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ELDER ABUSE: SOCIAL WORKER TRACK ETHICS Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney
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Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Dec 23, 2015

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Page 1: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

ELDER ABUSE:SOCIAL WORKER TRACKETHICS

Presented by

Harold S. Bartholomew, Jr.Assistant District Attorney:Elder Abuse Protection Unit22nd Judicial DistrictWalter P. Reed, District Attorney

Page 2: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

World Elder Abuse Awareness Day 2012June 11, 2012

The opinions expressed herein are not necessarily the opinions of the District Attorney’s Office. Each and every case is evaluated in light of the facts particular to that case.

Page 3: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

The aging of America

Between 1950 & 2000, the total population increased by 87%

Age 65+ - by 188% 85+ - by 635% By 2030 - 65+ will triple to over 70

million

Page 4: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1900

1910

1920

1930

1940

1950

1960

1970

1980

1990

2000

0

2

4

6

8

10

12

14

2.9 3 3.3 3.84.8

5.6 6.1 6.16.9 7.3

6.51 1.1 1.21.3

1.7

2.22.6 3

3.44

4.4

0.2 0.20.2

0.3

0.3

0.04

0.50.7

1

1.2 1.5

85+75-8465-74

Percent of Total Population Age 65 and Over:1900 to 2000

Source: U.S. Census Bureau, decennial census 1900 to 2000

Page 5: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

A growing Elderly population

2000 2010 2020 2030 2040 20500

5

10

15

20

25

12.4 13

16.3

19.6 20.4 20.6

Percent Aged 65 and Over of the Total Population 2000 to

2050

Source: U.S. Census Bureau

Page 6: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Population Growth

2000 2010 2020 2030 2040 20500

102030405060708090

3540.2

54.6

71.580

86.7

Population aged 65 and over, Millions

Source: U.S. Census Bureau.

Page 7: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Mandatory Reporting

La. R.S. 14:403.2 C. Any person, including but not limited to a health, mental health, and social service practitioner, having cause to believe that an adult's physical or mental health or welfare has been or may be further adversely affected by abuse, neglect, or exploitation shall report in accordance with Subsection D of this Section.

Page 8: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Mandatory Reporting

La. R.S. 14:403.2 requires reporting of abuse by ANY PERSON “having cause to believe.”

Failure to report is punishable by up to six months imprisonment and/or a five-hundred dollar fine.

Page 9: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Who do I call?

R.S. 15:1505.  Contents of report and agency to receive report

Report shall be made to any adult protection agency or to any local or state law enforcement agency.

Need not name the persons suspected Contain, name and address of the adult,

the name and address of the person responsible for the care of the adult, if available, and any other pertinent information.

Page 10: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

To Contact EPS

New Orleans Region Phone: (504) 832-1644 Toll Free (In-state only): 1-800-673-

4673 Fax: (504) 835-0409 State office Hotline: 800-259-4990 http://goea.louisiana.gov http://goea.louisiana.gov/index.cfm?md=pagebuilder&t

mp=home&pid=5&pnid=2&nid=16

Page 11: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Office of Aging and Adult Services

The Office of Aging and Adult Services (OAAS), Adult Protective Services (APS) DHH as the agency responsible for carrying out the mandate of 14:403.2 with regard to adults with disabilities ages 18-59

(225) 342-9057 or (800) 898-4910 

Fax (225) 342-9069 http://www.dhh.state.la.us/offices/Default.asp?ID=95&P

rint=1

Page 12: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Investigation

R.S. 15:1507.  Investigation of reports, assessment, actions taken, and court orders

Elderly Protective Services or Dept. Health & Hospitals (fact dependent) shall investigate

Face to face interview with adult Access to any records or documents,

including client-identifying information and medical, psychological, criminal or financial records necessary…

Agency is exempt from payment of fees for records

Page 13: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Understanding the Dynamics

