#10 Preventing Elder Abuse during COVID19

Aging with Altitude

PART 1: The Pikes Peak Elder Abuse Coalition has been working to keep vulnerable adults safe for 15 years and that work continues during COVID19 times. Dayton Romero, Chair of the Coalition and Director of Senior Assistance Programs with Silver Key, discusses the extenuating circumstances and challenges being faced during COVID19. Fraud abounds with specific COVID scams and abuse is heightened as people lack support and have more stressors. Learn how the Coalition is meeting the needs.

Aging with Altitude is recorded in the Pikes Peak region with a focus on topics of aging interest across the country. We talk about both the everyday and novel needs and approaches to age with altitude whether you’re in Ft. Lauderdale, Florida or Leadville, Colorado. The Pikes Peak Area Agency on Aging is the producer. Learn more at Pikes Peak Area Agency on Aging.

Transcript:

This is Aging with Altitude. Welcome to all. Brought to you by the Pikes Peak Area Council of Governments Area Agency on Aging. We strive to provide answers, assistance, and advocacy into our elders. Please know my guest today and I are sitting about 10 feet apart and practicing the social distance protocol for the coronavirus. I hope you are too.

Thank you for joining us today. Our topic today is elder abuse and how it is increasing during the Coronavirus pandemic. Domestic violence goes up whenever families spend more time together, such as the holidays, long weekends and summer vacations. Seniors have it several ways, physical abuse, sexual abuse, psychological abuse, financial exploitation, and neglect are all forms of elder abuse. And it can occur in any family or any setting. We are here today to talk about two ways abuse occurs; one through trusted folks like family as there may be more time together, and then there are the more fun scammers.

I am your host Cynthia Margiotta, geriatric social worker and volunteer with The Pikes Peak Area Council of Government Area Agency on Aging. With me today is Dayton Romero. Dayton is the co-chair of the senior abuse coalition and works at Silver Key here at Colorado Springs CO. Silver Key is a non-profit working with seniors doing many things to assist our elders. Dayton joined Silver Key in 2015 and serves as the director of senior assistance programs. He holds a BA in psychology with a minor in gerontology from the University of Colorado, Colorado Springs. Currently he is pursuing a masters degree In Public Health with a concentration in leadership and public practice at the University of Colorado Anschutz Medical Campus.

He is responsible for overseeing the administration and operations of several programs at Silver Key; including case management, guardianship, behavioral health, food pantry and commodity food programs and Silver Key Silver Line. He also acts as Guardian to court appointed wards and develops partnerships in collaboration with community partners. Dayton has a strong technical knowledge and serves as Silver Key’s senior assistance database administrator and data analysist. Dayton also actively participates on other nonprofit boards of directors and serves as chair of both the Pikes Peak elder abuse coalition and the Colorado coalition for elder rights and abuse profession.

Cynthia - Do you spend anytime at home?

Dayton: I yeah, quite a bit of time and just some being very involved with the community.

Cynthia – You are. you have a lot going on I'm very impressed.

Q - So let's get started with our first question about family or persons and trusted physicians in our lives. I'm sure you've been getting some very distressing calls, showing just how intense psychological as well as physical mistreatment can get when people are kept 24 hours a day together within a reduced space. can you share some stories you have heard? With no names of course.

A - Yeah Cynthia, I think in general that the climate is a little uncertain, it's uneasy. We're at a time where stress levels are high and if you compound that in an already strenuous arrangement whether it be a caregiver who's experiencing caregiver burnout, or in a situation where they have lost their job as a result of these sort of things. Those higher stressed positions really make for not so great environment and so it really is an uncertain time that's really kind of positioning people for uncertain circumstances. In terms of phone calls, I think primarily what we're seeing is individuals who are distressed by social isolation, and it's really ironic to me, (with) kind of the emphasis we're always putting out there of encouraging older adults or seniors to get out of their home, get involved, be active with the community and this totally just one 80 degree turn where we are having to self-isolate and in many cases stay home and kind of work around all the ways of getting out and getting exposed. And so social isolation really is a one of the higher risk factors for putting people at risk for mistreatment. Whether it be physical abuse, or financial exploitation, or scams, we really see those things coincide a lot of the time, so combating social isolation by keeping our clients connected has been our way of really doing our part to prevent those sort of things from happening.

