Adult Protective Services

Physical & Emotional Abuse

Physical abuse is defined as physical harm, bodily injury or attempt to cause physical harm or injury, or the fear of imminent physical harm or bodily injury on an elder or a disabled adult. Emotional Abuse is defined as a caretakes's willful, malicious and repeated infliction of sexually obscene acts (nudity or simulations) without consent; unreasonable confinement; harm, damage or destruction of property; or verbal harassment or threats to inflict phyiscal, emotional and psychological abuse. For a full definition of physical and emotional abuse please see SDCL 22-46-1.

Neglect

Neglect is defined as harm to the health or welfare of an elder or an adult with a disability, without reasonable medical justification, caused by a caretaker, within the means available for the elder or adult with a disability, including the failure to provide adequate food, clothing, shelter or medical care.

Exploitation

Exploitation is defined as the wrongful taking or exercising of control over property of an elder or adult with a disability with intent to defraud the elder or adult with a disability.

When to Report

The following indicators may be helpful when deciding whether abuse, neglect or exploitation may be taking place. 

Physical Indicators

• Injuries that have not been cared for properly.
  
• Injuries that are not compatible with history.
  
• Frequent use of the emergency room and/or hospital or health provider.
  
• Evidence of inadequate or inappropriate administration of medication.
  
• Lack of necessary equipment such as walkers, canes, bedside commode.
  
• Lack of necessities such as heat, food, water and unsafe conditions in the home.
  
• Poor hygiene.
  
• Soiled clothing or bed; untreated bed sores.
  
• Pain when touched.
  
• Bruises, welts, black eyes, lacerations, or rope marks.
  
• Bone fractures, broken bones and skull fractures.
  
• Cuts, lacerations, punctures, wounds, burns, untreated injuries in various healing stages.
  
• Dehydration and/or malnourishment without illness-related cause.
  
• Loss of weight.

Behavioral Indicators

• Agitation, anxiety
  
• Withdrawal
  
• Ambivalence
  
• Fear
  
• Depression
  
• Anger
  
• Isolation
  
• Resignation
  
• Hesitation to reply
  
• Non-responsiveness
  
• Contradictory statements
  
• Unusual behavior attributed to dementia

Indicators of Financial Exploitation

• Unusual activity in bank accounts.
  
• Power of attorney given when the person is unable to comprehend his or her financial situation, and in reality, is unable to give a valid power of attorney.
  
• Refusal manage funds appropriately when given the responsibility.
  
• Recent change of title of house in favor of a "friend" when the elder is incapable of understanding the nature of the transaction.
  
• Checks and documents signed when the older person cannot write.
  
• Signatures on checks or other documents by someone other than the owner of the account or a forged signature.
  
• Loss of personal belongings such as art, silverware, jewelry, or other valuable property.
  
• The inclusion of additional names on a bank signature card.

Indicators from Family/Caregivers

• The elder may not be allowed to speak for himself/herself, or to others without the presence of the caregivers.
  
• Obvious absence of assistance, attitudes of indifference, or anger toward the dependent person.
  
• Family member or caregiver "blames" the individual (for example, accusation that incontinence is a deliberate act).
  
• Failure to provide physical aids such as eyeglasses, hearing aids or dentures.
  
• Withholding of food and water, or failure to help with personal hygiene.
  
• Inappropriately leaving an older person alone for long periods of time.
  
• Aggressive behavior such as threats, insults, or other verbal harassment.
  
• Previous history of abuse to others.
  
• Withholding of security and affection.
  
• Alcohol and/or drugs abuse.
  
• Social isolation of the family or isolation or restriction of the older adult's activity in the family unit.
  
• Conflicting accounts of incidents by the family, supporters, or victim.
  
• Unwillingness or reluctance to comply with service providers in planning for care.
  
• Unauthorized withdrawal of an elder's funds using the elder's ATM card.
  

Mandatory Reporting

South Dakota law requires individuals in the medical and mental health professions and employees or entities that have ongoing contact with and exposure to elders and adults with disabilities, to report knowledge or reasonable suspicion of abuse, neglect or exploitation of elders and adults with disabilities.

• Abuse, Neglect and Exploitation of Elders or Adults with Disabilities Brochure
• Abuse, Neglect and Exploitation Video (with audio)

Mandatory Reporters
There are two groups of mandatory reporters and the process for reporting is different for each group.

The first group of mandatory reporters of abuse, neglect and exploitation includes:

• Physician, dentist, doctor of osteopathy, chiropractor, optometrist, podiatrist, religious healing practitioner, hospital intern or resident, nurse, paramedic, emergency medical technician, social worker or any health care professional;
• Psychologist, licensed mental health professional or counselor engaged in professional counseling; or
• State, county or municipal criminal justice employee or law enforcement officer.

These individuals must make an oral or written report within twenty-four hours to law enforcement, the state’s attorney or DSS.

The second group of mandatory reporters of abuse and neglect includes:

• Any staff member of a nursing facility, assisted living facility, adult day care center or community support provider, or any residential care giver, individual providing homemaker services, victim advocate or hospital personnel engaged in the admission, examination, care or treatment of elders or adults with disabilities.
• Any individual in this group must report to the person in charge of the institution where the elderly or adult with a disbility resides or is present, or the person in charge of providing the services within twenty-four hours.

The person in charge must also make an oral or written report within twenty-four hours to law enforcement, the state’s attorney or DSS.

What to Report

To report abuse, neglect, or exploitation of an elder or an adult with disabilities, please contact your local law enforcement agency, local state's attorney's office or the nearest Department of Social Services' office or email the Division of Adult Services and Aging.

In addition to mandatory reporting, people can make reports on a voluntary basis. Any person who knows or has reason to suspect that an elder or adult who is disabled has been abused, neglected or exploited may report that information. Persons who in good faith make a report of abuse, neglect or exploitation of an elderly or adult with a disability are immune from liability.

Facilities or programs that are licensed or regulated by the Department of Health or Department of Human Services will follow department procedures in place for reporting.

A mandatory reporter who knowingly fails to make the required report is guilty of a Class 1 misdemeanor.

Include the following if you know or have reason to believe someone needs protection from abuse, neglect or exploitation:

• The name, age, physical address and contact information of the elder or adult with a disability;
• The name, age, physical address and contact information of the person making the report;
• The name, age, physical address and contact information of the caretaker of the elder or adult with a disability;
• The name, age, physical address and contact information of the alleged perpetrator;
• The nature and extent of the elder or adult with a disability's injury, whether physical or financial, if any;
• The nature and extent of the condition that required the report to be made; and
• Any other pertinent information.

Confidentiality

All reports are confidential. Civil and criminal immunity is available for good faith reports by employees, agents or members of medical or dental staff of facilities regulated by the Department of Health.

Interventions

Referrals to:

• Resources, such as home health services, adult day care, adult foster care or caregiver services.
  
• Legal assistance for a power of attorney, durable power of attorney or other legal advice.
  
• Counseling, support groups or medical/mental health providers.
  
• Nutritional assistance.
  
• Placement assistance.
  
• Case Management.

Other Interventions may include referral for:

• Emergency commitment of the mentally ill or developmentally disabled.
  
• Guardianship of the person.
  
• Conservatorship for property.
  
• Appointment of a representative payee.
  
• Further investigation by law enforcement for violation of Chapter 22-46, abuse, neglect or exploitation of the elderly and adults with disabilities, or for investigation of other criminal offenses.