Elder Abuse Prevention Resources in Indian Country: National Indigenous Elder Justice Initiative

Elder Abuse Prevention Resources in Indian Country: National Indigenous Elder Justice Initiative


On behalf of the Centers of Medicare and Medicaid
Services, the Administration on Aging, and the Indian Health Service, I would like to
welcome everyone to the Long-Term Services and Supports webinar series. My name is Julie
Cahoon and I work for Kauffman & Associates. I will be the moderator for today’s webinar.
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being recorded and that the recording will be made available online in the near future
on CMS.gov. With those announcements made, I would like to welcome everyone to today’s
webinar. Today’s webinar is titled “Elder Abuse Prevention Resources in Indian Country:
National Indigenous Elder Justice Initiative.” Our presenter today is Dr. Jacque Gray. Dr.
Gray is a Choctaw, Cherokee Associate Professor and Associate Director at the Center for Rural
Health at the University of North Dakota. She is also the Director of the National Indigenous
Elder Justice Initiative that is funded by the National Center on Elder Abuse and Title
VI programs with the Administration for Community Living, to address the issues of elder abuse
in Indian Country. Dr. Gray has worked to address health, mental health, and health
disparities across Indian Country. Internationally, she has worked with the Maori on suicide prevention.
Dr. Gray is a mental health first aid instructor and is part of the Rural Mental Health for
State Initiative. She has worked with tribes across the country for over 35 years. She
received her doctorate from Oklahoma State University in 1999 and was then at the University
of North Dakota since 1999. I will now turn it over to Dr. Gray.
Thank you, Julie. Good afternoon and thank you all for listening in today. I’ve got
a little bit of a rough voice, so I’m going to try to make it through okay speaking while
we do this. This webinar is focused on the resources available on the NIEJI website.
And NIEJI is the National Indigenous Elder Justice Initiative. Um, this initiative is
a national resource center for indigenous elder abuse information and technical assistance
and it’s to use to increase awareness about elder abuse in Indian Country; to provide
culturally relevant materials on elder abuse; to provide technical assistance to indigenous
groups on establishing elder abuse codes, policies, and services; and to increase the
data available about indigenous elder abuse. So what exactly is elder abuse? It’s not
something that is common to our culture historically. So the National Center on Elder Abuse says,
“that it’s any knowing, intentional, or negligent act by a caregiver or any other
person that causes harm or a serious risk of harm to a vulnerable adult.” Uh, taking
these official definitions, sometimes it is difficult in Indian Country, because we don’t
like to be considered vulnerable adults. We don’t like to look at people doing intentional
harm or neglect to an elder and many times you hear elders in Indian Country not… When
they ask about elder abuse it’s, “No, they’ve not been abused.” But when you
ask about disrespect you start hearing the stories. And so, that is a term that is more
commonly used. We’re going to focus today on the NIEJE website and what’s available
on that site. So, I’ve got a number of screenshots to show you what it actually looks like. And
as Julie mentioned at the beginning, the NIEJE link under “resources” will take you to
that website, but make sure that you minimize that window so that you can come back into
the webinar if you go there. This is our home page and the… You know our logo is up here
in the left and NIEJI focuses on restoring respect and dignity by honoring indigenous
elders, which is our vision. It tells a little bit about our program here on the homepage
and then any free, you know, current or featured events and things like that its usually in
a box just to the right of the screen. Farther down on the homepage, there’s more information
about elder abuse awareness videos and we have one of those that we… We’ve had several,
but we have one on our website right now and it lists some elder abuse taglines in the
tribal language and in English and I’ll let Julie play the video now and then we’ll
come back and talk a little more about things that could be done with that.
Hi Jacque. Actually, I’m going to hold for just a second real quick. It looks like we’re
having some audio problems. So I’m just going to wait to play that video for just
a second. Okay.
(Beginning of video and sound of native flute playing – 7:02.)
*** (native language being spoken.) I stand for dignity.
*** (native language being spoken.) I will not stand for elder abuse.
*** (native language being spoken.) The time is now. Unite against elder abuse!
*** (native language being spoken.) Break the silence.
*** (native language being spoken.) Elder abuse is not traditional. Elder abuse
is not our way. (Flute continued to be played and end of video
– 8:09.) Okay, Jacque you can go ahead again, again.
