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

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

vulnerability

Answer 9

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

Question 10

types

Answer 10

Abuse by intention and abuse by omission
physical
psychological
sexual
financial
neglect (most common)
slavery (lease common)
domestic
self-neglect
organisational

Question 11

presentation/RF

Answer 11

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

recurrent/unexplained injury
non-treatment/new illness
poor personal care and poverty
depression/withdrawn/fearful/anx/SI
isolation
oversedation/meds misuse
cognitive/physical impairment
fearful of carer; mentions 'punishment'
FHx violence/ quality of relationship in ast
refusal of external services
financial issues/dependent financially
conflicting stories
disability/dementia

Question 12

management

Answer 12

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

Question 13

Principles governing safeguarding

Answer 13

Empowerment
Protection
Proportionality
Partnership
Accountability