Q - Often physical abuse doesn't come from a stranger it comes from someone you know and trust. At this time physical abuse is increasing. Can you tell our listeners about the reasons?

A – Again, I think it's really just the overall pressures and uncertainty of whether, you know the shelter in place I think causes some added pressure and keeping people in confined spaces as you mentioned and again you compound that with people like caregivers specifically where they really look to take care of these people and a lot of the time they rely on external resources (for) respite and getting out and really doing some self-care and those options may have some limitations now. And so again, that aspect of not really having alternative options or means of really getting away and distancing and really having some boundaries. It's a tough time to do that and so again the added stresses really adds to it. I pulled an article from the American Journal of Internal Medicine and it mentions how family members are the most common perpetrators of financial exploitation, and other forms of abuse. Which is then followed by friends and neighbors and then after that home care aides. And so really you see that trend in individuals who are those trusted entities, those trusted people in that older adults life and it's just really unfortunate to see where, (and) unfortunate to see those situations where people are just limited and really kind of feeling the pressures put on by this whole Covid situation that we're in right now.

Cynthia- It's mortifying actually, I mean I've been a caregiver from my mother. She had dementia and to be able for me (to serve as a caregiver) I was able to get out, I continued working, I continued date night with my husband, I these little things that gave me breathing room from being a caregiver were so helpful to me. I truly advocate for that. But right now the movie theaters closed, you know you know the restaurants are closed, you can't go or do anything away and so I can see how it just becomes crazy scary for the person who's being abused.

Q - Can victims of family abuse disregard the orders? Our governor has said we need to stay at home. Can they say I need to get away if they need to seek some kind of refuge? And then where can they go?

A – Yeah, safety is always number one and I know it is a little bit of a dilemma considering Covid, and exposures, and limiting that, but whenever that safety risk is right there and you're living it on a daily basis, I really think there are that's why we have a central and critical providers and that is our law enforcement. That is our caseworkers through adult Protective Services, who are still on the front lines and seeing these circumstances in the community, to address them and prevent them. And so with that being said, safety is always number one, especially in physical abuse situations and any other mistreatments. We want to ensure that, you know, those paths to getting refuge and getting access to safety is there. And the means of doing that is getting connected with our law enforcement. And we as a silver key as a nonprofit that serves older adults, we have an accountability where we are mandated reporters and so we really have to be on the lookout, have a keen eye and be really observant within our interactions with people who are reaching out for support, to notice any sort of things out of the ordinary that may be indicators of any abuse going on. And also make sure that our staff here are equipped with the answers and the resources to give those victims if they are experiencing that abuse. So, Law Enforcement and Adult Protective Services are key entities in finding a pathway to safety.

Q - So they can get away through contacting Adult Protective Services, they can call them, their phone numbers are readily available, they can also call Silver Key?

