to discuss but for which we have a number of practical pieces of advice and that is abuse of our senior citizens before becoming district attorney i spent a number of years as the chief of our elder and disabled protection unit investigating and prosecuting these cases and in addition to handling the cases i had the opportunity to develop a number of community based programs for prevention and intervention and we did that using some traditional and nontraditional community partners our health care providers our protective service workers our hospitals and also private providers in the community so the reality is that when we think about the good news that we have a very large baby boomer generation that's aging as well as the advances in medicine that are allowing people to live longer and healthier lives in the fact that we are also able with various services to allow many more people to age in place in their communities which is all good news the other side of that is we are beginning to see demographic shifts that show us that the senior is in those are people massachusetts over the age of sixty are becoming a larger and larger part of our population and for a number of reasons we're going to talk about today they may often fall victim to various kinds of abuse whether it be from family members care providers or strangers and today we're going to talk about that this problem with the input from some experts in various parts of the community all of whom are partnering with my office and some of the programs that we have going in this area and i'm very pleased to introduce on my left haley gleason who is a searcher from the gerontology institute at u mass boston to her left rene presta the protective services manager at minot me and senior services agencies and how they will start with you if you could tell us from minute what the gerontology institute is doing and you miss sure we actually are involved in a number of projects at the moment but it all really focuses on what you were talking about the aging of our population looking both at the state level but also at the local level so a couple of our programs that were working on right now the first is something called the toughs healthy aging data report and that was a collaboration that us boston and the gerontology institute was part of and what we did is we looked at again both state level as well as city level and town level healthy aging indicators and what we wanted to do with give the information to individuals in those communities to be able to make changes to better improve the community improve the health of their population as people are aging in place another program that project that we're working on is called community needs assessments so we have been partnering with councils on aging again at the local level and working with them to plan for the future of their aging population and what we do is use a number of different methods including focus groups interviews a sample survey and we start to look at what are the current needs of the seniors in the community as well as the future needs and then we provide that information back to the community so they can begin to plan for what what is it going to look like in the future and how can the programs and services be changed or updated to be able to provide what people need to stay in the community and just in population in massachusetts currently or as of two thousand and ten census there were fourteen percent of this population over sixty five fourteen percent of the population was over the age of sixty five two percent of those were over eighty five what we're seeing is that projections show that in twenty twenty that number's going to raise to seventeen percent over the age of sixty five and it's going to increase to twenty one percent in twenty thirty what that means is one out of every five people in massachusetts are going to be over the age of sixty five that is an enormous growth that's going to really meet going to make us look at every aspect of our communities to be able to serve these older adults it was interesting for us in middlesex county is that the ten cities across the state with the largest elder population five of those are within middlesex county so this is a particular issue for us and renee in terms of minuteman tell us a little bit just about minute man in the protective service programs all minuteman senior services is one of the states and designated aging service access points we cover sixteen cities and towns particularly in massachusetts and we help seniors stay in their home for as long as possible as safe as possible but we also try and work with the caregivers also to offer them support and see what we can do to help them out protective services particularly we investigate elder abuse of people over the age of sixty in our sixteen cities and towns every city and state in massachusetts does have a particular agency that you know does the same and you know specifically elder abuse that we investigate has to do and interpersonal relationships so there needs to be you know a loved one a spouse child family member friends that has a real interpersonal relationship with this person and besides the protective services department we offer our state home care services caregiver support services nutrition with meals on wheels we have a shine department that helps with the health benefits and so we do a range of things just to try and see what we can do to keep people at home  also protect one of our protective services workers for the past eight or so years has been running a group for women in difficult relationships and they meet once a month so that she helps them it's a support group for anyone over the age of sixty you don't have to be a minute me in service area to attend and really to majority of them that come are still living with their spouse but have grown and moved on and still come to the group for those supports consistent with what we talked about in terms of the numbers of aging population have you seen and i know we talked a little bit before about this the numbers that increase in the demand for your services tell us about that yet in protective services particularly intakes over sixty of them screened into a protective service worker which means we did an investigation of possible alleged elder abuse so that's a very significant increase it is a huge significant increase and actually just in the past couple years or so protective services team with a mini and has grown when i started eight years ago we were smaller team of about five workers in our nine workers and that was just within the last year we've added just two more workers just because of th privately owned company family owned and we service several communities in the middlesex area for all of the nine one one work so if you think if you call nine one in