Columns

World Elder Abuse Awareness Day is Friday, June 15. It’s quite possible, even likely, that it will come and go with little local recognition.

Every five seconds, an elderly person is abused. In 2011, California accounted for 10.6% of elder abuse cases in the United States. Five of California’s 58 counties account for over half of all elder abuse cases. ((Los Angeles, Orange, San Diego, Riverside and Santa Clara) Alameda County’s 233,823 elderly accounted for 25,827 abuse cases. California's elderly population will have doubled by 2025, to 6.4 million -- a larger growth rate than any other state. 

Just as abuse of children and abuse of wives have received attention, elder abuse has become a term used to spotlight this group of persons who are unable to defend or fend for themselves, positioned by society so that they lack power to control their lives. Definitions vary but do not differ substantially. Elder abuse can be defined as the physical or psychological mistreatment of a senior. The World Health Organization (WHO) defines elder abuse as “… a single or repeated act, or lack of appropriate action, occurring in any relationship where there is an expectation of trust that causes harm or distress to an older person.” 

Sam Houston State University’s Victoria Titterington investigated the nature and scope of crime impacting the elderly, defined as persons age 65+ and currently representing 12% of the national population. While the elderly are a minority of crime victims, they are at higher risk for property crimes, self-neglect and abuse. Female seniors are at greater risk for abuse than older men. 

Financial swindles are one of the fastest growing forms of abuse, according to National Center for Elder Abuse 2009 statistics. Most insidious among cases of defrauding senior citizens are the “affinity crimes” -- scammers committing crimes against those who share the same culture and language. 

The elderly also suffer more self-neglect. These particular victims are generally depressed, confused or extremely frail. The Elder Justice Act was passed in 2010, as part of the Patient Protection and Affordable Care Act. It is designed to address many of the weaknesses in current federal and state programs dealing with the abuse, neglect and exploitation of older people. 

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What constitutes elder abuse legally varies. However, elder abuse crimes typically occur within 4 categories: 

Physical abuse, including assaults, batteries, sexual assaults, false imprisonment and endangerment. Some examples are inadequately explained fractures, bruises, welts, cuts, sores, burns; pressure or “bed sores” (decubitis ulcers); and medications used to restrain victims. 

Physical neglect by a caregiver, including withholding medical services, or hygiene that exposes the elderly person to risk of serious harm. Some examples are lack of basic body or personal hygiene; lack of adequate food or water; lack of medical aids (glasses, walker, wheel chair, hearing aid, dentures, medications;) lack of clean appropriate clothing or linens; demented victim left alone and unsupervised; bed-bound victim left without proper care; home cluttered, filthy, in a state of disrepair or having health, fire and safety hazards; home lacking minimum equipment and facilities (stove, refrigerator, heat, cooling, working plumbing and electricity). 

Psychological (mental) abuse, including making threats or the infliction of emotional harm. For example, caretaker isolates victim—restricts visits, phone calls (unwilling to allow you to enter the home or speak to victim); caretaker is violent, aggressive, controlling, addicted or uncaring. 

Financial (fiduciary) abuse, including theft of such personal items as cash, investments, real property, jewelry. Some examples are lack of amenities that victim could afford; victim “voluntarily” giving inappropriate financial reimbursement for needed care and companionship; caretaker having control of victim’s money but failing to provide for victim’s needs; caretaker using victim’s financial resources for own needs; victim has signed property transfers, Power of Attorney, new will, etc. when unable to comprehend the transaction. 

California law requires some persons to report adult abuse. These mandated reporters are health care practitioners, clergy, care providers, law enforcement, financial institutions officers and employees, medical examiners. Any person who has assumed responsibility for care of an elder or dependent adult must report known or suspected abuse, by telephone 510-577-3500, immediately or as soon as practicably possible. A written report is sent within 2 working days on the Report of Suspected Elder or Dependent Abuse, form SOC 341, available for download from the California Department of Social Services web site. 

Mail the report to: Alameda County Department of Social Services, Adult Protective Services, 6955 Foothill Boulevard, Suite 300, Oakland, CA 94605, or fax it to 510-577-5615.  

Possibly so few cases are reported because 75% or more of all elder abuse is committed by a relative, either in the elder's own home or in the abuser's home. 

Without a cooperative victim, action is difficult. Even if legal action is taken, built-in problems hamper the odds of success: 

• difficulty of proving the case
• attorney cost
• slim possibility of actually collecting damages or recouping exploited money from the perpetrator
• slow pace of the judicial system
• lack of knowledge about elder abuse among lawyers, prosecutors, law enforcement officers and judges.