A - I, yeah, I see us as really being a holistic support and we are seeing a lot of individuals who, interestingly enough, really kind of bypassing some of their emotional needs, but more so focused on, you know how are they gonna get their next meal? And so we're seeing a lot of food insecure, a lot of food insecurity come out, and so we you know our Silver Line is receiving near, I think in March received 3,700 phone calls, just from individuals in the community who are looking to get connected. Whether it be for Meals on Wheels, or getting commodities, grocery items or those sort of things. So we're having to be really nimble programmatically to able to address that level of need and being able to make sure that people are getting access to food. And while doing so, we’re being subtle in our efforts of gaining an idea of the additional supports that they’re in need (of) during that initial phone call. So if they need to get connected to a case manager they are able to very easily, and through that they are able to be assessed, their situation be assessed, and really kind of see how we could set that person up for success, especially in the midst of all of this. But even further beyond that, and also you know, what we've also taken into consideration is with all the modifications going on throughout programs, not only internally at Silver Key, but externally. It's really calling out a big risk factor, which is social isolation again. These studies out there on social isolation and it being a risk factor for people who become mistreated, there's a lot of evidence on it. And so, with that being said, a lot of our programs internally really focus on the social piece. So for example we have congregate meal sites, we have 14 different congregate meal sites (that are) kind of spread around the community where it encourages seniors to come out have a meal, grab a bite with their buddy, and with that it's an opportunity to get out and be connected. And in light of the current public health crisis, we've modified it where we're preparing those meals for the week, dropping off once, and they’re able to just go in and pick up, and there is no opportunity to sit around at a table and have that contact with their friends, family, neighbors, whoever. And you know for our food pantry, we’re one of the largest food pantries in southern Colorado given the amount of people who come through our door. For a typical basis you would see our lobby for our food pantry just jam packed. It’s vibrant, people are talking, people are drinking coffee, and really just again using it as a way of just connecting with others and just fully enjoying the experience in the environment. But we've switched our program to a pick-up only model, where we're minimizing the amount of crowding in the lobby, and it's really just grab and go sort of thing, and so again we're minimizing that exposure, and (it’s) for everyone’s safety. But at the same time, we're effecting social isolation, where we’re essentially putting them in a position where they are socially isolated and so we're very cognizant of that I could say. In fact, we are really relying on volunteers right now, to help us a scale our existing Calls Of Reassurance program. And so, with our Calls Of Reassurance program, we're relying on volunteers to help us scale. We currently have outreach efforts going on to those clients, to our internal clients who are being effected. For example, for the pantry, we have near 2,500 people enrolled in that program. In our connections cafe we have upwards of thousands, upwards of 1,000 clients engaging in that program regularly, and so we're outreaching specifically to these individuals who are feeling the consequences of those modifications at the programs, and engaging, connecting. So we're checking in on that, seeing how they're doing, seeing if they need any additional supports right now, whether it be access to food or even transportation to their medical appointments, those sort of things. but we're also offering The Calls Of Reassurance program, which is done by mainly volunteers and they’re really checking in, having lighthearted conversations, one to three times a week. And they're also, a lot of the time, actually the basis of this program, the inception of it, was really targeted to prevent social isolation, especially among people who lack a social support system, and also our concern for their own well-being. So we've actually had people express that, you know if I were to fall, or if anything were to happen to me in my home, no one would know. And so they really look to us to be that check in with them, and we have protocols in place to respond appropriately in the situations where they're not answering their phone and that’s (not) kind of the ordinary to how they normally would respond to our calls.

Q - Are you looking for some short-term volunteers that would help with those calls?

A - Yes. Yes. Again, in order to scale, we're talking a good amount of clients, in fact our program steadily had near 30 people or so in it, and we've seen that increase by 100% just over this last week and a half. so a lot of people are seeing them value in it, and are really looking at it as a means of keeping connected, which is really essential in this, in this, again this uncertain time.

Q - There's a lot of folks that aren't working so much right now, for lots of reasons some of which are extraverts, that are looking for things to do that might be useful. So is there a phone number where people can call to offer their time?

A - Absolutely. We have a centralized call system here in Silver Key called the Silver Line and that is 719-884-2300. And it's really kind of the entry point to access any one of our services, whether you're a client and wanting to get connected to a program, or even a volunteer who is looking to give back or donate some of your time and talent, there's a really simple way of just getting into our system.

Cynthia - And that program where they make friendly phone calls, again what is that called?

Dayton- Silver Key Calls of Reassurance.

Cynthia - I think that would be really good for some of us who feeI, I don't want to say totally isolated, but we have time on our hands and we would like to give back even if it's short term.

Dayton - Absolutely

Cynthia - So that would be helpful.

Dayton - And within that program we’re privileged to have, we are a behavior health provider. And so we have behavioral health providers on staff who have been very helpful in making sure that those volunteers who are making those phone calls are equipped with the needed resources should any circumstances come up, whether it be any sort of expression on thoughts of suicide, suicidal ideations, or even mistreatment. So, how to really pick up on those things and have those resources at hand to be able to give that path to that person. And also the volunteers are versed on how to get that person connected back in (to) any of the internal programs at Silver Key as well. So they, they know how, if a person mentions that they haven't had food in two days and they can't get to the grocery store for another 3, how does Silver Key, how does the volunteer, respond to that situation? And we have some pretty solid mechanisms in place to be able to respond appropriately and make sure that that person doesn't go hungry.

Cynthia - Right so there's a lot of support within silver key for those volunteers who are trying to help others. I think that's essential.

Dayton - Absolutely

Cynthia - Food is important, it's one of those basic needs. I need it, you need it, we all need it.

Q - So if a person is being mistreated, and that’s really the technical term for abuse, if they're being mistreated and they decide it's time to go, it’s “I'm outta here” kind of thing. What should they bring with them?

