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William H. Staples, PT, DHSc, DPT, GCS, CEEAA

There are a few other issues that the geriatric physical therapist needs to understand. An important factor is understanding how the payment system works, in order to get paid for what you do. Writing a case study about Medicare payment is a risk because the laws, rules, and payment schedules change often. I have done the best under the current guidelines but some of the answers may be altered by subsequent health care regulation changes. Payment for providing services is essential to being considered a professional. All entry-level physical therapy programs in the United States provide a doctoral education and therapists should expect to be paid appropriately. But it is also essential to understand how payment for services works in order to justify that payment.

Elder abuse is another important factor to understand when treating older adults. Elder abuse can affect people of all ethnic backgrounds and social status and can affect both men and women. Elder abuse is an umbrella term referring to six areas of any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult. The specificity of laws may vary from state to state, but can be classified as physical, emotional, sexual, financial, neglect, and abandonment. The types of abuse may be briefly defined in the following paragraphs. 1-4

Physical abuse, the most obviously recognized form of abuse can be defined as inflicting, or threatening to inflict, physical pain or injury on a vulnerable elder, or depriving them of a basic need. Physical abuse may include, but is not limited to, such acts of violence as striking (with or without an object), hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. In addition, inappropriate use of drugs and physical restraints, force-feeding, and physical punishment of any kind also are examples of physical abuse. 1-4

Emotional abuse is the inflicting mental pain, anguish, or distress on an elder person through verbal or nonverbal acts. Emotional/psychological abuse includes, but is not limited, to verbal assaults, insults, threats, intimidation, humiliation, and harassment. In addition, treating an older person like an infant; isolating an elderly person from his/her family, friends, or regular activities; giving an older person the “silent treatment”; and enforced social isolation are all examples of emotional/psychological abuse. 1,3,4

Sexual abuse is the nonconsensual sexual contact of any kind. Sexual contact with any person incapable of giving consent is also considered sexual abuse. It includes, but is not limited to, unwanted touching, all types of sexual assault or battery, such as rape, sodomy, coerced nudity, and sexually explicit photographing. 1,3,4

Financial abuse or exploitation ...

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