Sign Oregon Permission Slip Safe

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> hi everybody this is Suanne Jackson > from the state unit on Aging welcome to > our continuing series for 2017 of the > monthly webinar that the state unit on > Aging does for the ADRC partners we're > pretty excited about this one today I am > here with me > sandy Abrams good afternoon everyone and > Thomas Swartz from the office > of adult abuse prevention > and investigations I'm so used to saying > OWAPI but I want to did not use lingo > so I we're really excited to have > Thomas with us and I'm going to let > him talk but first let's just do a > couple of housekeeping things that we > always do we are recording the webinar > today so we do have you guys all muted > please do your text chat questions and I > will keep an eye on those while Thomas > is talking and bring them to his > attention also if you're a group sight > please type in you know let us know who > all that your group site so we can keep > track of that we send materials out > yesterday but if you had registered by > then I also put the PowerPoint in the > handout section so theoretically you > should be able to download that out of > the handout section and we will have > some poll questions during the webinar > we tried those last time and they work > pretty well so we're going to try some > again today to help give you guys a > little bit of interaction with us if you > can't download the PowerPoint you can > also send an email to lori.c.watt@state.or.us > and just in the > subject line of the email tell her that > you need the webinar materials and > she'll shoot that right off to you that > way you can follow along with us also we > want to remind you that at the end of > the webinar we usually shoot a quick > email out in the next hour or so and ask > you to spend about five minutes on > Survey Monkey letting us know how we did > and I'll remind you again at the end > about that so at this point I want to > just introduce Thomas we're very excited > to have him here today and we are going > to let him talk now ok my name let's go > my name is Thomas Swartz and I've got > over years of specialized experience > with protecting vulnerable populations I > was a police officer and also an abuse > investigator for the state > of Oregon and some County agencies > currently I serve as a training and > development specialist for the office of > adult abuse prevention and > investigations Oh AAPI as many of you > know and I'll share a little > bit today about the role of Adult > Protective Services I just wanted > everyone to know that we're going to be > going through the slides fairly quickly > but there will be opportunities to > answer questions if you would please > take notes on anything that you are > wondering about when you find a breakin > we will go ahead and answer those for > you ok > so what you see up on the screen right > now it basically describes to you what > Oh OAPPI > where we provide support we reach out > with supports to a variety of different > programs and abuse investigations and > that includes Adult Protective Services > for aging and people with physical > disabilities the office of developmental > disability services Oregon Health > Authority with mental health programs > and there's others as well different > support agencies that protect vulnerable > adults and children in are OAAPI > analysts trainers and investigators and > administrative staff supported the field > on nearly reports of possible > abuse our office also conducts > investigations for child caring agencies > and the stabilization and crisis units > we also provide specialized > investigations when there are conflicts > of interests at the local level in the > mental health and developmental > disability services arena > as you can see up on the screen I don't > know can you read it possibly is it > large enough print for your read okay so > we have developmental disabilities > County investigators adult our APD > investigators and that includes our > AAA's and county mental health > investigators the > breakdown you see up there quality > management and prevention policy and > legal affairs investigations and field > operations our organizational chart is > changed recently we used to have four > different divisions now we have three > but it seems to be much more streamlined > and if you contact our office we'll get > you to the right people depending upon > what it is you're seeking > so Abuse Prevention Oregon citizens rely > on us to prevent abuse they rely on all > of us as citizens as people with > different jobs and in this presentation > today we're going to be focusing on > older adults and because well that's > what we're assigned to do but also older > adults are one of the largest > populations of vulnerable citizens in > the state there's four other groups that > we serve and they're also considered > potentially vulnerable they are children > adults with mental health issues adults > with physical disabilities and adults > with intellectual and developmental > disabilities so today's webinar is > relevant to every one of these groups > because they are all protected but you > are the frontline protection and > prevention from abuse so there's a > community responsibility > everyone should be responsible for the > safety of the people in their community > and anyone can and should report if they > believe a vulnerable person was abused > some people are required to report and > this leads to a very serious question > are you required to report abuse if you > are then you're called a mandatory > reporter and from what I understand in > discussion today everybody knows that > you're mandatory reporter is that > correct I'm not sure they all do but > we hope so okay so just a reminder that as a > contractor of the state unit on Aging > the Department of Human Services that is > how it's defined in rule that you're > then a mandatory reporter and you have > to comply with all of those sub pieces > that's one of the many reasons that we > wanted to have Thomas here with us today > to talk more about this so that you > become more familiar with your role as a > mandatory reporter okay awesome thank > you > so we're going to go through mandatory > reporters right now and there's our > question are you a mandatory reporter > are you required to report so who are > mandatory reporters there's a bunch of > people listed on here so I will just go > ahead and show you four people like you > who are professionals that interact with > others as part of their job there are > some things that are important to know > first and foremost you must know if > you're mandatory reporter people in > these jobs and roles are mandatory > reporters and I'm going to let you read > those because there's lots and lots of > them but please if you have questions > let me know I've seen quite a few of you > folks on those lists up there so from > what I understand what was said AAA > agencies are up there we've got Senior > Center employees you might come across > DHS OHA personnel there's just a number > of folks up there and I'm and I'm sure > that you may recognize some some people > that you may not have known our > mandatory reporters also and it the list > keeps on growing and growing > okay so we have a trueandfalse > question here I'm going to see if I can > launch it for you > so I opened up the poll if your job says > that you are a mandatory reporter it > means it's against the law and or > administrative rules if you fail to > report that's your fault > we'll give you guys just another few > seconds to vote it looks