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CENTER - HELPFUL INFORMATION You may download the individual parts or you can have the whole "Helpful Elder Guide" in one package free by clicking here. PRE-ELDER CARE, GETTING THINGS IN ORDER NOW!
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Legal Definition "Abuse" means the infliction of injury, unreasonable confinement, intimidation or cruel punishment with resulting physical harm or pain or mental anguish; sexual abuse or exploitation; or the willful deprivation of essential needs. There may be times when you observe signs of abuse but were not actually a witness to what happened. The tangible signs or indicators of abuse, neglect or exploitation described below tend to be ones that can be detected by trained observers such as facility staff members. More difficult to detect or to determine are intimidation and mental anguish. Facility residents who are ridiculed, maliciously teased, cursed at or threatened may fear retaliation if they speak up or complain about a family member, another resident or a member of the facility staff. It takes skill and sensitivity beyond that required for routine observation to find out if verbal abuse has occurred. Physical Abuse Indicators Physical assaults, cruel discipline, excessive use of physical or chemical restraints, and unnecessary or incorrect medication may cause any one of the following: Broken bones: Pain and inability to move a limb may be a sign of a broken bone. This may occur when a resident with osteoporosis is handled roughly by visitors or staff. Burns: Burns and blistering skin over a wide area may show up because a resident was placed in a scalding hot tub of water. A more confined spot of burned skin may indicate purposeful burning with a cigarette. Cuts: You may observe cuts or scratches because one resident jabbed another resident with a sharp object such as a pencil or scratched a resident with fingernails. Bites: These do occur, sometimes because one resident bites another. Internal Injuries: Watch for such signs as vomiting, pain, stuporous states, bleeding, swelling or bloody stools. You may observe any one or a combination of these if someone, for example, gave a resident alcohol or drugs that can cause sickness, or if someone overdoses a resident with anti-diarrhea medicine causing severe constipation, or if a blow to the stomach or head has caused internal injuries. Marks/Bruises: A resident may have a hand-print shaped bruise where a person slapped them across the face or buttocks. Scars: You may observe scars which could indicate that the resident has been a victim of repeated or past abuses. Sexual Abuse Indicators "Sexual abuse or exploitation" means contact or interaction of a sexual nature involving an incapacitated or dependent adult without that adult's consent. You notice that a family member offers affectionate gestures to a resident that are too lingering and seductive or become centered on the sex organs, anus or breasts. You observe injury to a resident's genitals, anus, breast or mouth following an overnight visit with family. You overhear a resident attempting to talk an incapacitated resident into sexual intercourse, fellatio, or cunnilingus. A young female resident tells you that her father manipulates her genitals, buttocks and breasts during his visits to the boarding home. You happen upon a staff member exposing his/her genitals to a resident. You learn of a visitor taking nude photographs of residents. Indicators of Neglect "Neglect" means a threat to an adult's health or welfare by physical or mental injury or impairment, deprivation of essential needs or lack of protection from these. Residents suffer from neglect when they are left alone, ignored by staff or left with staff who fail to care for them appropriately. Indicators of Exploitation "Exploitation" means the illegal or improper use of an incapacitated adult or his resources for another's profit or advantage.
