Sexual abuse is non-consensual sexual contact by one person upon another. Sexual abuse is a form of elder abuse that frequently goes underreported, under-investigated, and unnoticed. In today’s episode, attorneys Rob Schenk and Will Smith discuss the signs of sexual abuse and how to uncover when it may be occurring to a loved one.
Schenk: Hey out there. Welcome back to the show. My name is Rob Schenk.
Smith: And I’m Will Smith.
Schenk: And we are your co-hosts for this episode of the Nursing Home Abuse Podcast. The genesis of this podcast is two-fold. Number one, I got emailed sometime back with a brochure that was exceptionally well-done, very well put together by a group called Consumer Voice about what sexual abuse is in the nursing home context, and some of the signs the family members of loved ones can observe to uncover whether or not it’s occurring to their loved one. The second is the fact that there was a lawsuit filed, and we’ll get to that later in the show, involving a facility in which a woman was raped repeatedly. So with those in the background, we figured this would be a good time talk about this, and I don’t think this is something – not that it isn’t important – but this is something I don’t think we talked a lot on the Nursing Home Abuse Podcast, but that is sexual abuse and it is a growing problem in nursing homes, not just in Georgia, but across the country.
Smith: And it’s important to talk about what we mean when we say sexual abuse. For example, in Georgia, there are a wide variety of sexually based offenses and crimes you can commit, everything from rape, which involves some sort of vaginal penetration, to sodomy, aggravated sodomy, battery, both misdemeanor battery, sexual battery, and aggravated battery. So it’s really anything that is sexual in nature and you know it when you see it. It’s anything that involves the genitalia or other sensitive areas of the person’s body intended to be sexual, either by the perpetrator or against the residents themselves.
And it is a problem in nursing homes for a multitude of different reasons. It is not just done by people who work there. It can be done by other residents. There are – RRSA is a huge problem, that’s resident-resident sexual assault. But it is one of the disheartening and troubling problems facing nursing homes now.
Schenk: I agree. And to reiterate that, it’s important to understand that sexual abuse is sexual abuse regardless of who commits it.
Smith: It doesn’t matter.
Schenk: It doesn’t matter. It could be another resident. It can be a staff member. It can be a family member of another resident. And we see cases across the country that reiterate this point.
Smith: And I want to point out in a lot of pamphlets and a lot of discussions, they’ll say, they’ll start off that sexual abuse is unwanted sexual contact. I actually think that a better definition is that it’s nonconsensual. And I think that is an extremely important distinction when you get into nursing home residents.
Schenk: And that distinction is important because when you’re dealing with nonconsensual activities, an individual that has a cognitive impairment is incapable, by definition, of consenting.
Smith: Exactly. So it’s not just that this individual didn’t want it, it’s that they weren’t capable of consenting. And they could even be – it could be somebody who is in a coma. It’s any sexual contact that is not consented to is sexual abuse.
Schenk: Right, and so just a brief rundown, and this is not obviously all inclusive, but generally when we’re talking about sexual abuse, it’s going to be nonconsensual intimate touching of any kind, particularly to breasts or genital area, any type of rape, oral or nonconsensual anal sex, forced nudity, forced observation of masturbation or pornography, or the taking of – and this is becoming more and more common, but the taking of sexually explicit photographs or audio-video recordings of a resident and distributing them online. And this would include pictures of the residents in whatever state of undress. These are all forms – it’s not all-inclusive, but these are all forms of sexual abuse.
Most often, the victim of sexual abuse in a nursing home are females, and that’s statistically born out because more nursing home residents are female as well. By some stats, between 65 and 75 percent of nursing home residents across the country are female, and that just makes sense because…
Smith: Women tend to live longer.
Schenk: Women tend to live longer. So kind of one of the main things we want to talk about in this episode are what family members of loved ones can do to remain vigilant in protecting their loved one from sex abuse wherever it may occur, from the other residents, staff members, etc., and that is one of the main things you can do is to remain vigilant of not just the physical signs but the psychological signs of sex abuse.
Schenk: So the physical signs often are easier to see if you’re going to visit your loved one on a regular basis. We see that, at least our clients that are active – if there’s a wound, they’re changing the wound, they’re more likely to see these types of things, which is bruising, any type of scratches or abrasions to the genital area, unexplained infections, these types of things, unexplained bleeding from the genital areas, irritations, sometimes difficulties sitting, sometimes difficulty walking or disheveled or dirty or stained undergarments as well.
Schenk: These are some of the more principled signs of sexual abuse. And like I said, you might not have the opportunity to see your loved one’s undergarments or genital areas, so this is not something you might see on a daily basis, but if you’re there and they’re, your loved one is being changed, perhaps they’re incontinent or whatever, maybe keep an eye out for that. You don’t necessarily have to leave the room. This is your loved one that we’re talking about.
