New focus on sexual abuse of people with disabilities

Sexual abuse against the most vulnerable among us gained renewed focus this week. Fortunately, the tone was hopeful, not horrid.

We need only look back to 2008, when state Health Department inspectors found that young aides in an Albert Lea nursing home had abused 15 residents who had Alzheimer's and other forms of dementia. The allegations included poking one resident in the breast, placing a finger inside another, sitting on one resident's face and crawling into bed with another.

There was a moment of collective horror, then the topic dropped off the radar.

It returned in robust fashion Wednesday, as nearly 50 people who provide services to survivors of sexual violence, as well as others serving people with disabilities, gathered for a webinar, "Sexual Violence and People With Disabilities," sponsored by the Minnesota Coalition Against Sexual Assault (MNCASA).

"Your reaction matters," said presenter Nancy Fitzsimons, associate professor of social work at Minnesota State University, Mankato and co-author of a curriculum for police officers about the victimization of people with disabilities. "You may be the very first person who hears their story. Be thoughtful. Nothing will shut a person down more quickly than if your reaction is one of pity, or if the person somehow thinks he or she has done something wrong."

Working largely alone, Fitzsimons has researched abuse of people with disabilities for 14 years. "There are few people who work in this area," she said, noting that in 1994, Dick Sobsey wrote the "seminal" book, "Violence and Abuse in the Lives of People With Disabilities: The End of Silent Acceptance."

More like the end of the discussion. Few, it seemed, wanted to tackle this complex issue.

But Fitzsimons is no sky-is-falling professional. She argues for a respectful and refreshing approach that rejects many of the myths surrounding people with disabilities. A big one: All people with disabilities need others to constantly protect them.

"The word 'disability' is a really broad term, and the degree to which it impacts one's life varies greatly," she said. "Learn about the person and don't assume that everyone is vulnerable and unable to make choices for their lives. Start from a place of capability, not from a deficit."

Still, available statistics are troubling. A one-year study from 2009 by the Bureau of Justice Statistics found that rape and other forms of sexual violence are twice as likely to be committed against women with disabilities than against those without them. Males with disabilities are also victimized at a higher rate than women without disabilities.

Perpetrators, Fitzsimons said, may devalue people with disabilities, viewing them as "less than human." They may have issues of their own with impulse control or low self-esteem. As with abuse of children, power and control play a role, she and others say.

"I've heard a number of stories where the caregiver is the abuser and the victim depends on them, hour by hour," said Jeff Edleson, a professor in the School of Social Work at the University of Minnesota whose expertise is in familial abuse.

Fitzsimons has heard too many times that the victim "misunderstood" the caregiver's actions. "The literature abound with stories of not being believed," she said. "Being aware of that, a person may want to test the waters with a trusted advocate by saying, 'Somebody I know ... ' or 'I saw something on TV ... ' How you respond becomes really important."

Equally important is recognizing "huge red flags," such as torn or missing clothing, urinary pain, bite marks, frequent illness or sleep problems. One woman with an intellectual impairment kept pointing to her stomach and complaining of stomach problems. When she was given the right terminology, caregivers learned that she had been raped.

Despite such horror stories, Fitzsimons sees progress. One big shift is that such acts are finally being called what they are -- crimes. That's a boost for those with disabilities who have too often been told not to be a troublemaker, to not get angry, to not have an opinion, to not say no.

MNCASA and organizations like it, Fitzsimons said, help people "break free, so there is hope."