Terms in this set (45)
knowing, intentional or negligent act that causes harm or serious risk; specificity varies from state to state
inflicting physical pain or depriving of basic need
inflicting mental pain, anguish through verbal/nonverbal acts
non-consensual sexual act
illegal taking, misuse, or concealment of funds, property, assets
refusal to provide food, shelter, health care, protection; most common type of abuse
desertion of vulnerable elder
autonomy and self determination
ability of a person to make a free and informed decision without pressure or coercion
working in someone's best interest
doing no harm; deals with negligence or failing to act
limiting the freed of another person w/ the justification that such interference prevents harm
upholding what is right, with a fair distribution of benefits
abused elderly have a significantly increased risk of:
What might be the only opportunity for detection for mistreated elders?
an unexpected visit to the emergency department! (this is b/c mistreated elders are usually in relative isolation)
Elder abuse usually consists of:
repetitive instances of misconduct
Why is elder abuse underestimated? What patient factors play a role in this underestimation?
patient fear, shame, guilt, ignorance
Effect of race on elder abuse
white/nonhispanic (66%), black (19%), hispanic (10%), other (5%)
Effect of sex on elder abuse
women are most common; however, some say, there are no differences
What are warning signs for elderly abuse?
-physical: bruises, pressure marks, broken bones, burns
-unexplained withdrawal from normal activities
-bruises around breasts/genital area
-changes in financial situations
-bedsores, poor hygiene, weight loss
-belittling, threats, power control by spouses
-strained relationships (arguments)
As a doctor, what is it important to be?
ALERT because suffering can mean silence. If you notice changes in personality or behavior, question what is going on
What makes one vulnerable to elderly abuse? (3)
-social isolation, mental impairment
-living with someone else (caregiver or friend)
-history of domestic violence
What are the 4 causes of elderly abuse?
-physical and mental impairment of the patient
-psychopathology in the abuser
Physical and mental impairment of the patient
It decreases the elder's ability to defend themselves/escape and increases vulnerability
Caregiver stress: stress factors
caring for elderly patient + stress from outside world
-alcohol or drug abuse, potential injury from falls, incontinence, elderly verbal behavior, employment problems, low income
Stress is not a cause, but a _______ for abuse
Who are the most common perpetrators/abusers?
family violence is learned behavior that is passed down from generation to generation
Psychopathology in abuser
-psychological deficiency in development of abuser (drug & alcohol addiction, personality disorders, mental retardation, dementia) --> family members with these are more likely to be caretakers b/c they are home (lack of employment)
Other risk factors for elderly abuse
1) shared living arrangements
2) dependence of abuser
3) social isolation of elder
the medical record
report cause of injury in patient's own words & physical findings
common chief complaints
multiple visits, unexpected traumas, headache, insomnia, anxiety, depression, suicidal thoughts, chest pain, GI pain, pelvic pain, back pain
confidentiality & taking the history
try to interview the patient and with the caregiver to ensure confidentiality.
What are examples of screening questions?
1) do you need help taking care of yourself?
2) what is a typical day like for you?
3) who manages your finances?
4) who gives you your medications?
What are the factors involving treatment?
Abuse cannot be assessed quickly and require variations of treatment: simple social service --> removing patient from home.
1) immediate care
2) long term assessment and care
What is the clinician's highest priority in suspected abuse cases?
balancing the safety versus the autonomy of the patient
What is ultimate goal?
provide the aging adult with a more fulfilling and enjoyable life
safety planning: 3
1) provide patient with emergency contact info
2) follow local and hospital reporting policy
3) provide temporary admission to hospital/homecare
treating the physical manifestations of abuse and assuring the safety of the patient
-admitting to hospital, court order, safe home
long term assessment and care
-assessment involves visit to the home to evaluate environment and caretaker
-after visiting the patient can you determine the services needed
removing barriers to recognizing and reporting abuse & increasing awareness
what is the key to eradicating the barriers?
education --> which will increase public and professional awareness
what is considered instrumental in the prevention of elder abuse?
increasing awareness! --> services (meals on wheels, home health care, homemaker, chore services)
who are considered mandated reporters?
doctors and home health
do states have penalties for failing to report suspected elder abuse?
yes! 30 states do. if you don't report it, it can be a harm to your licensing authority!
what is physicians role in reporting elder abuse?
we must educate ourselves about the laws and legislation for reporting abuse in our state