Smith: Yeah. I think, and this is something that I’ve talked about in the past, if you have a loved one that is in a nursing home, I’m not really talking necessarily about an assisted living facility – typically people in assisted living facilities are able to ambulate on their own. They’re able to take care of themselves. They’re able to meet all of their activities daily living by themselves. But if you have a nursing home resident, especially somebody who has a cognitive impairment like dementia or they have other issues, incontinence, you can’t be too squeamish. It’s just like if you have children, you’re going to be exposed to things that you may not normally be exposed to just by your peers.
But to the extent that you’re not exposed to it, to the extent that you don’t feel comfortable – and that’s understandable. Some people don’t want to help get their parents dressed, some people don’t want to change their parents’ adult briefs, and I can understand that. I am not that way. I’ve seen hundreds of thousands of patients – hundreds of thousands may be a lot, it seems like that – tens of thousands of residents and patients, but to the extent that you don’t want to do that on your own, at least discuss it with the staff. Ask the staff, “Hey, when you changed Mother this morning, are you noticing anything?” Not only plant that in their head, but ask it just to find out because somebody could say, “Yeah, I’ve noticed on Eleanor Johnson that she’s got a lot of bruising around the thigh,” or “She’s got scratches,” or “Her undergarments seem torn.” You have to investigate to some extent.
Schenk: That’s right. So you’re wanting to be vigilant of those things, the undergarments, any unexplained bruising or abrasions in those areas, but those are the physical signs.
Schenk: Now there are psychological signs of sexual abuse that are more common than others, and those generally seem to be a sudden change in behavior. So for example, if your loved one is usually not quick to be agitated and now all of a sudden they get agitated very quickly or the opposite, where you walk in and it’s Grandma Johnson and she’s like, “You get out of here,” and now she’s not that boisterous, now she’s withdrawn, if it’s the opposite, whatever.
Smith: Withdrawn is an extremely important sign to take note of. It can be – there can be a lot of reasons for it. It’s not just that if somebody’s withdrawn they’re being sexually abused, but it’s a very important sign.
Schenk: Yeah, it’s something to look out for. So sudden changes in behavior, agitation, withdrawal, panic attacks, anxiety attacks, and something that should be a very blatant red flag is if your loved one is acting this way only around a certain person. So again, we’re not saying that if Ms. Johnson doesn’t want to get changed and gets mad at the CNA, that doesn’t mean that’s a sign of sex abuse, but if they’re acting scared or anxious around particular people, that might be something you consider and then follow up by asking questions.
Smith: Yeah, absolutely.
Schenk: So again, if you have a loved one in a nursing home and you’re seeing some of the physical symptoms, you’re seeing some of the psychological signs of sexual abuse, it is very important that you act. And one of the first things that you can do if you suspect this is go directly to the administrator of the nursing home and file a report. Make everything known to the administrator. Take pictures. Give the pictures to the administrator and rattle the cages in that way.
The next thing you want to do is get the local police department involved. Call the cops. Call the cops. In the time it takes you to go to the administrator, call the police. They come out and take a look. Make sure – and this is very important and Will has talked about this in previous episodes, but you have to make sure that, I don’t know if there’s any better way to put this, but it’s a crime scene, so you don’t want to interfere with the crime scene.
Smith: You don’t want to clean her clothes.
Schenk: Don’t clean her clothes.
Smith: You don’t want to clean her. And we’re, again, we’re using the female pronoun. It can happen to men as well, but you don’t want to clean the resident. You don’t want to clean their room. You don’t want to get rid of any evidence. So it’s a crime scene. You want to cordon it off, section it off and seal it effectively.
Schenk: That’s right. So you get the police, if it’s a reported potential rape, they’ll do a rape kit, and these things, the accuracy of them is eliminated if they’ve given her a shower, things like that, so it’s important you don’t do that.
The next thing you want to do, if you’re in Georgia, you want to contact the Department of Community Health to get an investigation started through that agency, and that number is 1-800-878-6442, again, 1-800-878-6442, and we’ll go ahead and flash up the DCH number if you’re a Georgia resident and you can see it on the screen.
Another thing to do if you suspect there’s some type of sexual abuse going on, then you can call your local long-term care ombudsman. And we’ve had ombudsmen on as guests on this show. We’ve had episodes dedicated to what the ombudsmen do, but the ombudsmen are advocates for your loved ones in that nursing home.
Smith: Yeah, and Melanie McNeill, who has been on this podcast before, is the head of the Georgia Long-Term Care Ombudsman Program, so if you can’t get your regional ombudsman, call her office. But these are the steps that you need to take to pursue this and see it through, because it’s extremely important.
