Self neglect the No.1 form of area elder abuse

GRAND FORKS, N.D. -- Most of the reported cases of elder abuse in this area have to do with “self-neglect,” said Kate Kenna, regional director of Northeast Human Service Center which covers four North Dakota counties — Grand Forks, Walsh, Nelson and Pembina.

For the nine months leading up to June 30, she said, reported cases fell into these categories:

35: Self-neglect (hygiene, moldy food, going without basic substances)

11: Neglect

7: Physical abuse

4: Financial exploitation

In cases of self-neglect, “neighbors, the family, friends or pastors may be trying to help, but it feels bigger than what they can handle,” Kenna said.

In cases of neglect, someone else is responsible for the elderly person’s welfare, but is not stepping up, she said.

“When the calls come in, our staff member asks a few screening questions. If the person is in imminent danger, we’d want to get out there right away. We may involve law enforcement.”

Police or sheriff’s officers would determine if a crime has been committed, she said. If so, the matter becomes a criminal case.

If it’s not an emergency, a staff member of Northeast Human Service Center would visit the home.

“It may be as simple as getting meals to the house, or homemaking services for the person. It’s a question of, ‘what is the least restrictive environment?’”

It boils down to, “How to live safely, but how they want to live,” she said. “Our core value is self-determination. For each person, each situation is unique.”

In Grand Forks, a team of professionals from various agencies “meets six times a year to look at cases that have come in,” Kenna said.

Partnerships like this make Grand Forks “somewhat unique,” and stem from cooperation born as the city recovered in the aftermath of the Flood of ’97.

“The strength of those relationships” has remained in place, she said.

Obstacles

For the elderly, having trusting relationships makes a difference, Kenna said. But there are obstacles.

“So many are isolated and families are far away. Everybody’s life is so busy, we overlook things. We don’t take time to get to know our neighbors.

“As people age, they lose their support network. They may have backed away from church involvement, for example,” she said. “They may feel helpless, the situation may overwhelm them, and they don’t know what to do.”

Many elderly people don’t speak up about their plight, she said. “Or, they just think they should be able to do it on their own.”

In rural areas, it’s difficult for people to report abuse but remain anonymous, she said. “They may want to look for informal resources — pastors, senior citizens clubs, church circles, birthday clubs.”

The advantage of living in rural areas, though, is that communities “are small enough to care about you.”

Those who abuse the elderly “are so often hurting themselves,” Kenna said. “They may be abusing drugs or alcohol, or gambling.

“They choose to right what’s wrong with themselves by taking advantage of someone else.”

‘Won’t deny children’

The elderly represent a population “that won’t deny their children or grandchildren anything,” said Joyce Austin of the Resource Team, a unit of the state’s Aging Services Division, located in the Grand Forks Senior Center. “They’re not willing to say ‘no.’

“They save everything for their kids.”

They may do so even to their own detriment.

Members of the Resource Team visit seniors living independently in their own homes and conduct assessments for home-delivered meals programs and help connect people with a broad range of home- and community-based services including nutritional, financial and transportation support, as well as health and medical equipment and services.

Austin finds that some of her clients are not eating right, she said. “If they have a memory problem, they don’t remember if they ate.”

Others are not attending to their health or going to doctors’ appointments because they lack transportation which “is a big issue, especially in rural areas,” she said.

And she watches for signs of physical abuse, poor personal hygiene and safe housekeeping practices.

“Spills on the floor, a loose railing or a rumpled rug could lead to falls.”

In her experience with vulnerable elderly adults, through Aging Services at the Grand Forks Senior Center, Sue Quirk said, “You see more emotional than physical abuse.”

Emotional distress is caused by verbal “put-downs, yelling, screaming, complaining and threatening to put the elderly person in a nursing home” if he or she doesn’t succumb to demands, she said.

In instances of financial exploitation, “it’s easy to do a little bit here and little there, pretty soon it’s a lot,” Austin said.

But when elderly people “are not willing to do anything, you’re stuck,” she said. “There’s not much you can do.”

A police matter?

Most elder abuse issues in this area are handled by families or health caregivers, said Brian Cofer, an officer with the Grand Forks Police Department.

Police officers see “not so much elder abuse, but neglect,” he said. “Neglect can be seen as an abuse situation.”

In some cases, the family is unable or unwilling to help out.

If an assault has occurred, it usually happens “after a long period of time,” he said, and because the caregiver “has gotten frustrated or stressed or doesn’t feel appreciated.”

Also, mental illness “a big problem,” Cofer said.

He cited the example of an elderly lady who lives alone, drives a vehicle and takes care of herself but had dementia, he said. She was calling local police “three or four times a day” with complaints that people were in her walls, trying to read her thoughts and trying to steal documents.

“Even when all the signs are there that mental health and medical help is called for, you can’t force them to get it, unless it’s court-ordered.”

It was hard for his officers, he said, because this woman — and others with whom they come into contact — “looks like anybody’s grandmother.”

Officers “think it should be a quick fix, but it’s not. There’s a lot more to it than just talking them into (getting help).

“They’re really untrusting. They don’t want help because they don’t think they need it.”

Sometimes, when police investigate charges that money has been taken from an elderly person’s bank account, they find that a relative has bought groceries or paid bills for that account-holder, with permission, he said.

“It becomes a matter of ‘who do you believe?’”

Cofer has also seen arguments over property. “That gets pretty messy.”

Signs of possible physical abuse — bruises, skin-tearing, injuries — can be “normal things,” he said. “The person may have just walked into a coffee table.”

Cofer recommended people contact Vulnerable Adult Protective Services if they want to seek help for an elderly person.

Families who are concerned about abuse or neglect should ask the Grand Forks Police Department to do a “welfare check” at the residence, he said. “We’ll get an officer to the house in a matter of minutes.”

The department would issue a report “if there’s something there.”

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