like people are > going and again we want to remind you if > you are a group size please text chat us > who else is at the group site looks like > we've got a good portion of you guys who > voted couple more still coming in > everybody saying it's true > why do you think Thomas I think they're > right and I'm really glad to see that > even if they even if they weren't all > required I would still want them to > report because we really want to > advocate for those who can't advocate > for themselves so we'll go ahead and > move forward here a little bit look I > think we're stuck yeah okay ha so > mandatory reporters they have to report > suspected abuse immediately and that is > for children that's hours a day seven > days a week that's for adults over > that's / as well but it is actually > it is a crime or pan it is violation of > administrative rules if you fail to > report in most instances let me back up > a little bit here because I think I'm > jumping ahead okay for those who work > with people are experiencing > developmental disabilities or people > experiencing mental illness you are > required to report only while on duty > now that I just heard as of today is > changing on the st of January so > all of our protected groups will be > under the / rule > and it's really good news for mandatory > reporting and ensuring people are safe > for me it could be a little complicated > I'm gonna have to change a whole lot of > training materials but I'm very happy > about it because I'm a strong advocate > for reporting but our office actually > assisted the legislators in writing up > that up those with changes and so just > know that as of the first they're all > covered st of January so we have a > question here before Thomas goes any > further let me let you have that one I > was about to give that away okay we told > you we were new at this so I have to get > you back to them okay here's the poll > guys > which if any of these are potential > consequences for a mandatory reporter if > you fail to report abuse so you've got > A B C D or E > it looks like everybody's pretty much > voted so we're going to close the poll > and share and it looks like % said all > of the above so what do you think Thomas > think that % of them are > correct if you fail to report it could > result in loss of a professional license > loss of ability to work within the > Medicaid Services or you could face > legal penalties they're usually in the > form of a fine these consequences are > usually only seen in the most egregious > situations more commonly if something > occurs it's people who fail to report > abuse will receive some kind of > disciplinary action by their employer or > even could lose their job because of > contract requirements that are written > in they're just job descriptions the > takeaway from this slide is make make > the report so you don't have to worry > about your job or any kind of > consequences but ultimately make sure > that we're taking care of people > I did want to back up on there just a > little bit we don't want everyone to > worry about losing your job or having > this happen we do have an understanding > that people don't always make the report > simply because they didn't understand > the the dynamics of what occurred it > does happen sometimes where we end up > being or we end up educating someone > through an investigation so when I > mentioned previously about it being a > most egregious that's where we're giving > that wiggle room if it's really obvious > and you didn't make the report we > probably wouldn't be able to to have any > wiggle room but we do want everyone to > know how to do it right > so to report suspected abuse well first > off it can be confusing to figure out if > something should be reported and what we > really advocate for is that if you're > just not sure a good tip is to pay > attention to that gut feeling your hair > may be standing up or you're just > sensing something isn't right I can give > an example of this when I was a police > officer I would walk up on a vehicle > that I'd made a traffic stop on and I > felt the hair stand up on my neck > I knew something was going on in that > car that I hadn't quite processed in my > mind yet so when that happened I knew > back up quickly and the way society > works these days with all the comforts > of being safe we don't have to worry > about being attacked by lions in the > forest so we don't often pay attention > to those little gut feelings and those > hair standing up on the back of the neck > but in these instances if you notice it > that's the moment where you need to go > hmm slow down back up and think about it > for a moment and then really pay > attention okay > so if you experienced this make the call > it will remove all doubt and you may > find out that little feeling was > actually abused or you may expose > problems that can lead to abuse or you > could even find out there were other > things that could have been harmful to > someone that were in their environment > or or how people are treating them you > might be able to do some preventative > work remember you can't get in trouble > for calling and you actually may be the > key to helping that person get what they > need > yeah I'm going to go ahead and read a > scenario to you and there'll be some > questions to follow and this is on a > similar note as far as the reporting so > here Stanley with > a year old gentleman living in rural > Oregon > staff from a local shelter called about > him and he had arrived to their > facility the day before in a taxi from > the emergency department after > reportedly being examined for slurred > speech and problems with incontinence > they told the taxi driver to take > Stanley back to the emergency department > and explained to them that they do not > have the staff that are qualified to > meet Stanley's care needs so now when > they call they said they just received a > call from the police and they were > looking for the shelter to help them > because there was a man wearing soiled > hospital gown and he was found sitting > in a restaurant drinking coffee after > being dropped off by a taxi earlier in > the night then there all night long > okay so the first question is yes or no > do we have some kind of abuse happening > here what do you think so we'll give you > seconds to vote so far it looks like > everybody today and yet people think > there is some kind of abuse happening > said everyone pretty close okay looks > like everybody said yes so the second > question is nice can I answer that by > the way oh yes so in this instance this > was actually not abuse this was a > breakdown in communication and it that's > what it was we'll go further now with > the next question so the next question > is what do you do in this situation > so there are several options here what > are you going to do are you going to > call the hospital call the governor's > office call the news agency tell APs > or all of the above so go ahead and > folks what are you going to do in this > scenario > Thomas says there is not > actual abuse happening but this is but > this person is definitely got some > issues going on we've got a few people > still voting we'll give you a couple > more seconds here looks like most > everybody's voted now okay so it looks > like most people said they're going to > call ApS and a few people said they > would call the hospital and file a > complaint okay and those are both valid > answers the most correct answer is > actually to call your local Adult > Protective Services Agency and calling > the hospital to file a complaint really > should be