Types of Abuse: Abuse may occur in a variety of ways. Roommates may abuse one another, caregivers may abuse care recipient or a care recipient may be abusive towards caregivers. Abuse may be an act of violence such as physical or sexual assault, or it may be verbal abuse, medication errors or failure to provide proper assistance that results in an injury. Risk factors for abuse can be related to caregivers, to conditions in the environment itself or to residents. Listed below are some factors that increase the risk of abuse. The more of them that are present in a situation, the greater the risk. There are also other forces that may contribute to a problem such as the season, holidays, reactions to family visits, weather and time of day. Being aware of what to watch for and averting a build up of such risk factors can help to prevent abuse. Caregivers' Risk Factors:
Adult Living Facility Risk Factors:
Resident Risk Factors:
Mandatory Reporting: Mandatory reporting requires that certain persons, while acting in their professional capacity, immediately report or cause a report to be made of suspected abuse, neglect, or exploitation of an adult, if there is reasonable cause to suspect that the adult is incapacitated. Professionals who must report:
Facility reporting:The law states that whenever a person is required to report in his or her capacity as a member of the staff of a medical, public or private institution, facility or agency, that person shall immediately notify the person in charge of the institution, facility or agency or a designated agent of the person in charge, who shall then cause a report to be made. The staff person shall also make a report directly to the appropriate department. When a staff person is required to report, they must make a report to the person in charge at the facility and to the appropriate department. The in-charge person will meet the "cause a report to be made" requirement of the law by ensuring the staff person has made a report to the appropriate department. Optional reporting: Any person may make a report if that person knows or has reasonable cause to suspect abuse, neglect or exploitation of a dependent or incapacitated adult, or has reasonable cause to suspect that an adult is incapacitated. Where to report: Mandatory or optional reports are made to the Department of Human Services, or when the alleged victim has mental retardation, to the Department of Mental Health and Mental Retardation. During office hours, reports to the departments are made through Regional Offices of the Bureau of Elder and Adult Services and the Department of Mental Health and Mental Retardation Office of Advocacy. Immunity: When reports are made in good faith, reporters are immune from any civil liability. Facility staff who comply with the mandatory reporting law also are protected from discharge, threats or discrimination regarding their conditions of employment by their employers. Liability: A fine of not more than $500 may be imposed upon a professional who is convicted of knowingly failing to report abuse, and the conviction will also be reported to the professional's licensing board or accrediting unit. Confidentiality: The Department will respect a request for confidentiality. Identity of reporters requesting confidentiality will not be revealed unless a court or grand jury determines it is required to protect the suspected abused adult from serious harm. Self-Abuse: Self-abuse or self-neglect must be recorded in the resident's chart and noted in an incident report. Accidents: Injuries from a known accident are not reportable but must be noted in the resident's chart.
In planning one's estate, trusts can be an important element. Trusts can be first divided into two variations. They are revocable trusts and irrevocable trusts. Irrevocable trusts cannot be changed (with a few exceptions) after they are put in place. They are important in tax planning for those with larger estates. They sometimes take the form of an insurance trust or charitable trust, each of which have many variations. Revocable Trusts Revocable trusts are the most common estate planning tool used for individuals today. They can be amended and changed at any time before the person making the trust becomes incapacitated or dies. The most commonly used revocable trust is an Intervivos or Living Trust. In this instrument, the maker of the trust places their assets into the trust immediately and then the successor trustee may manage those assets if the maker of the trust becomes incapacitated or dies. The successor trustee is the fiduciary, and has a legal duty to follow the terms of the trust as set out by the maker of the trust. The Intervivos Trust allows you to avoid probate at death, and avoid a conservatorship in the event of incapacity. It can be part of an estate plan in which the children will have a sub-trust built in to the main trust and not receive their money until they become a particular age in which the maker deems appropriate. In the case of a married couple it can be used to minimize estate taxes. The Revocable Intervivos Trust is a complicated document, and should be completed under the direction of a professional. The trust itself is an independent entity, and unless you properly put the assets into the trust, it is totally ineffective. Even though the trust owns the assets, the one who made the trust has the ability to control the assets, either as trustee, or by amendment to the trust. A second type of trust is the Testamentary Trust, which is a trust that takes effect after the death of the trustor. It is probated, but does allow for one to designate sub-trusts for the children, and marital estate planning. Its disadvantage is that it is subject to probate court jurisdiction at all times, but probate court jurisdiction does give greater security to the beneficiaries should the successor trustee not fulfill their proper fiduciary duties. Irrevocable Trusts Generally: There are a number of types of irrevocable trusts that can be used to make gifts to other persons with the assets under the control and management of a trustee. Gifts to an irrevocable trust are sometimes motivated by a desire to minimize federal transfer taxes or to shelter assets from the claims of future creditors and other claimants (including spouses in divorce cases and plaintiffs in civil lawsuits). To be effective for estate-reduction purposes, the trust must be irrevocable, and the trust's settlor should not be a beneficiary of the trust. It is also best if the settlor is not a trustee, either. In order to qualify for the $10,000 annual exclusion for gift-tax purposes, irrevocable trusts usually contain a provision giving the trust's beneficiaries a temporary right to withdraw annual contributions, at least in part. This withdrawal right is often called a "Crummey power" in reference to a Ninth Circuit Federal Court case involving a family with the "Crummey" surname.
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