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2002 HSAC Forum <br />S <br />however, that increase may result in part from greater awareness by county <br />residents and staff in the health and social services departments in <br />combination with increased efforts by county staff to follow-up and <br />substantiate reports. These efforts can be considered `vigilance.' <br />Forum moderator Mel Hurston presented the morning's panelists Dr. <br />Margaret Hudson, consultant on elder abuse and neglect; Hudson Fuller, <br />associate director with the UNC School of Law, Melissa Radcliff, community <br />services coordinator for the Family Violence Prevention Center of Orange <br />County; Joyce Moore, child medical evaluation program coordinator in the <br />N.C. office of the Chief Medical Examiner; and Darrell Renfroe> health <br />department supervisor for Family Home Services . <br />Elder abuse. Dr. Margaret Hudson's first remarks were concerned with <br />differentiating between elder abuse and elder neglect. Elder abuse involves <br />the use of different types of force whereas elder neglect occurs when <br />something that should be done to help an elder meet basic needs is not being <br />done. Elder mistreatment is typically hidden because elders are often not in <br />contact with the outside world. Elders may also hide abuse out of a fear of <br />retaliation. <br />Dr. Hudson also endeavored to answer the question, "So, how do you <br />recognize mistreatment and neglect?" Many of the signs of abuse are <br />prematurely excused based on the normal results of aging. These include <br />weight loss, poor appetite, and changes in behavior, especially in the <br />presence of caregivers or family members. She said that clinicians must <br />show cultural sensitivity to the elders being served - it is important to listen <br />and to establish trust and not conclusions. <br />Abuse of the disabled. Ms. Iludson Fuller has found that persons with <br />disabilities are at an increased risk of family violence. In fact, about 80% of <br />those she served were exposed to some form of family violence. She said <br />that about 43 million Americans have one or more physical or mental <br />disabilities (speaking outside of the narrow, legal definition of disability). <br />According to Ms. Fuller, crimes against the disabled are often under reported <br />and under prosecuted. Victims may be dependent on the perpetrator or may <br />not understand that the act is a crime. They may have communications or <br />mobility issues that prevent them from reporting the crime or from making a <br />good showing on a witness stand. Reporting agencies may not understand <br />that follow-up efforts (such as letters) must match the abilities of the client <br />(i.e., literacy). <br />2 <br />