Table of Contents About the Editor.................................................................................................................. iii Preface................................................................................................................................. v PART 1: PREVALENCE AND TYPES OF ABUSE Introduction . P1-3 Chapter 1: Prevalence . 1-1 An Examination of Elder Abuse Reports and Data Collection Systems Across the United States . 1-1 Summary of Findings of a National Survey on Adult Abuse Central Registries . 1-7 New Studies Find Indicators of Abuse and Higher Death Rates for Abused Elders . 1-10 Chapter 2: Physical and Emotional Abuse . 2-1 Fitting Elder Abuse Into the Family Violence Continuum . 2-1 Paradoxical Thinking About Abuse and Neglect . 2-4 The Connection Between Animals and Elder Abuse . 2-10 Chapter 3: Financial Exploitation . 3-1 Strengthening the Bridge Between Adult Protective Services and Law Enforcement: One State’s Example . 3-1 Financial Exploitation of Infirm Adults—A Prosecutor’s Perspective . 3-3 A Case Study: The Financial Exploitation and Abuse of Anne Morrow Lindbergh . 3-6 The Exploitation and Abuse of Anne Morrow Lindbergh: How Normal Interventions Failed . 3-11 Growing Activist Bankers . 3-15 Chapter 4: Domestic Violence in Later Life . 4-1 Family Violence in Later Life, Situations of Elder Mistreatment Often Form of Domestic Violence and Require Interdisciplinary Solutions . 4-1 Housing and the Older Battered Woman . 4-6 Rainbow Services: A New Beginning for Older Battered Women . 4-9 Developing Services for Older Women Who Are Victims of Domestic Violence or Sexual Assault . 4-11 Developing Services for Older Victims of Domestic Violence or Sexual Assault: The Approach of Wisconsin Coalitions . 4-18 Chapter 5: Neglect . 5-1 Hoarding Behaviors Discussed at National Conference . 5-1 TC-1 TC-2 ABUSE AND NEGLECT OF VULNERABLE ADULT POPULATIONS PART 2: SPECIFIC POPULATIONS Introduction . P2-3 Chapter 6: Patients in Long-Term Care Facilities . 6-1 Systemic Barriers to Reducing Patient Abuse and Neglect: Recognizing and Addressing Causes and Cures . 6-1 Barriers to Reducing Patient Abuse and Neglect . 6-5 The Psychiatric Use and Misuse of Restraints . 6-8 The Use and Misuse of Restraints with the Elderly . 6-11 Restraint and Seclusion: An Update . 6-13 Position Statement on Use of Restraint and Seclusion in Psychiatric Facilities . 6-17 Deinstitutionalization–The Next Phase? . 6-18 Community Sources of Information: Referral of Quality of Care Violations . 6-22 Feds’Attention Focuses on Abuse in Nursing Homes . 6-25 Chapter 7: Sexual Orientation and Minority Populations . 7-1 Abuse of Lesbian and Gay Male Elders . 7-1 Protocol for Culturally-Oriented Assessment . 7-4 When Our Elders Are Abused, We All Lose . 7-7 Chapter 8: Perpetrators of Abuse and Neglect . 8-1 Discussions With Perpetrators of Elder Abuse Can Lead to Best Overall Solution for Victims . 8-1 Working With Perpetrators of Elder Abuse . 8-7 S.E.A.M., Stop Elder Abuse and Mistreatment: A Psycho-Educational Program for Abusers of the Elderly . 8-9 PART 3: MENTALAND PHYSICAL DISABILITIES Introduction . P3-3 Chapter 9: Sexual Abuse . 9-1 Sex and Mental Disability . 9-1 Sex & Mental Disability: The Law of Consent . 9-4 Sex and Mental Disability: A Responsible Approach . 9-8 Mental Retardation Compounds Rape Trauma . 9-11 Assessing Sexual Assault With Individuals With Mental Retardation and Mental Illness: A Case Review . 9-14 Chapter 10: Special Considerations When Working With Disabled Adults . 10-1 Factors to Consider When Interviewing a Victim With a Disability . 10-1 Children and Adults With Developmental Disabilities: Sexual Maltreatment Update . 10-5 Sexual Maltreatment of Children and Adults With Developmental Disabilities: A Review of Strategies for Prosecution, Care, and Prevention . 10-11 A Model for Promoting Violence-Free TABLE OF CONTENTS TC-3 Relationships for Persons With Disabilities . 10-18 Unique Shelter Program Works to Reduce Violence Against and Exploitation of People With Disabilities . 10-21 Chapter 11: International Perspectives, Approaches, and Commentary . 11-1 China Mental Disabilities and Human Rights . 11-1 Human Rights and Mental Disability in China . 11-7 International Challenges in Implementing Human Rights of Persons With Mental Illness . .11-12 Human Subject Research: Cure or Curse for Those With Mental and Developmental Disabilities? . 11-17 Social Care Homes in Bulgaria . 11-21 Criminal Justice/Mental Health Consensus Project . 11-25 PART 4: PROFESSIONAL DEVELOPMENT, POLICIES, AND BEST PRACTICES Introduction . P4-3 Chapter 12: Training..................................................................................................... 