CONFERENCE FOCUSES ON ABUSE AND NEGLECT OF CHILDREN, ADULTS

At a time when stories of child abuse and neglect dominate the media, a conference Tuesday at St. Francis Medical Center gave equal time to a hidden problem -- adult abuse.

The conference, "Child and Adult Abuse and Neglect, A Review of Current Missouri Laws and Procedures," attracted about 100 social workers, doctors, nurses and health-care providers from around the area.

Participants learned the causes of abuse, how to identify victims and how cases are handled by the Division of Family Services and the Division of Aging.

Ken Green, a medical-social worker with St. Francis, said the conference was because of studies released in 1991.

That year, the American Hospital Association showed abuse and neglect were far greater problems than health-care workers imagined.

Emergency-room visits treated as routine were often the result of abuse, studies showed.

While child abuse was recognized as a problem decades ago, adult abuse was slow to follow due to social factors.

"There is so much denial," Green said. "There is a significant number of elderly people living in poverty. Grandma and Grandpa aren't necessarily living happily on the farm, waiting for the kids to come and visit at Christmas. They may be living in the city or in rural communities with no access to medical care or even grocery stores. We forget about them."

White, middle-class, middle-aged children are most likely to abuse the parents they care for. Other factors make for high-risk situations too, like when a care giver feels too inadequate to meet his patient's needs. Stress, drug use and social isolation may combine for explosive results.

Barbara Piney-Plummer, a training coordinator with the Division of Aging in Jefferson City, illustrated those results with slides showing victims of adult abuse and neglect.

One woman's toenails had grown so that they dug into the bottoms of her feet while her adult children discouraged her from seeking medical care.

Another woman had been purposefully placed into a tub of scalding water, resulting in severe burns all over her body.

Green said communication was the key to abuse prevention. Elderly people have to think about their future, staying close to medical care and to children who will be truly supportive.

Financial planning should begin early, too.

"There's no problem going into old age thinking about all the wonderful things, like retirement and travel," Green said.

"But families also need to talk about realistic things, like the community resources they will need," Green said. "It isn't easy."

Green said hospital personnel can talk with the elderly patients who come in with small problems.

Family members should be informed about the patient and what future problems may arise.

There are also several publications about caring for elderly family members, and the books may be purchased at any major bookstore.

If anyone sees signs of adult abuse, Piney-Plummer said, he should call the Division of Aging Hotline at 1-800-392-0210. The division respects all callers' confidentiality and will send a social worker to check on the victim.

Some signs of adult abuse

1. The victim is brought to the emergency room by someone other than the people who care for him.

2. There is a long interval between the victim's injury or illness and the care-giver's seeking medical attention for him.

3. The victim has a suspicious medical history, perhaps going from one doctor to another.

4. Medication is withheld or given irregularly. (In some cases, the elderly person may have done this on his own.)

5. There are unexplained injuries.

6. Injuries are inconsistent with their explanations.

7. There are untreated injuries.

8. A pattern of injuries is discovered, or several patients in a nursing home have the same injury.

If you see signs of adult abuse, call the Division of Aging Hotline at 1-800-392-0210. Caller confidentiality is respected.