45 - Dependent Adult and Child Abuse and Neglect II

Question 1

Describe the stories we see in physical abuse or injury

Answer 1

• at variance with the history given
• unreasonable confinement (by physical or pharmacological means)
• unreasonable punishment
• assault—painful, injurious, insulting, offensive, or an act intended to cause fear
• willful or negligent acts
• omissions
• breach of skill, care, and learning on the part of a caretaker (YOU can be charged with this if you don’t report)

Question 2

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

Answer 2

• Immediately report the incident to supervisory personnel
• Immediately separate the staff member/provider from the patient
• Complete an incident report
• The staff member/provider will be placed on administrative leave with no patient contact during the investigatory process
• The patient 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 as applicable, will be met
• An evaluation of the situation will include witness interviews and review of video recordings if available
• The evaluation will be completed within 3 business days following the reported allegation

Question 3

How do you date bruises?

This isn’t very scientific, but it is general

Answer 3

If you see a “rainbow,” it has probably been done on numerous occasions - ongoing abuse

0 -2 Days = Swollen, tender

0 – 5 Days = Red-blue

6 – 7 Days= Green

7 – 10 Days = Yellow

10 – 14 Days= Brown

2 – 4 Weeks= Clear

Question 4

What is different about sexual abuse?

Answer 4

CRIMINAL LAW ****

• under chapter 709 or section 726.2
• with or against a dependent adult
• willful or negligent acts or omissions of a caretaker

Question 5

What is sexual exploitation

Answer 5

Can NOT have sex with someone who you are paid to take care of

• consensual or nonconsensual sexual conduct
• purpose of arousing or satisfying the sexual desires of the caretaker or dependent adult
• transmission, display, or taking electronic images

Question 6

Describe sexual education

Answer 6

99% of persons with developmental disabilities have had no sex education

They don’t know what it is called, especially if they are developmentally delayed or not educated at all

Question 7

How is Sexual Abuse Different With Age or Frailty?

Answer 7

• lack of a 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 8

Describe financial exploitation

Answer 8

Caretaker knowingly

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

Question 9

What are resources that are financially exploited?

Answer 9

• funds
• assets
• medications
• property

Question 10

Describe denial or critical care or neglect by the caretaker

Answer 10

• deprivation of the minimum food, shelter, clothing, supervision, physical or mental health care, or other care
• willful or negligent acts or omissions of a caretaker

Question 11

Describe denial or critical care or neglect of SELF (community based)

Answer 11

• deprivation of the minimum food, shelter, clothing, supervision, physical or mental health care, or other care
• acts or omissions of the dependent adult

Ruled “incompetent” - a legal decision when they need help

It should be sent through a judge to make this decision

Question 12

What are the types of mandatory abuse reporters?

Answer 12

• 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 13

What are the types of permissive reporters of abuse?

Answer 13

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

If your heart hurts, make the report

Question 14

What should you have in your office?

Answer 14

Report forms

Question 15

Describe the specifics of reports

Answer 15

WHO
- the person suspecting the abuse

WHEN

• immediately (24 hours)
• notify the person in charge or designated agent
• law enforcement
• verbal within 24 hours
• written within 48 hours

Whoever becomes aware of it (staff, physician) - the FIRST person

Question 16

What are the potential report conclusions?

Answer 16

• Founded
• Confirmed, not registered
• Unfounded

Question 17

Describe a founded report

Answer 17

• abuse is determined by a preponderance of evidence

- maintained on the Central Abuse Registry for ten years

Question 18

Describe a confirmed, not registered report

Answer 18

• minor, isolated, and unlikely to reoccur
• not on Central Abuse Registry
• kept 5 years in local office
• subsequent reports kept for 10 years, then sealed

Question 19

Describe an unfounded report

Answer 19

• determined by a preponderance of evidence that abuse has not occurred
• unfounded reports are destroyed after five years

Question 20

Describe the charges you could be held responsible for if you do NOT report

Answer 20

• It’s a CRIME
• if you are a mandatory reporter
• the abuse has occurred while you were on the job
• and you knowingly and willingly failed to report it

You can be liable for what happens after you have failed to make a report - even death