All right. Thank you, Julie. Um, from the PSA that was on, you can hear that the part
of it was listed…it was in the tribal language, part of it was in English by some of our students
and staff. What we can do and there’s information… (Speaking to self.) Let me get the arrow again,
whenever it ended up. I can’t find the arrow now, but where it says, “Learn how to submit
your video,” that’s a hot link that you can click on and it will tell you if you want
to do one with your tribe in your language, how to go about doing that and submitting
it to us and we’ll edit it together with the taglines or you can do it yourself and
we’ll put it all together so you can have one that you can utilize in your own community
with your own tribal language. If you have any questions about that, feel free to contact
us. One of the next pages, if we go up to the top of the banner, uh, that resources
tab and you click on that, it will take you to this page which lists several different
things, whether it’s news events, upcoming conferences, seminars, other events that are
going on, publications, different documents, and other things that we have that are helpful
with relationship to elder abuse. Sometimes there’s fact sheets and things like that.
Presentations, examples of products. The other thing I’ll say about presentations is any
of our PowerPoints that are up there, feel free to take those and adapt them and use
them. The same with product examples. These are examples that different programs have
sent to us of things that they are doing around elder abuse; so that you can get some ideas
of some of the things that you can do. And then, web sites and tools and each of these
will take you to another page under the news and events. And one of the elder abuse prevention
grants that was received from Title VI programs, Thelma Whitewater at Winnebago, was presented
an award on elder abuse prevention and so we’ve got that up there. World Elder Abuse
Awareness Day is June 15th each year and there may be other events going on. We usually have
something here at NIEJI and then there are other things that other programs do throughout
the world. Past events: this lists some of the conferences, World Elder Abuse Awareness
Day events, and things like that that we have recorded and made available online. So, we
go to the next area which is publications and you can see these are some of the things
that we’ve put out. There’s a quality of life fact sheet. There’s one on identity
theft with American Indian and Alaska Native elders. There’s another one about technology
use among American Indians and Alaska Native elders. We have a booklet that has been used
in a lot of venues with IHS and with others to help train new staff coming in that may
be non-Indian. Just some general information about questions that they may have. We’ve
developed a model civil elder abuse code that deals with things on the noncriminal side
and then we also have a model criminal elder abuse code that tribes can use to help develop
their own. And we have a number of other documents in here that give you information about elder
abuse in Indian Country. The next section dealing with publications; again, there are
different things. There’s a number of different tips around financial exploitation and technology
tips and things like that; a fact sheet on understanding elder abuse. But a lot of useful
information that you can print out and use or make reference to. Under the product examples,
as I said, there’s a number of different things that have been shared by other grantees
and programs that they’re doing. This is a 2016 calendar. There’s a banner that was
developed. One program had a contest with youth to come up with a design to use for
a billboard that they were going to put up and then some placemats that were developed
for use on World Elder Abuse Awareness day. The other thing we have is—it says a flyer,
but it’s kind of like a poster. We print these out on an 11×17 heavier paper—it’s
called, “Ways to love our elders” poster and I can show you… This is the top part
of the poster and we have people that have framed these and posted in their senior centers
and things like this. The next slide goes ahead and shows a little lower on the poster.
When it’s as large as it is, it’s hard to get it where you can read it and get the
whole thing on one slide. So, I hope you can get enough of an idea of what it’s like
that you can see how… We wanted to keep things as positive as possible and so this
is one of the things that we developed and enabled…in order to do that. The next section
is on websites and tools and as you see, there’s a lot of resources here. Some of the things
that I’ll point out, the… Let’s see. We have a… We went through all of the states
to get their mandatory reporting requirements. We’ve got links to all of those statutes.
We’ve got a list to the National Center on Elder Abuse that is out of the University
of Southern California. National Congress of American Indians has some good resources.