Fears of many seniors Leads to underreporting Feelings of shame Concern that exposure will lead to

loss of independence Sometimes accompanied by threats

from perpetrator

Page 14: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Most Common Forms of Abuse Of substantiated reports Self-neglect was the most common

37% Caregiver neglect 20% Financial exploitation 15%

Page 15: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Lessons learned from Domestic Violence and Child Abuse

Self-determination is not the answer If not punished, the perpetrator WILL

abuse again We CAN convict even without the

assistance of the victim Abuse is a crime against not just the

abused but the taxpayers and the family of the victim

Page 16: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

No one is beyond abuse

65.7% female 42.8% were over 80 years of age 89.3% in domestic settings 6.2% of substantiated reports were in

long-term care settings,

Page 17: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Who Are The Perpetrators?

53% of alleged perpetrators were female

75% of alleged perpetrators under 60

Most common relationships adult child 33% other family member 22%

Page 18: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Code Of Ethics

Code of Ethicsof the National Association of Social Workers

Approved by the 1996 NASW Delegate Assembly and revised by the 2008 NASW Delegate Assembly

http://www.socialworkers.org/pubs/code/code.asp

Page 19: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Ethical Principles

The following broad ethical principles are based on social work’s core values of service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence. These principles set forth ideals to which all social workers should aspire.

Page 20: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Value: Service

Ethical Principle: Social workers’ primary goal is to help people in need and to address social problems.

Page 21: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Value: Social Justice

Ethical Principle: Social workers challenge social injustice.

Page 22: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Value: Dignity and Worth of the Person Ethical Principle: Social workers

respect the inherent dignity and worth of the person.

Page 23: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Value: Importance of Human Relationships Ethical Principle: Social workers

recognize the central importance of human relationships.

Page 24: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Value: Integrity

Ethical Principle: Social workers behave in a trustworthy manner

Page 25: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Value: Competence

Ethical Principle: Social workers practice within their areas of competence and develop and enhance their professional expertise.

Page 26: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Ethics and the Elderly

More than half of abuse is self-neglect or committed by family

Social Workers are arguably the best situated to prevent, minimize and treat the results of these problems

Page 27: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Ethical Standards

The following ethical standards are relevant to the professional activities of all social workers. These standards concern (1) social workers’ ethical responsibilities to clients, (2) social workers’ ethical responsibilities to colleagues, (3) social workers’ ethical responsibilities in practice settings, (4) social workers’ ethical responsibilities as professionals, (5) social workers’ ethical responsibilities to the social work profession, and (6) social workers’ ethical responsibilities to the broader society.

Some of the standards that follow are enforceable guidelines for professional conduct, and some are aspirational. The extent to which each standard is enforceable is a matter of professional judgment to be exercised by those responsible for reviewing alleged violations of ethical standards.

Page 28: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1. SOCIAL WORKERS’ ETHICAL RESPONSIBILITIES TO CLIENTS 1.02 Self Determination 1.06 Conflicts of Interest 1.07 Privacy and Confidentiality 1.14 Clients Who Lack Decision

Making Capacity

Page 29: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1.02 Self Determination

Social workers respect and promote the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals. Social workers may limit clients’ right to self -determination when, in the social workers’ professional judgment, clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others.

Page 30: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

A Note on Visitors

The Elderly Person Is Always In Charge Of Visitors NOT a relative NOT a person with Power of Attorney Only where Committed or Interdicted

does this change

Page 31: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1.06 Conflicts of Interest Hard to spot Where lawyers get into a lot of

trouble

Page 32: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1.06 Conflicts of Interest (a) Social workers should be alert to and avoid

conflicts of interest that interfere with the exercise of professional discretion and impartial judgment. Social workers should inform clients when a real or potential conflict of interest arises and take reasonable steps to resolve the issue in a manner that makes the clients’ interests primary and protects clients’ interests to the greatest extent possible. In some cases, protecting clients’ interests may require termination of the professional relationship with proper referral of the client.