secondary in this matter > because ApS is going to be able to get > services out the most quickly to help > someone like Stanley I'm going to tell > you a little bit more about him it was > actually very unfortunate for this > person and the names were changed just > so you know but it was based on real > events and Adult Protective Services > actually got the real call on a Friday > morning and they were able to enroll the > person in services through APD and then > adult foster home but over the weekend > the provider from the foster home took > the person back to the emergency > department after they noticed their > health was declining quickly and the > person died only a few hours later so > Adult Protective Services later learned > the person had gone to the hospital > several times in the weeks before and > was complaining about something being > wrong and they couldn't find anything > and the person was actually walking and > talking normally and those in those > other situations I don't know what the > situation was behind that when he was > having the he or she because actually > this was changed it could have been is > she the person they may not have > recognized that > changes it may have been a different > shift who knows but the bottom line is > there were some problems that were > occurring and maybe they could have > changed maybe they could have provided a > service would have helped so ultimately > what ended up happening was I'm sure the > hospital was called I'm sure who knows > maybe even the governor's office was > call ID and I didn't get enough of that > information actually no but we don't > know if this person was ever even aware > that no Protective Services could > connect them to services that would help > them and after the event they worked > with the hospital social worker with > police and shelter staff so they would > know how to work together and called ApS > for assistance when things like this > happen in the future how the positive > changes that happen or that the > community learned how to report when > things like this happen to prevent > tragedies in the future and so the main > takeaway here is to call the right > resource for the situation but even so > the other ones you can call but we want > to make sure if we call it we can call > ApS we can get it done quickly > and we did not have ADRC on that list > Thank You Kristi Murphy because we > could have had a ADRC on that list and if > you would call a ADRC they would get you > to APs well ADRC and say what's > happening they would have gotten you to > APs > so thanks for mentioning that we > appreciate that and then we just have > one question from somebody that said you > know what if you're concerned about the > safety of this person you know you're > going to report but what we do in the > meantime about the safety of this person > who's getting jumped around or whatever > okay so the numbers that were provided > on the previous page are all places that > you can call and they should all know at > these different places where to connect > you I'll explain a little bit more about > so the safe line that's that's a central > clearinghouse type number so when you > call it you would actually be prompted > through different prompts and it would > ask you are you calling a > someone in in the children's the > different Protective Service segments we > spoke up those pieces so children or > mental health or developmental > disabilities or adults over so you'll > get prompted through those things and > then it will ask you for your zip code > so you put your zip code in and it will > get you to the closest office > perspective to whatever you put in on > the other prompts it's helpful and you > can leave a recording after that if > there's someone on the other line > between the regular working hours > a.m. to p.m. during the week it > will get answered immediately but > there's the sticking point about that if > you leave a message and there's > something immediate like what happened > with Stanley we want to make sure > something's really going through so > local ApS offices it's really good to > know how to contact them directly and > those you can find on the website ADRC > can help get you directed in that way as > well but when we're speaking of > immediacy again they may not be able to > get you there as quickly as possible > law enforcement in this instance law > enforcement had to be educated but that > is part of the process of changes has > been happening and happening in Oregon > for a number of years now is to educate > law enforcement on how we interact > together and then of course works > with law enforcement as well does that > answer it well person is also asking it > is a financial elder abuse or physical > protection from an abuser immediately > and I sounds to me like you're saying > you would call in that situation > as well as reporting to a APS no yes okay > so you just spoke about two different > things and so financial is probably not > going to be as immediate right yes it > same as immediate when you're watching a > bank account disappearing but that would > still be something you're going to call > the APS but when we're thinking of > someone who's in harm's way we want you > to call if it's an emergency okay > so I'm just going to jump in for a quick > moment and say you know we're all human > services professional what > your agency is directing you to do is to > go out and sit with Stanley in the cafe > while the police are coming or whomever > yes that is fine we're people we have > skin on and some of our individuals we > work with we want to be that > compassionate but we do want to do a > warm hand over to our partners that > we're working with and we've gotten some > clarity here today and you also want to > say safe yourself exactly exactly > yes we want to make sure everyone's safe > out there and ultimately if it became an > unsafe situation let's say perhaps > Stanley became violent we would want to > make sure that you were calling > protection okay okay I think that's all > the questions for now and we're ready to > move on > okay and for this one we have a question > to see if anybody knows what are some of > the factors of the aging process the > normal aging process that can affect our > our vulnerability to abuse so > I'm going to launch this so we've got a > few answers here so take a look what are > some of the normal aging factors that > can affect our vulnerability for abuse > we've got some different things to > create visual acuity cognitive skills > beginning to slow shortterm memory > difficulty understanding speed of > processing information so go ahead and > answer we'll give you guys about > seconds you guys are just too good > you're too good so look > over half of you voted now so we'll go > ahead and close that up well we had a > couple more votes you guys are awesome > okay all right now they know okay > awesome so about % of you voted and > here's what you show and the correct > answer is all of them is Thomas all of > all of the above and I need to > do Oh activate that that's okay hi okay > okay well one thing I really want to > point out to you is that some older > adults will never be vulnerable to abuse > for a variety of reasons some of us we > keep our mental faculties for much > longer and others it depends I mean > there's all different factors that come > into play there the scenario we just > worked on required that really requires > us to think about some questions about > vulnerability and risk though and anyway > yes we do look at all of these different > things as possible possible things that > would make you vulnerable and had me at > higher risk so I'll go ahead and read > what we have we have decreased visual > acuity cognitive skills including > abstraction calculation word frequency > verbal comprehension and inductive > reasoning we'll all those things will > show slight or a gradual decline as we > get older > shortterm memory declines there's > difficulty understanding abstract > content speed of processing information > becomes slower reduced physical > abilities and increased medical needs I > can attest to this I had surgery two > months ago and I'm in relatively good > shape > and I have to say that it was a real > good dose of reality for me on how life > can be in the future when when I'm not > mobile and when I'm on medications that > are heavy and can't think straight > it's it's been months and it's still a > struggle for me with a lot of these > different things my energy levels lower > all of these things can have a great > effect on our risk yeah thank you we do > have another question how many layers of > reporting are necessary to cover > ourselves professionally the example > they want us to think about is a home > care worker and formed the case manager > and the case manager encourages the home > care worker to call it in as a > firsthand witness should the case > manager also call it in because home > care worker came to them about it or is > it just a direct witness only multiple > party reporters informing the case > manager should the case manager > you know report on top of those people > reporting I always say cover yourself ok > the bottom line is if you're trusting > someone else to do it who is a very busy > person and it slips their mind and you > or you or the person who was the > front line person and didn't make the > report there's a distinct possibility > that you're going to be the one who has > looked at is hey you never recorded this > you could say well I told Joel or Susie > to do that well you're still the one > saying but I told them to do that and > ultimately you're the you're the first > person to come across the information so > ultimately you're going to be one you're > going to want to be the one to do that > and we can sort out later on if multiple > calls have come in great thank you I > think that was a good question and I > think that was a great answer if you > know the more is better right right and > I'm glad that you asked that question > yeah thank you > where are we ok missed one of our button > player so vulnerability and risk there > are other things that make anyone more > vulnerable to abuse and but it does tend > to happen more > when when people get older and their > friends start dying and things of that > nature so and family members as well so > you're looking at social isolation > depending on others for tasks or > personal care living with others in a > group setting or with family or other > settings they've got no family nearby > there's few longterm relationships > limited close friendships and little to > no community support and these are > definitely flags for you guys out in the > field or even if you're in an > information referral specialist on the > phone if you're hearing some of these > kinds of things then you want to you > know put your radar screen up mmhmm and > one of the things so we're teaching a > class downstairs right now two > investigators are actually actually > Adult Protective Services specialist and > if you listen to them in their > discussions the difference between what > happens in Pendleton Oregon Klamath > Falls as opposed to Portland and > Multnomah County or the busier > metropolitan areas it's much much > different there's a lot more coverage > that happens in Portland they actually > have they have abuse lines that are > covered / in Multnomah County so > there's actually a human being answering > the phone of the time unless they're too > busy to get them but when we look at > Pendleton or for wherever Burns > that's what I was thinking of > the next one I was thinking yeah there's > going to be limited is going to be > limited access so the social isolation > also can come into play even more so in > those situations but it does happen in > cities as well when we look at a say > somebody who's who's declining in their > health maybe their cognitive abilities > have changed to the point where they're > not coming outside as much or maybe > they're having these problems with > incontinence or something of that nature > and they're feeling embarrassed to go > outside because they're afraid too > afraid to show themselves in public > because they might have a problem with > incontinence > so these are the kind of things that we > need to pay attention to so if a couple > or a person normally would come out into > the community and spend time and > suddenly they stop doing that pay a > little closer attention to them so > vulnerability and risk we're looking at > housekeeping needs home repair needs > upgrades and technology so there's some > other things that can happen as > vulnerability and risk increase and so > they may need people may need more > supports in their daily activities and > their environment might be changing they > might need help with cooking their > housekeeping they can't keep up with > their home repair needs and/or their old > neighborhood might literally becoming > the old neighborhood unsafe conditions > might be happening because the homes and > are just falling apart there's other > unsafe conditions in or around the home > that they can no longer deal with > because they can't get up and move > around like they used to or or maybe > maybe the person who is helping them > passed away and then of course > technology changes I don't know about > the rest of you I work with technology > all the time if I go from one piece of > technology to another I'm stumped and it > takes a while to learn those new things > okay so what is abuse we're going to go > over some of the definitions here > specifically for older adults we'll be > brief > there they're very brief they're > abbreviated as a matter of fact so and > we're also going to be speaking a little > bit about self neglect older adults have > self neglect as something that is looked > at as to where other other vulnerable > identified vulnerable populations do not > have self neglect abuse is essentially > causing harm or > taking advantage of a person and our > laws are similar for all groups of > people but those who are or older > they have their eight categories and > when we look at self neglect those get > investigated technically they're > investigated as abuse even though we > don't really have a perpetrator of that > abuse but they are investigated in that > way so Adult Protective Services is > still called in that instance and we > want to remember that older adults can > also be affected by mental illness or > intellectual and developmental > disabilities so there can be crossover > as far as these things come so we're > going to look at these abuse types now > so physical abuse > seems pretty pretty simple we're using > physical force that may cause pain or > harm or there's a physical injury that > is not an accident well if we're a > number of you promote I understand and > working over the phone lines and you're > not necessarily going to see these signs > of abuse but what we really want to > emphasize is please pay attention > someone is speaking about these things > hear them talking about getting a bruise > and it's just something doesn't feel > right > cuts or abrasions the story of how the > person was injured just doesn't make > sense > frequent