Multnomah County Gatekeeper Program by 5gG0BP

VIEWS: 7 PAGES: 31

									Working With
Adult Protective Services


               Multnomah County
               Aging and Disability Services
               April 2012
After training, participants will:


    Know the definitions of abuse
    Recognize abuse situations
    Understand the steps necessary to make a
    referral to APS
    Understand the adult protective service
    worker's role and responsibilities



  Multnomah County
  Aging and Disability Services
Guiding Principles of APS
 Do no further harm
 Pursue the least restrictive option
 Always consider the client’s choice and
  preferences

As long as they have capacity, do not harm others
 or commit a crime, clients have the right to
 choose freedom over safety


    Multnomah County
    Aging and Disability Services
Mandatory Reporting
  State law protects the confidentiality of all
  people reporting abuse
 Oregon’s abuse reporting law protects anyone
  who reports abuse in good faith
 When reporting suspected abuse, HIPAA
  protected information can be shared with APS.
  It is up to APS to protect that information.




    Multnomah County
    Aging and Disability Services
       Mandatory reporters of elder
             abuse include:
   Naturopathic, osteopathic, podiatric, chiropractic or general
    physician or surgeon, including an intern or resident
   licensed practical nurse, registered nurse, nurse's aide, home
    health aide or employee of an in-home health service
   psychologist, licensed clinical social worker, licensed professional
    counselor, licensed clinical social worker or licensed marriage and
    family therapist
   physical therapist, speech therapist, occupational therapist,
    audiologist or speech language pathologist
   firefighter or emergency medical technician, peace officer or
    member of the clergy
   any public official that comes in contact with older adults in the
    performance of the official's duties



        Multnomah County
        Aging and Disability Services
Making an APS Referral

 Contact APS Central Screener at 503-988-4450
 Screener will ask for information about the
  suspected abuse, the alleged perpetrator,
  witnesses and the victim
 Screener will determine risk factors and
  response time



    Multnomah County
    Aging and Disability Services
Risk of abuse increases with:
   Advanced age
   Demanding behaviors
   Dementia
   Physical impairment
   Substance abuse
   History of family violence
   Isolation
   Depression

      Multnomah County
      Aging and Disability Services
Types of Abuse
   Physical Abuse
   Neglect
   Financial Exploitation
   Emotional, Verbal or Psychological Abuse
   Abandonment
   Sexual Abuse
   Self Neglect



      Multnomah County
      Aging and Disability Services
 Physical Abuse
     Any physical injury caused by other than
     accidental means or that appears to be at
     variance with the explanation given for the
     injury; involuntary seclusion and/or
     physical or chemical restraints




Multnomah County
Aging and Disability Services
Indicators of Physical Abuse
   Bruising
   Injuries when explanation is implausible
   Abrasions
   Broken bones, sprains, dislocations
   Over or under medicated




      Multnomah County
      Aging and Disability Services
 Sexual Abuse
    Sexual contact that is forced, tricked,
    or otherwise coerced upon another
    person, inappropriate sexual
    comments or inability to consent to
    sexual contact




Multnomah County
Aging and Disability Services
Indicators of Sexual Abuse
   Fear exhibited toward caregiver, family member
   Sexually transmitted diseases
   Genital or anal pain, irritation or bleeding
   Bruises on inner thigh
   Change in behavior




      Multnomah County
      Aging and Disability Services
 Abandonment
 Desertion or forsaking of an elderly or
 disabled person or the neglect of duties
 and obligations owed a dependent adult
 by a caretaker or other person




Multnomah County
Aging and Disability Services
Indicators of Abandonment
 Care provider not showing up to work on time,
  leaving early or not covering assigned duties
 No one answers telephone
 No one present to let Meals-on-Wheels drivers
  into residence
 Wandering




    Multnomah County
    Aging and Disability Services
 Financial Exploitation

 Illegal or improper use of another’s
 resources for personal profit or gain or
 theft of items or medications




Multnomah County
Aging and Disability Services
Indicators of
Financial Exploitation
   Caregiver putting name on property or financial
    accounts or questionable house title changes
   Sweepstake “junkies”
   Sudden change in a bank account
   Bounced checks
   Bills going unpaid when they used to be paid
   New “best friend”