National Indian Council on Aging, the NICOA and a number of other… There’s a lot more
resources up here than what you can see just on this page, but all of these are links to
really good resources that can help in developing your elder abuse program. Farther down on
our list, we even have more that are great links to resources that are helpful in working
with elders around elder abuse; help lines and hotlines for suspected abuse down here
at the bottom; all kinds of services and interventions that are helpful. And although there are over
560 federally recognized tribes in the US, only a little over 50 have their own elder
abuse code and so all of those that were available that we have permission to, we have linked
onto this website and they’re listed by the state the tribe is in. So, all you have
to do is go click on this if you’re planning on developing an elder abuse code. You’ve
looked at the model codes, you want to see how some other tribes have adapted those things,
you can go to any of these and see how they’ve developed the elder abuse codes for their
tribe. This is another really wonderful resource. It’s our interactive map and on the right,
the link for the state hotlines will take you directly to this page. Again, if you go
to that page be sure you minimize and come back into the…to come back into the webinar.
But, you just have to click on your state. So, if we click on the state it will bring
up the resources for that state. At the bottom of that page, it also lists out all of the
states typed out and they’re hot linked to that state’s resources. So, you can do
it either way: either by clicking on the map or clicking on the name of the state. When
you do that, it takes you to a list of hotlines and this is the one for North Dakota where
we have the tribal hotlines and senior services listed, elder protection teams, elder outreach,
and all the resources for tribes are listed there. Okay. Whenever there are state resources
or for tribes that work with the states and have them do the elder abuse investigations
and elder abuse protection, those state resources are also listed. There are over 7,000 numbers
listed for the United States in this resource that we have available there. So, it’s the
most comprehensive one that exists for resources on elder abuse in Indian Country. Some of
the other resources that we’ll be adding here in the next couple of months is we’re
developing training modules for legal policy, financial exploitation, healthcare, social
services, and for caregivers and we’re hoping to… The plan is to have… We’ll have
an entrance gateway and some information about elder abuse and then modules on caregiving,
social services, and financial exploitation will be up by World Elder Abuse Awareness
Day which is June 15th this year. As well, we’re going to be adding additional resources
and more fact sheets as we get them developed. This is our staff and we also have the pictures
up there, so you kind of have a face to put with who it is you may be talking on the phone
or emailing with. Feel free to contact us at any time. We want to address your needs
as much as we can or direct you to a place that can help to address those needs and I,
you know, encourage you to brainstorm with us if there aren’t… Because a lot of the
resources don’t exist and we’re doing our best to develop things as quickly as we
can, but as I was explaining to someone a while back, when we talk about, “How do
you eat an elephant?” And in dealing with the elder abuse, what we’re finding is we’re
trying to eat a whole herd of elephants. So, there’s a lot of work to do and we’re
getting resources up on the website and available to people just as soon as we can. Sloan Henry
is our project coordinator. Brittany Belgarde is a project assistant and Susan Holden is
our administrative support person for the NIEJI project. So, I’ll turn it back over
to Julie now and we can do… We have plenty of time to do question and answer.
Thank you, Dr. Gray and I would like to… If you have questions for Dr. Gray, please
type your question into the Q&A box at this time. I’d also like to note that the webinar
is being recorded and that a recording will be made available in the near future. If you
are having problems with your audio over the web, I would recommend dialing into the phone
lines that are listed in the welcome box. So Dr. Gray, one question that came in is,
“Do you provide a certificate of completion?” We haven’t set that up yet, but we have
discussed it and I think we’re going to try and make it where it will work. Since
all of this is going to be online, it’s just a matter of getting everything linked
into it and that’s the plan is to be able to provide something like that.
And another question is, “Can you help to make the connection between elder abuse and
cardiovascular health/diabetes outcomes?” Well, I’m hoping that what you’re asking
is… What we find with elder abuse is those people that have multiple chronic conditions.
Whenever there is elder abuse that occurs, they have a much worse outcome with those
conditions. There’s a higher mortality rate and a much more difficult…negative prognosis
if elder abuse is going on as well. It’s also harder to manage pain.
Okay. Another question that has come in. “What are several key talking points when training
staff in long-term care settings?” Well, one I think is recognizing the signs
of elder abuse and neglect. Another is recognizing signs of stress in themselves and self-care.
