Investigator says mandated separation has drawbacks for elderly
By Heather Ruenz
Staff Writer
When one hears the word abuse, it typically conjures thoughts of someone being beaten physically. That notion can be even tougher to imagine when it involves those who are particularly vulnerable, in this case the elderly.
Though physical abuse to the elderly is not very common in Walworth County, COVID-19 has brought with it challenges in the awareness of those types of situations, according to Karen Gillingham, a full-time investigator for Walworth County’s Adult Protective Services. The APS is under the county’s Health and Human Services Department and its Aging and Disability Resource Center.
“It’s really hard right now with COVID-19 because families aren’t able to check in on their loved ones. And that regular in-person contact is an important part of us being made aware of concerns so we can look into it,” Gillingham said.
In light of that additional separation forced by coronavirus precautions, she said she’s relying on facilities to self-monitor and report if there are concerns.
“I’m easier on facilities than a lot of people but I see the good they’re doing and I know they’re holding people accountable. I also think they sometimes get a bad reputation,” Gillingham said.
She said reports of elder abuse in facilities is the least source of cases the APS receives and even in small group homes, all of the employees are required to report concerns. She said the APS is required to check out every complaint received and if it’s at an institution, they also send their report to Division of Quality Assurance, which sometimes will do its own investigation.
Neglect from a caregiver or paid caregiver is another area of elder abuse but can be tougher to prove, Gillingham said.
“But if there is a concern, someone reporting it can help because we make a visit and at least the caregivers – whether family or paid – know that they’re being watched,” she said.
In those cases, Gillingham said, APS staff show up unannounced; something she suggests family members keep in mind if they have a loved one in a facility.
“They should stop by when they want to but once in a while maybe not during their normal time of day or the same day of the week. Even if there aren’t obvious concerns like bed sores or neglect, it’s a good way to keep an eye on things,” she said.
In addition to those who work in nursing homes, assisted living facilities and group homes, she said police officers, and nurses at clinics and hospitals are also mandated reporters when abuse is suspected.
Loneliness plays a role
The main concerns with the elderly, Gillingham said, generally stem from those who are home alone, which makes them more susceptible to self-neglect or being scammed financially.
“Self-neglect is reported when someone believes a person cannot take care of himself or herself. Sometimes it’s due to drinking or drugs, other times dementia or another medical condition, and sometimes it’s just because they’re elderly and struggling,” she said.
However, she explained, unless a person is considered unable to make sound decisions, they cannot be forced from their home.
“We can’t pull someone from a home unless it’s a case of dementia or another mental issue, which we will go in and screen for. But more often than not we try to get them help in their home,” Gillingham said.
Dehydration is often an issue with the elderly, she said and can lead to a urinary tract infection, which can turn into disorientation, therefore, even if someone appears to be confused it can sometimes be attributed to improper nutrition or a lack of fluids.
The most difficult thing for people to understand, Gillingham said, is that if a person is of sound mind, they can die in their home if that’s what they want to do.
“And my job is to make sure they get that choice. In the majority of cases, they do know what’s going on and want to stay home,” she explained.
In those cases, Gillingham said they work to connect them with resources available, from assistance with shopping and cleaning to meal delivery and help with their finances.
The hard decisions
A service many don’t realize Gillingham and others at the ADRC offer is helping people decide when it’s time to place a family member in a facility.
“It’s not always easy to see the signs when you’re in the middle of it. Because we deal with it regularly, we’re able to see where a person is at and can recommend if it’s time to take the next step or getting close to that time,” she said.
Gillingham also reminds people the importance of having power of attorney in place, not only for health care, which a lot of people think to do, but also for finances.
“Not having those in place can cause us to have to get guardianship and that’s a process. People also don’t realize that with financial power of attorney they can request it doesn’t go into affect until they’re deemed incapacitated,” she said, adding that if they want that stipulated, it needs to be added to the POA paperwork because it’s not part of the normal paperwork.
She also recommends family members who become power of attorney – or even if it’s not officially POA but are helping with their finances – start a ledger that can be looked at in case it gets questioned.
“Unfortunately, the majority of financial abuse is by a close family member,” Gillingham said.
“People can always contact us and we’ll go out to their homes and help them with those documents. We also have notaries that can finalize those items once the decisions have been made.”
Be neighborly
Gillingham estimates 7-of-10 seniors is being taken advantage of by others and said one simple way people can help is by keeping their eyes open.
“Watch your neighbors. Ask them who was visiting, what are they helping with and where did they meet them. Don’t be afraid to ask questions because it’s usually lonely people who are befriended. The next thing you know, someone is paying more attention to them and then calling or stopping over,” she said.
“While it can be someone genuinely helping them, it can also be someone befriending them so they can take their money or their property. It’s always best to ask questions and if there’s a concern in the answers, please call us,” she added.
Gillingham said when they go out to speak with someone that may have fallen victim in a scam of some sort they often take a deputy or police officer with them so they can let the person know it happens to many people.
“They should never feel bad about it to the point of being afraid to tell someone or ask for help. Sometimes the money they’ve sent or paid is gone but we can hopefully prevent it from happening again,” she said. “Plus, it opens the door for us to connect them to resources.”
Gillingham said they are required to keep the name of those who call in a concern to staff only and while people can choose to do so anonymously, if they leave their phone number, it will allow them to be contacted if additional information is needed. But when ADRC staff make a visit, they’re very careful to not reveal who made the call.
“If someone tries to guess who it might have been, we won’t tell them or give any hints. It’s about seeing if people need help and if they do, getting them the resources they need,” she explained.
The APS uses a screen-in, screen-out process, which means the staff decides if a call received warrants a visit at that time, a decision that isn’t shared with the person who reported the concern.
“We want to know if a senior citizen lives alone and may need help, even if it’s just Meals on Wheels, which is an amazing program that provides a good meal and also puts eyes on them five days a week,” Gillingham said.
There is also a Friendly Visitor program in the county, which sends volunteers out to the homes of elderly to spend a couple of hours visiting, cooking a meal and so on. Gillingham said pairs of people have also gone out, which is more comfortable for some of them.
She said that program is still fairly new but they’re hoping it’ll continue to grow and said some of the challenge is getting senior citizens on board, so she hopes people will tell their elderly neighbors about it and encourage them to call.
“I hope anyone who has a concern, themselves or about someone they know, will take the time to contact us. We want to help and have a lot of resources but need a hand making that connection,” she said.
