t o El der A buse P ro f ess i on a l s S ex u al A bu se NC EA El d er A bu se Prese nt a t i on Sex u al A bu se httpsnceaaclgov ID: 781015
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Slide1
An Introduction to Elder Abuse Professionals:
Sexual Abuse
NC
EA Elder Abuse Presentation: Sexual Abuse • https://ncea.acl.gov/
1
Slide2NCEA Elder Abuse Presentat
ion: Sexual A
buse
• https://ncea.acl.gov/2
Slide3Learning ObjectivesAt the end of
this training,
you
will be able to:Define and describe sexual abuseLis
t
c
a
t
egories of elder sexual abuseIdentify indicators of sexual abuseIdentify strategies to respond to possible sexual abuse situations
NCEA Elder Abuse Presentation: Sexual Abuse • https://ncea.acl.gov/
3
Slide4Case ExampleAnita, a 78-year-old
female nursing home
resident ha
d moderate dementiaA nursing home staff member saw a male emp
loye
e
f
ond
ling Anita’s breasts and forcibly holding her as she orally copulated him.Anita had previously reported being attacked but her accounts were ignored due to her dementia.
NCEA Elder Abuse Presentation: Sexual Abuse • https://ncea.acl.gov/
4
Slide5Case Example (cont.)Tilly, a w
oman in her 90’s
, live
d with her grandson, Thomas (age 46). Tilly cleaned and cooked for him.Aft
e
r
m
on
ths of financial exploitation, one night Thomas beat Tilly, dragged her across a driveway and threw onto a bed where he raped her.When her grandson fell
asleep, Tilly called police.Tilly was covered in bruises, had in
j
u
ri
e
s
with glass fragments, and had a vaginal tear.
NCEA Elder Abuse Presentation: Sexual Abuse • https://ncea.acl.gov/
5
Slide6Sexual AbuseNon-consensual sexual contact of any kind
with an older adult.
Includes
any form of unwanted sexual contactIncludes sexual contact with a person legally unable to give consent
(
N
a
t
i
onal Center on Elder Abuse)NCEA Elder Abuse Presentation: Sexual Abuse • https://ncea.acl.gov/6
Slide7Consider adding stat
e, tribal,
or
territorial statutes relating to sexual abuse here. These m
ay
b
e
found in criminal law, protective services, or other, statutes.Consider discussing reporting laws in the R
esponse Section (slide 26).NCEA Elder Abuse Presentat
i
on
:
Sex
u
al Abuse • https://ncea.acl.gov/7
Slide8Significantly Under-Reported by Victim
sVictims
may b
e unable to report due to physical and cognitive limitations or other medical
cond
iti
ons
R
eports are often discounted and evidence is ignoredOlder victims may:Be uncomfortable discussing sexual subjectsFeel ashamed and embarrass
edFear of losing spouse, partner, family member or caregiver
B
e
unawa
re
c
onduct is sexual abuse (e.g., spousal rape)
NCEA Elder Abuse Presentation: Sexual Abuse • https://ncea.acl.gov/
8
Slide9Significantly Under-Reported by Profe
ssionalsProfess
ionals
may not report abuse because they may:Believe that older adults are
no
t
sexua
ll
y abusedBelieve that spouse, family member or caregiver would never harm the older adultNot know how or where to reportFear what
will happen to them or their job if they reportNCEA Elder
A
bu
se
Prese
ntation: Sexual Abuse • https://ncea.acl.gov/
9
Slide10VictimsMost victims are wom
en; although men ar
e also vi
ctimizedWhen abused by spouse, partner or family member, it is mos
t
o
ft
e
n part of a pattern of domestic violence or incestWhen abused in a facility, victims typically have significant disabilitiesWhen assaulted by strangers, victi
ms are often selected due to perceived physical vulnerabilitiesNCEA
El
d
er
A
bu
se Presentation: Sexual Abuse •
https://ncea.acl.gov/10
Slide11PerpetratorsPrimarily men but woman
can also be abusers
R
ange in age from minors to older adultsNCEA Elder Abuse
Prese
nt
a
t
ion: Sexual Abuse • https://ncea.acl.gov/11
Slide12Perpetrators Can BeSpouses and
intimate partners
Famil
y membersIn a FacilityFacility Staff and VolunteersVisit
o
r
s
R
es
identsStrangers or acquaintancesOn-line predatorsNCEA Elder Abuse Presentation: Sexual Abuse • https://ncea.acl.gov/12
Slide13Categories“Hands-On”“H
ands-Off”
“H
armful genital practices”(Ramsey-Klawsnik, 1996)NCEA El
d
er
A
bu
se Presentation: Sexual Abuse • https://ncea.acl.gov/13
Slide14“Hands-On”Nonconsensual sexual contact betwee
n the parties.
