Training+Module+2

==__Training Module 2: Warning Signs__ ==

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__** Introduction **__: Many times, the signs and symptoms of elder abuse overlap with symptoms of mental deterioration, but that does not mean you should ignore them. It is the driver's and volunteer's responsibility to not only be able to recognize different warning signs of abuse, but to talk with the elderly clients about the warning signs so the elderly can recognize them as well. Remember, often, Mobile Meals drivers and volunteers are the only regular human contacts the elderly have. This is why recognition of the warning signs is crucial! In the last training module, you learned how to recognize different types of abuse, including some kinds that are not common or not well known. Now you can learn about how to recognize some of the obvious and less obvious warning signs of abuse. ======

__**There are two general signs of elder abuse:** __

 * 1) **Frequent arguments or tension between the caregiver and the elderly person**
 * 2) **Changes in personality or behavior in the elder**


 * If you suspect elder abuse, but are unsure, look for similarities within the following physical and behavioral signs .**

**__Physical Abuse__**
 * Unexplained signs of bruises, welts, or scars
 * Broken bones, sprains, or dislocations
 * Failure to take medication regularly (prescription has more remaining than it should)
 * Broken eyeglasses or frames
 * Signs of restraint, such as rope marks on wrists
 * Refusal of the caregiver to allow you to see the elder alone
 * Slap marks and certain types of burns or blisters, such as cigarette burns

** __Emotional Abuse__ **
 * Threatening, belittling or controlling caregiver behavior that you witness
 * <span style="font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Behavior from the elder that resembles that of dementia, such as rocking, sucking, or mumbling to oneself
 * <span style="font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Elder withdraws from normal daily activities
 * <span style="font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Unexplained changes in alertness, or other unusal behavior changes

<span style="color: #008000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">**__ Sexual Abuse __** =<span style="color: #008000; font-family: Tahoma,Geneva,sans-serif; font-size: 129%;">__ Neglect Abuse __ =
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Bruises around breasts or genitals
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Unexplained sexually transmitted diseases or genital infections
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Unexplained vaginal or anal bleeding
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Torn, stained, and/or bloody underclothing
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 130%;">Unusual weight loss, malnutrition, dehydration
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 130%;">Untreated physical problems, such as bed sores
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 130%;">Unsanitary living conditions: dirt, bugs, soiled bedding and clothes
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 130%;">Elder left dirty or unbathed
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 130%;">Unsuitable clothing or covering for the weather
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 130%;">Unsafe living conditions (no heat or running water; faulty electrical wiring, etc.)
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 130%;">Lack of medical care being given to elder

<span style="color: #008000; font-family: Tahoma,Geneva,sans-serif; font-size: 156%;">**__Financial Exploitation__** Listen to this audio clip on Financial Abuse
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Significant withdrawals from the elder's accounts
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Sudden changes in elder's financial conditions
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Items or cash missing
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Suspicious changes in wills, power of attorney, titles, and policies
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Addition of names to the senior's signature card
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Unpaid bills or lack of medical care
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Financial activity the elder could not have done, such as ATM withdrawals when the account holder is bedridden
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Unnecessary services, goods, or subscriptions
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Checks written as "loans" or "gifts"

<span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 140%;">**<span style="color: #008000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">__Healthcare Fraud and Abuse__ **
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 140%;">Duplicate billings for the same medical service or device
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 140%;">Evidence of overmedication or undermedication
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif; font-size: 140%;">Inadequate care when bills are paid in full

Videos__** - watch the videos to see real-life stories of elder abuse.
 * __[[image:MCj04326180000[1].png width="54" height="54" align="left"]]

media type="youtube" key="cr7J64iqtz8" height="385" width="480"

media type="youtube" key="ZOxVTj1e9dI" height="344" width="425"

<span style="color: #008000; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">**__ Summary __**: It is the volunteer's and driver's social responsibility to recognize abuse. Unfortunately, because many assume that abuse involves obvious physical signs, other more subtle signs are missed. Be on the look out for how the elderly person is acting. Is she overly paranoid? Confused about missing money? Living in unsafe or unsanitary conditions? Talk with your clients about these issues, especially frauds and scams. Too often, the elderly are victims of con artists on the phone, or con artists sifting through their mail, or con artists swindling them out of money in other creative ways. Converse with your clients. Get to know them. The more you can learn about your clients' lives, the better you will be able to help them or teach them how to live safe and healthy lives.

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