Elder Abuse Flashcards
Describe the term elder abuse
Any pattern of behaviour by a person or caregiver resulting in physical or mental harm to an older person
Compare and contrast the terms “elder abuse” and “elder neglect”
abuse: Implies actions taken by caregiver, relative or acquaintance causing injury or creating unmet needs
Acts of commission
neglect: Implies failure or refusal to fulfill any part of a person’s obligations or duties to an elder
Acts of omission
What is an informal caregiver?
Family member or friend whose assistance allows people to be able to live in the community.
Unpaid care provided by family and/or friends
What are the 7 categories of elder abuse?
Financial Psychological / emotional Physical Neglect Medication abuse Sexual abuse Violation of rights
Theories of Elder Abuse
- Exchange Theory or Dependency Theory
Emphasizes care recipient’s dependency on others through physical or mental impairments - Political Economic Theory
Changing roles via loss of independence and income - Situational Theory
Care recipient viewed as source of stress to abuser (caregiver)
Unrelenting responsibility of chronically ill older person may trigger abuse
Theories Cont’d
- Transgenerational (Social Learning)
Violence as learned set of behaviours passed from generation to generation - Pathologic Personality Theory
Focuses on abuser
Low tolerance for frustration, passive- aggressive, sadistic tendencies, habitual use of aggression i.e. ineffective coping patterns / marital or family conflict, substance abuser, mental illness
Primary stressors and informal caregivers
Informal Caregiver Objective Stressors: Concrete manifestations of the caregiving situation
Cognitive impairment, problematic behavior, ADL dependency and resistance
Informal Caregiver Subjective Stressors: Issues within the caregiver
Unremitting feelings of entrapment, confinement, exhaustion, depression and burnout
Secondary stressors and informal caregivers
The extent to which caregiving intrudes into non-care elements of Informal Caregiver’s life
family conflict, work conflict, financial strain, intimacy, social availability
Primary and Secondary Stressors together can result in a loss of self, loss of competence, a sense of hopelessness and depression
What are the manifestations of psychological abuse?
Covert:
Ambivalence, deference to caregiver
Passivity, denial, mild anxiety, non-responsiveness, implausible stories when compared to their physical condition
Overt:
Isolation, trembling, cowering in presence of caregiver
Confusion, anger, agitation when caregiver present
Fearfulness, depression, helplessness, hopelessness, severe anxiety, nervous breakdown
What are the manifestations of physical abuse?
Multiple injuries or fractures in various stages of healing
Bruises in clusters or in shape of objects i.e. ‘wraparound injuries’ or shape of belt buckles
Bilateral or parallel injuries i.e. control or forceful restraining/shaking
Burn marks i.e. soles of feet, palms
Sprains / dislocations
Unusual hair loss, swollen scalp, scalp hemorrhage
Manifestations of neglect
Deteriorating health i.e. cachexia, wasting Dehydration/malnutrition Pressure ulcers or contractures Excessive dirt or odor on body/clothing Urine burns Glasses, dentures, hearing aids, walking devices in poor repair, or missing Left alone or unsafe for long periods Over or under medication
Potential profiles of the abused
Abused: 65 years or older Living with relatives or informal caregiver Females Isolated, lack of social contacts Physical or mental impairments
Potential profiles of the abuser/perpetrator.
Middle aged
Poor mental health, drug ,or alcohol dependence
In same household as victim
Financially or psychologically dependent on the victim
Often Male, most often spouse ( physical abuse)
Adults abused as children 20x likely to abuse
History of aggressive episodes
Feelings of powerlessness, vulnerability, dependency
Assessing telling behaviours
Interactions
Tone of conversation
Reactions
The Nurse’s role
Education - to prevent Elder abuse
Assessment – thorough documentation
Intervention – patient safety