Schenk: Yeah, because the number one thing is the safety of your loved one. So by calling the cops, alerting the administrator, then it’s likely the offender is going to be prevented from committing this crime again, at least to your loved one. But once the police have investigated and everything is, your loved one is safe, then you can think about, “Hey, maybe I want to sue,” or whatever, and that’s what we’re going to talk about right now is that…
Smith: A terrible, terrible situation in Missouri.
Schenk: Yeah, a case out of Missouri that caught our attention. A Missouri family wants justice and filed a $1 billion lawsuit after their elderly mother inflicted with Alzheimer’s disease was allegedly raped repeatedly during her eight years in a nursing home. On Thursday, I believe this was in September of 2018, this is a couple months ago, the children of 84-year-old Dolores Green made rape and sodomy claims in a $1 billion lawsuit filed against the Christian Care Home in Ferguson, Missouri, for its alleged abuse against the elderly patient.
The family said Green’s Alzheimer’s disease made her vulnerable to abuse because it caused her limbs to stiffen. This is a family member, said that in August, she paid her mother a visit and proceeded to bathe her. That’s when she said she found bruising around her vagina and rectum area. She notified the Ferguson Police Department, and she said her mother’s bruising increasingly got worse. Medical officials told family that Green had been raped repeatedly, raped, sodomized and no telling when it started. This is what one family member said.
So this instance, the family member was able to see the physical signs because they were bathing their mother, and so they acted on it, and when the cops came, they did the rape kit.
Smith: And from what I understand the investigation, they have a suspect in mind and it’s another resident. That’s still the nursing home’s fault. That is something that they should have stopped and they should have taken notice of after eight years. But yeah, the way that they discovered this is that the nursing staff had missed this and luckily the daughter was giving her mother a bath and she was the one that noticed it and brought it up. If it had been going on for eight years, I’m still baffled how no one noticed it before then.
And as far as the billion-dollar damages issue, I don’t know that much about Missouri law or what’s going on out there as far as what they’re allowed to claim. I would imagine a lot of that is probably punitive and it should be, because that is an absolutely horrible thing to allow that to happen to an elderly resident over almost a decade. I can’t imagine it.
Schenk: Yeah. So their claims are likely going to be that – federal law and I’m assuming state law in Missouri disallows, prohibits, a nursing home from employing anyone who has a history of abuse, let alone sexual abuse. So when they hire somebody without doing the appropriate background check, or they should have constructive knowledge of that history of sexual abuse but they hire that individual anyways, then that will potentially make them liable for whatever sexual abuse that that employee commits, because the facility, even though the facility might say, “Well we employed him but that’s not in his job description to do that,” it doesn’t matter. They should have known that. They should have had the knowledge of his background. And if that’s the case, then…
Smith: Anybody that they let in there – I think in one podcast when we did cover this issue, we discussed how a local pastor or a chaplain or somebody like that, who would come to the nursing home during the activities session was actually molesting one of the residents. So it’s anybody who has access to the nursing home, the nursing home is responsible for them.
Schenk: Yeah, or at least that’s one of the many ways that a nursing home can be responsible for the sexual abuse that is committed by another resident or by the staff member. And again, the nursing home is required by federal and state law to keep their residents safe from sexual abuse regardless of who it’s from. So if it is another resident and they have reason to believe that, then they are obligated to make interventions to prevent it from happening, so moving to different rooms, making sure their schedules don’t meet so they run into each other, maybe limiting the offender from – switching wings, these types of things can be done to limit the likelihood of a sexual abuse, to even kicking the person out.
So we’re going to flash some information up on the screen at this point. If you want additional information about this, you can go to these websites. One is the National Sexual Violence Resource Center, and that is NSVRC.org. The National Adult Protective Services Association, which is NAPSA-NOW.org, and we always recommend going to our friends over at the National Consumer Voice for Quality of Long-Term Care’s website, and that is TheConsumerVoice.org – TheConsumerVoice.org. And each one of those websites will have more information about recognizing the signs of sexual abuse in nursing home residents and resources to report it and then resources to survive it and get past it, because like we mentioned, the psychological signs include PTSD-like symptoms that require medical treatment to get past, to be treated for.
So with that, I think that concludes this. It’ll be a relatively short episode. We wanted to get right to the point. But if you enjoyed the content of this episode and found it informative, we’d appreciate it if you’d maybe watch other episodes, and you can do that by going to our YouTube channel or checking out our website, which is NursingHomeAbusePodcast.com, or you can listen to the podcast wherever you get your podcast from.
Schenk: Google Play.
Smith: Anywhere else that you go, it’s free. You never have to pay for it.
Schenk: That’s right.
Smith: Anywhere that you get a podcast, however you choose to digest podcasts, ours is on there.
Schenk: That’s right. So thank you for your time and with that, we will see you next time.
Smith: See you next time.