44 - Dependent Adult and Child Abuse and Neglect I Flashcards
What is common in abused teenagers?
- Blank face
- Not sharing a lot of information
- They may or may not ever share this information
- The parents and teens stories will be different
- Most of the bruising will be on torso (hips, abdomen)
What is common in abused elders?
- Bruised on the head or face
- Rope burns from being tied to wheel chair
- Same blank face
- A lot of dispair, depression, isolation
- If you can isolate someone, you can do whatever you want to them
- Infections let go on and prevent medical care, can lead to blindness, amputation, etc.
Describe some of the living conditions that your patients may be living in
- Hoarding
- ## Animals in house (urine, feces)
What are the two laws on dependent adults in Iowa?
DHS Chapter 235B for dependent adults in the COMMUNITY.
DIA Chapter 235E for dependent adults who live in FACILITIES.
Check what the laws are in your state.
What does the DIA do?
Licensing for facilities and hospitals
What law covers your clinic?
The DHS (not for facilities, for the community)
What are dependent adults?
Age 18 to death, must be dependent
What is an elder?
Age 60+ may or may not be dependent
What type of laws are these? Civil or criminal?
Civil
This meas they are not enforced by criminal measures initially
What is the difference between reported and founded abuse reports?
Big gap
A lot of reports “fall through the cracks”
Not many are actually sentenced, so we are not protected from the abuser
What is an additional problem in reporting?
A lot of abused adults will refuse to report
What are the reportable criteria?
- Dependent adult
- Caretaker
- Allegation of abuse
It is your OBLIGATION to report
Define a dependent adult
MUST meet these two…
- eighteen years of age
- requires assistance from another
And one of the following…
- unable to protect own interests or
- unable to perform or
- unable to obtain services
Services are limited… The nearest service might be 3 hours away (common to have a problem with this in Iowa)
Define a caretaker
- responsibility for the protection, care, or custody of a dependent adult
- assuming the responsibility voluntarily, by contract, through employment, or by court order
There is a large number of people who abuse elders, but do not meet these standards (minister, land lord, neighbor, etc.) - They fall through the cracks
Define dependent adult abuse
Abuse as a result of:
- willful misconduct
- gross negligence
- reckless act
- omission
Totality of circumstances (guilty or proven otherwise)
What does this mean? If you’re an abused wife by your husband then you leave your kids alone with him and he abuses them, you are guilty by omission
What ISN’T 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 treatment based on terminal illness
- Domestic abuse when the victim is not a dependent adult
- Persons incarcerated in a penal setting
If you are using religion, it HAS to be the religion of the dependent adult, NOT the religion of the caretaker
Verbal consent or implied consent = the patient said one time, I don’t want life support
Look into relationships with family members, the daughter might be lying to benefit from the mother dying
If there is domestic abuse, and the victim is not a dependent adult or the abuser is not the care taker, it doesn’t meet the requirements for dependent adult abuse
Why does abuse occur?
- Retaliation
- For fun
- Violence is a way of life
- Unresolved conflict
- Lack of close family ties
- Lack of financial resources
- Greed
- Resentment of dependency
- Increased life expectancy
- Mental or emotional problems
- Alcohol and drug abuse
- Unemployment
A lot of time there is financial gain involved in abuse
Drug addiction is present regardless of age
Why isn’t abuse reported?
- Family secrecy
- Self blame
- Isolation
- Fear
- Embarrassment
84% of the time it is NOT reported
I beat you when you were a kid and no one reported me, so now you’re abusing me and I’m not going to report you
Older women will not report sexual abuse because they are embarrassed to talk about it
What is a motive to NOT report abuse?
Victims will put up with anything to prevent being institutionalized.
How can the “trauma reactive syndrome” affect neonates
If mom is being abused, endorphins flare and the “fight or flight” affects infant before abuse
It comes full circle in families
- Prenatal abuse
- Child abuse
- Sibling abuse
- Courtship violence
- Spousal abuse
- Elder abuse
How do myths, attitudes and disabilities play a role in abuse?
- “Dehumanization”
- “Damaged Merchandise”
- “Feeling No Pain”
- “Disabled Menace”
- “Helplessness”
How many people in the US have a disability
- 54 million persons with disabilities
- 18% of Iowa’s population
- 58% of Iowa’s homeless population
70-100% report abuse (on a private survey)
- Verbal
- Emotional
- Sexual
- Neglect
- Financial
Describe of bullying of dependent adults
73% of persons with disabilities report being bullied
- School, sports team, workplace, neighborhood/home, internet/cyberspace
What are the trends of abuse?
- Perpetrators groom the victims
Indicators of grooming:
- Special interest
- Gifts
- Touch, massage
- Setting up time to be alone (Bathing late evening, Transportation)
