44-46: Dependent Adult and Child Abuse & Neglect

Question 1

reportable criteria (3)

Answer 1

• dependent adult
• caretaker
• allegation of abuse

Question 2

definition of dependent adult

Answer 2

• at least 18
• requires assistance from another
• unable to protect own interests or unable to perform or unable to obtain services

Question 3

definition of caretaker

Answer 3

• responsibility for the protection, care or custody of a dependent adult
• assuming the responsibility voluntarily, by contract, through employment, or by court order

Question 4

abuse =

Answer 4

• willful misconduct
• gross negligence
• reckless act
• omission

totality of circumstances ( innocent until guilty )

Question 5

are the following dependent adult abuse?

• failure to provide care if the caretaker lacks the means or access to the means for care
• refusal of medical treatment or care based on religious beliefs, stated or implied consent
• withholding, withdrawing or refusing medical tx based on terminal illness
• domestic abuse when victim is not a dependent adult
• persons incarcerated in penal setting

Answer 5

ALL are NOT

needs to be all three components of dependent adult abuse

*has to be dependent’s religion

Question 6

why isn’t abuse reported?

Answer 6

• family secrecy
• self blame
• isolation
• fear
• embarrassment

victims will put up with anything to prevent being institutionalized

Question 7

myths, attitudes & disabilities

Answer 7

• dehumanization
• damaged merchandise
• feeling no pain
• disabled menace
• helplessness

Question 8

who has disabilities?

Answer 8

18% Iowa Pop
58% Iowa homeless pop

70-100% report abuse
73% of persons with disabilities report being bullied

Question 9

5 types of offenders

Answer 9

1. well-intentioned, but overwhelmed caregiver
2. well-intentioned, but ignorant caregiver
3. unwilling, could care less caregiver
4. abusive personality
5. sadistic personality

Question 10

Iowa law for community vs. facilities

Answer 10

DHS- community

DIA - facilities

these are civil laws

sexual abuse - falls under criminal

Question 11

in the event witnessed or suspected abuse by a staff member or provider has occurred, the following actions MUST be taken

Answer 11

• immediately report the incident to supervisory personnel
• immediately separate the staff member/provider from pt
• complete an incident report
• staff/provider will be placed on administrative leave with no pt contact during the investigatory process
• pt will be reassigned
• supervisory personnel will notify risk management and administration
• all legally required reporting requirements, such as DHS/DIA, licensing boards, and law enforcement a applicable will be met
• an evaluation of the situation will include witness interviews and review of video recording if available
• evaluation completed w/i 3 d following reported allegation

Question 12

things that qualify as physical abuse

Answer 12

• unreasonable confinement
• unreasonable punishment
• assault
• willful or negligent acts
• omissions
• breach of skill on part of caretaker

Question 13

dating of bruises

swollen tender
red-blue
green
yellow
brown
clear

Answer 13

0-2 d
0-5 d
6-7 d
7-10 d
10-14 d
2-4 wk

a rainbow = multiple events, abuse

Question 14

how is sexual abuse different with age or frailty?

Answer 14

• lack of strong support system
• beliefs about sexual abuse increase feelings of shame and guilt
• may complicate an existing illness
• longer recovery time dealing with abuse
• increased chance of sustaining serious injury
• increased genital tearing and bruising
• increased risk of infections
• pelvis or hip bones can be broken by friction and weight

Question 15

financial exploitation

Answer 15

caretaker knowingly

• takes unfair advantage of resources
• obtains, uses, endeavors to obtain to use
• misappropriates for personal profit
• without informed consent

Question 16

deprivation of minimum food, shelter, clothing, supervision, physical or mental health care, or other care =

Answer 16

denial of critical care

can also be self-neglect or denial of critical care

willful or negligent acts or omissions of a caretaker = neglect by caretaker

Question 17

mandatory reporters =

Answer 17

• in the course of employment examines, attends, counsels, or treats a dependent adult
• staff
• reasonably believes a dependent adult has suffered dependent adult abuse

Question 18

permissive reporters

Answer 18

• any person who believes a dependent adult has suffered dependent adult abuse
• a mandatory reporter who is off duty

Question 19

reports
who =
when =

Answer 19

person suspecting abuse

immediately
notify the person in charge or designated agent
law enforcement
verbal w/i 24 hrs
written w/i 48 hrs

Question 20

what happens if report is founded?

Answer 20

• abuse is determined by a preponderance of evidence

- maintained on the central abuse registry for ten yrs

Question 21

what happens if report is confirmed, not registered?

Answer 21

• minor, isolated, and unliekly to reoccur
• not on central abuse registry
• kept 5 yrs in local office
• subsequent reports kept for 10 yrs, then sealed

Question 22

what happens if report is unfounded?

Answer 22

• determined by preponderance of evidence that abuse has not occurred
• unfounded reports are destroyed after 5 yrs

Question 23

you are a mandatory reporter, the abuse occurs while on job and you knowingly and willingly fail to report =

Answer 23

crime (simple misdemeanor)

could also be held legally responsible for the damages done (wrongful death - felony)

Question 24

3 Cs of child abuse

Answer 24

• child (anyone under 18 - not married)
• caretaker (anyone responsible for care of child)
• circumstance (abusive incident suspected)

exception to the 3 Cs - sexual abuse, with the victim under 12 must be reported to DHS even if there is no caretaker involved

Question 25

all sex crimes are reported to…

Answer 25

law enforcement

Question 26

legal age of consent in Iowa for sexual contact is..

Answer 26

16

if other person is in authority its 18

felony under 13

14 and 15 can consent is other person is less than 4 yrs older; 16 and 17 having sex with child 5 yrs younger are referred to juvenille court

Question 27

evidence indicates between ___ of female and ___ of males with history of sexual abuse

Answer 27

15-30%

3-15%

Question 28

observable substantial impairment in the ability to function w/i normal range of performance and behvaior based on age

Answer 28

mental injury

can be caused by: ignoring the child and failing to provide stimulation, responsiveness, and validation of worth
; rejecting the child’s values and needs; isolating the child and denying normal human contact