Abusing the elderly (Part 2)

There is no set age for being called an elder, but it may be defined as when a reaches the age of at least sixty.

Every year an estimated 2.1 million elders in the United States alone are victims of physical, psychological, or other forms of abuse and neglect. For every case of elder abuse and neglect reported to authorities, experts estimate that there may be as many as 5 cases not reported. It is estimated that somewhere between four and ten per cent of seniors in Canada experience some kind of abuse; which also often remains hidden or goes undetected.

As elders become more physically frail, they’re less able to stand up to bullying and or fight back if attacked. They may not see or hear as well or think as clearly as they used to, leaving openings for unscrupulous people to take advantage of them. Mental or physical ailments may make them more difficult to live with.

Elder abuse is a serious issue that affects a growing population. There are four kinds of abuses that elderly people are subjected to. They are; physical, neglect, financial and psychological.

Physical abuse

90% of elder abuse and neglect incidents are by known perpetrators, usually family members, 2/3rds are adult children or spouses. 42% of murder victims over 60 were killed by their own offspring. Spouses were the perpetrators in 24% of family murders of persons over 60.

When we think of elder abuse, the abuse of older women promptly comes to mind. People generally presume that men are more capable of protecting themselves from abuse however, older men are also abused. What follows is a case in point.

A 69-year-old emaciated stroke-victim man was found by the police, tied to his bed with a dog leash in his apartment in Richmond Hill, Ontario. The police were called after his adult daughter found him in that way when she visited him. The man’s so-called live-in girlfriend, Yasmin Madi and her real boyfriend, Ghassem Shakeri were living in the apartment also. Further, theyhad placed make-up on his body from head to toe and the catheter hadn’t been changed. He also suffered from three broken fingers and a badly swollen arm. Madi had tried to conceal Mr. Shakeri's repeated assaults on Mr. Butler, who weighed just 68 pounds when his daughter found him. The victim had been paralyzed since 2004.

Madi, 42, was sent to prison for eighteen months after pleading guilty to failing to provide the necessities of life. A day earlier, Madi's heroin-abusing boyfriend, Ghassem Shakeri, pleaded guilty to assaulting Mr. Butler and to breaching probation. In custody since his arrest in April 2008, Shakeri, 42, was released and handed a further 18 months probation.

Signs of physical abuse

Overt signs of physical trauma (e.g. scratches, bruises, cuts, burns, punctures, choke marks); signs of restraint trauma (e.g. rope burns, gag marks, welts); Injury - particularly if repeated (e.g. sprains, fractures, detached retina, dislocation, paralysis); additional physical indicators; hypothermia, pain upon being touched; repeated "unexplained" injuries; inconsistent explanations of the injuries; a physical examination revealing that the older person has injuries which the caregiver has failed to disclose; a history of doctor or emergency room shopping; and repeated time lags between the time of any injury or fall and medical treatment.

Neglect

David Ribarchik, 47, of Flint Township, in New York was charged with a felony that is punishable by up to 15 years in prison. His own mother was the purported victim. On November 25, 2009, medics got a call about a 75-year-old woman who had fallen from a chair. It was later determined she had actually been lying on the floor at least three days. Before she fell out of the chair, she virtually lived in it. The victim had been sleeping in the chair by the door for at least two months. There were sores on her body and her physical condition was not good at all. She had been under her son's care for at least one year.

Signs of neglect

Evidence that personal care is lacking or neglected; Signs of malnourishment (e.g. sunken eyes, loss of weight); chronic health problems both physical and/or psychiatric; dehydration (extreme thirst); pressure sores (bed sores)

Doctors are for the most part, required by law to report suspected elder abuse of their patients. Unfortnately, many of them do not do this even if they fear that their silence may subject an elderly person to continued abuse at the hands of a caregiver.

Financial

Financial abuse refers to the misuse of a senior’s money, property or other assets by
a relative or a person in a position of trust.A relative may be a spouse, sibling, or child, and a person in a position of trust may be a neighbour, home care worker, or staff person in a care facility.

Some examples are: forcing or tricking a senior into selling his or her property; stealing money or personal possessions; forcing a senior’s signature on pension cheques or legal documents; misusing a Power of Attorney.

Detecting financial abuse

Financial abuse is often difficult to detect and frequently occurs over a long period
of time. Some behavioural indicators of financially abused seniors are: sudden removal of large sums of money from a bank account; unexplained inability to pay bills, purchase food or personal care items; fear or anxiety when discussing finances or being visited by a family member only when pension cheques arrive; inaccurate or no knowledge of the person’s finances; unexpected revision of a will or sale of property.

In December 2009, a woman in Genesee, New York was arrested and charged with dozens of charges for allegedly embezzling up to $1.4 million from her elderly brother. Mary Jo Davis had been her brother's guardian. At the time of this writing, she faces 35 counts including embezzlement, fraud and then first-degree vulnerable adult abuse, which carries a maximum penalty of 15 years in prison.