Page 33: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1.06 Conflicts of Interest (b) Social workers should not take

unfair advantage of any professional relationship or exploit others to further their personal, religious, political, or business interests.

Page 34: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1.06 Conflicts of Interest (c) Social workers should not engage in dual or

multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, social workers should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries. (Dual or multiple relationships occur when social workers relate to clients in more than one relationship, whether professional, social, or business. Dual or multiple relationships can occur simultaneously or consecutively.)

Page 35: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1.06 Conflicts of Interest (d) When social workers provide services to two or

more people who have a relationship with each other (for example, couples, family members), social workers should clarify with all parties which individuals will be considered clients and the nature of social workers’ professional obligations to the various individuals who are receiving services. Social workers who anticipate a conflict of interest among the individuals receiving services or who anticipate having to perform in potentially conflicting roles (for example, when a social worker is asked to testify in a child custody dispute or divorce proceedings involving clients) should clarify their role with the parties involved and take appropriate action to minimize any conflict of interest.

Page 36: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1.06 Conflicts of Interest Let’s discuss: Gifts?

How big is too big? How big will a family member see as too

big? How big will law enforcement see as too

big? Family Members

Get close to Elder and their adult child?

Page 37: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Undue Influence

Louisiana recognizes the concept of undue influence in La. C. C. Art. 1479.

A donation inter vivos or mortis causa shall be declared null upon proof that it is the product of influence by the donee or another person that so impaired the volition of the donor as to substitute the volition of the donee or other person for the volition of the donor.

Page 38: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Warning Signs of Undue Influence Isolation of elder from social contact,

family, friends Control of elder’s mail, phone calls,

visitors, outings Promises to elder she/he will be

taken care of for life Elderly Protective Services will

investigate complaints of Isolation

Page 39: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1.07 Privacy and Confidentiality (e) Social workers should discuss with clients

and other interested parties the nature of confidentiality and limitations of clients’ right to confidentiality. Social workers should review with clients circumstances where confidential information may be requested and where disclosure of confidential information may be legally required. This discussion should occur as soon as possible in the social worker client relationship and as needed throughout the course of the relationship.

Page 40: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1.07 Privacy and Confidentiality Does 1.07 allow disclosure to EPS? Nursing Home Ombudsmen? The Office of Aging and Adult

Services (OAAS), Adult Protective Services (APS) DHH?

Mandatory Reporting and “disclosure of confidential information may be legally required. “

Page 41: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1.14 Clients Who Lack Decision Making Capacity When social workers act on behalf of

clients who lack the capacity to make informed decisions, social workers should take reasonable steps to safeguard the interests and rights of those clients. Reporting? Interdiction? Discussion?

Page 42: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

C.C. Art. 362.  Persons subject to interdiction. Persons subject to mental or physical

illness or disability, whether of a temporary or permanent nature, of such a degree as to render them subject to interdiction, under the provisions of Title IX hereof, remain subject to interdiction as provided in Articles 389 to 399, inclusive, and such other laws as may relate thereto.

Acts 1966, No. 496, §2.

Page 43: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Art. 389.  Full interdiction A court may order the full

interdiction of a natural person of the age of majority, or an emancipated minor, who due to an infirmity, is unable consistently to make reasoned decisions regarding the care of his person and property, or to communicate those decisions, and whose interests cannot be protected by less restrictive means.

Page 44: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Art. 390.  Limited interdiction A court may order the limited

interdiction of a natural person of the age of majority, or an emancipated minor, who due to an infirmity is unable consistently to make reasoned decisions regarding the care of his person or property, or any aspect of either, or to communicate those decisions, and whose interests cannot be protected by less restrictive means.

Page 45: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Art. 391.  Temporary and preliminary interdiction When a petition for interdiction is

pending, a court may order a temporary or preliminary interdiction when there is a substantial likelihood that grounds for interdiction exist and substantial harm to the health, safety, or property of the person sought to be interdicted is imminent.