certain communities you know you'll see armstrong emails you know working with the fire department b l s as a partner and some communities where we do the whole system itself the us and the b l s are paramedic and e m t s so what that that's our emergency side we also operate in an emergency side where we transport  patients to and from hospitals from their homes to the hospital or to whatever medical appointments they need to get to and we also work with a lot of the v n a's and as well as senior centers and assist the limits so we see the patient at all levels and critical times and just transportation needs but what we get to see is their home or in their house a lot we see them a lot this is where you go there that say that we see the patients more than their primary care physicians so we really  value when we get to the emergency room we get to the physician's office or whomever we're dealing with from the health care side and we can describe a better picture of what the home which like and you know i always say we're sort of that sentinel eye that we can really paint a very good picture of what t host looks like and is there a need for the patient housed as well as when they mention that relationship so who else you see at the house right who's interacting with was providing care that's sort of a now you're seeing the same kind of increase in terms of demand for your services yes so coming into this episode here we ran some dater and when you do a four year look back the data of tripping falls on elderly greater than sixty five it's significant it is a significant shift for us and again we ran another data that we transported people that we had a couple over one hundred we had our oldest patient was one hundred eight years old last year and we see a significant shift in men then we measured the trip in falls and we see a research side but maybe don't you know the general population doesn't realize is that falls are very common among older adults about one out of three older adults people over sixty five fall each year and that risk increases as people age and so in two thousand and ten fourteen percent of massachusetts adults over the age of sixty five reported at least one fall in the past three months so falls are happening very frequently and i think another thing that people don't realize is that falls of the leaves a leading cause of injury death for older adults for those over sixty five and so it's not just the fall it's the fact that the fall can cause significant injury to the older adult and every time an older adult falls there their their likelihood of falling again goes up two to three times so if someone falls one time they're just that much more likely to fall again and then have an injury from the fall so falls are really a serious concern for older adults and not just the fall i would expect but you go to the hospital you may have surgery you would personal risk there's a recovery period  what the connection can be a scenario between a fall and abuse sure protective services we investigate six types of abuse there's the physical abuse there's the non accidental the act of actually physically pushing kicking tripping that can result in a fall there's the emotional abuse the name calling the swearing a lot of times falls can come from someone just being so stressed high anxiety you know they're walking around their house you know on eggshells with this person and they're not really just focused on what's around them we have caretaker neglect which is the refusal of a caregiver to provide one of more than elders essential needs and in that case it could be that the family member who are the caretaker is refusing to give another of their important medications that may have some side effects of side effects of dizziness that can relate to the falls self neglect self neglecting care to going back to the kind of use interchangeably where it's the older who's refusing so it similarly with caretaker neglect the refusing of the medications we're seeing more and more clutter and hoarding cases so they're having  tripper falls over items limited pathways you know things like that and we also investigate financial exploitation and sexual abuse but other you know falls have been just kind of in the realm of them is you know a senior may be trying to get away from someone who is abusing them and have a fall there is that while i felt that maybe they didn't really fall they're just using that as an excuse for some other injury there's just you know we are seeing a lot more falls happen also seniors in our caregivers are also refusing to use their canes their walkers their furniture walking or using the walls to get by which is resulting involves you know we go into a case where it could be something totally different and then we're seeing a history of long history of falls or a lot of our reports to specifically say and then that recall history history of falls so they're being isolated to certain areas of the house where they're not have stairs and that's another form of abuse so it's just it's increasing and as you mentioned earlier the falls are relating to going to the hospital you know having surgery in rehab for longer periods of time and they're coming home and if they're coming home to a house where the alleged abuser is or th at house is hoarded again it's just a cycle there which approach how much was the percentage of calls that you would say to a senior that are involving some type of fall so it looks to from our stats over sixty five years old that patient population greater than sixty five on our typical men one call volume it's in the fifteen to less than twenty percent of the calls are from the trip falls are we also do a lot of  we see a lot of hep's and that's also from the ice but you know we also see them overstretching to to whatever may be in the fall and in the kitchen are you know wherever you know the other comm one is the bathroom they'll always fall in the bathroom from what floor on the the mat not being down properly and they'll fall and those tight spaces and it really it's tricky to get him out of those type of spots and you know it's you can tell right away that the that the hip is is either broken are dislocated and it makes for a long extrication and a lot of rehab to a long recovery now recognizing that connection between falls and the possibility  obvious reached out to you last year and as a result we put together the middlesex senior health and safety right initiative we launched it last june at the your office and there's two components to that program the training  mts as well as the file of life program let's talk a little bit about that training aspect can you tell us about that and how it was received by the members of your staff so the training was sort of twofold where we talked about trip fall has its and  of like i said