The role of Designated Agencies when responding to adult abuse, neglect, and self-neglect Alana Prashad RSW ReAct Adult Protection Program Vancouver Coastal Health 21 October 2014 1 Agenda  Who  ReAct Adult Protection Program at Vancouver Coastal Health  What  Designated Agencies under the Adult Guardianship Act  Principles and presumptions  Musts  Tools and response process  Contact   Referrals for specific cases of abuse, neglect, and self-neglect Collaboration with the community 2 VCH ReAct Adult Protection Program     Receives reports Provides clinical consultation Coordinates responses Trains VCH staff to recognize, report, and respond to situations of abuse, neglect, or self-neglect of vulnerable adults 3 What is abuse?  The deliberate mistreatment of an adult that causes the adult   physical, mental or emotional harm damage or loss with respect to financial affairs  Includes intimidation, humiliation, physical assault, sexual assault, overmedication, withholding medication, censoring mail, invasion or denial of privacy, denial of access to visitors 4 Who abuses?     Intimate Partners Caregivers Family members Predators 5 Self-neglect Failure of adult to take care of him/herself that causes or reasonably likely to cause within a short period of time serious physical or mental harm or substantial financial damage or loss 6 Legal Framework for Adult Protection in British Columbia  Adult Guardianship Legislation    Representation Agreement Act Health Care (Consent) and Care Facility (Admission) Act Adult Guardianship Act  Sections 2.1 and 3  Patients Property Act   Committee of Person Committee of Estate  Mental Health Act 7 Getting our Acts together       Power of Attorney Licensing Criminal Code Hospital Act Marriage Act Community Care and Assisted Living Act  Public Guardian & Trustee Act 8 Adult Guardianship Act Part 3 Abused, neglected, self-neglected and unable to seek support and assistance due to:  Physical restraint  A physical handicap that limits their ability to seek help  An illness, disease, injury or other condition that affects their ability to make decisions about the abuse and neglect 9 Guiding principles and presumptions     Self-determination and choice Most effective but least intrusive support Adults are presumed capable Court is last resort 10 Designated Agencies  5 regional health authorities      Vancouver Coastal Health Fraser Health Authority Interior Health Island Health Northern Health  Providence Health  Community Living BC N.B. Public Guardian and Trustee and the police have a role, but are not “designated” 11 Within Designated Agencies       Hospitals Residential care settings Private homes in the community Assisted living settings Mental health centres Community health centres 12 What the Designated Agency MUST do     Look into the situation Involve the adult as much as possible Report criminal offences Keep the identity of the person who made the report confidential 13 Two pivotal questions Is the adult abused, neglected, or selfneglecting? Is the adult able to seek or refuse support and assistance on his/her own? 14 Adult Guardianship Act Part 3 Tools        Mandate Power to investigate Access order Warrant to enter for purpose of interview Interim restraining order Emergency provisions Support and assistance order 15 Designated Responder Process 1. 2. 3. 4. 5. 6. 7. Document each step Interview the adult Assess the urgency of the situation Coordinate the collection of collateral information Coordinate the assessment of abuse, neglect, and selfneglect Determine if the adult has a representative, committee, or Power of Attorney Coordinate the development of a care plan to provide support and assistance 16 Designated Responder Process 8. Advise the most responsible physician of the situation and actions taken 9. Make reports as necessary to the Public Guardian Trustee to safeguard the adult’s assets 10. Report crimes committed against vulnerable adults who are unable to seek support and assistance to the police 11. Keep the identity of the person who made the report confidential 17 18 19 Factors           68 years old Female Sponsored immigrant Does not speak English Complex medical history Environment – no toilet, ventilation, heat, food, telephone Frostbite Pneumonia Malnutrition Adult does not speak, son says back off 20 21 Questions? 22 Thank you! Visit us at www.vchreact.ca 23