The victim was a 78-year-old paraplegic with dementia and hypertension, was being taken advantage of by her sister. She has written checks to people totally unrelated to his care. She spent some of the money on court costs for a man charged with third-degree criminal sexual conduct, her home repairs, new appliances and other items from Home Depot. She also spent money on two vehicles and even a race car shop. The police originally tbgought she embessled $700,000 but now suspect that the loss could be as high as $1.4 million.

For Victoria Gilbert, the seventh question on the caretaker agency’s background form was easy: Have you ever been convicted of a felony? Fresh from three years in a Nevada slammer for felony embezzlement, Gilbert said “No.”

The San Diego caretaker agency hired her on the spot. She went to National City and took care of an 86-year-old man who had suffered two strokes. Within seven days, she had persuaded him she needed to move in with him to provide 24-hour care. Within another week, her boyfriend, whom she had described as her husband (he wasn’t) and as a deputy U.S. marshal (he wasn’t), moved in also. The pair took the elderly man for a financial ride, using a credit card they stole from him while at the same time, they neglected his health. They literally ate caviar and drank expensive wines while he was fed hamburger.

In December 2009, Anthony D. Marshall, who is 85, was convicted of siphoning millions of dollars from his mother, Brooke Astor. He was sentenced to one to three years in prison.The sentence was for the most serious of 14 counts on which Mr. Marshall was convicted: first-degree grand larceny, for giving himself a retroactive lump-sum raise of about $1 million for managing his mother’s finances. Justice Bartley also sentenced Mr. Marshall to one year on each of the 13 other charges he was convicted of, to run at the same time as the longer sentence.

The trial focused on a tangle of wills and codicils that the prosecution said Marshall’s mother signed under pressure from Mr. Marshall. Most prominent among them was the will she signed in 2002 calling for most of her fortune to go to him. Mrs. Astor, who all but single-handedly gave away nearly $200 million of her late husband’s money while she was alive, had promised millions more to institutions like the New York Public Library and the Metropolitan Museum of Art on her death.

An elderly woman in Canada gave her credit cards to a gambling addict between September 2007 and July 2008 because she couldn't get out as much to do her own shopping. Carol Jean McQuade, 60, stole $28,500 from the elderly woman she was being paid to care for. McQuade began caring for the victim in her home when she and her husband moved in with the elderly woman in 2008. The victim was a 92-year-old retired public health nurse who served as a nurse in the European theatre during the Second World War. She has befriended McQuade in 2001. In 2007, McQuade was paid to provide in-home care through a Veterans Affairs Canada program designed to benefit veterans who served overseas. The victim underwent surgery in 2007 and it became hard for her to get around.That's when she entrusted McQuade with her debit cards and PIN numbers. She completed depleted a TD Bank account of thousands and then turned her attention to a Royal Bank account. The court also heard Thursday that McQuade has a theft conviction on her record.In 1997, when she was working as a teacher in Fredericton, she was tasked with collecting money from parents for a student trip to Quebec. All told, she collected $12,000, which then disappeared. She was sentenced to one year in prison for stealing from the woman she was hired to care for. She was given until the end of her probation to repay the money she stole otherwise she would go back to prison to serve more time.

Denise Elizabeth Sheaves, 29, of Fredrickton, New Brunswick, was a home-care worker who who forged cheques on an elderly client's account and impersonated her to get a credit card and a computer. She was an employee of ‘We Care Home Health Services’ and in that capacity worked for 13 months as a home-care worker for an 83-year-old Fredericton woman. Sheaves wrote four cheques to herself on her client's account in the amounts of $50, $100, $120 and $700. Sheaves told the court she used the money from the cheques and credit card to help a friend who needed money to feed her kids and pay her rent. Sheaves had found the elderly woman's social insurance number and other personal information in a letter from the Canada Revenue Agency so she
used that information to fill out an HBC credit card application in the elderly woman's name, but had the card and bills sent to her own address.

Obviously, greater care must be undertaken before someone his retained to care for an elderly person. Background checks are paramount.


Government abuse of the elderly

Some institutions are operated by local governments or are at least, answerable to them. Here is a rather sad case where the government abused an older man.

Al Gosling was 82 years of age when he was a tenant in a Toronto Community Housing Corporation building. He had had some rent problems in the past, and for a couple of years in a row he neglected to fill out his annual declaration of income form, a requirement of tenancy. Bear in mind that his only income is his pension; he has no hidden source of cash, no secretly lucrative job.

The TCHC took his case to the Landlord and Tenant Board and got an eviction order, after which they changed the lock on his door. When he came home, he had no other place to sleep but under the stairts in his building.

After a week, the cops came and took him to the hospital; he stayed there for a few days, and then the hospital sent him to a shelter. Al could not sleep or eat properly in the shelter. He picked up an infection, and he ended up in the Sherbourne Community Health Centre. When Al was unable to fight off the infection, he was sent to Toronto General Hospital. He was out on a life-support.

