Types of Abuses

Definition:

1. use (something) to bad effect or for a bad purpose; misuse.

2. treat (a person or an animal) with cruelty or violence, especially regularly or repeatedly.

All of the abuses that you are about to learn here today unfortunately still very much happen in our world today. The statistics of cases on the maps will be data taken in August 2018. Abuse happens everywhere around the world but this story map will only provide information within the state of California. For the most part, only human beings are capable of being abusive, because only human beings are capable of understanding how things should be treated in the first place and then violating that standard anyway.

The Hotline provides lifesaving tools and immediate support to empower victims and survivors to find safety and live free of abuse. We also provide support to friends and family members who are concerned about a loved one. Resources and help can be found by calling 1-800-799-SAFE (7233).

Individuals who are Deaf or hard of hearing may use TTY 1-800-787-3224. Additionally, advocates who are Deaf are available 24/7 through the National Deaf Hotline by video phone at 1-855-812-1001, Instant Messenger (DeafHotline) or email (nationaldeafhotline@adwas.org).

The above map shows the how elderly people are abused in a financial state. I combined both the August 2017 and August 2018 because the maps were exactly the same and from this I concluded that there wasn't much change in financial abuse in the elderly but it was consistent which was also not a good thing.

Some of the ways the the elderly are being abuse are by for example cashing out their checks without them knowing, signing documents and making it seem like they signed them, some people even go far enough where they steal from the elderly.

A policy recommendation that could possible improve elderly abuse in the financial section would be to be more strict and have more rules when it comes to the elderlies money. For example the their checks would only be released when they are present, this could prevent their checks from being stolen or taken away from them.

Everyone wants to feel safe when they are at work, especially if its a handsy job and there are a lot of safety hazards. Working at great heights, with electricity or chemicals can contain a lot of violations just to name a few. Down below we have a map of safety hazard cases in California in the year of 2018.

 Spending a little bit of money up front on prevention can save you money on the back end

1. Working at height
2. Poor housekeeping
3. Electrical - Extension Cords
4. Forklifts
5. Lockout/Tagout
6. Chemicals
7. Confined Spaces

The darker shades of the map indicate greater than 200 cases of health and safety hazard cases in the year of 2018. the 2017 map is relatively similar with just a bit less darker in the same areas meaning cases have gone up. In northern California there are more cases in the city of Sacramento and San Francisco than anywhere else but this also is due to the fact that there is a bigger population in those cities and more hazardous warehouses. The good news is that the numbers didn't have such a dramatic increase and although it does seem like there aren't much more people being neglected with safety at work, nobody is doing anything to decrease those numbers from what they are at already.

A lot of cases in California are due to electrical problems. The SCE (Southern California Edison) has put together a report on their improvements in work related safety called Risk and Safety Aspect of 2018-2020. They have put together sort of a test score sheet on how they're going to check and rate themselves on how safe their employees are across the state. " Since there could be multiple outcomes for a risk event, SCE calculates a risk score across five impact dimensions (safety, reliability, environmental, compliance, financial) for each outcome without applying any weights across the impact dimensions." Hopefully in the years to come not only SCE but other hazardous California companies can narrow down the number of cases in safety hazard and start giving their employees a safer and more reliable work space.

Medical Care abuse is defined as practices that are inconsistent with accepted sound fiscal, business, or medical practices, and result in an unnecessary cost or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for health care.

• Misusing codes on a claim
• Charging excessively for services and/or supplies
• Billing for services that were not medically necessary

The darkest shadings on the map below indicate more than 120 cases within that region. In Northern California San Fransisco has the most cases, but things were not the same the previous year when Santa Cruz's shade was a bit darker than it tells us below. This means cases have dropped, not entirely but have showed better results and in the near future hopefully all shaded can be lighter in our state. Medi-cal is trying its best so that nobody is left with out medical assistance in California. The federal government is projected to pay for at least 85% of total new Medi-Cal spending between 2014 and 2019.

Protecting your personal information is the best line of defense in the fight against Medicare fraud and abuse. Take an active role in protecting your healthcare benefits:

1. Protect your personal information. Guard your Medicare, Social Security and bank account numbers numbers carefully. Don’t give these to anyone over the phone or in person, unless you initiated the conversation, you know the person, and you write down their name, number and title.
2. Don’t leave your Medicare number in a phone message, and don’t carry your Medicare card unless you will need it. Only take it to doctor’s appointments, visits to your hospital or clinic, or trips to the pharmacy.
3. Don’t accept offers of money, free food or gifts for medical care. Watch out for incentives like “It’s free!” or “We know how to bill Medicare.”
4. Don’t accept any offer of “free” services or supplies in return for your Medicare number. Don’t accept medical supplies from door-to-door salespeople. Medicare will never call or visit to sell you anything.
5. Don’t let anyone convince you to see a doctor for a service you don’t need.
6. Keep track of your doctor visits, tests and procedures by taking notes in a healthcare journal or calendar.

According to The Adult Protective Services, self-neglect among elders is, “The referral to or failure to provide oneself with care and protection in areas of food, water, clothing, hygiene, medication, healthy living environments, and safety precautions.”

Reasons for elder self-neglect:

Self-neglect is not an easy topic to research. Professionals do not have the right answers to why elders decide to neglect themselves. One explanation could be depression and loneliness. The question stands if depression causes self-neglect or if self-neglect causes depression. Elders experience loneliness as families do not pay their parents, grandparents, siblings, or friends a visit as often as they should. Once an elderly realizes their lonesomeness, then they begin to give up on themselves leading to self-neglect.