I think those are probably two key talking points in addressing that kind of training.
Okay. “Do you know if other tribes are seeking their own assisted living homes and if there
are some, are they successful?” I think it’s been about a year and a half
ago, we did a site visit to Tohono O’odham in Arizona and they have a really nice assisted
living facility and they were planning on building more and I would suggest contacting
them with questions about it, because I was really impressed with what we saw there. Others,
I’m not sure of, but that one I did visit and I do know about.
Okay, Dr. Gray. Another question is, “Can you talk about the interaction between tribes
and the long-term care ombudsman program?” I really don’t know how all of that works
together. So I really can’t address that specifically.
Okay. Another question is, “How do folks register for the courses?”
Uh, it will be on our website, where people will just be able to go in and the other thing,
it’s taking us a while to put this together because one of the things we wanted to do
is we wanted it where if people had the highest speed Internet and the best equipment they
could have an interactive opportunity for the training as well as those that might have
dial-up or intermittent ability. And so, trying to make it where it will cover all of those
different types of settings, we wanted it where everyone would be able to access it.
So, it’s taking a little longer and we’re developing all of that. It will be on our
website where all you have to do is click to go into it and put in any information we
need. Okay and another question is, “Are there
examples of successful practices or tribes that are doing a good job in addressing elder
abuse in their communities?” Uh, I think Standing Rock, it covers North
and South Dakota. It’s on both sides of the state line. It has a really good program.
Warm Springs in Oregon has a great multi-disciplinary elder protection team that I think is doing
a great job and they work in collaboration with the state for investigations. Um, Tohono
O’odham, I was really impressed when we were down there and saw their adult protective
services program. So, you know, I think there are some. We can help to direct you to the
ones that we know about and if people know about some and want to share those with us,
you know, we would gladly accept those referrals so that we know about programs and can share
them with other people who are interested in finding out more information.
Okay and here’s a comment and a question. This attendee appreciated your comment about
disrespect versus abuse. Um, she finds that many times when investigating elder abuse,
elder covers up for their family member. “Do you have any suggestions on how to handle
situations like that?” That’s one of the ways that the elder protection
team I think is really helpful and some of those other more restorative justice models,
um, is that it can really be approached in, “We want to help your family be healthier
and so if we know what’s going on…” You know, it’s not that we want to punish
people unless that’s what we have to do, but if there are ways that we can go about…
You know, and that’s the difference in the civil and the criminal codes. If you have
both of them, then they may be able to work through the civil code to kind of set up a
treatment plan and work with them and use the hammer of the criminal code only when
necessary and you can’t get people to respond to those positive attempts to make corrections
and improvements. And I know Tohono O’odham has a restorative justice program with their
adult protective services. Some of the elder protection teams have been very effective
with some of these things and out at the Pueblos they’ve gone to the traditional elder councils
to address some of that that has been very effective. So, I think really coming at it
from a helping perspective rather than the criminal, um, punishment type of perspective
is how most people perceive authorities and to try to turn that around where you’re
engaging… I know your intent is to help, but sometimes it’s not perceived that way.
So, trying to change that perception to a more helping model.
Okay, great. Another question that has come in is, “When working with an elder with
dementia or Alzheimer’s, how do you recognize stress or depression?”
Uh, I’m not sure if it’s with the elder or with the caregiver. Those are very stressful
situations for caregivers and a lot of need for support and respite for those caregivers.
But also with the elder there’s a lot of, you know, confusion, a lot of the anger and
lashing out is, you know, out of fear and not knowing what’s going on. So, that can
be very difficult. The VA has a program called “Reach” and it’s training for caregivers
and as far as working with Alzheimer’s and dementia. And when I was at the Banner Institute
Conference for American Indian and Alaska Native Alzheimer’s and Dementia last fall,
I talked with a number of people that had been trained with that program and they were
very positive about how helpful it was and how to handle different situations and to
having that caregiver have someone to go to that could give them ideas on ways to handle
situations and I know that they are, the VA is reaching out with their Reach program to
do training with tribes. And that information is available through the ACL, Administration
on Community Living. Okay, great. One question that came in is,
“Adult Protective Services issues and investigates elder abuse in New Jersey. Is there a separate
APS type investigation for those in Indian Country?”
