Human Rights & Elderly
Rights Workshop
Payal Patel, Mercer University PharmD
Candidate 2012
Dorris Ottens, University of Georgia
PharmD Candidate 2012
Human Rights

Fundamental rights to which a person is
inherently entitled because she or he is a
human being

Cornerstone of public policy

Continuous philosophical debate over what is
meant by “right”

Started during the Protestant Reformation
and continued to the Bill of Rights and United
States Constitution
Universal Declaration of
Human Rights

Adopted in 1948 by the United Nations
General Assembly, secondary to WWII
Holocaust atrocities

This document outlines 30 Articles which
promote specific freedoms.
Highlights of Declaration of Human
Rights

All humans are born free and equal

Everyone is entitled to all rights set forth,
without distinction of race, colour, sex,
language, religion, political opinion, national
origin, property, birth, or other status.

Right to life, liberty, and security

No slavery or servitude

Right to recognition as a person
Highlights continued…

All people are equal before the law

No arbitrary detention or exile

Freedom of movement, residence, and leave

Right to social security and resources of
economic, social, and cultural resources of
each State

Right to work, with equal pay for equal work

Right to education and culture
Highlights continued…

Right to standard of living adequate for his
health and well-being: food, clothing,
housing, and medical care and necessary
social services

Right to security in the event of
unemployment, sickness, disability,
widowhood, old age or other
circumstances beyond his control
Patient Case

60 yo wf

CC: worsening dementia and secondary
Parkinsonism

HPI: MVA with head injury 10 yr prior with
loss of consciousness.

Diagnosed with normal pressure hydrocephalus

Shunt x 4 years, stable

Rapid decline: aphasia, increased falling and
confusion
Elderly Prevalence

12.5% of the US population is 65 years of age or older

This group will increase by 5.5% by the year 2020

45 million people over the age of 60 and 3 million over the
age of 85

As the number of elderly Americans increase, the number
of abuse cases will increase

With the increase in the number of elderly people, there is
an increased need to address elderly rights and abuse
Prevalence

In US, over 2 million older adults are mistreated
every year

3 to 10% elderly are neglected or abused

For every 1 case of elderly abuse, about 5 cases
go unreported

Approximately 1.5 million seniors live in nursing
homes

30% of the nursing homes have been cited for
abuse that can potentially harm the patients
Introduction

Most victims are older, frail and vulnerable and
depend on others for basic needs

Most seniors do not get the help they need

Elderly people are often subject to
discrimination/abuse because they are viewed as
being easily taken advantage of
Introduction

Many governments have support systems for
elderly people




Social security
Medicare
Senior citizen discounts
Adult protective services agencies


Receives and investigates reports of
abuse/neglect
Provide services to the victims
Rights of an elderly person

The rights of an elderly person can be broken
down in 3 main categories



Protection: securing the physical, psychological
and emotional safety in regards to their
vulnerability to mistreatment and abuse
Participation: To create a greater and more active
role for the elderly
Image: To define a more positive and less
degrading idea of the elderly and their capabilities
Elderly Abuse

Definition: Intentional or neglectful acts by a
caregiver or any person that can cause harm to an
elderly individual

Self-neglect can also be considered mistreatment

Elderly abuse can occur anywhere – in the house,
nursing homes, or any other location

Abusers can be spouses, family members, personal
acquaintances or opportunistic strangers
Risk factors of abuse





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
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Older age
Lack of access to resources
Low income
Elderly women are more vulnerable and more likely
to be a victim
Dementia
Social Isolation
Low level of education
Functional impairment
Substance abuse by elder or caregiver
Types of Elderly Abuse




Physical abuse: using force to physically
injure a vulnerable elder
Emotional abuse: verbal threats, rejection,
isolation that can cause a mental distress to
an elderly
Sexual abuse: forced or threatened sexual
contact on an elderly person
Exploitation: Gaining control over an elderly
person’s money or property by misusing
authority or fraud
Types of Elderly Abuse



Neglect: Failure of a caregiver to provide the
needed safety, physical or emotional needs
of an elderly person
Abandonment: Abandoning an elderly person
by the caregiver
Self-neglect: not being able to understand the
consequences of your own action or inaction
leading to harm
What is self-neglect?