Page 46: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Ask yourself

Does it feel right? Not just ‘not wrong’ but “right” Would I be proud of this on the front

page of the paper?

Page 47: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Over 50% Of Perpetrators are Family Caregiver Stress, Is There Help?

Page 48: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Caregiver Stress and Elder Abuse

Caregiver Stress and Elder Abuse Lisa Nerenberg, M.S.W., M.P.H This publication was produced under a contract with the

Institute on Aging for the National Center on Elder Abuse. The NCEA is funded by grant No. 90-AP-2144 from the U.S. Administration on Aging, and consists of six partner organizations: National Association of State Units on Aging, which is the lead agency: Commission on Legal Problems of the Elderly of the American Bar Association; the Clearinghouse on Abuse and Neglect of the Elderly of the University of Delaware; the San Francisco Consortium for Elder Abuse Prevention of the Institute on Aging; National Association of Adult Protective Services Administrators; and National Committee for the Prevention of Elder Abuse.

www.ncea.aoa.gov/main_site/pdf/family/caregiver.pdf

Page 49: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

National Center on Elder AbuseFact Sheet Caregivers can: ■ Get help. Making use of social and

support services, including support groups, respite care, home delivered meals, adult day care and assessment services, can reduce the stress associated with abuse.

■ Learn to recognize their “triggers,” those factors that cause them the greatest stress or anxiety.

Page 50: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

National Center on Elder AbuseFact Sheet ■ Learn to recognize and understand the causes of difficult

behaviors and techniques for handling them more effectively. ■ Develop relationships with other caregivers. Caregivers with

strong emotional support from other caregivers are less likely to report stress or to fear that they will become abusive.

■ Get healthy. Exercise, relaxation, good nutrition and adequate rest have been shown to reduce stress and help caregivers cope.

■ Hire helpers. Attendants, chore workers, homemakers or personal care attendants can provide assistance with most daily activities. Caregivers who cannot afford to hire helpers may qualify for public assistance.

■ Plan for the future. Careful planning can relieve stress by reducing uncertainty, preserving resources and preventing crises. A variety of instruments exist to help plan for the future including powers of attorney, advanced directives for health care, trusts and wills.

Page 51: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.
Page 52: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

http://www.ncea.aoa.gov/ncearoot/Main_Site/index.aspx

Page 53: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

http://www.ncea.aoa.gov/NCEAroot/Main_Site/Find_Help/State_Resources_Directory.aspx?state_id=la

Page 54: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Caregiver Ethics

Is There Guidance?

Page 55: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

A Code Of Ethics

Page 56: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Rule 1 - Decision-Making: General Principles: Rule 1 - Decision-Making: General

Principles: A GUARDIAN SHALL EXERCISE

EXTREME CARE AND DILIGENCE WHEN MAKING DECISIONS

ON BEHALF OF A WARD. ALL DECISIONS SHALL BE MADE IN A MANNER

WHICH PROTECTS THE CIVIL RIGHTS AND LIBERTIES OF THE WARD AND MAXIMIZES

INDEPENDENCE AND SELF-RELIANCE.

Page 57: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1.1 The guardian shall make all reasonable efforts to ascertain the preferences of the ward, both past

and current, regarding all decisions which the guardian is empowered to make.

1.2 The guardian shall make decisions in accordance with the ascertainable preferences of the ward,

past or current, in all instances except those in which a guardian is reasonably certain that substantial

harm will result from such a decision.

Page 58: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1.3 When the preferences of the ward cannot be ascertained, a guardian is responsible for making decisions which are in the best interests of the ward.

1.4 The guardian shall be cognizant of his or her own limitations of knowledge, shall carefully consider the views and opinions of those involved in the treatment and care of the ward, and shall also seek independent opinions when necessary.

Page 59: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

1.5 The guardian must recognize that his or her decisions are open to the scrutiny of other interested

parties and, consequently, to criticism and challenge. Nonetheless, the guardian alone is ultimately responsible for decisions made on behalf of the ward.