It varies. Some tribes are what they call Public Law 280 states. In which there is an
agreement with the state that the state will do those investigations and, you know, there’s
a working relationship between the tribe and the state. Other states where they don’t
have that, the tribes are sovereign and they may have an individual Memorandum of Understanding
or agreement with the state around those or not. If they don’t, some tribes don’t
have that agreement, don’t have an elder protection code, and so there is nothing in
place for the elders. Others have their own code; have their own Adult Protective Services
that do all their own investigations. So, there are many different types of situations
throughout Indian Country. Okay. This next question kind of falls into
the line about jurisdiction; but, “How important is it to implement tribal codes about elder
abuse? Do tribal codes apply to people who live off reservation or tribal lands?”
As far as I know, the tribal codes apply to where the tribe has jurisdiction which usually
is within their tribal lands. There is… One resource that we have on our website is
the Bureau of Indian Affairs Adult Protective Services handbook which really outlines the
various jurisdictions and how all those different things work. That’s one thing that’s very
confusing in Indian Country, because it varies a lot as to what is enforced by whom and the
Tribal Law and Order Act tried to address that, but most tribes don’t have the resources
to implement that. And so, a lot of progress hasn’t been done with it. But there are
different tribes in different locations that have made some progress with it. You know,
one thing that is really difficult as far as jurisdiction in Indian Country is financial
exploitation. If it’s something that goes through a bank and the bank is on state land
and the elder is on tribal land and then was it a tribal elder or was it a non-Indian that
did the exploitation. And it’s very confusing as to who has jurisdiction with all of that.
I’m sorry I don’t have better answers, but it’s all pretty murky.
Okay. The next question is about the challenge of or lack of elders reporting abuse, uh,
refusal to report elders not admitting to abuse or not willing to complete a police
report or refusing to talk to APS. “How much of a challenge is this and what are ways
that folks can overcome this?” Well, one of the things is talking about the
disrespect instead of abuse or in relation to sexual types of things bothering, instead
of sexual abuse. You’re more apt to get more information. One of the things… One
of the programs I think is really doing a great job is Project Golden Shield out of
the Anadarko Agency and BIA police and social services work together and social services
identify at-risk elders and then when the BIA police don’t have other calls to make,
they drop in and visit the elders. Just have coffee with them or talk with them for a while
and develop a relationship. And, you know, they’ll take gifts at holidays or a meal
at Thanksgiving; you know, different things like that. And build that relationship with
the elders so that they’re more apt to ask for help from the police if they, if they
need it. And the police are more apt to see something if, you know, and changes and things
like that when those visits. Some of the other programs, you know, I think any of those things
that can do more of the community policing types of things or law enforcement, but also
the elder protection teams where if someone hasn’t seen someone for a while and they
are, you know, are concerned, can just ask someone on the team to do a drop-in and check
on things. Those multi-disciplinary teams can go a long way in helping people to connect
and address the situation before it gets to the point of being health or life threatening.
Okay. And do you… “Do you work with Adult Protective Services and guardianship?”
We provide resources and help connect people, but we don’t work directly with them.
Okay. The next question focuses on financial abuse of elders which is becoming more frequent.
“Are you addressing this in the training and resources available?”
Yes, the financial exploitation module really comes at it and it’s focused for people
like that work in banks, merchants, and anyone, casino workers. Anyone that deals with any
financial aspect as far as how they can recognize it and ways they might intervene and things
that they can do if they notice something that is, uh, they have question about as far
as an elders finances. Okay. “Are you aware of emergency shelters
that are available for abused elders that they can turn to?”
Not specifically. I do know that the National Center on Elder Abuse is working with the
Department of Justice Office of Victims of Crime and the Violence Against Women’s Act
to utilize domestic violence shelters. In some places some tribes use a hotel to put
the elder up in temporarily. I think there’s some creative things. I do know that there
is some Violence Against Women’s Act money that is available through Department of Justice
that tribes can apply for and they’ve told me that they haven’t received any, but they
would love to see some grant applications from tribes. And that can be used for victim
services including possibly developing a shelter if there was a need for that much housing.