sprains repetitive hospital > visits or broken glasses that could be > an indication someone was struck and > remember also the person tells you that > they've been hit or pushed or > mishandled and this is a sign of abuse > make sure you make the call types of > abuse or neglect not providing basic > care or our health and safety needs for > a person when there is a > responsibility to do so basically when > these actions are putting someone at > risk of harm then we may have a case to > investigate we don't expect you to > determine whether their risk or > miRNA we just want you to to react if > you have that feeling or that notion so > some of the things that come up and they > may be common things but I'll tell you > some signs of neglect that we look at > when we're doing investigations our > urinary tract infections fragile skin > that sores malnutrition dirty clothes > their home is dirty despite having a > caregiver assigned to do this kind of > work they're not getting medication as > prescribed or they're wearing > inappropriate clothes for the winner > some examples home care worker may leave > without doing a an example of > neglect a home care worker may leave > without doing range of motion activities > with an individual that can result in > painful muscle contractions thus > resulting in harm if they've been > they've had pain inflicted on them > that's unusual that way > but try and think about those things as > you're listening sometimes though when > it comes to responsibility or or > assumption of a responsibility it's not > necessarily formal obviously with the > home care worker its formal they've been > hired to do a job but say the person is > is receiving some kind of supports from > people outside that are considered > natural supports what this means really > is that someone's coming over and > helping them regularly and it's gotten > to a point where they have an > expectation support from that person and > then suddenly they just stop then we can > actually look into that as an abuse of > potential abuse and again if someone is > telling you that they're not getting > what they need Adult Protective Services > or the ADRC they can help you figure > those things out as well so types of > abuse for abandonment so > talking about deserting a person whom > you agreed to provide care to but this > has to result in harm > or a risk of serious harm so when we > think about abandonment it's actually an > egregious form of neglect and we're than > the deserting or forsaking someone > placed them in jeopardy and most often > things that feel like abandonment will > actually end up being neglect but just > remember it's not up to you to know if > it's neglect or abuse or excuse me our > abandonment that the person is > experiencing the APS specialist is going > to figure that stuff out for you and > again if it doesn't feel right call it > so verbal or emotional abuse talking > about written spoken or gesture directed > to the vulnerable person causing > significant anguish or distress so what > are some warning signs of this change in > behavior when a caregiver a person in > their life enters the room changing > friendliness in other words you see a > change in how a person who normally was > chatty in the past all of a sudden isn't > I can be a sign they might seem afraid > to talk in general or about specific > topics there might be a change in > appetite or weight there may be stories > that don't make sense > there might be an onset of depression or > anxiety or they might be upset or anger > easily another warning sign again is if > they tell you but keep in mind that > verbal abuse often goes hand in hand > with other types of abuse and people may > be threatening to keep them from > disclosing abuse that's happening to > them so verbal sometimes will be a > threat if you say this I'm going to do > this but physical abuse or domestic > violence might be happening as well that > could that could also be a factor in why > somebody's not speaking to you in that > way so just don't shrug off potential > for verbal abuse because you think it's > not a big deal it actually can be really > harmful > so financial exploitation talking about > taking money things or property without > permission taking a person for > medication spending money on things that > are not for the person's benefit so > warning signs that we're going to want > to look out for are the person suddenly > unable to pay bills and one of our > gatekeepers often times may be the > Postal Service they suddenly see all > these bills that are they're seeing > these late notices being dropped in the > mailbox or there's a disparity out of > the next one disparity between income > and the way they're living so in the > past you've seen that they've had > adequate income and they may still have > that but suddenly they're not able to > afford food or is that money going the > person is not open to the idea of > assistance with managing finances > checkbooks their bills their lifestyle > or status of the caregivers or the > family members don't match up with their > economic situation so you've got > somebody who was once a poor caregiver > and now they're driving a brandnew just > say Mercedes to throw it out I have my > doubts of that good to happen that quick > but but you will see in financial > situations that can happen the > progressive lifestyle change even > happening where it doesn't really make > sense with who they were once you when > you saw them before the person the > vulnerable person may not be allowed to > go anywhere independently like the store > or the bank so someone might take them > to the bank and they're cutting them off > from saying things as they're trying to > speak to the bank teller like oh they're > so forgetful I'll take care of this for > them and this person may be getting > slowly beaten down to think that they > are forgetful they may not be forgetful > it may have made a mistake in the person > decided to use that against them as a > means of getting to what it is that they > wanted > okay so indications of increased risk > again we spoke previously about visual > acuity that there could be a decrease in > that > their cognitive skills may be limited > they might have trouble with calculation > or word frequency verbal comprehension > verbal country comprehension our > inductive reasoning and you may be > seeing slight declines in that also > shortterm memory can decline you might > have difficulty understanding abstract > things and speed of processing > information becomes a bit slower sexual > abuse pretty much you can I'll let you > read that up there but I'm just going to > say it all right pretty much anything > you think is sexually wrong or know as a > crime is going to be sexual abuse the > administrative rules duplicate the all > of the all the criminal statutes are > included regarding sexual abuse within > the Oregon administrative rules there > are some differences when we do our > investigations and this isn't for the > frontline people to take care of but > it's for us to know if it's done without > consent so if a consent means that a > person voluntarily agrees or there's a > concurrence of wills between the people > that are in the act > Ahmir failure to not object though is > not in and of itself constitute an > expression of consent > so involuntary seclusion someone is > restricting a number of different things > it could be contact or activities with > family or friends restricting phone or > email mail they may be restricting > movement by limiting a person to one > area of the home or wherever that > they're