elder abuse

Question 1

physical abuse

Answer 1

-use of force resulting in physical injury or discomfort
-Striking shoving, shaking, beating, restraining, forceful feeding, sexual assault and unwarranted administration of drugs

Question 2

psychologic abuse

Answer 2

-Use of words, acts, or other means to cause emotional stress or anguish.
-Threats, insults, and harsh commands, silence and ignoring the person.
-Patronizing ageism (infantilization)

Question 3

neglect

Answer 3

failure or refusal to provide food, meds, personal care, or other necessities
-abandonment

Question 4

financial abuse

Answer 4

-exploitation of or inattention to a person’s possessions or funds.
-Swindling, pressuring a person to distribute assets, and managing a person’s money irresponsibly

Question 5

risk factors for elder abuse

Answer 5

-For the elder:
-Impairment - chronic disorders, functional impairment, cognitive impairment
-Social isolation

-For the perpetrator: Substance abuse, psychiatric disorders, a history of violence, stress, and dependence on the victim

Question 6

dx of elder abuse

Answer 6

-Delay of injury/illness and seeking of medical attention
-Disparities in pt’s and caregiver’s accounts
-Injury severity that is incompatible with the caregiver’s explanation
-Implausible or vague explanation of the injury by pt or caregiver
-Frequent visits to ED for exacerbations of a chronic disorder despite appropriate care plan and adequate resources
-Absence of caregiver when functionally impaired pt presents to physician
-Lab findings that are inconsistent with hx
-Reluctance of caregiver to accept home health care (eg, a visiting nurse) or leave pt alone with provider

Question 7

signs of abuse in each body area

Answer 7

Question 8

management of elder abuse

Answer 8

-prevention
-Interdisciplinary team
-Intervention:
-Medical assistance
-Culturally sensitive education
-Trauma-informed psychologic support
-Law enforcement and legal intervention
-Alternative housing
-Referral to services to provide basic support (such as transportation and food assistance) and reduce social isolation

-5 strategies:
-1. caregiver support interventions,
-2. MONEY management programs that provide financial management assistance for vulnerable older adults,
-3. HELPLINES where caregivers and patients can seek information about and assistance with elder mistreatment,
-4. emergency SHELTERS for victims of mistreatment to prevent additional mistreatment and allow time to plan for safe housing, and
-5. multidisciplinary TEAMS to facilitate coordination of available resources

Question 9

caregiver issues

Answer 9

-Immersed in their caregiving roles
-Socially isolated
-Lack an objective frame of reference for what constitutes normal caregiving
-Depression
-Increase in stress-related disorders
-Shrinking social network
-Prevention
-Solutions: Adult day care, respite programs, and home health care

(eg, teaching victims about abuse and available options, helping them devise safety plans)

(eg, arrest of the perpetrator, orders of protection, legal advocacy including asset protection)