1.6 A guardian shall refrain from decision making in areas outside the scope of the guardianship order and, when necessary, assist the ward by ensuring such decisions are made in an autonomous fashion.

Page 60: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Rule 2 - Relationship Between Guardian and Ward: THE GUARDIAN SHALL EXHIBIT THE

HIGHEST DEGREE OF TRUST, LOYALTY, AND FIDELITY IN RELATION TO THE WARD.

Page 61: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

2.1 The guardian shall protect the personal and pecuniary interests of the ward and foster the ward’s growth, independence and self reliance to the maximum degree.

2.2 The guardian shall scrupulously avoid conflict of interest and self-dealing in relations with the ward.

2.3 The guardian shall vigorously protect the rights of the ward against infringement by third parties.

2.4 The guardian shall, whenever possible, provide all pertinent information to the ward unless the guardian is reasonably certain that substantial harm will result from providing such information.

Page 62: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Rule 3 - Custody of the Person; Establishing a Place of Abode: THE GUARDIAN SHALL ASSUME

LEGAL CUSTODY OF THE WARD AND SHALL ENSURE THE WARD RESIDES IN THE LEAST RESTRICTIVE ENVIRONMENT AVAILABLE.

Page 63: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

3.1 The guardian shall be informed and aware of the options and alternatives available for establishing the ward’s place of abode.

3.2 The guardian shall make decisions in conformity with the preferences of the ward in establishing the ward’s place of abode unless the guardian is reasonably certain that such a decision will result in substantial harm.

Page 64: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

3.3 When the preferences of the ward cannot be ascertained or where they will result in substantial harm, the guardian shall make decisions with respect to the ward’s place of abode which are in conformity with the best interests of the ward.

3.4 The guardian shall not remove the ward from his or her home or separate the ward from family and friends unless such removal is necessary to prevent substantial harm. The guardian shall make every reasonable effort to ensure the ward resides at home or in a community setting.

Page 65: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

3.5 The guardian shall seek professional evaluations and assessments wherever necessary to determine whether the current or proposed placement of the ward represents the least restrictive environment available to the ward. The guardian shall work cooperatively with community based organizations which may be available to assist in ensuring that the ward resides in a non-institutional environment.

3.6 The guardian shall have a strong preference against placement of the ward in an institution or other setting which provides only custodial care.

Page 66: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

3.7 The guardian shall monitor the placement of the ward on an on-going basis to ensure its continued appropriateness, and shall consent to changes as they become necessary or advantageous for the ward.

3.8 In the event that the only available placement is not the most appropriate and least restrictive, the guardian shall advocate for the ward’s rights and negotiate a more desirable placement with a minimum of delay, retaining legal counsel to assist if necessary.

Page 67: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Rule 4 - Custody of the Person: Consent to Care, Treatment and Services THE GUARDIAN SHALL ASSUME

RESPONSIBILITY TO PROVIDE INFORMED CONSENT ON BEHALF OF THE WARD FOR THE PROVISION OF CARE, TREATMENT AND SERVICES AND SHALL ENSURE THAT SUCH CARE, TREATMENT AND SERVICES REPRESENTS THE LEAST RESTRICTIVE FORM OF INTERVENTION AVAILABLE

Page 68: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

4.1 The guardian shall make decisions in conformity with the preferences of the ward when providing consent for the provision of care, treatment and services, unless the guardian is reasonably certain that such decisions will result in substantial harm to the ward.

4.2 When the preferences of the ward cannot be ascertained or will result in substantial harm, the guardian shall make decisions with respect to care, treatment and services which are in conformity with the best interests of the ward.

Page 69: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

4.3 In the event the only available treatment, care or services is not the most appropriate and least restrictive, the guardian shall advocate for the ward’s right to a more desirable form of treatment, care or services, retaining legal counsel to assist if necessary.