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Nursing homes are potential loci of abuse of old people. A nursing home is a residential facility for persons with chronic illness or disability, particularly older people who have mobility and eating problems. It has been defined as a facility with 3+ beds that is licensed by the state and usually certified for federal reimbursement as a Medicaid (in California, known as Med-I-Cal) and/or skilled Medicare nursing facility. 

The California State Department of Finance claims that the number of California residents age 85+ -- those who are most likely to need nursing homes --- will nearly double by the year 2030, when many baby boomers come of age. 

If you have been a patient in a hospital or nursing/rehabilitation establishment, you have likely overheard “pseudomonas” and or “MRSA.” Bacteriology textbooks describe Pseudomonas aeruginosa as the epitome of an opportunistic pathogen of humans, meaning that it exploits some break in the host’s defenses to initiate an infection. It causes urinary tract infections, respiratory system infections, dermatitis, soft tissue infections, bacteremia, bone and joint infections, gastrointestinal infections and a variety of systemic infections, particularly in patients who are immunosuppressed. MRSA stands for methicillin-resistant Staphylococcus aureus. It is a “staph” germ that does not get better with the first-line antibiotics that usually cure staph infections. MRSA is especially troublesome in hospitals, dialysis centers, long-term care facilities and nursing homes, where patients with open wounds, invasive devices, and weakened immune systems are at greater risk of infection than the general public. 

NYU professor Laura Wagner, Ph.D., R.N.’s study found that accreditation improves the safety culture at nursing homes. Surprise, surprise. “Accreditation” refers to granting approval to an institution by an official review board after meeting specific requirements, which may be quantitative and qualitative. It may be geographic (regional) or professional. For example, “Hokum University lost its regional accreditation about the same time that its Dental School lost its professional accreditation.” 

One in four California nursing home residents receive powerful antipsychotic medications despite FDA "Black Box" warnings that they are dangerous and even fatal for the elderly with dementia and are outperformed by less expensive and more humane dementia care options. Moreover, the drugs are often administered without consent in order to "chemically restrain" residents. Overdrugging costs taxpayers hundreds of millions of dollars nationally because more than half of these prescriptions do not comply with federal reimbursement criteria. Medicare is attempting to curb overuse of antipsychotic drugs in nursing homes, with a goal of cutting unneeded antipsychotic drugs for the elderly by 15% this year. 

The federal Centers for Medicare and Medicaid Services (CMS) requires that nursing homes be certified before receiving reimbursement for Medicare and/or Medicaid residents. At Medicare.gov one can find and compare nursing homes in several ways. A 5 ***** star rating system considers health inspections, nursing home staffing, and quality measures. Of 6 nursing homes located in Berkeley, California, none has received a 5 star overall rating. One is nonprofit; it participates in Medicaid and Medicare. (This time last year, I reported that, of 5 nursing homes located in Berkeley, one received a 5 star overall rating, a nonprofit participant in Medicaid.) 

While nursing homes are the place where an estimated 30% of Americans die, there currently exists no way to compare which institutions do a better job managing end of life care. A new study appearing in the April 2012 Journal of Palliative Medicine emphasizes need to create end of life quality measures. By 2020, the percentage of people who die in nursing homes will grow to 40%. While there is an explosion of health care ‘report cards,’ none can identify which nursing homes are better at providing end of life care. The CMS information is compiled from staffing levels, inspection results, and measures of the quality of care – such as pressure sores, infections, and incontinence – for more than 16,000 nursing homes. (Data are published on the CMS Nursing Home Compare website.) While this information allows consumers to compare the performance of nursing homes for a number of aspects of care, it does not indicate how well or how poorly a facility provides end of life care. 

A few examples of suggested measures of the quality of end of life care in nursing homes include the number of hospital transfers, use of hospice, pain management and shortness of breath, etc. ["Study Recommends Ways to Evaluate End of Life Care in Nursing Homes." (University of Rochester [New York] Medical Center news.) 

An invitation. Candidates for election are welcome to share statements of their accomplishments and plans vis a vis senior citizens and elders. Please email them to me at pen136@dslextreme.com.  

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MARK YOUR CALENDAR: Be sure to confirm. Readers are welcome to share by email news of future events and deadlines that may interest boomers, seniors and elders. Daytime, free, and Bay Area events preferred. pen136@dslextreme.com.  