we're at satellite so size up the scene and figure out ok you know trip patients saying that they tripped and fell but does the laceration does the injury also go along with with the story and sometimes we look at that sometimes we don't but i think now more and more that we are training that orientation to be aware of that and when we are aware of it they are noted and the trip report they're reporting that to the hospital and a lot of times if they're not too sure what to do now we have  ability to call your office and say something just doesn't seem right here do you mind talking to us about that so it's really helped us a whole lot to understand that trip and fall might not always be triple falls and i think one of the ones i remember from the lecture was is there an overbearing person in the house with them making sure that they don't answer the questions or perkily are there they're trying to answer the question for the patient that should put the antenna up that there's probably something going wrong there so the lecture that part of it was was really well for me and m in and some of the other protective service agencies have helped us with that in terms of just a learning people to another resource and for folks that i'm familiar with calling something like protective services people are able to call just talk through an issue is that right absolutely you can call any of your local protective service agency if you don't know it you can call the if the person doesn't live in your city or town you don't know if that's agency you can call them will connect you but you can call  anonymously you don't have to give the name of the elder of yourself and just run the situation by and a supervisor in the protective service team can tell you it's reportable this is you know how we do our investigation this is what we do or we can just always give you advice enough of your services and you know giving give you a resource is that stated like there which another part of the program that we talked about was the file of like many people have seen these file of life cards that type of cards that go on the refrigerator that are helpful to the first responders in terms of just quickly being able to grab and go contains the seniors medical history as well as contact information and one new aspect of this program was the wallet size card so if a person should sustain a fall outside of the home they could have this on their person makes it easy to climb techs i went in to know who their primary care doctor is and what their history is and tell us a little bit about some of the other pieces that we put in place with terms of armstrong in terms of having people h with your office what we want to do is is give them a simple phone number that they can call either fed for whatever the community is that they can call into the senior center and they can request someone to come by and help fill out that that form then paramedic side of it so that will go into our database and when that address comes up then we can say ok we know there's a file of life in the home that will cue the paramedics to walk into the home and look on the refrigerator f twenty plus year paramedic that makes along a lot of different for patient care if they can't talk to the medication list that can give us sort of a picture of what this could potentially be as a cardiac as a respiratory whatever it may be and the big one is  treat some unconscious patient if we're going to give medication they're allergic to it it could be like me so having access to that is great and especially in today's health care also listed on there will be what the silly to go to so we're transporting them to the correct facility and we're not you know increasing health care costs by bringing into iraq with saudi and having to move all the records or move the patient again so the files life really is great from the nine one one between the he a mouse the fi mouse and working with the police as well it really helps us do our job better for the patients and for those watching at home we're going to give you a number at the end of the show that will give you give you a place to call to feel yourself the file of life cards as well as information about help in filling them out and if they live in the community served by armstrong registering that information with armstrong and just talk just a little bit which about just the practical pieces in terms of you know where in the winter falls of all common life so he was healthy as could be up until this trip at eighty years old that trip and fall really was catastrophic so we really look at this and sort of take it personally and we want to do what we can to help out but we've gone to different have ice around don't even try to walk on ice it's not worth it and then the walkers you want to make sure that there is some sort of a glide on it they have new guides on it or tennis balls but always be very cautious pick it up and the r a protective services standpoint you know get checked out you know it could just be a quick you know e r visit but it could be something more and we get a lot of reports of seniors who have falls we go in there they're refusing medical and they end up with broken bones or bruises or something that needs physical therapy or occupational therapy or something like that if you don't have anybody to shovel your snow outside you can call us we can try and find we often work at local senior centers who are volunteers or can find maybe a neighbor who can help out we have a lot of seniors who feel like they're still independent and will go outside and shovel and we're not here to tell them to lose their independence we just want to help them stay in their home longer so  yeah just get medically checked out and ask for help it's not you're not going to lose your independence for asking for some help and we do get a lot of the throw rug the electrical cords the clutter the clutter and a senior has a right to you know live how they want to live you know what if we can give them some advice you know because it could be that one fall that you break your help you break both hips and it could cause you to net not go back home and fortune i really enjoyed this conversation this morning and want to thank our guests for being with us today and i want to be clear that is district attorney one of my goals is really to protect that greatest generation to both put together the community based partnerships that are aimed at prevention to use the research looking at where we need to be addressing issues and then when we ha instances where people are suffering in their own home to really aggressively work with protective services and the police departments to investigate and prosecute those cases so i want to thank you we're going to be offering the information at the end of the show about violent life