Elder Abuse Flashcards
What is the definition of elder abuse?
A single, or repeated act, or a lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person
What are the types of elder abuse?
Psychological
Financial
Neglect
Physical
Sexual
Self-Neglect
Abandonment
What are clinical manifestations of elder abuse?
- Poorly explained or unusual locations of abrasions, lacerations, bruises, burns
- Spiral fractures of long bones, fractures at site other than wrist, hip or vertebrae in non alcoholic older person
- Malnutrition, dehydration
- Pressure ulcers
- STIs
- Pain in oral or anal-genital region
- Vaginal rectal bleeding
- Anxiety, fearfulness, withdrawal, social isolation
- Poor hygiene, nails
- Delay between injury and medical attention
- Doctor shopping
- Conflicting stories
What is the prevalence of elder abuse in community setting in Canada?
10%
What are reasons for under reporting of elder abuse?
- Reluctance to acknowledge
- HCP limited knowledge
- Lack of protocols
- Fear of liability
- Small number of support services
- Fear of retaliation
- Dependence for food, shelter, clothing, healthcare
- Inability to communicate
Risk factors for elder abuse in the patient
- Cognitive impairment
- Behavioural problems
- Psychiatric illness
- Functional dependence
- Poor physical health/frailty
- Low income
- Trauma or past abuse
- Ethnicity
Risk factors for abuse in the perpetrator
- Caregiver burden or stress
- Psychiatric illness
- Conflictual relationships
- Low social support
- Living with others
- Low SES
- Hx of trauma/abuse
- Substance abuse
- Financial dependence on older adult
What are protective factors for elder abuse?
- Social support
- Age >85
- Lower education
- Single
- Living alone
- Female
What are some consequences of elder abuse?
Premature mortality
Depression
Cognitive decline
Financial problems
Nursing home
What screening tool can you use for elder abuse?
Elder Abuse Suspicion Index
Lack of studies so not really recommended however
- Have you relied on people for any of: bathing, dressing, meals, shopping or banking?
- Has anyone prevented you from getting food, clothes, medication, glasses, HA or medical care or from being with people you wanted to be with?
- Have you been upset because someone talked to you in a way that made you feel shamed or threatened?
- Has anyone tried to force you to sign papers or to use your money against your will?
- Has anyone made you afraid, touched you in a ways that you did not want or hurt you physically?
What are some preventative measures for elder abuse?
Multidisciplinary teams
Caregiver interventions to relieve burden
Money management programs
Helplines and emergency shelters
Raising public awareness
What are the reporting guidelines for elder abuse?
Mandatory for LTC or RH
Everyone is responsible for reporting
What is the definition of ageism?
Stereotyping, prejudice and discrimination against people on the basis of their age
What is systemic/institutional abuse of elders? What are a few examples of this?
Rules that are made for an apparently neutral purpose but hurt the individual
- Physical restraints to prevent falls
- Diapering patient instead of helping them to bathroom
- Not allowing visitors/caregivers at bedside
Define self-neglect
Behaviour of an elderly person that threatens their own health and safety
Refusal or failure to provide themselves with adequate food, clothing, shelter, hygiene, medication and safety
Management flow chart for elder abuse
How would you develop a policy for elder abuse in LTC?