Depends on how much someone may need. They may need to start with having like a hotel
or something like that that would be covered. And then as they build up the usage and more
and more maybe identified or needed then moving toward getting funds for development of the
shelter. Okay and this next question focuses on grant
writing and statistics. “Are you aware of any statistics that folks could use when writing
grants for elder abuse for tribes or about tribal members?”
There isn’t a whole lot. We do have links to articles and we have all the articles if
someone wanted to contact us about maybe sharing some resources with them. But there’s not
a lot of information out there about elder abuse. Also the National Resource Center on
Native American Aging, on their elder needs survey and I’m not sure… I would guess
that Navajo participates in that. One of the… When it looks at the services that are provided
or could be provided, one of the questions was about elder abuse services. And you could
actually have some data from the elders in your tribe, if you will go to that, on how
many use elder abuse services or how many would use it if they were available on your
reservation. And I would work with the Title VI director to get that information. They
have that report. That’s the best I can do as far as tribal specific information.
It’s not real focused and it’s pretty, you know, just use of services and who would
use them or wouldn’t use them. But it’s about all we’ve got. We are working to get
some funding to develop an elder abuse survey that would be like that survey that we would
have done by Title VI programs with the elders and then we would be able to have more data
on Native elders and be able to give tribes that information. But currently there’s
nothing being done. Okay. This next question comes with best scenario.
This individual is a long term care ombudsman. “If a tribal member is placed in a non-tribal
land skilled nursing home, who would have jurisdiction? As far as being an advocate
for an elder in that placement, who would be the person for the ombudsman to contact?”
It would probably be through the state Adult Protective Services. But they could involve
the tribe if, you know, to help with that so that they could be there to help protect
some of the elders needs and elders rights. But because it would be off tribal land, I
think primary would probably be the state. I’m not an attorney; so I’m not the absolute
authority on any of that by any means. Okay. This next question comes from an individual
whose tribal nation recently implemented a tribal protection code. Elder abuse is prevalent
in their nation. “How is enforcement initially done having just implemented their code?”
Yeah, one of the things that we’ve discovered is it’s not just about passing a code, because
once you have the code then you need the policies and the procedures to do the investigation,
the intervention, the enforcement, all of that. And so, those things have to be built
right along following the code to say, “Who’s going to investigate? Who’s going to follow
up? Who has authority on different things?” And on the model code, I believe we have a
presentation up on our website on developing the elder abuse model code, or developing
a code. And it goes through all of those different steps that it can be laid out in the code
who has all of those authorities. But still, if you don’t have Adult Protective Services
or someone that’s going to be doing the investigation you’ve got a code that’s
not enforceable. So, those things have to work together. I’m learning a whole lot
about policy I never knew as to the complexities of what all has to be done in order to make
all of this work together. “Is there a specific training for elder
law attorneys specialized in various forms of elder abuse?”
I know that the Department of Justice has had several trainings for prosecutors on elder
abuse. And that might be a good starting point to find out what else there might be for…for
attorneys other than prosecutors. And if people will contact me I’ll try to help them connect
with someone that can give them better answers. Okay. This next question is to any… “Are
you aware of any tribes that combine foster youth and elders to help heal each other?”
Not specifically. I know there are some… There’s Dave Baldrige has the Thousand Grandmothers
Program, but that’s not specifically with elder abuse. That’s with grandmothers basically
working with younger mothers in developing or helping them to learn to parent. I know
there are some that do kind of a foster grand-parenting with youth that they come and work with an
elder maybe through the senior centers and things like this; but I can’t give you specific
programs. (Pause.) And I’m glad we left a lot of time for questions, because I know
people have lots of questions that aren’t covered on our website.
And another question that has come in is, “What efforts has IHS done towards addressing
elder abuse?” We’ve been working with IHS as they’re
trying to develop policy for reporting of elder abuse with the inconsistencies across
tribes and things like that, that makes it a little difficult. But Bruce Finke with Indian
Health Service is trying to get a policy developed that they will be able to implement cross
the US. “Is there a list of tribal ombudsman across
the nation?” I think the Title VI program has a list of
them. I do not. (Pause.)