Oft
en crimes such as rape, sexual battery, oral copulation, sodomyAlso
i
nc
l
udes:
Unwanted forcible sexual contactSexual contact with a person legally incapable of giving consentUnwanted touchingTraffickingNCEA El
der Abuse Presentation: Sexual Abuse • https://ncea.acl.gov/14
Slide15“Hands-Off”Nonconsensual sexualized conduct c
ommitted against the v
ictim
without physical contact between victim and abuser.ExamplesForc
in
g
a
n
older adult to view pornography or others engaged in sexual activityVoyeurismSexually explicit photographingForcing an elder to remove clothing an
d be viewed by othersNCEA Elder Abuse Presentation: Sexual
A
bu
se
•
https://ncea.acl.gov/15
Slide16“Harmful Genital Practices”Unnecessary,
obsessive or pain
ful t
ouching of the genital area that is not part of a prescribed nursing care plan
E
x
a
m
ples
Inserting fingers into an older adult’s rectum or vaginaApplication or insertion of creams, enemas, soap, and washcloths when not medically prescribed
Cleansing inner and outer genital areas with alcohol wipes.Perpetrators j
u
st
i
fy
t
heir behavior(Ramsey-Klawsnik, 2010, 1996)
NCEA Elder Abuse Presentation: Sexual Abuse • https://ncea.acl.gov/
16
Slide17Physical IndicatorsBruises to ou
ter arms, chest, mouth, geni
tals, abdo
men, pelvis, or inside thighsBite marksDifficulty wa
l
k
i
ng
or sittingTorn, stained, and/or bloody clothing including underwear, bedding, or furnishingsUnexplained sexually transmitted diseases or HIVNCEA
Elder Abuse Presentation: Sexual Abuse • https://ncea.acl.gov/17
Slide18Behavioral IndicatorsUnexplained
or sudden chang
es su
ch as:Mood or temperamentPersonal hygieneSubstance use or abuseRegr
ess
i
ve
behav
iorsCovering up in many layers of clothingTrying to flee a residence or facilityNCEA Elder Abuse Presentation: Sexual Abuse
• https://ncea.acl.gov/18
Slide19Behavioral Indicators(Cont..)Une
xplained or s
udden ch
anges such as:Sleep disturbancesRecent resistance to cert
a
i
n
k
inds of caregiving such as bathingHyper-vigilanceDoes not want to be touchedAvoidance or fear of specific peopleNCEA Elder Abuse Presentation: Sexu
al Abuse • https://ncea.acl.gov/19
Slide20Behavioral Indicators(Cont.)Coded
disclosures by ol
der adul
t:“He’s my boyfriend”“He loves me”“I’m his favorite girl”
“
I’m 8
0—
should
I have VD? Could I be pregnant?”Potential offender (family or caregiver) behaves in inappropriate or romantic waysNCEA Elder Abuse Presentati
on: Sexual Abuse • https://ncea.acl.gov/20
Slide21NCEA Elder Abuse Presentat
ion: Sexual A
buse
• https://ncea.acl.gov/21
Slide22Victim SafetyAll responses and interventions m
ust consider and prior
itize victim
safety.NCEA Elder Abuse Presentation: Sexual Abuse
•
https://ncea.acl.gov/
22
Slide23What You Can DoRecognize the sign
s of Sexual Abus
e
AskReport or referNCEA Elder Abuse Presentation
:
Sex
u
al
Abuse • https://ncea.acl.gov/23
Slide24If Older Adult Can Answer Questions, Consider Asking:H
as anyone asked you to
do so
mething that was uncomfortable? Did it cause you pain?I see bruises (or marks)
o
n
your
arms. Can you tell me how you may have gotten them?Is someone touching you in a way that makes you uncomfortable?*Ask privately in an area
where you will not be overheardNCEA Elder Abuse Presentati
on
:
Sex
u
al
Abuse • https://ncea.acl.gov/24
Slide25Report - ReferREPORT911 or law enf
orcement (life threaten
ing or possi
ble crime)Adult protective servicesLicensing board (if abuse
occu
r
s
i
n a facility)REFERDomestic violence or sexual assault organizationAging network agencyOmbudsman (if abuse is in a facility)NCEA Elder Abuse Prese
ntation: Sexual Abuse • https://ncea.acl.gov/25
Slide26Consider inserti
ng slides
descri
bing the local jurisdiction’s elder abu
s
e
/ v
u
l
nerable adult reporting lawNCEA Elder Abuse Presentation: Sexual Abuse • https://ncea.acl.gov/26
Slide27Consider adding l
ocal resou
rce
s and programs. (See “A Guide to
P
l
ann
i
ng Your Elder Abuse Presentation” at ***** for more information.)NCEA Elder
Abuse Presentation: Sexual Abuse • https://ncea.acl.gov/27
Slide28Additional ResourcesRape,
Abuse & Incest N
ati
onal Network (RAINN)(800-656-HOPE)National Sexual
V
i
o
l
ence
Resource Center877.739.3895Ramsey-Klawsnik (2010) Sexual Violence in Later Life Information Packet available at the National Viol
ence Resource CenterNCEA Elder Abuse Presentation
:
Sex
u
al
Abuse • https://ncea.acl.gov/28
Slide29For more information, visit us!n
cea.acl.govAlso
on
Facebook, Twitter, YouTubecenteronelderabuse.org Also on Facebook, YouTubeNCEA
El
d
er
A
buse Presentation: Sexual Abuse • https://ncea.acl.gov/29
Slide30For additional resources, visit
https://ncea.acl.govT
his s
lide set was created for the National Clearinghouse on Abuse in Later Life for the Nat
i
onal Center
on
Elder Abuse and is supported in part by a grant (No. 90AB0002/01) from the Administration on Aging, U.S. Department of Health and Human Services (DHHS). Grantees carrying out projects
under government sponsorship are encouraged to express freely their f
i
nd
i
ngs and
c
onclusions. Therefore, points of view or opi
nions do not necessarily represent official Administration on Aging
or
DHHS
po
li
c
y
.”
NC
EA
El
d
er
A
bu
se
Prese
nt
a
t
i
on
:
Sex
u
al
A
bu
se
•
https://ncea.acl.gov/
30