Until June 30. Gallery Hours: Tuesday - Friday, Noon - 5:30pm; Saturday, Noon - 4:30 P.M. Kala Gallery, 2990 San Pablo Avenue: Visions from the New California. The Visions from the New California award is an initiative of the Alliance of Artists Communities and is supported by the James Irvine Foundation. Each year the awards program celebrates six outstanding California visual artists from diverse communities. The awardees are artists whose work may as yet be unfamiliar to a wide audience, but whose compelling visions help define California. Free. 510-841-7000. 

Until August 31. Environmental Education Center in Tilden Regional Park. North End Central Park Drive. Tuesday through Sunday, 10:00 A.M.-4:30 P.M. Tilden Exhibit Celebrates Conservation Successes. Art exhibit celebrating the successes of conservation in the region, state and nationally. Show features works by 60 artists portraying plants and animals no longer listed as endangered species due to conservation efforts. The exhibit calls attention to the successful strategies of land managers, volunteers and rangers throughout the state and local parks. Includes both two-dimensional and three-dimensional works, including pastels, watercolors and oil paintings, as well as carved sculptures and mixed-media creations. Some of the featured species include the brown pelican, the tiger salamander, the salt marsh harvest mouse, and tule elk. Exhibit sponsors include the East Bay Regional Park District and the Merritt College Environmental Management and Technology Dept. Free. www.ebparks.org 

Until Sept. 2. Berkeley Arts Festival Gallery presents a new exhibition of the work of creative visual artists. Robert Brokl, paintings/prints. Mark Bulwinkle, painted steel screens. Art Hazelwood, linocuts. Roberta Loach, prints. Mari Marks, encaustic paintings 2133 University Av. Free. 510-644-6893. www.berkeleyartcenter.org 

Until Sept. 29. Thursdays, Fridays and Saturdays, 1-4 P.M. Joanna Gewertz Harris, Ph.D, Bay Area dancer, dance historian and author of Beyond Isadora: Bay Area Dancing 1915-1965, will discuss the history of East Bay performers, choreographers and pioneers of today’s dance community. The exhibit explores dance in the East Bay and includes a video by Margaretta Mitchell, an interview with Frank Shawl, and archival footage of Hanya Holm. Jeanine Castello-Lin and Tonya Staros, Co-Curators. Wheelchair accessible. Berkeley History Center, 1931 Center St. Free. 510-848-0181 

Wednesday, June 6. Noon. Playreaders at Central Berkeley Public Library. Kittredge at Shattuck. Free. 510-981-6100. 

Fridays, June 8 – July 27. 3 P.M. Central Berkeley Public Library, 2090 Kittredge. Super Cinema. Explore a different theme or genre in film each month. June: Satirical Cinema. June 8: Waiting for Guffman. Free. 510-981-6241. Also, June 15, 22, 29 and July 6, 13, 20, 27. 

Saturday, June 9. 2 P.M. Artist's Reception. Central Berkeley Public Library. Berkeley-based photographer Michael Layefsky will discuss his aerial photographs during a free artist’s reception. 510-981-6100. 

Saturday, June 9. 2-4 P.M. Meet Dora Sorell, Holocaust survivor, author of Tell the children. North branch Library, 1170 The Alameda, Berkeley. 510-981-6250. 

Sunday, June 10. 2 P.M. Blue Suede Jews. Central Berkeley Public Library, 2090 Kittredge. Local rock historian Richie Unterberger presents lecture/footage of Jewish musicians in the golden age of rock roll, including Bob Dylan, Carole King and many more. 510-981-6100. 

Tuesday, June 12. 1-3:30 P.M. Gay Pride Celebration. North Berkeley Senior Center, 1901 Hearst, corner MLK. 510-981-5190. 

Tuesday, June 12. 7-8 P.M. Social Security and Retirement Planning. A seminar on Social Security and Retirement Planning sponsored by West Coast Financial Wealth Management will be held at the Rockridge Branch Library. This is a Free Event. (The Library and the City of Oakland do not endorse products or speakers). Rockridge Branch, 5366 College Ave. 510-597-5017. 

Wednesday, June 13. 12 Noon-1 P.M. Playreaders at Central Berkeley Public Library. 

2090 Kittredge. Meets weekly to read aloud from great plays, changing parts frequently. Intended for adult participants. 510-981-6100. 

Thursday, June 14. 8:45 P.M. Cafe Literario. West Berkeley Public Library, 1125 University Av. Facilitated Spanish language book discussion. June title: Margarita, Está Linda la Mar by Sergio Ramirez. 510-981-6270. 