12-1 Newly Released Elder Abuse and Dementia Training Kit...................................... 12-1 Elder Abuse Training Materials..............................................................................12-2 From Finland, With Love...................................................................................... 12-5 Building Training Partnerships.............................................................................. 12-7 Elder Abuse Education in Schools of Social Work: A Look at Current Levels of Training and Implications for Practice ................................ 12-12 Video Tips for Adult Protective Services Providers ............................................. 12-16 National Action Agenda on Elder Abuse Created ................................................ 12-20 Chapter 13: Adult Protective Services.......................................................................... 13-1 Benchmarking in Adult Protective Services .......................................................... 13-1 Expanding an APS Training Program Through Collaboration ............................... 13-5 Identifying Adult Protective Services “Competencies”: Guidance for Professionals and Questions to Ask................................................................. 13-11 Wisconsin’s Adult Protective Services Modernization Project, Report to DHFS Secretary Phyllis Dube, August 2001 ................................... 13-19 Agency Policy Considerations and Training Issues for Victim and Worker Safety ...............................................................................13-25 Ohio Undertakes Unique State Assessment of APS ............................................. 13-30 Chapter 14: Interdisciplinary Collaboration .............................................................. 14-1 Vallejo’s Senior Advocate ..................................................................................... 14-1 Elvis Spotted at Salem Senior Center.....................................................................14-5 Bioethics Committee Aids APS Workers in Making Complex Medical Decisions for Incapacitated Adults.......................................................14-7 Oregon Gets District Attorneys Involved ...............................................................14-9 Physicians and Elder Mistreatment: Development and Function of the TEAM Institute.......................................................................14-13 Public-Private Partnership Effectively Fights Elder Abuse ...................................14-15 TC-4 ABUSE AND NEGLECT OF VULNERABLE ADULT POPULATIONS Task Force on Elderly Abuse, Neglect, and Exploitation: The Palm Beach County Experience ...............................................................14-18 An Interdisciplinary Team (“I-Team”) Manual Arises From Wisconsin’s Fight Against Elder Abuse ...........................................................14-21 Wisconsin’s Experiences With Elder Abuse Give Rise to an Interdisciplinary Team Manual........................................................................14-29 AARP ElderWatch...............................................................................................14-37 PART 5: LEGAL RESPONSES TO ABUSE OF VULNERABLE ADULTS Introduction . P5-3 Chapter 15: Legal Initiatives and Court Decisions . 15-1 Federal District Court Holds Mentally Retarded Plaintiff May Pursue Section 1983 Claim Against Private Nonprofit Community Assisted Living Facility Owner . 15-1 llinois Court Holds Arbitration Award Reinstating Abusive Nurse Aide Violates State’s Public Policy of Protecting Elderly From Abuse . 15-3 West Virginia Court Upholds Constitutionality of its Criminal Statute Penalizing Elder Abuse and Neglect . 15-5 California Legislature Passes Sweeping Elder Abuse Reform . 15-7 Prison Sentence of Caregiver Who Stole $250,000 From Elderly Women Upheld by Michigan Court of Appeals . 15-10 Texas Legislature Passes Bills to Improve Quality of Care and Protect Residents of Residential Facilities and Recipients of Home Care . 15-12 Massachusetts Holds That Victim Witness Advocates’ Notes Are Protected . 15-15 States Continue to Enact Protections for Elderly and Disabled . 15-16 Alabama Protective Services Act Confers Absolute Immunity on Reporters of Abuse . 15-19 Illinois Joins the Ranks of Mandatory Reporting States . 15-20 State Legislative Update . 15-21 New Minnesota Law Allows Nursing Home Residents to Demand Side Rails on Beds . 15-26 Florida Improves Consumer Access to Information About Long-Term Care Facilities . 15-26 Legislative Updates From Around the Country . 15-27 Legislative Roundup–New State Laws Protecting Vulnerable Adults . 15-32 State Adult Guardianship Legislation . 15-37 Report From Washington . 15-43 Report From Washington . 15-45 Report From Washington . 15-48 Report From Washington . ..