I always looked forward to my trip over the bridge to see my client, Mrs. Ford, in her skilled nursing facility in West Seattle.
Mrs. Ford had a long history of smoking before the stroke that took away most of her ability to speak and to move, so she was quite frail and had difficulty breathing. Despite the fact that she couldn't talk to me, and that she was mostly paralyzed, she was a sweet, cheerful lady, who managed to communicate a lot of meaning without being able to speak.
We worked out a system, much like "20 Questions", where I'd ask a yes-or-no question, and--based on the answer to that question--I'd choose the next question to ask. Depending on the quality of her sigh in response, I knew the answer was "yes" or "no", and then we'd proceed to the next question, until I was sure she was comfortable, securely positioned, and ready for her massage.
It was a laborious method, but it met her communication needs in the absence of her being able to speak.
Since I was so used to communicating with her in this way, I was totally blown away one day when, lying supine on the table, she grabbed my wrist in a death grip, and pulled me close to her face.
In a breathy whisper, she slowly forced her lips to form the words "Shheee's.......hurrttingg......mmmeeeee."
One of the nursing assistants had been abusing her, knowing that she was unable to defend herself.
Do you know what the laws are in the state regarding your status as a mandated reporter--one who is required to report cases of suspected abuse or neglect of a member of a vulnerable population?
Are you considered a mandated reporter?
If so, what populations are you responsible for making reports about, if you suspect that someone is being abused or neglected?
What counts as abuse? Physical? Sexual? Emotional? Financial? Neglect?
RAINN (The Rape, Abuse, and Incest National Network) provides information pages about the laws in different states.
They also provide this information:
Who Must Report?
Standard of Knowledge
Definition of Applicable Victim
Reports Made To
Contents of Report
They seem pretty good, but it would also not hurt to check them against other information sources, such as the local chapter of your professional organization, for example.
The reason I'm not sure it's right is that, for my state (Washington), it lists MTs as mandated reporters for elder abuse, but not for children.
It's not impossible that that's the way the law really reads, but I want to double-check that before assuming.
In a way, it doesn't matter, because I am not about to sit on my hands and say, oh, well, a child's being abused, but I'm not required to report it, la la la. So it won't change what I would ever do if I did learn that a child was being abused.
But on the other hand, it does seem odd that elder abuse reporting is mandated, but child abuse is not.
So for the moment, at least, I'd treat this source much as I treat Wikipedia--a good portal or jumping-off place, but not the be-all and end-all of necessary information that I depend on to get exactly right.
What happened with Mrs. Ford was this: I asked her daughter what she might be talking about, because I did not fully understand. Her daughter suspected she knew who her mother was talking about, and confirmed it with her mother.
We then went to the director of the skilled nursing facility to report it.
It turned out that this nursing assistant had a checkered track record, and was on probation. Abusing Mrs. Ford was the last straw, and the nursing assistant was let go after an investigation of the accusation.
I continued to work with Mrs. Ford for a couple of years after that, and when I returned to school, she was the only client that I kept on working with while trying to adjust to the grad school environment and the course load.
I stayed her MT until she passed away.
But except for that one time, she never tried to speak verbally to me again.
Source: National Committee for the Prevention of Elder Abuse, "Preventing Abuse to Elders" http://www.preventelderabuse.org/images/img03.jpg accessed 22 August 2012