Proactive Steps to Prevent Elder Abuse

Tens of thousands of seniors are abused every year – in their own homes and in facilities responsible for their care.  Elder abuse takes on many forms: emotional, physical, sexual, and neglect.   Learning the signs of abuse can help you recognize when someone is being hurt, and strengthen your own defenses against elder abuse.

Recognizing the Signs of Elder Abuse

Countless caregivers have discounted signs of abuse as just part of the elderly one’s mental deterioration or dementia.  Never should you, or anyone, dismiss signs or reports of abuse.

Signs of Abuse

  • Tension or arguments between the caregiver and elderly person
  • Changes in personality
  • Unexplained signs of injury such as welts, cuts, or bruises
  • Serious injuries such as broken bones or sprains
  • Rope marks on wrists
  • Broken eyeglasses
  • Unexplained genital infections or diseases
  • Caregiver’s refusal to allow you to see elderly person alone
  • Unusual weight loss or dehydration
  • Unsanitary living conditions such as soiled sheets or dirty clothes
  • Untreated bed sores, or poor hygiene

Obviously this is not an exhaustive list of all the signs and symptoms of abuse.  Any suspicious or unusual behaviors should be checked into immediately.

Preventing Elder Abuse

With elder abuse on the rise, it’s more important than ever to take proactive steps in preventing these tragedies.  Three main ways to help are:

  • Listening to seniors
  • Intervening when you suspect abuse
  • Educating others on recognizing the signs of abuse

If you have a loved one in the care of a nursing home, assisted living facility, or professional caregiver, you must stay as involved as possible.  Keeping a close eye on your loved one is essential in recognizing changes in behavior that could indicate abuse.

When considering different nursing homes or assisted living facilities, find out as much as possible about their reputation.  Ask for referrals, and check the internet for reviews.  Interview the staff members to get a feel for their personalities and commitment to care.

When hiring private care, it’s very important to check references and ask for a complete background check – not only for the primary caregiver, but any back-up providers as well.  Working with an agency that offers care management software is highly recommended so you can have real-time updates on your loved one’s daily care.

Periodically check the elderly person’s medications to make sure they are being administered correctly.  Check the senior’s body for sores or bruises, and be watchful for any changes in appetite, habits, or mood.

According to data from elder care services, for every case of elder abuse reported, 12 or 13 are not.  If you are an elderly person being abused, don’t be ashamed to reach out for help.  Tell your doctor, a family member, or a trusted friend.  You can also call 1-800-677-1116 to speak to a representative for Eldercare Locator.  You will be referred to a local agency that will help make sure you are never harmed again.

How to Approach Caregiver with Problems or Concerns

You’ve finally found the caregiver who is “just right.”  Your parent/grandparent loves her, you know she’s capable and competent, and the situation has been more than more than satisfying….until now.  All of a sudden, problems are beginning to crop up.  Perhaps the caregiver has gotten too comfortable in her role as caretaker and has begun instituting her own rules.  Perhaps she has been late to her last few shifts.  Whatever the reason may be, if you have cause for concern, you may be wondering how to approach the caregiver.

First of all, it’s commendable that you’ve recognized there is a problem.  Staying in close contact with your loved one and his caregiver is extremely important.  Now that you’ve identified an area of concern, you can take appropriate steps to address and correct the issue.