The officials realized that it was wrong to evict this unfortunate man because no one had gone to the trouble to help the man fill out the necessary forms. They repainted his room so that he could return to it when he weas released from the hospital. Unfortunately, Goslin died shortly after that while stll in the hospital.

Abuse in Nursing Homes

Jerry Rankin was told he was on the road to recovery when doctors checked him into a California nursing home for a short stay to heal sores on his legs caused by diabetes. Rankin says his room was so filthy he almost lost his legs. He said, "I looked down at my left leg and it was totally covered with ants," says Rankin. "I mean, thousands of ants on my leg. When his legs got worse, his family insisted he be taken to the hospital. Instead, the Manorcare home he was libing in refused to take hiom to a hospital. He laid in his bed in the nursing home for almost a year trying to get his legs healed. Rankin then sued Manorcare, one of the nation's largest and most profitable nursing home chains for their nerglect of him.

There was a major lawsuit against every Manorcare home in California accusesing the company of fraud -- putting "profits over proper medical care."

Basic care was an issue for Bruce Lemoine at one Manorcare. He died from exposure after he was left outside, strapped in his wheelchair, in near 100-degree heat. He was so dehydrated, he was like a mummy. The home settled his family's lawsuit and further, it paid the state $52,000.

In fact, families across the United States and elsewhere are suing nursing homes, claiming the care they were promised is not what loved ones got. Unfortunately, every year there is a substantial number of nursing home abuse victims who are unable to recover from the wounds they’ve received from either the direct abuse or intentional neglect of the staff supposedly dedicated to helping them. Many nursing home employees are taken to court and criminally convicted of these crimes each year. Although criminal charges may provide satisfaction that the wrongdoer is punishedf, criminal claims who are abused in some of these nursing homes do not typically provide any sort of financial compensation to a victim’s loved one.

But for quality care, don't rely on the tours of nursing homes. Take the time to look at complaint files, inspection reports and lawsuits that reveal a nursing home's true track record. And equaqlly important, talk to the residents.

I was very fortunate. My mother and stepfather were in the eighties when they decided to sell their home in Hawaii and moved into a nursing home in Olympia,Washington. Everyone in that place was well treated. They all had their own apartments and could eat in the dining room if they so choose to do so. They were taken on shopping trips and site-seeing trips. Medical care was always available to them when needed.

Psychological and Emotional abuse

Older women more than older men are often shouted at, put down, or otherwise denigrated. Such mistreatment may lead to anxiety, depression, high blood pressure, or other health problems. Emotional abuse is a form of family violence. Psychological or emotional abuse occurs when an abuser or someone causes mental or emotional pain, distress, suffering, or anguish to an elder. This may be unknowingly or purposely done by family members or any person that is caring for an elder. Psychological or emotional abuse includes insulting, threatening, humiliating, intimidating, or harassing through words or actions. This may also involve ignoring the elder, giving silent treatment, keeping the elder inside the house and not letting other people call or visit him, not giving mail, electronic mail, or phone calls to the elder, not allowing or making it possible for the elder do his usual activities, such as going to church, or visiting friends and preventing the elder from deciding or acting for himself even if he has a sound mind.

There are many things that may cause someone to psychologically abuse an elder. Poor or crowded living conditions may be one of the reasons why it occurs. The following are other possible causes and conditions that may increase an elderly person's risk of psychological abuse.

The abuser depends heavily on the elder for things such as money or housing, drinks alcohol or uses illegal drugs, such as cocaine, heroin, and marijuana, has a personality disorder, depression, or another mental illness, has a history of family violence, such as physical or sexual abuse, has stress due to work, taking care of the elder, or financial problems.

Summary

I believe that every state or province should have a seniors ombudsman who has the authority to look into accusations of elder abuse, be it in a private home or nursing facility. Many years ago when the United States made it manditory that every state have an ombudsman that acted on behalf of seniors in each state, my mother and stepfather were very fortunate indeed when they lived in Hawaii. The governor of that state appointed my stepfather to be the ombudsman for seniors for that state. In that capacity, he was only answerable to the legislature of the state of Hawaii.

I feel that everyone who is hired to care for a person who is either elderly or infirm irrespective as to whether or not the person in need is in a private home, or nursing home or government institution, should be licenced after a thorough background check is undertaken to determine the fitness of the caretaker.

Further, there should be inspectors who have unfettered authority to enter a private home or nursing facility or government institution at any time to investigate suspicions of elder abuse. Animal rights inspectors can do this, so why shouldn't we protect senior citizens the same way?

I am a senior person since I am 76 years of age. Fortunately for me, I am mentally sound and not physically infirm even though I have difficulty in walking. No one is taking advantage of me, of that you can be sure. But if anyone should be stupid enough to try it, they do so at their own risk. But unfortunately, many of my contemporaries are not so fortunate. It is these people we have to help.

If anyone suspects that a elder is being abused, they should contact the authorities. It is the right thing to do.