In California, the reporting of elder abuse is legally required of certain professionals— including physicians, nurses, pharmacists and all other medical practitioners licensed under Division 2 of the California Business & Professions Code. The obligation does not extend to members of a physician’s office staff who are not licensed healthcare providers.

The notion that what happens at home is “private” can be a major factor in keeping elder or dependent adults locked in abusive situations. Shame and embarrassment make it difficult for many people to reveal that they’re being abused. But this doesn’t minimize your legal obligation to report such abuse.

Under California Welfare and Institutions Code §15630 (b), persons subject to the mandatory reporting obligation must report when, within their professional capacity or scope of employment, they have observed or have knowledge of an incident that reasonably appears to involve any of the following:

• physical abuse
• abandonment
• abduction
• isolation
• financial abuse
• neglect.

The requirement applies if mandated reporters are told by elder or dependent adults that they have experienced such behavior. This includes any acts or omissions that constitute any of the above-noted types of abuse. However, a report is not required when a mandated reporter has been told by an elder or dependent adult that he or she has been abused, but all of the following situations also exist:

• The reporter is not aware of any independent corroborative evidence.
• The elder or dependent adult has been diagnosed with a mental illness, defect dementia or incapacity, or is the subject of a court-ordered conservatorship because of a mental illness, defect dementia or incapacity.
• In the exercise of clinical judgment, the reporter reasonably believes the abuse did not occur.

Reports must be made by telephone and in writing to the following…

• For abuse alleged to have occurred in a long-term care facility: Report to the long-term care ombudsman coordinator or local law enforcement agency.
• For abuse alleged to have occurred in a state mental hospital or state developmental center: Report to the designated investigators of the state Department of Mental Health, to the state Department of Developmental Services or to a law enforcement agency.
• For abuse alleged to have occurred anywhere else: Report to the county adult protective services agency, county welfare department or local law enforcement agency.

Telephone reports should be made immediately or as soon as practical. Written reports must be sent within two working days of the observation of the abuse or from the time the abuse becomes known to the reporter. A copy of form SOC-341 (“Report of Suspected Dependent Adult/Elder Abuse”) may be obtained by faxing a request to the California Department of Social Services warehouse at 916/371-3518, or on the Internet at www.dss.cahwnet.gov.

Failure to report is a misdemeanor punishable by up to six months in jail and/or a $1,000 fine. If great bodily injury or death results, the penalty increases to up to one year in jail and/or a $5,000 fine.

Victims or possible victims of elder abuse have the right to privacy and confidentiality concerning anything discussed with individuals who receive or investigate abuse reports.

Under the privacy rules of the Health Insurance Portability and Accountability Act (HIPAA), a physician may disclose protected health information about an individual whom the physician reasonably believes to be a victim of abuse, neglect or domestic violence, to the extent that such disclosure is required by, complies with, and is limited to the relevant requirements of the law.

Physicians covered by HIPAA must promptly inform the victim or possible victim that a report will be, or has been, made, unless the physician believes informing the individual will place that person at risk of serious harm. Under HIPAA privacy rules, patients have the right to receive an accounting of all disclosures of protected health information made in the prior six years. Such disclosures include reports of elder or dependent adult abuse.

From Myth to Reality
Every year, an estimated 2.1 million older Americans are victims of physical, psychological or other forms of abuse and neglect. And that figure does not tell the whole story: Experts estimate that for every case reported to authorities, as many as five are not reported.

Gaining a true understanding of elder abuse is especially important for anyone required by law to report such cases. The reality of elder abuse is very different from some commonly held assumptions:

Myth: Most elder abuse occurs in nursing homes.
Reality: Only about 4% of older adults live in nursing homes, and the vast majority of nursing home residents have their physical needs met without experiencing abuse.

Myth: Elder abuse rarely takes place at home.
Reality: A great majority of older people live on their own or with their spouse, children, siblings or other relatives. When elder abuse takes place, family, other household members or paid caregivers usually are the abusers.

Myth: Elder abuse is obvious and easy to discern.
Reality: The distinction between normal interpersonal stress and abuse is not always clear. There is no single pattern of elder abuse; sometimes it is a continuation of longstanding patterns of physical or emotional abuse within the family. Frequently, the abuse is related to changes in living situations and relationships brought about by the older person’s growing frailty and dependence on others for companionship and for meeting basic needs.

Myth: Only certain types of elderly people suffer abuse.
Reality: Not only infirm or mentally impaired individuals are vulnerable to elder abuse. Elderly people who are ill, frail, disabled, mentally impaired or depressed are at greater risk of abuse, but even those who do not have these obvious risk factors can find themselves in abusive situations and relationships.