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Utahns urged to look for signs of abuse of elderly

The hours of agony captured on tape last month in Cottonwood Heights - a supposed caregiver apparently slapping a helpless 80-year-old woman and calling her such names as "big fat cow," "you retard" and "dumb, dumb, dumb, lazy old lady" - reinforces the need to be alert for signs of abuse of the elderly.

It's not as if those claims are an isolated incident, according to Dr. Cherie Brunker."The number of elderly Utahns who are abused, neglected or exploited every year is 15,300," said Brunker, one of two experts who will answer questions about elderly abuse and a host of other problems of aging Saturday morning in the Deseret News/Intermountain Health Care offering, Health Care Hotline.

Brunker is the medical director of the IHC Senior Clinic at St. Joseph's Villa and is on the staff of LDS Hospital. She will be joined on the call-in feature by Carol Hughes, a geriatrics nurse practitioner at the clinic.

"The abuser is often a caregiver," Brunker said. In fact, the perpetrator easily could be a family member.

Only about one in 14 incidents of elderly abuse is reported. So where does the figure 15,300 come from? It is an estimate based on detailed surveys of patients, Brunker said. Physicians examine groups of patients, delve into their problems and sometimes discover abuse.

Abuse can show up as physical signs, such as bruises, "but it can also be psychological abuse. Neglect is lack of providing care, and exploitation is abuse of their resources or taking control of their money or property or whatever," she said. All are forms of abuse.

Victims are usually women over 75 who are either widowed or single and dependent on the abuser for their needs. "If needs aren't met or things are stolen, that's neglect and exploitation," she added.

Just as child abuse must be reported, anyone who knows or suspects elderly abuse is happening is required to tell authorities. "It's mandatory to report it," she said.

Locally, the place to call is the Salt Lake County office of Adult Protective Services, 487-34665.

To call the number, a person doesn't need proof that a victim really is being abused. "It may be just a suspicion or a concern. For example, if I see a patient who's not getting food, or is unclean or not being taken care of, I can address those issues with a family member, but I can also call Adult Protective Services."

Protective Services will show up in a non-threatening posture. They will be members of a team trying to meet the needs of the elderly person, she said.

The abused person need not be old to fall under the umbrella of Adult Protective Services, according to Brunker. Any impaired adult should be protected.

Signs of physical abuse include bruises, especially if they are of different ages; bruises change color with time, and an indication that someone has been bruised at various dates may indicate ongoing abuse rather than a single fall. Also, welts may indicate striking.

In addition, those who are concerned should look for "unexplained injuries, such as fractures or cuts, various injuries." Sometimes an older person may seem hopeless or fearful. "Those are signs of abuse."

Signs of neglect include dehydration or malnutrition. "If they're oversedated, (that's) an inappropriate use of medication." Nursing homes, with their strict requirements, are less likely to over-medicate than individual caregivers in another setting. Sometimes the older person may inadvertently overdose himself with medicine.

If an older person's condition changes, it's important to talk to a physician, she said. One reason might be neglect.

Sometimes caregivers need a break, and both the county and the Eccles Foundation have programs that provide some respite. St. Joseph's Villa and Neighborhood House, a program that is located in three different areas of Salt Lake County, offers day care on a sliding fee, so people with lower incomes pay less to have their relatives looked after for a while.

Indications that an older person is being exploited are such things as overcharging by a repairman. Or a person may not be capable of making financial decisions and a "distant family member has them sign the house over." Or the elderly person's belongings may begin to disappear.

Responding to the wry comment that we all have a wonderful future to look forward to, Brunker said, "I'm in this field for a selfish reason - I want to be older and comfortable and protected."