Vulnerable populations and abuse include the economically challenge, racial and ethnic minorities, individual who has a lacking insurance, low-income individuals, the elderly, the homeless and those with other health conditions, including severe mental illness. It may also include rural residents or barbaric places, who often encounter barriers to accessing healthcare services because of hindrances like transportation and support from their local government. The vulnerability of these individuals is enhanced by their race, ethnicity, age, sex, and factors such as income, insurance coverage (or lack thereof), and absence of a usual source of care. Their health and healthcare problems intersect with social factors, including housing, poverty, and inadequate education.
It can be difficult to identify abuse. But being aware of the risk factors can help. These include; a.) Being dependent on others and let other people do your responsibilities, b.) Family conflict like fights between siblings or worst to your parents, c.) Family violence like you is being neglected as a member of the family, d.) Being alone, e.) Stress in care or guidance relationships f.) Mature age children or dependents with a disability or health issues g.) Mental illness such as psychological incapacity and dementia such as Alzheimer’s disease h.) Poor literacy and/or awareness of rights as a citizen or individual
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Current Situation of elderly abuse (New Zealand Healthcare Setting)
Elder abuse is not only a problem in New Zealand but also a global concern. Sometimes, things don’t work as they should or as we want them to be. Abuse can happen to anyone especially to elderly, and the likelihood is that it’s going to be at home at the hands of family members or “friends”. Sadly, Age Concern says they uncover at least two new cases of abuse or neglect of older people every day in New Zealand, and it’s just the tip of the iceberg. Age Concern New Zealand concluded that 10% of the population aged over 65 years’ experience abuse. In the healthcare setting, an analysis from Age Concern which was released in 2007 states that 68% of the reported abuse happened in rest homes followed by 16% and 13% happened in hospitals and retirement villages respectively.
Responsibilities and avenues for reporting (under the code of rights)
Elderly people are significant and valuable members of the society. They deserve our respect, our care and our attention because they also once been like us who provide, respect and care for the people and for we always say that we all grow old and be in that situation also. Unfortunately, some people take advantage of the vulnerability and weakness that age often brings. If you’re an older person, you’re entitled to the same rights as anyone else. If you feel you’re not being treated right, or if you’re concerned about how an elderly is being treated, you can get help from your local government unit. In cases where issues are not resolved within the organization, they can be brought to concerned agencies such as Age Concern and the like. As a DT and a part of a service provider for instance, you are obliged to report whenever the rights of the clients under Code of Health and Disability Services Consumers’ Rights are being violated.
Practical scenario:
A vulnerable dementia sufferer was so badly neglected by her niece that she was found with her body fused to a couch, an ulcer down to her bone and skin peeling off her body. The 89-year-old woman was under the care of her niece and her niece's husband in Auckland, who have both pleaded guilty to failing to protect a vulnerable adult. The couple, who cannot be named for legal reasons, had taken on caring for the elderly woman in April 2017 as she suffered from acute dementia, incontinence and immobility. Because of her inability to take care of herself, it was the niece's responsibility to bathe her, take her to the toilet, prepare meals, feed and transport her, according to court documents seen by the NZ Herald. Court documents revealed one morning in November 2017, the niece found her aunt unresponsive on the couch, so she called an ambulance. Emergency crews arrived to what they described as a horrific scene as the 89-year-old was naked on the couch, with just a blanket covering her. Under the blanket they found her body had fused to the couch and she had urine feces and pus which had created the adhesive that fused her to the sofa. Police were also notified of the horrific scene and attended the home to investigate, where they found a 'strong unpleasant odor'. Upon investigation, police found used diapers strewn across the lounge room and visible remains of bodily fluids on the couch. Paramedics had no way of removing the elderly woman from the couch without further injuring her, so they took to cutting the couch away. She was rushed to Middlemore Hospital with the sofa material still glued to her left thigh, hip and lower back, court documents said. Medical staff said the woman was in a life-threatening condition, suffering from dehydration, bacteremia and low albumin. Doctors found the 89-year-old was suffering from multiple stage-four pressure ulcers, with one so bad it had reached her bone. She also had broken down skin and parts of the skin on her back was so dry it was peeling off. Medical staff noted the woman was severely underweight and said they do not know how long it may have taken for the injuries to develop. The niece admitted that she should have called for help sooner while her husband also confessed he should have called an ambulance. Both the niece and her husband are set to be sentenced later in the year and face a maximum prison term of ten years. Chief executive for the New Zealand Aged Care Association (NZACA), Simon Wallace, said the elderly woman's case was 'appalling'.
Legislations:
1. 3PR Act (Protection of Personal and Property Rights Act 1988)
The 3PR Act aims to protect the personal and property rights of people who cannot fully manage their own affairs. The PPPR Act covers situations where a person is able to make their own decisions but may need some help dealing with their affairs now or in the future (through an enduring power of attorney) and also when the person has lost all mental capacity (Court orders). This is the main law that safeguards the elderly from such abuse. While they are mentally capable, this act helps them to prepare ahead by arranging a power of attorney (POA) to someone qualified. This POA authorize a person or a company to act on the don’s behalf. An individual or organization can be the POA to both health and property or there could be two separate attorneys of each. In an event when there’s a conflict for both attorneys, the personal care attorney prevails in making decisions on the donor’s behalf. However, either attorney can consult the family court for guidance. From the scenario given above, the niece was not able to do such POA because both the niece and her husband are set to be sentenced later in the year and face a maximum prison term of ten years.
2. Crimes Act 1961
This is an Act of the Parliament of New Zealand that forms a leading part of the criminal law in New Zealand that mainly states that anyone who is 18 years of age or above, member of a household or a hospital staff has the responsibility to report any serious abuse of a vulnerable adult. From the scenario given above, the 89-year-old woman has been neglected by both the niece and her husband, by not bringing her to the hospital for treatment. She was also abused physically, financially and emotionally. It was very clear that both the niece and her husband violated Crimes Act section 195A by failing to protect the 89-year-old woman. They are proven guilty and face a maximum imprisonment for ten years.
3. Domestic Violence Act 1995
Enables individuals affected by domestic violence to apply to the Family Court for a protection order. This act serves to protect an adult from an abusive domestic relationship. Older adults are the ones vulnerable to abuse by their children, siblings, spouse or live-in careers. Through this act, they can apply for a Protection Order from the Family Court whenever they are at risk to protect them from further abuse. From the scenario given above, it was said that the 89-year-old has been abused and the protection order that was granted to her protects her from her abuser.
Supporting a client to promote self-advocacy
Some older people experience elder abuse. Elder abuse occurs when someone in a position of trust (usually family, friends or a care worker) causes a person physical, psychological, sexual, emotional, or financial harm or neglect. That’s why there are some strategies to promote self-advocacy to the elderly abuse. One is to provide you with information and advice about your rights and responsibilities; two is to support you to be involved in decisions affecting your life; three is to assist you to resolve problems or complaints in relation to aged care services; and lastly is to promote the rights of older persons to aged care service providers and the wider community. It is, therefore, everyone’s duty to support this population to build their confidence to speak or to ask someone to advocate for them. Supporting a client to promote self-advocacy also means respecting their choices and decisions. From the scenario given above, the niece admitted that she should have called for help sooner while her husband also confessed he should have called an ambulance.
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