A n I n t roduc ti on - PowerPoint Presentation

Slide1

An Introduction to Elder Abuse Professionals:

Sexual Abuse

NC

EA Elder Abuse Presentation: Sexual Abuse • https://ncea.acl.gov/

1

Slide2

NCEA Elder Abuse Presentat

ion: Sexual A

buse

• https://ncea.acl.gov/2

Slide3

Learning 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/

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Slide4

Case 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

Slide5

Case 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/

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Slide6

Sexual 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

Slide7

Consider 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

Slide8

Significantly 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

Slide9

Significantly 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

Slide10

VictimsMost 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

Slide11

PerpetratorsPrimarily 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

Slide12

Perpetrators 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

Slide13

Categories“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

Slide17

Physical 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

Slide18

Behavioral 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

Slide19

Behavioral 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

Slide20

Behavioral 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

Slide21

NCEA Elder Abuse Presentat

ion: Sexual A

buse

• https://ncea.acl.gov/21

Slide22

Victim SafetyAll responses and interventions m

ust consider and prior

itize victim

safety.NCEA Elder Abuse Presentation: Sexual Abuse

•

https://ncea.acl.gov/

22

Slide23

What 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

Slide24

If 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

Slide25

Report - 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

Slide26

Consider 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

Slide27

Consider 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

Slide28

Additional 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

Slide29

For 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

Slide30

For 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