Which type of elder abuse is seen in this case study? Who is/are victims in this case? (Mr. Barnum, Mrs. Barnum, Bob, Home Health Aide) Explain your answer. Who is the perpetrator of abuse? (The in-home caregiver, Mr. Barnum; Mrs. Barnum; Bob, the grandson; doctor prescribing the pain medications; the neighbor)

Understanding Health Insurance: A Guide to Billing and Reimbursement
14th Edition
ISBN:9781337679480
Author:GREEN
Publisher:GREEN
Chapter7: Cpt Coding
Section: Chapter Questions
Problem 11R
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Scenario

 

Mr. and Mrs. Barnum is a retired couple living in a large house in an affluent neighborhood in central Minnesota. Mr. Barnum, 86 years old, is a retired naval officer who is orderly, controlling, and very "set in his ways." He suffers from hearing loss and severe back pain for which he takes strong pain medication. Mrs. Barnum, 80 years old, always has been a housewife and caregiver for the family. After several bouts of cancer she is weak and frail. Though quite well off financially, Mr. and Mrs. Barnum have always lived a very private and isolated life with no real support network. They have had a long-standing dispute with their immediate neighbor and are suspicious of the "newcomers" on the block. No family members live nearby except their grandson Bob.

Bob is a 37 year old divorcee and always "between jobs." He is estranged from his parents and siblings. He used to occasionally stop by and do odd jobs around his grandparent’s home, but he spends most of his free time partying with his friends.

When Mr. and Mrs. Barnum’s needs increased, they hired an in-home caregiver. The caregiver quit after a few weeks, overwhelmed with the daily demands of the job. Acknowledging they again needed help, Mrs. Barnum asked Bob to move in. He was eager to save rent money and agreed although now he is responsible for grocery shopping, driving to doctor appointments (of which there are many), and some cooking and laundry. He accepted the responsibility, but quickly grew to resent it.

Bob has to raise his voice to speak to his partially deaf grandfather, who is often sleeping or seems confused and somewhat helpless. His grandmother is dependent and weak and Bob hates seeing the one family member he was close to in such decline.

Bob has little patience and often loses his temper, yelling at, humiliating, and degrading his grandparents. Mr. Barnum does nothing to stop this abuse. Mrs. Barnum then starts crying, for which Bob feels guilty. Bob is threatening to sell the house and put both grandparents in a nursing home. He has begun having loud parties at their home that go late into the night. He feels he needs to unwind and relieve his stress from the demands of care-giving.

A neighbor has called the police to report the loud parties and yelling.

Questions

  1. Which type of elder abuse is seen in this case study?
  2. Who is/are victims in this case? (Mr. Barnum, Mrs. Barnum, Bob, Home Health Aide) Explain your answer.
  3. Who is the perpetrator of abuse? (The in-home caregiver, Mr. Barnum; Mrs. Barnum; Bob, the grandson; doctor prescribing the pain medications; the neighbor)
  4. Explain the possible family dynamics in this scenario that suggest the presence of abuse? (Check the four choices)
    1. The abused elder financially depends on the abuser.
    2. The abused elder refuses to accept help.
    3. The caregiver (Bob) has a history of poor family relationships and inadequate coping skills.
    4. When raising their children, the older adults failed to agree on a parenting strategy.
  5. If you were the in-home caregiver or the neighbor and aware of this situation, would you report this case? Explain your rationale.
  6. Who would you report to?
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