Elder Abuse and How To Report It, Prevent It

Florida Law requires that any person who knows, or has reasonable cause to suspect, that a vulnerable adult has been or is being abused, neglected, or exploited shall immediately report such knowledge or suspicion to the Florida Abuse Hotline on the toll-free telephone number, 1-800-96-ABUSE (1-800-962-2873). The TDD (Telephone Device for the Deaf) number for reporting adult abuse is 1-800-955-8770. Vulnerable adults are persons eighteen and over (including senior adults sixty and over) who, because of their age or disability, may be unable to adequately provide for their own care or protection. The Florida Abuse Hotline accepts calls 24 hours per day, seven days a week. The Abuse Hotline counselor is required to let the person calling know whether the information provided has been accepted as a report for investigation.

Abuse may be physical, mental, emotional, or sexual. Neglect can be self-neglect or neglect by a caregiver. A caregiver may be a family member, an in-home paid worker, a staff person of a program such as an adult day care center or of a facility such as a nursing home, or another person. Exploitation means that a person in a position of trust knowingly, by deception and intimidation, obtains and uses or tries to obtain and use a vulnerable person's funds, assets, or property. This includes failure to use the vulnerable person's income and assets to provide for the necessities required for that person's care.

When you call the Abuse Hotline to make a report, have this information ready:

• Victim's name, address or location, approximate age, race, and sex.
• A brief description of the adult victim's disability or infirmity.
• Signs or indications of harm or injury, including a physical description if possible.
• Name, address, and telephone number of any possibly responsible person/ perpetrator.
• Relationship of the possibly responsible person/perpetrator to the victim, if possible. If the relationship is unknown, a report may still meet requirements for investigation.
• As the reporter, your name, address, and telephone number. This information is never given out. The reporter may choose to remain anonymous.

The Florida Department of Children and Families (DCF) is responsible for providing services to detect and correct abuse, neglect, and exploitation of adults. This must be done so as to place the fewest possible restrictions on personal liberty and constitutional rights. In other words, DCF cannot forcibly remove a competent adult from a situation he or she refuses to leave. Some elders are unwilling to leave an abusive situation or to press charges against family members. Only if the person is found to be mentally impaired enough that judgment and decision making are impaired can the worker intervene to protect the person against his or her will. Law enforcement takes the lead in all criminal investigations and prosecutions for abuse, neglect, or exploitation of a vulnerable adult by another person.

Groups most at risk for elder abuse include:

• Older women are most commonly reported. Older men may be just as much or even more at risk but are less frequently reported.
• The higher the age, the greater the risk.
• Those who live with a caregiver or depend on someone for care and assistance.
• Physically frail or disabled.
• Confused, disoriented, or mentally impaired.

Individual characteristics include:

• Very loyal to the caregiver. Willing to accept blame.
• Socially isolated and history of poor relationship with caregiver.
• Alcohol, medication, or drug abuse.
• Has illness that causes behavior that is stressful for caregiver (verbal outbursts, incontinence, wandering, agitation).
• Displays behavior that provokes caregiver (ungrateful, overly-demanding, unpleasant).

The more of the following observable indicators are present, the greater the risk:

• Physical indicators such as bruises, burns, unexplained fractures, bedsores, being dirty and unkempt, inadequate clothing, showing evidence of malnutrition.

• Behavioral indicators such as being nervous or agitated, avoiding eye contract, hesitant to talk openly, depressed or despairing, feeling hopeless, withdrawn, denying problems, covering up for caregiver, confused or disoriented, suspicious.

• Environmental indicators such as dirty, cramped, unsanitary living space with inadequate light, heat, or cooling; health and safety hazards such as doors with no locks, rodents or insects, open space heaters, broken plumbing, no water or electricity, fire hazards, repairs needed to roof, stairs, railing; and questionable care as evidenced by lack of food, medicine not managed, soiled bedding, or patient is restrained.

Many times the abuser is a family member who is providing unpaid care to the vulnerable person.

A caregiver is more at risk of being an abuser if he or she:

• Has personal problems such as alcohol or medication abuse, mental or emotional illness, physical health problems, or low self-esteem.

• Was abused as a child, grew up in a household where violence was used to resolve disputes, or has a history of conflict with the older person.

• Is experiencing stresses such as marital conflict, unemployment, economic problems, lack of activities outside the home, or caring for both parents and children.

• Lacks experience and skills as a caregiver, does not understand the older person's disease, has little support from other family members, or has unrealistic expectations for being a caregiver.

Observable factors that could indicate that abuse by a caregiver is happening include:

• Not letting the older person speak for himself/herself or have a conversation without the caregiver present.

• Family members blaming the older person for being a burden or perceiving symptoms of a disease as intentional behavior.

• Conflicting accounts of an incident by family members and the victim.

• Caregiver is financially dependent on the older person.

• Older person lives in overcrowded environment with caregiver and is socially isolated outside the family.

Some of the risk factors for abuse by caregivers can be changed through caregiver education and support. The Area Agency on Aging of Pasco-Pinellas, Inc. (AAAPP) offers two caregiver programs, but caregivers most in need of this help may be the ones least likely to hear about and accept assistance. It is up to all of us to inform caregivers we know and to encourage them to ask for support to preserve their own health and allow them to provide care longer with less risk of abuse or neglect.

The National Family Caregiver Support Program, which serves caregivers of persons sixty and over. Services such as respite care, counseling, and chore services are available. Grandparents sixty and over caring for children eighteen and younger are eligible for similar services. This program is available in other areas of Florida and the U.S. For referral statewide call the toll-free state Elder Helpline number, 1-800-96ELDER (1-800-963-5337). Nationally, use the Eldercare Locator's toll-free number, 1-800-677-1116 or use the Eldercare Locator web site, www.eldercare.gov.

For information on how to prevent caregiver burnout that can lead to abuse if there is no relief, see The Four Stages of Caregiving, Stage Three, section 1. Recognize and prevent caregiver burnout. For ways to cool down immediately and the numbers of several crisis counseling or prayer lines available 24 hours a day that is described in The Four Stages of Caregiving, click here

There are additional resources to help victims of spouse abuse. The Center Against Spouse Abuse (CASA) in St. Petersburg, Florida, has a 24-hour crisis line, 727-895-4912. This organization provides support, advocacy, safety planning, shelter, etc. The Florida Domestic Violence Hotline may be called toll-free at 1-800-500-1119. For more information call

The Senior Helpline
serving Pasco and Pinellas Counties
1-800-96-ELDER
(1-800-963-5337)
For inquiries from outside of the area call 727-217-8111

In October of 2003 the Area Agency of Pasco-Pinellas, Inc. joined with the Pasco Aging Network to sponsor a conference on caregiving. One of the presentations addressed the topic of elder abuse and was given by Teresa Hays, M.P.A., Health and Wellness Trainer, Florida Department of Elder Affairs. The Powerpoint presentation that was displayed that day is attached. Click on the title to download the presentation. DOEA Abuse Presentation 2003 (This may take a few minutes to download.)