  • Set a specific time to speak with the caregiver.  Leaving a conversation like this “up to chance” will only prolong your anxiety.  As soon as you’re aware of a problem, call the caregiver and request a meeting.  If you feel it’s appropriate, include your parent in the discussion, but be careful the caregiver does not feel ganged up on.
  • Speak honestly.   No one likes confrontation.  It may be your natural tendency to sugarcoat the issue or even make excuses for the caregiver’s unacceptable behavior.  This approach will not do anyone any favors.  The issue will likely continue, and you will feel worse.  Speaking frankly is the only way to address the concern in a way that will yield results. 
  • Be specific.  Let the caregiver know exactly what your concern is.  While making it clear that you appreciate her hard work, strongly remind her that you expect her to follow the guidelines that were set up in the very beginning.  You can do this in a non-threatening way, but don’t back down if she begins to argue.  If there is more than one problem that needs to be addressed, make sure you cover them all.
  • Encourage the caregiver to speak her mind.  This discussion should be an open conversation between you and the caregiver.  Ask her how she feels about her work, and what prompted the unacceptable behavior.  Is she feeling overworked?  Does she need more specific guidelines for daily tasks?  Is there a personality conflict that makes communication difficult?  If you can address any concerns the caregiver has, you will be more successful in solving the problem.

After you’ve discussed the problem with your parent’s caregiver, it’s important that you closely monitor her behavior in the future.  If the problem persists, a second discussion is necessary.  Be more forceful during this conversation, reminding the caregiver that her position is in jeopardy.  Whatever the unacceptable behavior is, let the caregiver know it will not be tolerated any longer.  If you don’t see any progress after this second discussion, it’s time to look for a different caregiver.

Questions to Ask Potential Caregivers

Deciding on a caregiver for your loved one may seem challenging.  With elder abuse and fraud on the rise, the thought of leaving your mother or father in another’s care might fill you with apprehension.  However, armed with the right information you can make a sound decision and hire a suitable caregiver.

Factors to Consider

Because hiring a caregiver is largely an emotional issue, sometimes the more practical aspects are overlooked.  “Families need to be aware of all the implications when considering hiring home help for their aging parent or loved one,” says Cheryl Smith, President and CEO of Kansas City Home Care, Inc.  She adds, “Most people don’t think about the potential tax or liability issues when researching home health care.”

These issues need to be addressed before you decide on hiring a private caregiver or going through an agency.   Homecare poses the risk for injury, so make sure your caregiver has workers’ compensation insurance.  If there is no policy in place and the caregiver is injured, you will be responsible for all medical and disability payments.

Many families find that hiring a home care agency directly eliminates financial and legal worries and eases the stress of the entire process.

Questions to Ask

Not all homecare agencies are created equal.  Some agencies offer limited supervision of their providers, and not all caregivers have the necessary skills to provide quality care.  Rosemarie Tamunday, owner of RIGHT ACCORD Private Duty-Home Health Care in Sarasota, Florida, says, “Training, or lack of it, is the issue. We’ve always insisted on a standardized training program for our caregivers. But we’re an exception. Many companion care companies, some of them franchises, offer very limited caregiver training.”

To overcome this potential problem, interview at least two or three agencies.  Make your expectations clear, and ask as many questions as you need to help you understand the agency and their policies.

When meeting with agency directors, ask:

  • How long they’ve been in business
  • How quality control is monitored and ensured
  • If their workers are bonded and insured
  • For a list of references
  • How extensive are their background/criminal checks
  • Are there limitations as to what the caregiver can and cannot do
  • What is the company’s replacement policy or guarantee
  • Are rates negotiable
  • How much training do the caregivers receive

This is just a basic list of questions you should have answered.  If you think of more, by all means, ask them.  Your loved one’s safety and health is on the line so it is vitally important to find a caregiver you trust.

How to Discuss Assisted Living with Your Parents

Many (if not most) seniors are resistant to accepting the fact that they need assistance with daily tasks.  If the time has come for “The Talk” with your parents, consider how you’ll do so.  Before you barge into your parents’ home and demand they start packing up their beloved belongings, you may want to try a gentler approach.

Plan in Advance

An important key that many families overlook is to have the conversation before a crisis arrives.  Broaching the subject before the need is imminent will give your parents time to adjust, as well as be involved in the planning process.  Seniors are much more likely to be receptive to care suggestions when they are physically and mentally healthy.