Fridays, June 15 – July 27. 3 P.M. Central Berkeley Public Library, 2090 Kittredge. Super Cinema. Explore a different theme or genre in film each month. June: Satirical Cinema. June 15: Little Miss Sunshine. Free. 510-981-6241. Also June 22, 29 and July 6, 13, 20, 27. 

Saturday, June 16. 5 P.M. Claremont branch, Berkeley Public library, 2940 Benvenue Av. Melanie O’Reilly will perform original music inspired by Joyce’s writings. 510-981-6280. 

Saturday, June 16. 1-5 P.M. California Writers' Club. A workshop open to all writers. At Rockridge Branch Library, Oakland. 5366 College Ave. Anne Fox, 510-420-8775. 510-597-5017 

Monday, June 18. 7 P.M. Art historian Michael Stehr will discuss Gian Lorenz Bernini, the Michelangelo of the Baroque. He will also present a slide show. Kensington Library, 61 Arlington Avenue. Free. 510-524-3043. 

Wednesday, June 20. 12 Noon-1 P.M. Playreaders at Central Berkeley Public Library. 

2090 Kittredge. Meets weekly to read aloud from great plays, changing parts frequently. Intended for adult participants. 510-981-6100. 

Wednesday, June 20. 1:30 P.M. Berkeley Commission on Aging meeting. North Berkeley Senior Center, 1901 Hearst. 510-981-5178. Be sure to confirm. 

Fridays, June 22 – July 27. 3 P.M. Central Berkeley Public Library, 2090 Kittredge. Super Cinema. Explore a different theme or genre in film each month. June: Satirical Cinema. June 22: The Gods Must be Crazy. Free. 510-981-6241. Also June 29 and July 6, 13, 20, 27. 

Friday, June 22. 1-4 P.M. 2012 Dragon Festival Celebration. North Berkeley Senior Center, 1901 Hearst. 510-981-5190. 

Saturday, June 23. 2 – 3:30 P.M. Strength in Diversity: The Poetry of Ecology. Central Berkeley Public Library, 2090 Kittredge St. Award winning poets Adam David Miller and Kim Shuck, headline a free multicultural and multigenerational poetry reading by six poets. The program is presented jointly by the Ecology Center and the Berkeley Public Library in the 3rd floor Community Meeting Room of the Berkeley Public Library, Central Branch. 510-981-6100. 

Monday June 25. 7 P.M. Kensington Library Book Club: The Chosen by Chaim Potok. 61 Arlington Av. Free. 510-524-3043. 

Tuesday, June 26. 3-4 P.M. Tea and Cookies. Central Berkeley Public Library. 2090 Kittredge. A book club for people who want to share the books they have read. 510-981-6100. 

Wednesday, June 27. 12 Noon-1 P.M. Playreaders at Central Berkeley Public Library. 

2090 Kittredge. Meets weekly to read aloud from great plays, changing parts frequently. Intended for adult participants. 510-981-6100. 

Wednesday, June 27. 1:30-2:30P.M. Great Books discussion group. July’s People by Nadine Gordimer. Rosalie Gonzales, group facilitator. Albany Library, 1247 Marin Av. 510-526-3720. 

Wednesday, June 27. 1:30 P.M. Gray Panthers. North Berkeley Senior Center, 1901 Hearst. 510-981-5190. 

Thursday, June 28. 7 P.M. Balinese Dance Performance. The Gamelan Sekar Jaya will give a performance of Balinese dances. The dancers will present pieces that give a taste of the wide range of characters, movements, and moods of this unique dance form. Steeped in the rich culture and traditions of Bali, Indonesia, the audience will have the opportunity to meet the performers and understand the magic of this style of dance. Free 45 minute program provided by the Contra Costa County Library Summer Reading Festival. El Cerrito Library, 6510 Stockton Avenue. 510-526-7512. 

Fridays, June 29 – July 27. 3 P.M. Central Berkeley Public Library, 2090 Kittredge. Super Cinema. Explore a different theme or genre in film each month. June: Satirical Cinema. June 29: Thank You For Smoking. Free. 510-981-6241. Also July 6, 13, 20, 27. 

Fridays, July 6 – July 27. 3 P.M. Central Berkeley Public Library, 2090 Kittredge. Super Cinema. Explore a different theme or genre in film each month. July: Our Weeks With Marilyn. July 6: Gentlemen Prefer Blondes. Free. 510-981-6241. Also July 13, 20, 27. 