A - It's a great question. They definitely will need their identification a lot of the time to navigate any governmental program, (and) proof of income, Social Security award letters is important. I would also recommend if any sort of advanced planning has been done, any key documents that have been put in place, to kind of keep copies of those with you. Of course, medicine lists, all those essentials that would be hard to produce without having to take a trip somewhere or have to wait seven business days to get it again. So really kind of just having that list of documents such as that handy would be really good. You’ve mentioned where can they go? With that in mind, our community has a program called the Emergency Shelter Network Program, and it was a foundational piece to the Pikes Peak Elder Abuse Coalition. And it is a means of finding or having shelter for abused or mistreated older adults to go to. You know, we have community partners, some skilled nursing facilities, some assisted living, who will take those individuals in. There is kind of a path to that, in where some have gone through the emergency department, some are working directly with the caseworker, with an adult Protective Services caseworker and those are the two primary entry points to gain access to that program, and then be placed into one of those facilities as a means of shelter. We have a pretty unique program in and of itself here in our community, where we're the Pikes Peak Elder Abuse Coalition, and that subcommittee specifically, is involved with a national entity, and they help keep benchmarking and standards for that program, and also help out with the data tracking and these pieces, so that we were informed on the usage of that program in our community. So I think we're lucky here in Colorado Springs to have such an innovative program, and it really speaks to the collaborative nature of our community, especially when you have care facilities involved and willing to, you know, say they have a bed for an individual who has been, whether it be physically abused or these other pieces that really call for them to be removed from that environment.

Q - Do you have a contact where they would call adult Protective Services, basically on themselves, in order to get hooked up with this possible space to stay temporarily?

A - Yeah, so there there's some nuance involved in terms of navigating Medicaid long term care, Medicaid and these other pieces, but generally speaking, the emergency department or the Adult Protective Services caseworkers are the people in tune with the criteria for people to access that program. So the adult Protective Services, they have its own process right to get to the point of being assigned an adult caseworker in their system, and then from there, it would be up to the caseworker to really kind of do that that checking out the criteria (for) that individual.

Cynthia - We need that for people. 'Cause right now it's hard find a space, somewhere to go, we have a lot of older people. I think we were talking the other day, who are older, they feel like they have nowhere to go, and maybe as an advocate for women, the income for a woman who spouse is still alive, specially that older population, their income, their Social Security check, may not be enough to survive.

Dayton - Yeah it's something we see too often, in terms of the financial constraints among a lot of our clients. So Silver Key serves around 7,000 clients a year, and among those, the income is close to $1,200 per month on average among those clients, and so (the) options, you kind of juxtapose that with our current housing market in our community, so even finding an apartment makes it very, very challenging. Whenever you have a fixed income the likelihood of employment, and the chances of employment, is challenged, and then on top of that, again the competitive housing market that calls for you, you know, to even to be considered, your income having to be two to three times the amount of the rent in itself. It really limits so many options for so many people. and so from there you're looking at not many options to go, to go anywhere. And then the hotel situation, there are few if any resources that are there to assist people (to) kind of continuously stay within a hotel, and so hotel vouchers and these sort of things are hard to come by. And subsidized housing and housing vouchers are hard to come by, and so it's a little disheartening. However, there are many smart people, kind of behind the scenes right now that I'm aware of, who are aware of this issue and kind of working on solutions on housing, specifically for seniors, because of those financial constraints, mobility constraints, accessibility considerations, those sort of pieces.

Cynthia - Well we have a new program here in the Springs, that's not really gotten off the ground level yet, the shared housing program. I’m hoping to interview her, hint hint if she's listening, pretty soon here about that program, but I think that would be a useful tool for folks. You know if I owned a home a little bit of income for me with an independent roommate. I think that would be nice. So that is one that I know of. I'm sure there's lots of them

Cynthia - Thank you for joining us today everyone. This was part one of our topic, elder abuse and how it's increasing during their COVID-19 pandemic. With us today was Dayton Romero from Silver Key senior services, a local nonprofit here helping elderly. He is the chair of the domestic violence program here in Colorado Springs. We have more questions for Dayton and we will be having a Part 2 where he comes back in about 2 weeks. So please join us then. Thank you all for joining us and please be safe, don't be sorry. Thanks.