The transition into an assisted living facility will go much more smoothly when it’s been planned out well in advance.  This may call for an attitude adjustment for the children.  Yes, it’s not only the elderly who are hesitant to accept this new phase of life.  Adult children may have just as much difficulty with the idea, possibly even considering it to be a precursor to nursing home care – or worse.  Make sure you have a positive, upbeat attitude regarding assisted living or your reservations will cloud the conversation.

Use Good Communication

Many children think they need to go to their parents armed with facts and figures, glossy brochures and a mile-long list of assisted living benefits.  The truth is, the most two important things you can bring to the discussion are respect and empathy.  These two qualities will help you stay calm, refrain from arguing, and ask for your parents’ opinions.

A few other tips to keep in mind:

  • Listen to your parents’ concerns and fears – even if you think they are being irrational.  You must allow them the freedom to express themselves.
  • Make sure you include your parent to the extent appropriate for their age and health condition.  If a parent feels they have no say in the matter, it will only make the situation worse.
  • Don’t rush the discussion.  Trying to push your parents into making a decision will make them feel cornered and stressed.  It’s okay to have several short discussions instead of one long one.
  • Be honest.  Don’t try to sugarcoat the situation – your parents will likely see right through it.

Bring Assisted Living to Life

Talking about assisted living facilities will get the ball rolling, but it’s only the beginning.   An essential part of the planning process should include site visits.  Checking out different homes not only gives your parents options, but it also gives them a chance to see what the facilities are actually like.  Assisted living facilities often seems less daunting once parents have all the facts, and have had a chance to see them up close.

Talking to your parents about assisted living isn’t easy, but with these tips, you’ll enjoy a much better conversation.

Exercise May Reduce the Risk of Dementia

We’ve heard all our lives how exercise is good for us.  It promotes good health, keeps us from becoming overweight, and boosts our mood.  A recent study published in September’s Mayo Clinic Proceedings gives us one more reason to break out the sweatbands and sneakers: exercise may reduce the risk of developing dementia or age-related mental decline.

The study, entitled Physical Exercise as a Preventive or Disease-Modifying Treatment of Dementia and Brain Aging, was supervised by Dr. J. Eric Ahlskog, a neurologist at the Mayo Clinic.  Together with his research team, Dr. Ahlskog analyzed more than 1,600 scientific research papers that focused on the correlation between exercise and cognition.  In a statement released with his findings, Dr. Ahlskog reported “you can make a very compelling argument for exercise as a disease-modifying strategy to prevent dementia and mild cognitive impairment, and for favorably modifying these processes once they have developed.”

In one study, made up of 1,324 dementia-free volunteers, the results concluded that those who engaged in moderate exercise were 39 percent less likely to have cognitive impairment.  With exercise there is increased blood flow to the brain, production of nerve-protecting compounds, decreased risk of heart and blood vessel diseases, improved development and survival of neurons – all significant ways our body’s fight against cognitive impairment.

According to a second study which included adults with an average age of 70, results were similarly encouraging.  These seniors, who had mild cognitive impairment, were randomly assigned to do high-intensity aerobics, or join a control group that simply did stretching exercises.  After six months, the seniors in the aerobics group had improved cognitive function compared to those in the control group.

Another study corroborates these findings.  Researchers at the University of California at San Francisco measured the brain function of nearly 6,000 women during an eight-year period. The results were correlated with the women’s normal activity level, including routine walking and stair-climbing.

“In the higher-energy groups, we saw much less cognitive decline,” reported neurologist Kristine Yaffe, MD.   Dr. Yaffe, Chief of Geriatric Psychiatry at the San Francisco Veterans Administration Medical Center, also stated, “Of the women who walked the least (a half-mile per week), 24 percent had significant declines in their test scores, compared to only 17 percent of the most active women (17 miles per week).  “We also found that for every extra mile walked per week there was a 13 percent less chance of cognitive decline.”

As these studies report, there are real scientific reasons why walking “clears our head.”  And since walking is free and something almost anyone can do, there should be no reason why more of us aren’t more active.  Our physical and mental health depends on it.