4.4 The guardian shall seek professional evaluations and assessments whenever necessary to determine whether the current or proposed care, treatment and services represent the least restrictive form of intervention available.

Page 70: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

4.5 The guardian shall work cooperatively with individuals and organizations which may be available to assist in ensuring the ward receives care, treatment and services which represent the least restrictive form of intervention available and are consistent with the wishes or best interests of the ward.

4.6 The guardian shall not consent to sterilization, electro-convulsive therapy, experimental treatment or service without seeking review by the court or the ward’s attorney or other representative.

Page 71: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

4.7 The guardian shall be familiar with the law of the state regarding the withholding or withdrawal of lifesustaining treatment.

4.8 The guardian shall monitor the care, treatment and services the ward is receiving to ensure its continued appropriateness, and shall consent to changes as they become necessary or advantageous to the ward.

Page 72: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Rule 5 - Management of the Estate: THE GUARDIAN OF THE ESTATE

SHALL PROVIDE COMPETENT MANAGEMENT OF THE PROPERTY AND INCOME OF THE ESTATE. IN THE DISCHARGE OF THIS DUTY, THE GUARDIAN SHALL EXERCISE INTELLIGENCE, PRUDENCE AND DILIGENCE AND AVOID ANY SELF-INTEREST.

Page 73: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

5.1 Upon appointment, the guardian shall take steps to inform himself or herself of the statutory requirements for managing a ward’s estate.

5.2 The guardian shall manage the income of the estate with the primary goal of providing for the needs of the ward, and in certain cases, the needs of the ward’s dependents for support and maintenance.

Page 74: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

5.3 The guardian has a duty to exercise prudence in the investment of surplus funds of the estate.

5.4 Where the liquid estate of the ward is sufficient, the guardian may make such gifts as are consistent with the wishes or past behavior of the ward, bearing in mind both the foreseeable requirements of the ward and the tax advantages of such gifts.

Page 75: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

5.5 There shall be no self-interest in the management of the estate by the guardian; the guardian shall exercise caution to avoid even the appearance of self-interest.

Page 76: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Role of Elderly Protective Services and Law Enforcement

Page 77: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Elderly Protective Services Elderly Protective Services acts to prevent,

remedy, halt or hinder acts of abuse and neglect against an elder adult in the community, while promoting the maximum possible degree of personal freedom, dignity and self-determination.

Only when other efforts fail will EPS recommend referral or admission to an appropriate care facility for the elder adult, or

Seek judicial remedy to the situation, DA can file restraining order.

Page 78: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Records Available to EPS

The statute also makes certain records available to Elderly Protective Services without an authorization or warrant.

Note that E.P.S. does not pay a copying charge.

Page 79: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Investigation

R.S. 15:1507.  Investigation of reports, assessment, actions taken, and court orders

Elderly Protective Services or Dept. Health & Hospitals (fact dependent) shall investigate

Face to face interview with adult Access to any records or documents,

including client-identifying information and medical, psychological, criminal or financial records necessary…

Agency is exempt from payment of fees for records

Page 80: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

The following slides on what EPS does and does not do are taken from the presentation of Ms. Lutricia McDonald done at the St. Tammany SALT sponsored World Elder Abuse Day Seminar in June 2009. Please see her entire presentation available on the St. Tammany SALT web site.

Page 81: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

What EPS Does:

Locate and refer individuals to community agencies and facilities that offer the services they need. When necessary, advocate ( that is recommend, support and /or defend their rights.)

Page 82: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

What EPS Does:

Provide short-term, limited , case management services. That is monitor the case for stability

Work with law enforcement to provide protection

Page 83: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

What EPS Does:

Work with the judiciary system to remedy problems that require legal action from the D.A. or Judge when legal intervention is warranted. Methods of Legal intervention are

Page 84: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

What EPS Does:

Order to Enter Home

Interdiction - full/limited

Order for Injunctive Relief- Restraining Order

Page 85: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

What EPS Does:

Order for Mandatory Counseling Order for

Medical/Psychiatric/Psychological Evaluation

Power of Attorney Admission by Emergency

Certificate Order for Protective Custody

Page 86: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

What EPS Does:

Judicial Commitment

Protective Service Order- temporary custody by EPS to place elder in a protected environment until a more permanent solution can be arranged.

