Adult Protective Services

Illinois Adult Day Services AssociationCarol W. Mauck, MSW, LCSW

Today you will learn:

• Definitions of types of adult abuse• Risk indicators for all types of abuse• Who are mandated reporters• How to make an adult abuse report• Recommended adult protective

procedures for centers

Adult Protective Services in Illinois

Adult Abuse is to be reported for any Illinois resident age 18-59 living with a disability

An adult 60 years of age or older who lives

in a domestic setting.

Adult Abuse Types• Physical, sexual or emotional abuse• Neglect-failure to provide necessities of life• Confinement-restraining or isolating• Financial exploitation- withholding financial

resources• Willful deprivation-deliberate denying

care/treatments• Self-neglect-a condition that is the result of an

adult’s inability, due to physical or mental impairments, or diminished capacity*

What

t Professionals Need to Know, State of Illinois, Department on Aging (2014))

Financial Exploitation IndicatorsIt is about access:Caregivers situations who have access to account

information/passwordsHired caregivers who have access to a purse with credit cards and

checksClients who have credit cards, bank cards with account info in

walletFamilies who live out of town and cannot monitor hired caregiverNo social support system for client or caregiver

General Risk IndicatorsClient has memory loss Impairments in sight and hearingClient has mobility issuesClient’s physical appearance has declined

through illness, weakness, or poor careBody and house odorNo food in houseMedication not refilledObservations of reactions between caregiver/client-speech

context/physical touching Shows lack of concern

General Risk Indicators (cont.)

Aggressive caregivers-verbal and physicalVerbal threats like putting loved-one in a

nursing home“I will leave you alone if you don’t give me the

money”Pain medication in the homeEstranged family members moves inFinancial and sellable resources in the house

Caregiver Risks IndicatorsClose to age of clientNot in good physical healthThinks client is “faking it”Does not get enough of a break or sleep, no opportunities

to get “away”Has their own health and/or cognitive problemsDoes not accept disabilities or acknowledge issuesUnable to accept “role reversals”Refuses help/servicesDelays in seeking care

Neglect Indicators

Client cannot help themselvesCaregivers workingClient living in family home with several generations Decreased functional abilityIncontinencePhysical environment of client

Definition of Self-neglectA condition that results of adult’s inability, due to physical or mental impairments, or both, or a diminished capacity, to perform essential self-care tasks that threatens their health, including:essential food, clothing, shelter and health care; and obtaining goods and services necessary to maintain physical health, mental health, emotional well-being, and safety.

Self-Neglect Indicators

Refusing interventions Doesn’t go to physician May have physical/mental problems Items begin to “pile up” in living environment Decision-making is impaired about what items are garbage Hoarding syndrome Refuses family intervention Unable to see safety issuesNote: The amendments to the APS Act did not make reporting self-neglect mandatory for professionals.

Behavioral Indicators

Observations of behaviors of the client, by themselves may not indicate abuse or neglect; combined with other indicators may change interpretation

fear confusionwithdrawal disorientationhelplessness contradictory statements resignation angerhesitation to talk openly denial implausible stories agitationanxiety sleep disturbancesnon-responsiveness unexplained changes in behavior or appearance

Deciding when to ReportTypes of reporters: mandated-must report by law voluntary-everyone encouraged to report in all cases of adult abuseself-reporting-by alleged victim

Adults because of a disability or impairment who are unable to seek assistance come to the attention of professionals/ state employees must with in 24 hours make a suspected abuse report. The requirement to report is any time the mandated reporter is work engaged.

If a mandated reporter is undecided whether or not the adult is being mistreated is able to self-report,IDOA encourages the reporter to voluntarily report the suspected abuse.

Physical or mental conditions which might render the adult unable to self-report such as dementia, paralysis, bed-ridden, speech disorder or unable to use a phone. Professional’s decide whether or not the adult is able to self-report.

Deciding mental capacity

• Is the adult able to understand the facts?• Is the adult able to express a

free choice about the situation?• Is the adult able to understand

risks and benefits of the choice?

“Mandated Reporter” includes any of the following people who suspect abuse of an adult living in a domestic setting while engaged in carrying out their professional duties:

A professional / professional delegate while engaged in:• Social services • Adult care workers • Law enforcement• Education• Medicine/coroner/medical examiner• State services to seniors• A person who performs the duties of EMT/paramedic• Any occupation required to be licensed under……….*

What Professionals Need to Know, State of Illinois, Department on Aging (8/13 *

Example of ADS Procedures Center personnel should routinely screen for signs of abuse, neglect or exploitation through routine client care or daily contact with clients (such as bathing and nursing assessments)

Center personnel should inquire as part of a on-going routine assessment process with clients if they have any concerns or issues about their care. Documentation should be made of these conversations.

If abuse, neglect or exploitation is suspected, the person making the assessment should complete an “Incident Report Form” and follow center policy to report to APS

What happens when a report is made?

Intake: Agency will need information. Be prepared to answer: Alleged victim’s name, address, telephone number, sex, age and

general condition Alleged abuser’s name, age, relationship to victim and condition Circumstances that lead to the report If the person is in immediate danger Best time to contact the person Callers confidential information Any other relevant information

What happens when a report is made? (cont.)

Assessment: depending on the nature and seriousness of the allegations, a trained caseworker will make a face to face contact with the alleged victim within the following time frame:

24 hours if life threatening situations72 hours for most neglect and non-life threatening physical abuse report7calendar days for most financial exploitation and emotional abuse reports

What happens when a report is made? (con't)

Caseworker has 30 days to complete a comprehensive assessment both to determine if abuse happened and need for treatment and intervention. Follow-up: case may be kept open for 15 months from the date of intake to monitor the situation and to reassess the need for different interventions.

Can victims refuse services?

State of Illinois is a client’s right to self-determination program

80% of client’s whose abuse is substantiated accept services Clients can refuse protection services &

interventions If client has neurocognitive impairment Court

petition for Guardianship is filed. Court decides best plan of care to assure all needs are met.

Slides reprinted through permission ofLaura Mosequda, M. D.,Associate Dean of Primary CareChair and Professor of Family Medicine and GeriatricsKeck School of Medicine of the University of Southern California

Report Suspected Abuse

Remember:Protecting your clients is yourjob by reportingsuspected abuse of any typeMake the call.Remember:It is not your job to decided if there is alleged abuse. Assessing the situation is the job of adult protective workers.