Care givers, and elder abuse

Question 1

carer epidemiology

Answer 1

1in8 people; 6.5 million, 9 million by 2037
6,000 new per day, 2m/y
58% F; peak 50-59y (20%)
3million working age, 1in5 give up work
13m >50h/week

Question 2

carer demographics

Answer 2

58% F, 20% 50-59yo
parents/in-laws 40%
partner 26%
friend/neighbour 9%
grandparents 4%
other relatives 7%

Question 3

Carer health impact

Answer 3

2x risk of permanent illness/disability
625000 direct physical/mental issues
83% neg physical, 87% neg mental
40% delay own treatments
longer care duration increases risk

Question 4

carer Social burden

Answer 4

isolation, relationships, asking for help
37% no support
29% family but no SS support
40% no break in 18 months, no holiday in 5 years

Question 5

carer financial burden

Answer 5

reduced/stopped work
benefits insufficient
lose up to £30,000 income
74% bills, 78% home repairs, 52% reducing food, 32% rent/mortgage issues

Question 6

carer legal issues

Answer 6

autonomy, capacity, harm

Question 7

carer services

Answer 7

listen and involve in decisions
direct to support services
social services
carers allowance
care packages from employers

Question 8

Elder abuse epidemiology

Answer 8

4% prevalence (342000 per year)
5% verbal abuse
2% physical abuse
2% financial abuse
2.1% of men, 5.4% of women in past year

34% psychological, 20% financial, 19% physical, 12% neglect, 3% sexual

35% partner, 33% family, 9% home help, 3% friend, 33% neighbours
can be institutions

Question 9

background

Answer 9

vulnerable (cognition, dependence, trust)
family common
safeguarding issues and needs

Question 10

vulnerability

Answer 10

cognition e.g. dementia (5% >65y, 20% >80y)
refuge centres not accessible or suitable
reluctance to incarcerate older perpetrators

Question 11

types

Answer 11

physical
psychological
sexual
financial
neglect
slavery
domestic
self-neglect
organisational

Question 12

presentation/RF

Answer 12

typical victim: >75y, F, Fx, no role, lone, at home, adult child

recurrent/unexplained injury
non-treatment/new illness
poor personal care
depression/withdrawn/fearful/anx/SI
isolation
oversedation/meds misuse
cognitive/physical impairment
fearful of carer; mentions 'punishment'
FHx violence
refusal of external services
financial issues/dependent financially
conflicting stories, hostility
'physician shopping'

Question 13

management

Answer 13

MDT approach incl. SW, police, psych, safe-guarding
documentation
contact safeguarding
safe environment, supportive, calm and empathetic