Provide information and referral

service to individuals who do not meet the criteria for elderly protective services.

Page 87: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

What EPS does not do:

EPS does not remove elders from their homes against their will unless it is determined that they are a danger to themselves or others. If this is determined, our office request an Order for Protective Custody from the Coroner or a District Judge and if granted, the elder is transported by a law enforcement officer to a facility for evaluation and/or treatment.

Page 88: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

What EPS does not do:

EPS does not force nursing home placement unless a doctor/psychiatrist determines that the elder is no longer mentally capable of making decisions, there is no family member/s available or willing or capable of caring for the elder and a court of law deems the elder incapable of caring for themselves or having the mental capacity to know.

Page 89: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

What EPS does not do:

EPS does not provide discharge planning for medical or other facilities.

Page 90: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

What EPS does not do:

EPS does not provide crisis intervention on an emergency basis.

Not on 24 hour call.

Page 91: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Law Enforcement

Law Enforcement may receive calls from EPS, DHH, other government agencies, nursing homes, social workers, physicians, or private individuals.

There are many special laws protecting the elderly.

Page 92: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Elder Abuse is Exploding

Fastest growing age group No known cure for dementia Victims often do not report Third fastest growth job is home care Minimal background checks High temptation, low risk

Page 93: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Multiple criminal statutes apply specifically to elderly victims

14:35.2 Simple battery of the infirm. Minimum 30 days

14:42 Aggravated Rape. 14:50.2 Perpetration or attempted perpetration

of certain crimes of violence against a victim sixty-five years of age or older. Adds 3 years to maximum, at court’s discretion. Consider putting this in the Bill of Information.

14:67.16 C. (1) (b) Identity theft. If victim 60 years of age or older, minimum goes from 0 years to 2 years.

14:67.21 Theft of assets of aged person,

Page 94: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Multiple criminal statutes apply specifically to elderly victims, cont’d 14:93.3 Cruelty to the infirmed, 14:93.4 Exploitation of the infirmed, 14:93.5 Sexual battery of the infirm, 14:403.2 Abuse and neglect of adults; reports;

investigation; waiver of privileges; penalties; immunity. Makes reporting of elder abuse mandatory, and empowers District Attorneys to take steps to protect the elderly.

C.E. Art. 803, Hearsay Exceptions. Keep (5) Recorded Recollection in mind where the elderly person is available for trial, but has an impaired memory.

Page 95: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Multiple criminal statutes apply specifically to elderly victims

14:35.2 Simple battery of the infirm. Minimum 30 days

14:42 Aggravated Rape.

Page 96: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Multiple criminal statutes apply specifically to elderly victims

14:50.2 Perpetration or attempted perpetration of certain crimes of violence against a victim sixty-five years of age or older. Adds 3 years to maximum, at court’s discretion. .

14:67.16 C. (1) (b) Identity theft. If victim 60 years of age or older, minimum goes from 0 years to 2 years.

Page 97: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Multiple criminal statutes apply specifically to elderly victims

14:67.21 Theft of assets of aged person,

14:93.3 Cruelty to the infirmed,

Page 98: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Multiple criminal statutes apply specifically to elderly victims

14:93.4 Exploitation of the infirmed, 14:93.5 Sexual battery of the infirm,

Page 99: Presented by Harold S. Bartholomew, Jr. Assistant District Attorney: Elder Abuse Protection Unit 22nd Judicial District Walter P. Reed, District Attorney.

Enhanced Penalties

La. R.S. 14:50.2, Perpetration or attempted perpetration of certain “crimes of violence” against a victim sixty-five years of age or older. Adds 3 years to the maximum sentence for

crimes of violence