A dependent adult is defined as a person between the ages of 18 and 64, who has physical or mental limitations, which restrict him or her from carrying out normal activities and of protecting his or her rights, including, but not limited to, persons who have physical or developmental disabilities or whose physical or mental abilities have diminished because of age. A dependent adult can also include any person between the ages of 18 and 64 who is admitted as an inpatient to a 24-hour health facility as defined in Section 1250, 1250.2 and 1250.3 of the Health and Safety Code.
You can use the following steps detect and report dependent adult abuse:
1. A physician conducts a thorough assessment, which includes a history and physical examination of the elder or dependent adult suspected of being a victim of abuse.
2. For known or suspected sexual assaults, follow examination protocol per Penal Code 13823.5, 13823.7, 13823.9 and 13823.11.
3. Perform X-rays, CT scans, bone scans, or other laboratory studies to determine and define the current trauma and previous traumas and to exclude other medical conditions as follows:
•Assess the elder or dependent adult’s immediate medical needs.
•Compile the past medical and social history of the elder or dependent adult and family members (if applicable).
•Assess the plausibility of the history being provided in light of pre-existing medical conditions.
•Determine how great a risk it would be if the elder or dependent adult were to return to their living situation or residence.
Medical Record Documentation
Medical Record documentation, maintained by the physician, should include but not be limited to the following:
•Name of abuse victim.
•Date/time abuse became known.
•Physical assessment/evaluation, location, extent, and character of injuries.
•Map of the location of the injuries on the abuse victim’s body documented at the time of the health care service.
•Name/identity of the alleged abuser.
•Description of the abusive event or abuse victim complaints in their own words.
•Medical and relevant social history of the abuse victim.
•Physician follow-up, such as reporting.
Reporting
Reporting is required of physicians, nurses, pharmacists, and all other medical physicians licensed under Division 2 of the Business and Professions Code. It is also required of certain non-medical practitioners, such as coroners, social workers, psychologists, family counselors, nursing home ombudsmen, care custodians, law officers, and probation and welfare personnel. The law does not extend to members of a physician’s office support staff who are not licensed physicians.
One individual may make the required report for an entire group, and facilities may develop reporting protocols, so long as they are consistent with the statutory requirements. Reporting is required for physical abuse as defined above. Those required to report may but are not required to report known or reasonably suspected instances of other types of abuse, including cases of mental abuse, fiduciary abuse, neglect, abandonment, isolation, or other treatment with resulting physical harm or pain, mental suffering, or the deprivation by care custodian of goods or services that are necessary to avoid physical harm or mental suffering.
When the reporter has knowledge or reasonable suspicion that abuse has occurred, the telephone report must be made immediately or as soon as possible to one of the following:
•The long-term care ombudsman coordinator when the abuse is alleged to have occurred in a long-term care facility.
•State Department of Mental Health, State Department of Developmental Services, or to a local law enforcement agency when the abuse is alleged to have occurred in a state mental hospital or state developmental center.
•County Adult Protective Services Agency or County Welfare Department when the abuse is alleged to have occurred anywhere else.
The report should include the name of the person making the report, the name, address, and age of the elder or dependent adult, the nature and extent of the dependent adult’s or elderly person’s condition, present location of the elder or dependent adult, the names and addresses of family members or any other person responsible for the elder or dependent adult (if known), the alleged incident of elder or dependent adult abuse, and any other information, including what led the person to suspect elder or dependent adult abuse. The 24-hour toll-free number for the Department of Aging Crisis Hotline is 800-231-4024.
A written report must be completed within 48 hours of the telephone report, on a California Department of Social Services form SOC341 entitled “Report of Suspected Elder or Dependent Adult Physical Abuse,” and mailed to the address indicated by the agency that took the phone reports and the county department of adult protective services. This form is obtainable from the County Adult Protective Services Agency or the local long-term care ombudsman program.
The law provides that care custodians, health physicians, or employees of adult protective services agencies or local law enforcement agencies will not incur either civil or criminal liability for any report they are required or permitted to make under this law. However, any person who knowingly fails to report, when required, an instance of elder abuse is statutorily guilty of a misdemeanor punishable by a fine not to exceed $1,000, or imprisonment in the county jail not exceeding six (6) months or both. A physician may also be liable in civil court for damages that occur if the elder or dependent adult is further victimized because of failure to report the abuse.