allowed wherever they can freely > access normally so what we are going to > want to do is watch for changes in > typical activities so similar to one of > the other ones we said such is not going > to events they're typically attending > you're going to want to listen for > disclosure like the protected > person tells you they're being told that > they cannot leave the house our family > and friends are being told that they > shouldn't come over for visits and this > may be by a caregiver or the protected > person maybe they've been saying this > because they're afraid the caregiver or > have been instructed by the caregiver > tell them don't come home types of abuse > we're looking at right now physical and > chemical restraint things you want to > pay attention to they're our bruises on > the wrists or arms or ankles if someone's > got unusual sleepiness or unusual > slurring of words it's not uncommon for > people I don't know all of you know this > about benadryl but I'll go ahead and > tell you this a warning sign might be if > a person tells you Betty says I get > cranky and when I'm tired > she gives me benadryl so I'm not cranky > and she can get her work done okay so > what is Betty doing she is giving this > person benadryl to make them go to sleep > so she can do whatever she wants maybe > it's not her work whatever but she's > doing it for her own convenience and as > a caregiver that's not something we're > allowed to do self neglect okay self > neglect does not > not excuse me does not involve > wrongdoing what it does involve though > is harm or risk of harm and this is the > same situation where an individual > places themself at serious risk because > they lack the ability to understand the > consequences of their decisions so we're > thinking about two different parts here > first is the person is at risk of harm > because their basic needs are not being > met and then the second piece is the > person does not understand the > consequences so we don't expect you to > find that stuff out but if you come > across something that you where you > believe there's a problem you can go > ahead and make the report and we'll > we'll do the figuring on that but just > remember also everybody has the ability > to make a bad > choice in their life but we encourage > you to make the call if you think > there's a problem > so Adult Protective Services specialist > they understand that there's a balance > between selfdetermination and risk of > harm and even though people have a right > to choose an alternate approach to their > priorities or their lifestyle we have to > remember if it doesn't look right or > feel right make the call > they're trained to deal with those > situations and they'll do their best to > to work out whatever it is to help find > the best option so we have another > scenario before we go to the scenario > Thomas can I just asked you I know > one of the things I hear as a trainer of > frontline field folks is that you know > we're all so busy we all have such huge > amount of cases and you know they're > worried about you know everybody's > overworked and so we're worried about > you know calling and you keep saying you > know call call call call so could you > just talk a little bit > I'm sure ApS have the same caseloads but > other people and are just as busy but we > should still be calling in right that's > still the APS folks of course they > cringe when we say it but we have to say > it and we really want to say it because > when that person slips through the > cracks then ultimately we honestly don't > want to be putting them in that > situation and we also don't want to be > the person who carries that burden on > their heart later on and they realized > oh wow I knew about this and they didn't > do something about it > it can really be traumatizing for the > four to even make a report alone but if > you saw the abuse and didn't make the > report it could really be bad so make a > call make the call don't worry about it > right please do thank you we have time > please no absolutely okay we have > another scenario that Thomas is going to > read and then we have some questions > around this okay > so a woman named Rose called asking what > she can do about her brother's > david and charles david has he hasn't > had a job for about her for several > years and he's been living with her > year old father richard david claims to > be taking care richard but he's been > spending all of his money on extravagant > things for himself like remodeling the > entire basement that he now uses as his > personal apartment also david has moved > his daughter julie into the house and > he's she living in the apartment with > him and she's also got a child of her > own now Rose finds out that Charles > moved in upstairs that's the other > brother and he moved in with Richard > because he lost his job and he doesn't > have a place to live while he's going > back to vocational school here's where > things get interesting and they're > already pretty interesting Rose she said > that Charles and David don't get along > the moment I need and Rose says > that they've been arguing and using > profanity in front of Richard and this > is especially after Charles found out > that Richard bought a car for David on > top of the apartment being remodeled and > he's changed his will giving David the > house after he dies so Richard is very > conservative and Rose is really concerned > because her dad is distressed when her > brothers are fighting and now Charles is > telling Richard his father that he has > to buy a house for him as well Rose > tried to intervene at this point and she > said he should Charles says we should > buy a house for me too it's only fair > so roses been trying to contact Richards > older brother Ralph and anyways he is > the patriarch of the family and > apparently he makes more sense than > anyone else in the family Senate so > that was a convoluted scenario but the > bottom line is we want to know yes or no > is there potential abuse going on here > so we'll give you guys a seconds > here do you think there's potential > abuse going on here > based on all the things that Thomas has > been talking with us about looks like > everybody's feeling like there might be > looks like yes is the answer here okay > and yes is the correct answer okay so we > have another question for you so now > that everybody feels like there is > potential abuse what kind of abuse do > you think it is so we have three choices > is it financial abuse is it verbal abuse > or is it something else so we'll give > you about seconds on this one let us > know what you think okay looks like most > of you have voted looks like > let me show everybody what we got here > so % says financial % said verbal > and then we have up what % said > something else okay well they're all > correct financial is of course the > biggest red flag that we have there and > verbal it does meet the criteria because > those the arguing and gestures are being > directed at Richard but he's also > feeling this distress from having this > these events happening in front of him > this is his home he should be able to > feel comfortable in his own home now we > don't go on to solve every little petty > argument that goes on but the bottom > line is they're threatening him a lot by > the sounds of it and making his life so > very very miserable and what are they > doing in the process emptying his bank > account another thing could be also that > this could be causing him to feel and > voluntarily secluded maybe he's maybe > he's not even leaving the home simply > because all these activities