State Bar of Michigan
Committee on Justice Initiatives and Equal Access Initiative Disabilities Project
From the Michigan Penal Code (750.145m—definitions), “Vulnerable Adult” means one or more of the following:
(i) An individual age 18 or over who, because of age, developmental disability, mental illness, or physical disability requires supervision or personal care or lacks the personal and social skills required to live independently.
(ii) An adult as defined in section 3(1)(b) of the adult foster care facility-licensing act, MCL 400.703.
(iii) An adult as defined in section 11(b) of the social welfare act, MCL 400.11.
Many individuals involved in the field of criminal and civil legal justice are familiar with the topics of domestic and sexual violence, thanks in part to increased funding and attention through legislation such as the Violence Against Women Act. Originally passed in 1994, subsequent reauthorization of the act has included additional language addressing the needs of women with disabilities, and providing funding for expanded protection, services, and education. Individuals and systems that continue to become more aware of the dynamics of abuse are better able to respond appropriately to victims and ensure accountability for perpetrators. However, response to violence against people with disabilities and elders is still a particularly under-recognized and under-reported social problem and crime.
It is crucial that attorneys and other individuals working with vulnerable adults learn to recognize and respond to suspected abuse and neglect. It is the goal of this article to assist the practicing bar in understanding individual roles and responsibilities and to learn where additional support and referral services are available for clients. While no one can realistically be an expert in all areas of service, it is in everyone’s best interest to understand individual roles and responsibilities, and to learn where additional support and referral services are available for clients.
Individuals with disabilities experience forms of violence and abuse similar to those without disabilities, such as physical injury, sexual assault, emotional trauma, isolation, and financial abuse. However, persons with disabilities also face unique forms of abuse, such as removal or disabling of assistive equipment, manipulating or withholding medications, or refusal to provide essential personal assistance. The exertion of power and control of one individual over another is a shared characteristic of vulnerable adult abuse and domestic violence. Unique to vulnerable adult abuse is the role of caregiver or personal care assistant in perpetrating the abuse or neglect.
When interacting with a client, it may be possible to identify signs of abuse or neglect. For example, is the individual easily frightened or fearful? Exhibiting denial? Agitated or trembling? Hesitant to talk openly? Offering implausible explanations for signs of injury or recent actions? Making contradictory statements?
What do you notice about availability of equipment or adaptive devises, the condition of the equipment, the client’s personal hygiene and/or unsafe unclean living conditions, suspected dehydration and/or malnutrition, unattended or untreated medical conditions? All of the above may be indicators that abuse or neglect is present.
Individuals present and purporting to be assisting your client might exhibit suspicious behavior as well. Does the caretaker or family member regularly describe the person in their care as “difficult,” “stupid,” or “clumsy”? Are they overly attentive to the person in the presence of others? Do they actively try to convince others that the individual is crazy or incompetent? Do they refuse to allow an interview or examination without being present? These may be signs of a controlling or abusive situation, or that the caregiver has something to hide.
In working with elders or people with disabilities, attorneys may be expected to interact with voluntary and/or court appointed decision-makers. This may include individuals with Durable Power of Attorney (for healthcare and/or fiscal management issues), a Guardian (appointed by Probate Court to make various decisions about the care of someone determined unable to make those decisions on their own), or a Conservator (a person or bank appointed by probate court to handle some or all of an individual’s assets and financial affairs). While the role of these individuals is to support the vulnerable adult, these people are in perhaps the easiest position to take advantage of the situation. It may be tempting to rely on the caregiver or appointed representative for information, but every attempt should be made to speak directly with the individual, and to gather information from multiple sources.
Individuals with disabilities are not only at greater risk of abuse, they have greater barriers to seeking or accessing resources and support, such as not being believed or taken seriously. These barriers that deny or limit access to quality advocacy and services for victims of abuse and neglect also include lack of formal screening for domestic violence, sexual assault or other forms of abuse for people with disabilities, and failure of other professionals to identify and adequately address the needs of vulnerable adults.
To address these and other gaps in meeting the needs of vulnerable adults, the Michigan Elder Abuse Task Force was established by Executive Order 2005-11 on May 25, 2005, by Governor Jennifer Granholm. The Task Force released its report on August 23, 2006, which included a number of recommendations for increased support, accountability, and policy change. A link to the full report can be found below.
According to the report, “during calendar year 2005, Michigan’s Adult Protective Services Program through the Department of Human Services received 14,641 referrals of suspected abuse, neglect, and/or exploitation of elderly and disabled persons. Based on national statistics, the incidence of reporting is one in five for abuse, neglect, and/or exploitation. For Michigan, this translates to 73,205 residents suspected of being abused, neglected, and/or exploited. This does not take into account the number of calls received by state and local law enforcement agencies regarding elderly victims of crime.”
Governmental and community-based resources are available to provide support and assistance to vulnerable adults and professionals that work on their behalf. The primary contact when abuse and/or neglect are suspected is Adult Protective Services (APS) through the Department of Human Services. Goals of that agency are designed to provide immediate (within 24 hours) investigation and assessment, to assure adults in need of protection are living in a safe and stable environment, and to provide assistance in the least intrusive or restrictive manner possible.
Other statewide partners include Michigan Protection and Advocacy Services (MPAS), Office of Services to the Aging (OSA), Michigan Commission on Disability Concerns, and the Michigan Disability Rights Coalition. Regional resources include local Area Agency on Aging, Centers for Independent Living, and Regional Interagency Coordinating Councils. Other disability specific resources include Community Mental Health offices, Michigan Developmental Disabilities Council, ARC Michigan (formerly Association for Retarded Citizens), and United Cerebral Palsy (UCP).
Finally, remember that an important concept in working with people with disabilities and elders is autonomy and self-determination, or person-directed services. Knowledge emerging from both violence research and investigations of outcomes associated with person-directed services documents that individuals are generally best able to maintain their safety when they control their services and supports.1 In other words, it is not up to the service provider or professional to make all the decisions for the individual. This is summed up well in the mantra from the disability community: “Nothing about us without us.” Similarly, the concept of “people-first language” (i.e. referring to an individual as a person with a disability rather than a disabled person) reflects that regardless of their physical or developmental status, these individuals are people and deserve the right to make decisions that affect their lives.
If you suspect a client is a victim of domestic or sexual violence or for more information on various forms of mental or physical disabilities, refer to the resources identified below, or contact Tammy Lemmer at the Michigan Coalition Against Domestic and Sexual Violence at firstname.lastname@example.org.
1 Violence and Abuse Against People With Disabilities: Experiences, Barriers and Prevention Strategies, Laurie E. Powers, Ph.D., Mary Oschwald, Ph.D. Center on Self-Determination, Oregon Institute on Disability and Development, Oregon Health & Science University, 2004
Michigan Vulnerable Adult Hotline
Disability Resources Monthly (online resource)
Michigan Task Force on Elder Abuse Final Report
Michigan Resource Center on Domestic and Sexual Violence
Available bibliographies include:
National Coalition Against Domestic Violence
Fact Sheet: Domestic Violence and Disabilities
The National Council for Support of Disability Issues
Mission Statement: The National Council for Support of Disability Issues shall help advance public attitudes, awareness, respect, and consideration and advance the success of people with all types of disabilities.
Violence and Abuse Against People with Disabilities: Experiences, Barriers, and Prevention Strategies, Powers and Oschwald (2004)