Sometimes elders neglect their own care,
which can cause illness or injury. Such
behaviors include:





Hoarding
Failure to take medications or refusal to seek
medical treatment
Poor hygiene
Not wearing suitable clothing for the weather
Dehydration
Warning Signs

Physical abuse: marks, bruises, burns (ex: cigarette
burns), blisters

Neglect: malnutrition, lack of medical care, filth

Emotional abuse: depression, unusual behavioral
changes, withdrawal from usual activities

Sexual abuse: marks/bruises around breasts or genital
area, STDs

Exploitation: unusual bank activities, property loss,
altered wills
Problems in a nursing home



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Low staff-to-patient ratios
Rotating nurses and nursing assistants
Staff not well trained
Facility characteristics
Personality problems of the caregiver
Clues for elder abuse in nursing homes

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Bruises or skin tears
Multiple fractures due to falls
Unintended weight loss
Poor hygiene
dehydration
Preventing abuse in nursing homes

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Screening potential employees for history of
abuse, neglect or mistreatment
Training all employees
Staffing appropriately
Observing residents for signs of abuse
Investing all types of incidents and reporting
results to the proper authorities
What can the elderly do to prevent
abuse?




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Take care of one’s own health
Seek professional help for drug, alcohol and
depression concerns
Spouses can attend support groups
Plan for the future with a power of attorney or
a living will
Stay active in the community
Stay connected with friends and family
Report any form of mistreatment or abuse
What can the elderly do to protect
their rights?

Living Will



Directions for a terminally ill patient
Instructions specifying what actions should be
taken if the patient is not able to make decisions
due to their illness or incapacity
Durable Power of Attorney for Health Care
(Health Care Proxy)

Allows the patient to choose a person who can
make decisions related to the patient’s healthcare
Patient Case Continued…




Husband was given ample prescription
samples from the physician’s office
Patient kept deteriorating cognitively and
physically
Home health nurses were sent to give care,
and reported plenty of medications were at
the home, although husband asked for more
Patient missed/cancelled several
appointments
Case Continued…




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At next office visit, a middle-aged woman
came as caregiver with the couple
Patient’s symptoms continued to accelerate
Husband picked up samples, and reported he
was dating the “caregiver”
PCP concerned about this conflict of interest
Patient’s husband eventually refused home
healthcare services
Case continued…

Neighbors noticed the “caregiver” was not
there during the day, but sometimes at the
home for two to three days



Also reportedly saw the husband and caregiver
having sex
Neighbors called the police, who then
invoked Adult Protection
Husband jailed for spousal abuse x 4 years
What can healthcare professionals do?

Healthcare professionals are often the first to notice
abuse and neglect and are in a key position to help
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Identify signs and symptoms of abuse
Evaluate the validity of the explanations provided for
the injuries
Evaluate the cognitive status and health factors
Treat injuries and health problems
Perform screenings for possible abuse
What can you do?


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Do not let abuse go undetected
If you suspect abuse, contact your local adult
protective services agency
If you suspect abuse in a nursing home or
long term care facility, contact your state
specific agency
Resources for the Elderly

The National Center on Elder Abuse (NCEA):


Information on elderly rights, resources for
families, caregivers, adult protective services,
helpful phone numbers to report abuse
Georgia Department of Human Services –
Division of Aging Services

Information on disability, elderly programs, senior
employment program, adult protective services
References

http://www.un.org/en/documents/udhr/ ; the Universal
Declaration of Human Rights found on the United Nations
website. Accessed Feb 2012.

http://www.ncea.aoa.gov/ncearoot/Main_Site/index.aspx
National Center on Elder Abuse website. Accessed Feb 2012.

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http://aging.dhr.georgia.gov/portal/site/DHS-DAS/
Georgia Division of Aging Services website. Accessed
Feb 2012.
http://www.gpoaccess.gov/wmprints/green/2004.html
House Ways and Means Committee Prints, Green Book.
Accessed Feb 2012.