As seen on the map, the darker areas, the more elderly self-neglect there is in that specific area. The hot spots of this type of elderly abuse is greater among the cities such as Los Angeles and around the areas of San Francisco and Sacramento.

The categories to physical care, or elderly care, are being provided with or having access to services such as "assisted living, adult day care, long term care, nursing homes (often referred to as residential care), hospice care, and home care." Overall, a place to call home for the elderly, with a safe and healthy environment.

The image on the left displays high scarcity of services in parts of California. The darkest purple for instance, indicates San Bernardino, Riverside, Orange, and Los Angeles County in the month of August 2018. In addition, we can see areas surrounding near Los Angeles have a lighter purple shade.

Residential care homes are licensed and surveyed by the State of California. Online websites such as  Carewatchers.org  is an established elder/senior home placement and referral agency, that state to offer personalized service "at no cost to the potential resident." For updated and further information on residential care homes in California visit  https://www.carewatchers.org/ca/senior-care-residential-care-facilities-california.html .

Malnutrition specifies as "the lack of proper nutrition". The proper nourishment and balance meal requires three proper meals a day with sufficient fluids. Likewise dehydration involves "a harmful reduction in the amount of water in the body." Therefore, given there are elderly people who experience both situations, it can be an indicator of "neglect" and places their health at risk.

The map above shows Tulare, Los Angeles, and San Francisco County to be the most affected, where it indicates the darkest shade. However, not far behind is the second shade that takes places such as Kern, Ventura, and Riverside, or even higher north in Shasta County.

In comparing both maps above, there is a visible dramatic shift to the areas of malnutrition and dehydration faced by elderly in the state of California. Despite having a lighter pink shade in August of 2018, within four months, San Bernardino County shades the darkest and highest in cases by December 2018, along with Los Angeles County. Whereas Sonoma, Contra Costa, and Alameda County remain fairly the same.

The health and safety of workers plays a huge part in the motivation of these workers to keep contributing. We believe that the most important factor there should be on maintaining a safe work environment should be the work background on every employee and see if that employee is right for the job due to their knowledge for the specific job. If the person is not comfortable or does not seem qualified enough to do that job it is best to have patience with that person so that they have full knowledge and understanding of what it is they will be doing or to hire a better worker someone who seems to be more qualified and more professional. This should definitely play a part especially if the job is one of the seven jobs listed in the Health and Safety Hazard section of this story map.Another recommendation to make the work environment safer is to provide surveys to the workers that are already in those fields and their voices should heard about how they feel and what it is that could be improved so that they feel more comfortable and safer while they complete their occupations tasks. The last important recommendation that we have for this topic is having the substantial research that is needed on the physiological, pathological, and functional effects on common and potentially harmful worksite exposures on these workers. Having to go through these jobs potentially five days of the week can really put some weight on some peoples shoulders and can cause not just physical damage on someone but also mental, which is much more complicated to fix. This research should should determine what effect performing these jobs has on an individual and what effects play a part from their past jobs so that no voice is left unheard and our true hard workers are cherished for playing such a dangerous role in society.

Medical care abuse is one of the biggest abuse cases that exist in the United States. According to the most recent Health Care Fraud and Abuse Control Program Annual Report, in one case a management company “pressured and incentivized” dentists to meet specific production goals through a system that disciplined “unproductive” dentists and awarded cash bonuses tied to the revenue from procedures even though this is including many allegedly medically unnecessary services that were performed. This has come at a price: escalating costs, fraud and abuse, medically unnecessary services, adverse effects on patient safety, and physician burnout. In order to break all of the acts of this bad behavior due to financial incentives and narrows things down to the core ethical issues in the practice of medicine, we need to better front end data analytic that will identify and focus investigations on fraud and abuse on certain practice sites. Billing errors and mistakes, misclassification of a diagnosis or procedure, or improper documentation can indicate lack of program integrity education. People need to stand up fo themselves. Physicians will often try to confuse patients with fancy word play or by maintaining an intellectual persona that patients think they can trust, this way they sign or agree to terms that are not necessary within their case. To contain costs, payers may routinely deny initial claims, forcing physicians to submit appeals to insurers, knowing that most physicians lack sufficient resources to engage in the appeals process.

Physical care means "the right and responsibility to maintain a home for." Therefore, all elderly (65+) should have the right to a home in a safe and healthy environment. With higher health risks, being unable to find a home, should not be another thing to worry about. Furthermore, the attention to areas that lack elderly services should help raise funds toward creating more housing. In 2018-2019 according to the California Department of Housing and Community Development, HCD awarded 276 grants and loans totaling more than $1.2 billion projected to:

• Preserve 4,747 housing units, subject to affordable rent or home ownership requirements.
• Rehabilitate 671 substandard housing units.
• Create 7,513 new housing units.

In terms of preventing malnutrition and dehydration, the proper nutrition is essential to the health of the elderly. Especially, when they are assigned certain medications that can affect their dietary needs. Being healthy involves consuming the right foods and undergoing the right exercise. Therefore, it's also important they are placed under the right caregiver and supervision who will know and keep track of their balanced meals. Thus, places such as nursing homes should make sure to administer the adequate expertise for hired caregivers to avoid any form of malnutrition or dehydration.