you are now -- in your parents' or relatives' home you become a jealous, powerless little girl again.
• Disagreements over an elder's condition and capabilities. It's common for family members to have very different ideas about what's wrong with a loved one and what should be done about it. You may be convinced that your family member is no longer capable of driving, while your brothers argue that he needs to maintain his independence.

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What Mental Health Practitioners Need to Know about the Elder Justice Act

Mental Health Practitioners should take note of two realities about elder abuse: a large majority of elder abuse is perpetrated by family members, and the average victim of elder abuse is an older women between 75 and 80 who is living alone, and as a result of isolation and loneliness can entrust the wrong individuals with responsibility for their finances or care. When that trust is violated, elder abuse occurs.

The landmark Elder Justice Act of 2010 (EJA, an amendment to the Affordable Care Act) provides America an opportunity to engage the federal government’s resources and resourcefulness in the fight against elder abuse, neglect and exploitation. The law’s premise is that only a coordinated and comprehensive federal commitment, working with existing state and local entities, will allow us to promote elder justice by reducing elder abuse.

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How To Keep Your Cool When Dealing With a Difficult Resident

You don't have to work in long term care for long before you encounter a difficult person. Sometimes it's a resident, other times a coworker, or even someone outside the facility like a resident's family member or doctor. Beyond the golden rule, what can you, as a health worker, do to improve these encounters? To simplify things, I'm going to address issues with residents here. A lot of these tips are universal and can help with any difficult person, but some are very specific to long term care residents.

First off, no matter how difficult it is, keep your temper in check. It's easy to get your hackles up when people are being belligerent - moreso when you know you're right and they're wrong - but nothing will
ruin the encounter faster than a lost temper. If you need to leave the room or turn away to regain your composure, do so. Taking a deep breath and letting it out slowly, or counting to ten in your head,
really does help.

Composed and ready to face the situation now? Great. It's important to remember that many residents are adjusting to many changes in their lives. It is very rarely about you, and almost always about something
else that's bothering the resident, so don't take outbursts personally. The loss of health and independence can be very hard to face. Fear, anger, sadness, and pain can pervade almost every aspect of a person's life when they first transition to assisted care. Keep in mind that any of these things might be behind a resident's rudeness or inappropriate behavior. Instead of scolding the resident, or getting your feathers ruffled, use your empathy skills to gently encourage a resident to share what is bothering him or her. A leading question like, "I hear a lot of tension in your voice. Is your pain worse today?"  can give the resident the chance to tell his or her side of the story. Let your residents know that you're on their side
and will do everything in your power to help address their issues.

Now, with a belligerent resident, this might be an invitation to carry on about problems and pains, whether real or imagined. Do your best to get to the heart of their issues and offer solutions. Is Mr. Smith's wheelchair pad worn and causing discomfort? Is Ms. Jones' robe aggravating her skin condition? It's often the simple fix that can diffuse the litany of complaints. If fear is the root of the problem,
demonstrating empathy and sharing your knowledge might be all it takes to set a resident's mind at ease. Perhaps a resident is balking at taking medication because he or she doesn't fully understand why it is
necessary. Telling the resident to "take it because the doctor said so" won't help the situation. Use your knowledge to explain, as best you can, what a medication does or doesn't do, and set the resident's mind at ease. A resident might also lash out due to loneliness. Do whatever you can to be a friend to your residents. Sometimes all they need is someone to listen. Talk to your facility's Activity Director or Social Services representative and arrange for the resident to attend a group activity or have a volunteer stop by and visit with the resident.

Another issue that faces residents as they transition to a nursing facility is the feeling of a loss of  responsibility. Many resent going from being parents and caretakers to being dependent on others. Refusing to take medicine, or not wanting to attend meals in the dining room can point to a deeper issue. Residents are going from being in control of their own schedules to being forced into a facility's schedule, and that can be tough. You can help by offering residents choices and allowing them to exercise independence and judgment on their own. Instead of offering water with pills, let the resident chose between water, milk and juice (according to the diet plan). Ask residents what time they like to eat meals, and if the time is different from your facility's dining hours, see if it would be possible to arrange for an
in-room meal at a time more fitting for the resident.

In all encounters, focus on the positive. If you need to get through an awkward or unpleasant activity (like a sponge bath) chat about a TV show coming on later that day, or about the facility-wide Bingo game
that evening. If a resident is fighting you as you try to change a wound dressing, remind them that the sooner you finish, the sooner the resident can go back to doing something he or she enjoys. Let them see that by sitting quietly and letting you do your work, they can move on to more pleasant things more quickly.

Finally, be on the lookout for residents who suffer in silence. Most people are taught to keep a stiff upper lip, or to remain stoic in the face of troubles, so it can be very hard for your residents to admit they are hurting and need help. Use your skill at reading body language to help see beyond the surface behavior to what might be going on under the surface. Stiff posture or fidgeting might indicate a person is in pain. Staring into space or frequent sighing can clue you in that your resident's mind is on something other than the here and now. It might be too embarrassing for residents to discuss medical problems with you at first, but if you demonstrate an air of trust and make your residents feel safe, you can help them to express what's really behind "bad" behavior.

Want to read more on this topic? Check out these articles.
http://nursinglink.monster.com/careers/articles/5771-difficult-patients-why-theyre-that-way-and-how-to-handle-them

http://ezinearticles.com/?Elder-Care-Solutions---Dealing-With-Difficult-Aging-Parents&id=3901872

Elder Abuse and Neglect

Every year, tens of thousands of elderly Americans are abused in their own homes, in relatives’ homes, and even in  facilities responsible for their care. You may suspect that an elderly person you know is being harmed physically or emotionally by a neglectful or overwhelmed caregiver or being preyed upon financially. By learning the signs and symptoms of elder abuse and how to act on behalf of an elderly person who is being abused, you’ll not only be helping someone else but strengthening your own defenses against elder abuse in the future.

It’s difficult to take care of a senior when he or she has many different needs, and it’s difficult to be elderly when age brings with it infirmities and dependence. Both the demands of caregiving and the needs of the elder can create situations in which abuse is more likely to occur.

Many nonprofessional caregivers, spouses, adult children, other relatives and friends find taking care of an elder to be satisfying and enriching. But the responsibilities and demands of elder care giving, which escalate as the elder's condition deteriorates, can also be extremely stressful. The stress of elder care can lead to mental and physical health problems that make caregivers burned out, impatient, and unable to keep from lashing out against elders in their care.

Among caregivers, significant risk factors for elder abuse are

• Inability to cope with stress (lack of resilience)
• Depression, which is common among caregivers
• Lack of support from other potential caregivers
• The caregiver's perception that taking care of the elder is burdensome and without psychological reward

Substance abuse

Even caregivers in institutional settings can experience stress at levels that lead to elder abuse. Nursing home staff may be prone to elder abuse if they lack training, have too many responsibilities, are unsuited to care giving, or work under poor conditions.

The elder's condition and history

Several factors concerning elders themselves, while they don't excuse abuse, influence whether they are at greater risk for abuse:

• The intensity of an elderly person's illness or dementia
• Social isolation; i.e., the elder and caregiver are alone together almost all the time
• The elder's role, at an earlier time, as an abusive parent or spouse
• A history of domestic violence in the home

The elder's own tendency toward verbal or physical aggression

In many cases, elder abuse, though real, is unintentional. Caregivers pushed beyond their capabilities or psychological resources may not mean to yell at, strike, or ignore the needs of the elders in their care. (The preceding is an excerpt from helpguide.org.  Click HERE for the full article.)

Below is  presentation with more information on Elder Abuse.