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Safe environment, predictable routine lead to recovery
More than 12% of the substantiated elder abuse cases reported involve financial or material exploitation, according to statistics compiled by the National Center on Elder Abuse. Caring for victims of exploitation after the abuser is removed requires more than just meeting their medical and daily living needs, says Gwen W. Watkins, MSW, LSW, director of marketing for Wellspring Personal Care in Chicago. "These patients have been traumatized by a family member or other person who they trusted, and we have to create a sense of order and safety for them before they can begin to recover," she points out.
Wellspring’s team for elder abuse consists of nurses, aides, and social workers trained to recognize signs of abuse, including physical, emotional, and financial, and to work with the patient to develop a trusting relationship, she says. Once the agency receives a referral from a bank trust officer, attorney, or family member who suspects abuse, a team responds within 24 hours to assess the patient’s medical condition as well as the home environment. If there are signs of abuse, they are reported to the referral source or to the appropriate authorities, Watkins explains.
Signs of neglect can be little or no food in the refrigerator or pantry, dirty bed linens or clothing, unkempt appearance of the patient, and lack of necessary medical supplies. Signs of emotional abuse are more subtle, she adds. "Abuse victims look and act like victims of war. They are fearful, anxious, fatigued, and reliant on another person to answer questions or make decisions," Watkins says.
Techniques used to exploit and manipulate an older person include destruction of the routine of normal life and creation of turmoil, she says. That turmoil makes the person feel unsafe and dependent upon the abuser, she says. "Our role is to come into the person’s home to restore order and create a safe environment," Watkins adds. "We use the same nurses and aides for as long as it takes to stabilize the patient so that he or she is not seeing new faces every day," she says. "We also work with our medical director to make sure medical conditions are addressed, and may suggest medications to help the patients sleep until they feel safe enough to fall asleep on their own," Watkins adds.
Agency staff members try to re-establish daily routines. "We have one client who loved to have her hair done at a certain salon before her exploitation. She is unable to go to the salon now, but the stylist does come to her home," Watkins adds.
While stabilizing the patient, Watkins' agency looks for ways to keep the patients out of a nursing home and either in their own home or in the home of a nonabusive family member. "These patients want to stay independent as long as possible, and when they have financial resources to support care in their homes, we suggest ways to accomplish this," she says.
Adult day care programs and home health aides can help a person stay independent. "The goal is to make sure that the patient isn’t placed in a position where he or she is at risk of exploitation again," she says.
If your agency takes on victims of financial exploitation, make sure you don’t put yourself in a position where you can be accused of exploitation as well, Watkins suggests. "We do purchase groceries, medical supplies such as incontinence [supplies], or clothing that they need, if necessary. But we pay for it, submit a receipt, and are reimbursed by an agent of authority who pays us from a trust," she adds.
One of the major components of a program to help victims of abuse must be strong case management, Watkins continues. "A nurse must plan to be on-site frequently during the first few weeks to help the aide or other caregiver establish a trusting relationship," she says.
Elder Abuse Resources
• National Center on Elder Abuse, 1201 15th St., N.W., Suite 350, Washington, DC 20005-2800. Telephone: (202) 898-2586. Fax: (202) 898-2583. E-mail: NCEA@nasua.org. Web site: www.elderabusecenter.org/. The site contains fact sheets, publications, caregiver resources, state statutes, research, and links to other resources on elder abuse.
• National Committee for the Prevention of Elder Abuse, 1612 K St., N.W., Washington, DC 20006 (c/o Bob Blancato). Telephone: (202) 682-4140. Fax: (202) 223-2099. E-mail: firstname.lastname@example.org. Web site: www.preventelderabuse.org/. The organization offers a variety of publications and research materials related to elder abuse.
• Clearinghouse on Abuse and Neglect of the Elderly (CANE). This is the nation’s largest archive of published research, training resources, government documents, and other sources on elder abuse. The CANE collection is fully computerized. Web site for database: www.elderabusecenter.org/. Click on Clearinghouse on Abuse and Neglect of the Elderly on the right navigational bar.