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By:  Jill Rosner, R.N., B.S.N. – Guest Contributor – Rosner Healthcare Navigation On June 15, the World Health Organization (WHO) acknowledged Elder Abuse Awareness Day. Communities across the world participated in activities to bring awareness to a problem that faces many elders and oftentimes goes unnoticed. I share information about elder abuse every year to bring awareness to our community and perhaps alert others to keep their eyes open to this growing problem. The WHO has adopted the following definition of elder abuse: Elder abuse (also called “elder mistreatment,” “senior abuse,” “abuse in later life,” “abuse of older adults,” “abuse of older women,” and “abuse of older men") is “a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person.” The key words “any relationship where there is an element of trust” are particularly important. A person or persons known to the elder commit most elder abuse. Elder abuse may present in various ways and unfortunately is on the rise. Abuse may manifest in one or more aspects such as physical, emotional/psychological, sexual or financial. The National Adult Protective Services Association provides a list of the most reported types of abuse: Physical abuse: may include slapping, hitting, beating, bruising or causing someone physical pain, injury or suffering. This also could include confining an adult against his/her will, such as locking someone in a room or tying him/her to furniture. Emotional abuse: involves creating emotional pain, distress or anguish through the use of threats, intimidation or humiliation. This includes insults, yelling or threats of harm and/or isolation, or non-verbal actions such as throwing objects or glaring to project fear and/or intimidation. Neglect: includes failures by individuals to support the physical, emotional and social needs of adults dependent on others for their primary care. Neglect can take the form of withholding food, medications or access to health care professionals. Isolation: involves restricting visits from family and friends or preventing contact via telephone or mail correspondence. Financial or material exploitation: includes the misuse, mishandling or exploitation of property, possessions or assets of adults. Also includes using another’s assets without consent, under false pretense, or through coercion and/or manipulation. Abandonment: involves desertion by anyone who assumed caregiving responsibilities for an adult. Sexual abuse: includes physical force, threats or coercion to facilitate non-consensual touching, fondling, intercourse or other sexual activities. This is particularly true with vulnerable adults who are unable to give consent or comprehend the nature of these actions. Self-neglect: involves seniors or adults with disabilities who fail to meet their own essential physical, psychological or social needs, which threatens their health, safety and well-being. This includes failure to provide adequate food, clothing, shelter and health care for one's own needs. Abuse and exploitation can be committed by spouses, family members, formal caregivers in the home or in assisted living housing or nursing homes or strangers who prey on the aging population among others who may be trusted friends or acquaintances. It can be argued that the exploitation of elders that comes in the form of constant barrages of requests from charities, phone solicitation for products to aid a senior and marketing to seniors can also be perceived as a trusted source. It seems as though as soon as the golden age of retirement approaches seniors receive constant and unyielding piles of mail and calls to donate, buy or participate in some way. We must all be very judicious and diligent to protect ourselves from the predators that exploit the older population. The statement “if you see something, say something” is a perfect reminder that minding your own business is not always the soundest advice. Elder abuse is oftentimes noticed by neighbors, bank employees, family members, friends and acquaintances and either denied or ignored because people don’t want to get involved or “stick their noses in.” Trust me, if we all paid attention to the warning signs, the true extent of the problem would finally be appreciated. There is much work to be done to strengthen laws, increase and enforce punishment for this serious crime. I remind the banking industry, there is a mandatory reporting law that you must report any suspicious activity such as someone bringing a customer to the bank and changing their accounts, any suspicion of undue influence to pressure or coerce one to make changes to accounts, withdrawals or moving money. This applies to those who may seem competent to you but may seem to be told what to do and those who you may have noticed odd behaviors over time. Those suffering from even the earliest effects of some type of dementia become preoccupied with their accounts and may come into the bank or call frequently to “check” on their accounts and balances. They may make repeated withdrawals. They may exhibit some paranoia about their accounts being tampered with or having money stolen from them. This must be reported! I am personally fed up with banking personnel looking the other way and not knowing what to do. It is your responsibility to protect your customers from abusers and oftentimes from themselves if they clearly seem off or confused and constantly stressed about their accounts. Please report suspicious activity to Adult Protective Services (APS). Just a call can save an elder from abuse or misuse of their funds. Jill Rosner is a registered nurse, certified aging life care manager and owner of Rosner Healthcare Navigation. She provides patient advocacy and care management services to clients with health and aging issues. Contact her at jillrosnerrn@aol.com or 410-591-6378.