that are > going on these are things at ApS are > going to want to look into and we can > sort all that sort all that out > so it is all potential again > you guys said frontline workers don't > have to know that it is or is an abuse > you're just you just need to know that > something is potentially happening so if > you received this call and you were on > the phone line or you with options > counselor are you with a case manager > and this was the information you had > what would you do > so here's your options you can > you call Richards older brother Ralph > call the ADRC call the police call the > Oregon SAFE line or potentially all of > the above so go ahead and vote so we > know what you think good job I see some > folks saying call that ADRC to me we'll > give you all about another seconds > here so much okay looks like most > people are voted so what have we got > here okay well Ralph he might be a good > he might be a good option but he may > want a new a house as well so actually > the ADRC police and the oregon safe line > are all legal options that will lead you > to Adult Protective Services and as > mandatory abuse reporters that will also > fulfill your your requirement as a > mandatory reporter okay so > Ralph his older brother would be an > option to but the three in the middle > the ADRC to police in the state line I > think Ralph would be the last person you > want to call will let Rose do that > because we don't want to we don't want > to invite more fires or more fuel into > the fire yeah okay okay question um okay > we have a lot of people dying from > substance abuse there often > diagnosed with failure to thrive how > often should their welfare be reported > in the course of their addiction they > have the right to refuse treatment and > intervention but they are still at risk > and it still could be self neglect so > how often should they so I can't give > you a how often I can't give you a > specific canned answer to that but if > you're working with somebody that you > know has these addiction problems and > you're seeing a serious decline in their > health happening you're welcome to give > a call there are different and there's > obviously different conditions that > occur as as people abuse their > bodies over time and they can become > more in serious health and it really is > a good idea if you're really concerned > about it to give the call to APS and > they can send somebody out there and you > can end up being part of the monitoring > system if it is something that ends up > having to be monitored they may go out > there and find who there really is > something really bad and they might be > able to help them find some supports > because just because somebody has an > addiction problem doesn't mean that > there aren't supports out there that > could possibly help them I hope that > answers the question well well let us > know if it didn't okay we > can't give you a how often it's you know > it's pretty much your own judgement > you're the one working with a person you > know how much they're deteriorating so > again if you get that gut feeling like > wow this isn't right because even like > our example previously Stanley he could > have had some problems that were going > on maybe Stanley was a drinker or had > drug problems and maybe that was the > reason that they weren't paying > attention to him but the bottom line is > if you are seeing something a sudden > change in that person because you've > known them for a long time make a report > and and get somebody to pay attention we > don't get in trouble if we remember > before there's no no you don't get in > any kind of trouble so it's better to > err on the side of making the report > than not exactly so back to this other > scenario that we were on this the slide is > in relation to that and it speaks about > the relationship of abusers statistics > and as you look at that you can see a > breakdown of who the abusers were and > this is for statistics at our > office put out there and I'll go ahead > and tell you what the actual numbers are > so the breakdown of two thousand eight > hundred and sixty perpetrators that were > substantiated for abuse in for two > hundred ninety seven spouses eighteen > Guardians grandchildren three > hundred and six caregivers three hundred > and eighty other people fifteen parents > seventy six siblings acquaintances > and one thousand fifty nine children so > included in those numbers also are fifty > three daughtersinlaw and forty three > sonsinlaw so what we're picking up > from this really is that much of the > abuse is coming from people that they > know and these statistics even though > they're from that numbers in > regards to family it's pretty accurate > representation of how it plays out it's > usually about half or more and in this > instance more coming from family so > we're going to want to be watchful in a > couple of situations personal stress of > the person who's protected or the people > who provide support it can serve as an > alert to risk of abuse either party may > be experiencing a divorce or > relationship issue problems with > children or work there could be carried > in caregiver stress many are really > really good caregivers to take out a > responsibility and it turns out to be > more than they can handle but an > investigation if it gets called in we > may be able to reveal they need more > training and they just don't know where > to get it a good ending > that care stress is going on is that > they're not able to get enough sleep or > take care of themselves another thing > that we want to think about is people > living with protected people they're not > only to have counts on us they have a > constant opportunity to take advantage > of situations and they may be under high > stress because that person's declining > health or whatever it may be and they > don't often get a break APs again are > trained to sort these things out and > then also keep in mind we mentioned > about about children and so on they may > be depending on this person for their > care needs as well so what we wanted > what we want to do here is to > watch listen and communicate collaborate > and take action so we want to use all of > our senses to pay attention to people we > want to get to know people in our daily > lives and we want to get to know them > through interaction you may not > recognize it but if you see somebody a > couple of times here's somebody a couple > of times on the phone you are going to > pick up on these different things so > just pay attention if there's a change > take them take a moment to process > things that are different and if you see > if you see them in a change it maybe > there's something to pay attention to as > far as abuse or neglect or again self > neglect and we want to take action by > connecting people how do we do that we > make the phone call as we've said over > and over again and we apologize for not > having the ADRC number on here okay > okay I apologize for that personally so > what do you say when you call we want > you to give the name there's actually > those were mandatory reporters our legal > obligations to gather up as much of this > information as possible but what do you > say the name of the victim where the > event happened > a name of a possible abuser and your > contact information another thing to > keep in mind there is if there are > dangers in that situation so you can > help that Adult Protective Services > worker or someone else from a different > agency know or maybe one of your > coworkers that works directly with you > another thing to keep in mind is that > you