Sunday, July 8. 1 – 4:30 P.M. The 2012 Berkeley Rent Board Convention will be held in the main meeting room of the downtown, central Berkeley Public Library, 2090 Kittredge, corner of Shattuck. A slate of candidates for the November 2012 election will be chosen. Contact: www.berkeleyrentboard.org 510-981-6100. 

Monday, July 9. 7 P.M. Author Talk and Slide Show. Author and naturalist Laura Cunningham will discuss her book A State of Change: forgotten landscapes of California. Ms. Cunningham has not only written the text but has also lavishly illustrated this lovely book. She has written and painted a picture of what California was like before European contact. Free. 510-524-3043 

Wednesday, July 11 6-8 P.M. Lawyer in the Library. Albany Library, 1247 Marin Av. Free 15 minute consultation with an attorney who will clarify your situation, advise you of your options, get you started with a solution, and make a referral when needed. Sign up in person at the Reference desk or call 510-526-3720 ext. 5 during library hours. 

Also August 1, Sept. 5, Oct. 3, Nov. 7 and Dec. 5. 

Fridays, July 13 – July 27. 3 P.M. Central Berkeley Public Library, 2090 Kittredge. Super Cinema. Explore a different theme or genre in film each month. July: Our Weeks With Marilyn. July 13: All About Eve. Free. 510-981-6241. Also July 20, 27. 

Fridays, July 20– July 27. 3 P.M. Central Berkeley Public Library, 2090 Kittredge. Super Cinema. Explore a different theme or genre in film each month. July: Our Weeks With Marilyn. July 20: Monkey Business. Free. 510-981-6241. Also July 27. 

Friday July 27. 3 P.M. Central Berkeley Public Library, 2090 Kittredge. Super Cinema. Explore a different theme or genre in film each month. July: Our Weeks With Marilyn. July 27: The Seven Year Itch. Free. 510-981-6241. 

Wednesday, August 1. 6-8 P.M. Lawyer in the Library. Albany Library, 1247 Marin Av. Free 15 minute consultation with an attorney who will clarify your situation, advise you of your options, get you started with a solution, and make a referral when needed. Sign up in person at the Reference desk or call 510-526-3720 ext. 5 during library hours. 

Also Sept. 5, Oct. 3, Nov. 7 and Dec. 5. 

Wednesday, August 22. 1:30-2:30P.M. Great Books discussion group. Selections from The Bhagavad Gita. Rosalie Gonzales, group facilitator. Albany Library, 1247 Marin Av. 510-526-3720. 

Wednesday, Sept. 5. 6-8 P.M. Lawyer in the Library. Albany Library, 1247 Marin Av. Free 15 minute consultation with an attorney who will clarify your situation, advise you of your options, get you started with a solution, and make a referral when needed. Sign up in person at the Reference desk or call 510-526-3720 ext. 5 during library hours. 

Also Oct. 3, Nov. 7 and Dec. 5. 

Wednesday, Sept. 26. 1:30-2:30P.M. Great Books discussion group. Things Fall Apart by Chinua Achebe. Rosalie Gonzales, group facilitator. Albany Library, 1247 Marin Av. 510-526-3720. 

Wednesday, Oct. 3. 6-8 P.M. Lawyer in the Library. Albany Library, 1247 Marin Av. Free 15 minute consultation with an attorney who will clarify your situation, advise you of your options, get you started with a solution, and make a referral when needed. Sign up in person at the Reference desk or call 510-526-3720 ext. 5 during library hours. 

Also Nov. 7 and Dec. 5. 

Wednesday, October 24. 1:30-2:30P.M. Great Books discussion group. Troth, by Gregor von Rezzon. Rosalie Gonzales, group facilitator. Albany Library, 1247 Marin Av. 510-526-3720. 

Wednesday, Nov 7. July 11 6-8 P.M. Lawyer in the Library. Albany Library, 1247 Marin Av. Free 15 minute consultation with an attorney who will clarify your situation, advise you of your options, get you started with a solution, and make a referral when needed. Sign up in person at the Reference desk or call 510-526-3720 ext. 5 during library hours. Also Dec. 5. 

Wednesday, November 28. 1:30-2:30P.M. Great Books discussion group. Sunday Morning, by Wallace Stevens. Rosalie Gonzales, group facilitator. Albany Library, 1247 Marin Av. 510-526-3720. 

Wednesday, Dec. 5. 6-8 P.M. Lawyer in the Library. Albany Library, 1247 Marin Av. Free 15 minute consultation with an attorney who will clarify your situation, advise you of your options, get you started with a solution, and make a referral when needed. Sign up in person at the Reference desk or call 510-526-3720 ext. 5 during library hours. 

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