      Multnomah County
      Aging and Disability Services
 Emotional, Psychological
 or Verbal Abuse
 Use of derogatory names, profanity,
 ridicule, harassment, coercion, threats,
 isolation, or intimidation toward an
 individual. Denial of civil rights which
 threatens emotional injury




Multnomah County
Aging and Disability Services
Indicators of Emotional,
Psychological or Verbal Abuse
•   Shows fear of caregiver or family member


•   Fears making independent decisions


•   Any reference or inference of punishment by
    caregiver



      Multnomah County
      Aging and Disability Services
 Neglect
 Failure to provide basic care or maintain
 emotional well being when agreed to by
 legal, contractual or otherwise assumed
 responsibility




Multnomah County
Aging and Disability Services
Indicators of Neglect
   Malnutrition or dehydration
   Poor hygiene
   Skin ulcers
   Over or under medicated
   Wandering
   Frequent falls
   Improperly clothed
   Untreated medical or mental conditions

      Multnomah County
      Aging and Disability Services
 Self Neglect
  Inability to understand the
  consequences of action or inaction that
  may lead to harm or endangerment due
  to cognitive deficits




Multnomah County
Aging and Disability Services
Indicators of Self Neglect
   Poor hygiene
   Lack of food, clothing
   Lack of medical care
   Failure to use medical care appropriately or to
    follow medical recommendations
   Malnutrition
   Change in behavior causing endangerment



      Multnomah County
      Aging and Disability Services
After the Referral —
What to Expect of APS

 All initial APS visits are unannounced
 Investigates complaints by interviewing victims,
  perpetrators, witnesses and examining pertinent
  records
 Offers intervention and services as available,
  such as law enforcement, MDT or Public
  Guardians office


    Multnomah County
    Aging and Disability Services
     APS in Multnomah County
   APS receives about 9000 calls per year
   Investigators write about 4200 reports per year
   Self neglect was the most common type of
    abuse followed by financial exploitation
   60 % of victims were female
   Family members were also the most common
    perpetrators, followed by the victims
    themselves


      Multnomah County
      Aging and Disability Services
All crimes are abuse but not all
abuse is a crime
 Abuse is not necessarily a crime
 Abuse situations may be brought to the law
  enforcement staffing by APS for consultation
 A crime may be investigated through law
  enforcement and may be prosecuted by the
  District Attorney’s office
 Not all abuse will be investigated by law
  enforcement


    Multnomah County
    Aging and Disability Services
When is law enforcement called?

   APS workers must notify law enforcement when they
    believe a crime has occurred

   APS may call law enforcement when confronted with an
    unsafe situation or a confrontational perpetrator

   APS meets monthly with law enforcement to discuss
    mutual cases and strategize interventions



       Multnomah County
       Aging and Disability Services
FAST Team                     Financial Abuse Specialist Team



   Two investigators have been assigned to specialize
    in financial cases

   FAST team often get more complicated cases of
    financial abuse

   All teams can refer cases to law enforcement



      Multnomah County
      Aging and Disability Services
Protective Services Tools
   Restraining orders
   Relocations
   Guardianships or Conservatorships
   Police involvement
   Mental health involvement
   MDT
   Basic cognitive screenings



      Multnomah County
      Aging and Disability Services
The Multidisciplinary Team
Each area has an MDT which consists of:
  –   Social worker
  –   Community health nurse
  –   Mental health specialist
  –   Case manager
  –   APS investigator, as appropriate

  Only ADS or District Center case managers can make
   referrals to MDT


      Multnomah County
      Aging and Disability Services
The MDT (multidisciplinary team):
   Provides consultation to case managers and
    other professionals
   Develops intervention strategies to deal with
    complex cases
   Identifies gaps in services
   Examines ethical issues
   Collaborates with other disciplines
   Cultural specialists


      Multnomah County
      Aging and Disability Services
The APS team thanks you for
          your time


                The End
 Multnomah County
 Aging and Disability Services

								
To top