can remain anonymous now in most > situations you're not going to be able > to remain anonymous as a mandatory > reporter on your in your duty situation > but if you're offduty and you're > required to make the call you can remain > anonymous biggest thing you have to > remember is don't tell us who you are > because if you tell us who you are we > have to record it we're legally > obligated to do that that doesn't change > the fact that it's still going to be > kept confidential but if you want to be > completely out of the picture then > remember don't say who you are but only > when you're offduty when you're on duty > well there's there may be contractual > issues now there are people who do make > anonymous calls when they're on duty > and if I know that it's somebody who's > on duty and is a mandatory reporter I > will tell them you are allowed to make > an anonymous call however if we do an > investigation and we don't have the > benefit of knowing that you are the one > who made the call you may be looked at > as a failed to report so that helps > remove the doubt I know there are > situations though where people still > wanna remain anonymous maybe they're a > family member of the person who's doing > the abuse you know it's there's a number > of different situations that can come > into play that or their boss is the > abuser I mean we would want to remain > anonymous then usually these things will > surface eventually but if you don't want > to be the one to make the call or the > one who is identified as the caller > that's okay now you can also ask to be > kept in the loop make sure you ask this > in advance because we're not required to > tell everyone but if you're a > complaining witness makes the call and > asks us we'll make a note of that we'll > make sure we get back to you and let you > know if it was substantiated or not > okay the next slide is just going to > show you the rings of the phone > that we received last year are different > different places that receive calls as > you can see the top one there is > referrals to resources and we were > actually referring to people to the ADRC > ombudsman education and training and > other community resources > there's a lot of calls that come in and > if you don't have further questions that > is the end of our presentation well > thank you so much Thomas for everything > you've shared it it strikes so close to > home because with a program like Oregon > project independence which many of our > folks are involved in and work with > they're involved at the request of ApS > to go and see this consumer maybe they > are working with trying to get them on > APD but consumer does a lot to have a > claim against their estate or something > and OPI still doesn't have a claim so > they get involved and it's then figuring > out they're just offering a modicum of > services they're not meeting the whole > mean so there's still vulnerability and > issues and so it's nice to know it's > okay to have an ongoing conversation > perhaps with investigators looking at > this person's life and trying to assist > them with making good decisions and > helping them through that maze so > absolutely and you know we've got we've > got holes and the safety nets that > they're inherently it may be because of > laws or whathaveyou but if we work as > a community together we can help fill > those holes that might be there and we > can also we can ensure their safety and > and maybe maybe make it life happier > yeah wouldn't that be a great outcome > I'd like that > and where there is one more slide I > think with > Thomas' information the very last > clinically it has a certain hell address > and his phone number > there's a couple of you asking to be > able to talk to him outside the > presentation with specific questions and > I think he's happy to do that I will do > that I can't move that forward to them > all so they can see that though because > they blocked yeah there we go all right > there is my information and you're > welcome to contact us it will probably > be referred to well I will do my best to > make a referral but also we have our > training we have our training number > excuse me we have our training email > actually have to look that up > I should haven't memorized because they > use it daily so he's happy to take these > calls and then the help forward them > to wherever they need to go so you see > his email up there and you can also send > questions to me and Sandy and I am > Thomas can work together to figure out > who needs to be the person to take those > questions ok I'm going to I'm going to > give you two numbers actually as far as > contacting her two email addresses that > are separate from mine because I'm not > always here sometimes I get hurt like I > did when I needed surgery > so OAPPI training is Oaapi.training@dhsoha.state.or.us > > and the next one is a little > bit longer it is oaapi.apstechassistance@hdsoha.state.or.us > and they can answer a lot of > the technical questions they're the ones > that actually speak to the investigators > but I would prefer that you lean towards > making the call actually to the safe > line really ultimately the safe line is > going to get you directed better than we > can but this is the technical assistance > location and they > help you with legal questions so > oaapi.apstechassistance@hdsoha.state.or.us > > so i > really want to thank you again Thomas we > really appreciate you being on the on > the webinar today i want to remind you > guys that we did record it and we will > get it closed caption and get it up > probably by the middle of next week on > the webinar on the website with the rest > of the webinar and we will be sending > you an email watch for an email within > about an hour when we close the webinar > and please take about five minutes to do > the Survey Monkey so we'll know how we > did and how we can make it better next > time and we'll give some feedback > Thomas about how useful this > information was I'm not seeing anymore > questions and is and we're through the > PowerPoint so hopefully you guys are > good and I appreciate you being here > next month it's the second Wednesday of > the month in the afternoon we're not > sure what our topic is going to be yet > so if there's anything in particular you > guys would love to hear about shoot me > an email or sandy an email and let us > know we're still in the process of > developing what that one will be but we > do have August's we'll be talking with > somebody from ACL about working with the > tribes in our areas and then in > September we're going to be talking with > our legal aid developer person about > abuse and legal aid and guardianship and > those kinds of things so we're excited > to have these we look forward to be with > you each month and thanks again so much > and we'll talk to you next month > and this is Sandi for just a quick > commercial break > next Wednesday we have our Oregon project > independence power hour you know > there still is nothing official at all > regarding our OPI budget for this > upcoming year we haven't heard anything > from the legislature to know what > programs are or are not funded and at > what level so I don't think I'll have a > magic wand to share but if I do you'll > be the first to know but we do have > plenty of other topics for us to go over > and review I'll be sending you out an > agenda for those of you who are OPI case > managers you'll see that come out on > Monday and I'm looking forward to > spending some time with you so thank you > again for your time this afternoon and I > wish you all the best bye everybody > thank you