Wednesday, May 22, 2019

What to consider when an aging loved one needs long-term care as complaints of elder abuse rise

SALT LAKE CITY — Utah as a whole is continuing to grow older, and state administrators say a troubling trend has accompanied the demographic shift.

They have received more and more complaints alleging abuse of vulnerable and elderly Utahns.

"It happens in facilities. It happens in their own home," said Nan Mendenhall, director of Utah Adult Protective Services. "It's not discriminatory. It happens to anybody."

Utahns reported 5,325 instances of abuse to Mendenhall's agency in 2017, a 40 percent increase from just three years earlier, when it documented 3,030. Recent criminal cases have also drawn attention to the misconduct. A former Clearfield nurse's aide is now serving a year in jail for punching and shoving two Alzheimer's patients after a camera captured some of the abuse.

The exploitation is not just physical and sexual, but also financial. And while there are steps families can take to protect loved ones, Utah's experts on aging say the Beehive State must do more to prepare for its aging population.

Those over 65 years old now have outpaced children and teens as the fastest-growing age group in Utah. State demographers estimate the retirement-age share will doubleover the next 50 years to 1 in 5, according to a Januaryanalysisfrom the Kem C. Gardner Policy Institute.

The rate of those with Alzheimer's will grow even faster, more than tripling in the same time frame to a total of 112,000, the report estimates. The disease is one type of dementia, a decline in mental function that can lead to memory loss and changes in personality or reasoning skills. It has no cure, but drugs can ease symptoms.

"We tend to have a healthier population, which means that people live longer," said Ronnie Daniel with the Utah chapter of the Alzheimer's Association. "The single largest risk factor for getting Alzheimer's and other related dementia is age."

His group worked with state health and licensing managers to create a 2017 requirement for employees of long-term care facilities to receive at least four hours of training on how to work with those who have dementia in order to renew their licenses.

"We don't believe that's enough," he said, "but that's a good start."

Rob Ence, executive director of the governor's Commission on Aging, said despite some progress, "we are still falling short where we are today, let alone taking steps to be prepared for the future."

The groundwork he envisions ranges from more doctors encouraging dance and exercise, which can help stave off Alzheimer's, to more affordable housing for aging Utahns and incentives to draw more of the workforce to care giving. Utah still must grow state programs to investigate abuse and advocate for patients' rights, Ence said.

In 2017, nearly half of complaints to Adult Protective Services alleged financial exploitation, Mendenhall said. She is now urging lawmakers them to codify tougher penalties on those who transfer an aging family member's deeds and property without permission.

Physical and sexual abuse claims account for 20 percent of the total, but Mendenhall said they are often underreported, especially when they occur in group settings.

"On the sexual side, the victims are targeted because they have their cognitive ability of not being able to remember," she said. Mendenhall declined to say whether her agency investigated Jason Herald Knox, the Clearfield nurse's aide convicted of aggravated abuse of a vulnerable adult who led his employer to believe he was taking ongoing training even though his certification had expired.

Knox's victims had routine visitors, but predators will typically opt to take advantage of those more isolated, Mendenhall said. "If you don't have active eyes coming in to see your loved ones, they're more likely to be abused."

Utah law requires anyone who suspects exploitation of a vulnerable adult to tell either police or her agency, which creates plans protect the victim from further abuse.

As the workload for the two dozen investigators across Utah has grown, their budget has shrunk, Mendenhall noted. She is seeking the money to add three more, a request she hopes lawmakers will grant in a special session later this year

Some resources and tips from the experts:

• After a diagnosis, seek out a care strategy as soon as possible so that your aging loved one can have a say in the plan. For those wondering where to begins, the Alzheimer's Association runs a 24-hour hotline: (800)272-3900. Utah's area agencies on aging, mostly run by counties, also can help.

• Families shopping for a longterm care facility should drop by at different times of day to observe interactions between staff and residents, Mendenhall said. On planned visits, you're less likely to spot telling interactions. A database operated by Medicare.gov issues report cards on nursing homes nationwide.

• When hiring someone to care for a loved one in their own home, be sure to do a background check and call references, preferably at agencies with a strong reputation.

• You can report abuse of a vulnerable adult in Utah by calling Adult Protective Services (800)371-7897 or online through the agency's website.

• Help is also available through the agency for family members who become overwhelmed by a loved one's needs and would like training on how to cope with the stress .

• Utah has a long-term care ombudsman, plus several local liaisons, who advocate for the rights of those in group settings when it comes to concerns from suspected criminal behavior down to meal preferences.

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What to consider when an aging loved one needs long-term care as complaints of elder abuse rise

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