If an elder is considered competent and makes bad decisions, must family bail them out? If family knows that elder cannot safely live alone, and elder refuses to get the care they need, can elder insist that family do what is necessary so elder can live alone? Can they blackmail family with possibility of neglect charge? Can family insist elder go into assisted living, nursing home, etc. and wash their hands of responsibility if elder refuses? (and tells family to rescue them or face being charged with neglect.) How could family that felt it necessary to go no or low contact protect themselves from being roped into elder's agenda? After all, most child abusers do not die in prison; should they be able to torment people just because they are parents?
Neglect may include the failure to provide sufficient supervision, nourishment, or medical care, or the failure to fulfill other needs for which the victim cannot provide themselves. The term is also applied when necessary care is withheld by those responsible for providing it from animals, plants, and even inanimate objects. Neglect can carry on in a child's life falling into many long-term side effects such as: physical injuries, low self-esteem, attention disorders, violent behavior, and can even cause death.
Neglect is one thing that the elderly are so vulnerable to.
Get so caught up in their roles they don't eat/sleep properly.
Our cared for need care, but so do we,
(These come from the Elder Assessment Instrument which was created for this purpose. Stephanie modified them to apply primarily to people with dementia)
This information may be helpful if you suspect abuse of your LO either by a family member or the staff at a long term care facility."
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Observe the general condition of your LO.
Is their clothing clean and are they dressed according to the environment?
Are your LO hygiene needs being met? (Bathing, dental care, incontinence care?)
Are their nutritional needs being met? Needs will change according to stage of the disease. The key is to observe for weight, hydration, redness or irritation on bony prominence as inadequate protein can add to the risk of decubitus ulcers. In the later stages of dementia when a person becomes bedridden and has problems swallowing, weight loss is expected but there should be an assessment of swallowing and adjustment of the diet to accommodate their needs (perhaps finger foods or puree foods and thickened liquids)
Skin integrity – Are there decubitus ulcers? Were they avoidable? (Ask a professional to assess this) Are there contractures of the arms and legs and fingers? (Unable to straighten out due to lack of range of motion exercises) Contractures are very preventable, when they occur they are painful to the person and are usually permanent.
Possible Abuse Indicators:
Bruising. Occasional bruises and skin tears will happen in the older adult, especially in the later stages of dementia. However bruises in unusual places (like the middle of the back or stomach, inner thigh, upper arms, etc.) and unexplained bruises that occur regularly, are red flags. These MAY be coming from rough handling or even hitting. HITTING, SLAPPING, PINCHING, KICKING, ROUGH HANDLING ETC. ARE ALL PHYSICAL ABUSE These need investigation by the staff and if the explanation is not satisfactory, call Adult Protective Services (APS) and let them assess it.
Lacerations and fractures can occur with falls. When this happens, or especially if there is no explanation (ie: no one saw it happen) an investigation should be done. If this happens more than once, or you are not satisfied with the explanation, call APS and let them assess it.
Competent vulnerable adults have a right to self-determination, including reusal of services. Vulnerable adults have a right to the least restrictive available alternative in living situatin and treatment.
Physical Abuse: Is the sustaining of any physical pain or injury by a vulnerable ault as a result of cruel or inhumane treatment or as a result of a malicious act by any person.
Exploitation: Is any action which involves the misuse of a vulnerable adult's funds, property or person. This would includ sexual exploitation.
Neglect: The willful derivation of adequate food, clothing, medica treatment, or rehabilitative therapy, shelter or supervision from a vulnerable adult.
Self Neglect: The inability of a vulnerable adult to provide for himself the services that are necessary for his phyical and mental health; and also the absence of which impairs or threatens his well being.
Keep in mind that a person has a right to personal dignity, quality of life, privacy and the "right to make choices."
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