Having been a police lieutenant in the States and uncovering the first elder abuse case in South Carolina involving serious neglect in 1985 which became a precedent criminal case, I have researched, investigated, consulted on, and provided education on elder abuse cases not only in the USA but also in Australia for the past 24 years. I am also the Director of the Elder Abuse Prevention Association in Australia.

Due to a horrendous and shocking series of sexual assaults in a nursing home over a six-month period in 2005 whereby four bedridden dementia female victims were repeatedly sexually assaulted, our Association brought the matter to ABC News Lateline on 20 February 2006 for broadcast to the Australian public.

As a result the Australian Federal Government enacted the Protection Bill 2007 on 1 July 2007 which makes all residential care facility staff mandatory reporters on two forms of elder abuse: sexual assault and unreasonable use of force which includes all serious forms of physical assault as well as lesser forms.

While Australia still needs to incorporate the other forms of abuse, i.e. neglect, psychological abuse, financial exploitation into the Protection Bill, the majority of facilities have incorporated zero tolerance on all forms of abuse into their internal policies - a factor which I applaud wholeheartedly.

Those residents with dementia are the MOST mistreated of all due to various reasons: a) Some cannot verbalise for themselves, b) They are not believed, c) Their family members are reticent about making a complaint, d) The families have had great difficultiy in finding an "appropriate" facility and do not wish to uproot them to an unknown facility, thus they keep quiet.

Nursing home residents are afraid to report as well as afraid of being threatened, intimidated, and/or harmed in retaliation by staff members or others. They cannot leave the facility and are subject to the various forms of daily neglects i.e. failure ot staff to change incontinence pads filled with urine in a timely manner, lack of dignity type of episodes, and subtle threats.

I hope this has added a new dimension to your discussion and please feel free to contact me at lillian@eapa.asn.au

Lillian Jeter