Again, if you have a question please go ahead and type your question into the Q&A box. Okay,
one question that has come in is… Julie, I’ve lost you.
Oh, sorry. Oh, okay.
The next question is, “For folks who work directly with elders, is there mentoring or
stress relief training for caregivers?” One of the things that we will have, are some
suggestions on stress management or self-care on the caregiver module that we’ll have
up. I know there have been various things on caregiver self-care. We’ll try to get
something up on the website specifically about that that can be a resource. But I’m just
drawing a blank right now. There is… Let me say this, with the National Resource Center
on Native American Aging, they have developed a Native caregiver, a Native American care,
elder, Native Elder Caregiver Curriculum. I will get it out. And that curriculum I know
has been put into place in two of the tribal colleges here in North Dakota. But it has
a lot of resources in there and it’s on their website which is NRCNAA.org.
Okay. The next question is, “What are your suggestions for the first step or even the
next step for a tribe that wants to do something about elder abuse in their community?”
I’ve seen a lot of elder groups come together and work on letting their leaders know that
this is something that needs to be addressed and work with those leaders to help develop
what they want. The other thing that I would suggest is, if you have a Title VI program
that has done the Native Elder Needs Survey with the National Resource Center on Native
American Aging, get with that Title VI director to get that data; that you can use that to
work and develop a justification for what the elder’s needs are and addressing that
with the leadership to start moving things forward. And, you know, we’re happy to provide
materials and things like that to any of those groups that want to get started with anything.
This next question ties back into your comments about bothering and disrespect. “Do you
have any other tips or advice for luring this information out of elders?”
You know I think just having, having conversations about…and it’s kind of a screening type
of approach with, you know, “Has anybody been hurting you? Can you tell me how? Has
anybody bothered you? Well, how have they bothered you?” Uh, to kind of get into that
discussion about it that just going directly, you know, “Have you been abused?” you’re
going to get “No,” and just move on. On some of the presentations that I have on the
website, in some of the later slides in those presentations, there’s a series of questions
and ways that you might ask some of that. So, some of that is available if you want
to look at it. I keep referring back to the website, but I think you’ll find there’s
a lot of really good resources up there that you can make use of.
Okay. We have enough time for a few more questions. I’m going to go ahead and click the slide
back to contact information. And if you have a question, go ahead and type your question
into the Q&A box. (Pause.)
Yeah, we just kept mainly focused on the website today, but there are lots of other tangents
we can go down with all the information. And like I said, there’s probably more questions
than answers, but we’re doing our best. I think this is a good question to leave off
with. “Are there any upcoming trainings offered by NIEJI?”
We usually do several presentations at the Title VI Conference in…it’s going to be
in Denver the 1st of August this year for Title VI directors. Also, there’s plans
to present at the IHS Behavioral Health Conference. We don’t have anything else right in the
works right now, but that doesn’t mean that we won’t be setting things up and we try
to keep those things up on the website as they’re coming up.
Another question that came in is, “How do you become an Adult Protective Services agency?
Is it difficult?” I would suggest contacting the National Adult
Protective Services Association to find someone that’s more knowledgeable about that or
the… It’s Kathleen Quinn and Andrew Capehart at the National APS’s Resource Center. They’d
be able to help more with that. They’re one of our sister organizations.
(Pause.) Okay, any final… Jacque, Dr. Gray, any final
comments you’d like to leave with everyone? Just any way that you can step in and start
doing something helps. So, even if you’re starting with just making people more aware
of elder abuse; start there. Do something for World Elder Abuse Awareness Day. There
are plenty of steps and plenty of things to be done, but start somewhere. And any way
we can be of help, we will do that. Okay. We have reached the top of the hour.
In closing, I would like to remind everyone that today’s webinar was recorded and that
the audio and PowerPoint will be made available online at CMS.gov. Thank you, Dr. Gray for
your time. Thank you.
And thank you for joining today’s webinar. Our session is now concluded.

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