Elder Abuse/Mistreatment, Frailty, HAIs

Question 1

theories of elder mistreatment (5)

Answer 1

• situational - result of caregiver strain/stress
• psychopathology - stems from perpetrator’s own psych issues
• exchange - related to victim-perpetrator long-term relationship and dependency
• social learning - how abuse was learned
• political economy - focuses on challenges faced by older adults in society

Question 2

risk factors for elder abuse (7)

Answer 2

• functional impairment
• dependency on others
• cognitive impairment
• history of childhood trauma/abuse, substance abuse, depression, mental health disorders
• social isolation
• lack of support system
• low SES

Question 3

elder abuse perpetrator characteristics (11)

Answer 3

• family member in 80-90% of cases
• long history of conflict with victim
• living w/ victim for extended time frame
• caregiver strain/stress
• recent financial stress or job loss
• history of substance abuse, gambling issue, depression, mental health disorder
• dependency on victim
• lack of support system
• social isolation
• poor housing
• low SES

Question 4

elder mistreatment screening tools (2)

Answer 4

• Elder Assessment Instrument (EAI) - relies on objective assessment by clinician (ex. general appearance, etc.)
• Hwalek-Sengstock Elder Abuse Screening Test (HS-EAST) - self-report instrument that focuses on older history

Question 5

caregiver strain screening tool

Answer 5

Modified Caregiver Strain Index - 13 questions

Question 6

frailty definition

Answer 6

• dependence in 1 or more ADLs
• three or more co-morbid conditions
• one or more geriatric syndrome (ex. delirium, incontinence, falls, pressure ulcers, gait disturbance)
• 3 or more of the following: unplanned weight loss, weakness, poor endurance/energy, slowness, low activity

Question 7

risk factors of frailty

Answer 7

• dependency
• institutionalization, hospitalization
• falls
• injuries
• slow recovery from illness
• increased risk of mortality

Question 8

cascade iatrogenesis

Answer 8

• initial medical interventions trigger a series of complicating events; cascade of decline
• complications brought on by being in the healthcare system

Question 9

risk factors of cascade iatrogenesis (3)

Answer 9

• older
• more functional impairment
• higher acuity on admission

Question 10

common HAIs (4)

Answer 10

• CAUTI
• surgical site infection
• lungs - pneumonia, VAP, aspiration pneumonia
• CLABSI

Question 11

airborne precautions

Answer 11

• N95 mask, gown, gloves, negative airflow room, HEPA filter

- for: TB, measles, chicken pox

Question 12

droplet precautions

Answer 12

• mask, gown, gloves
• protects against droplets that can travel 3 feet
• for: influenza, mumps, pertussis, meningitis

Question 13

contact precautions

Answer 13

• gown and gloves
• for known or suspected infections transmitted by direct contact or contact with items in the environment
• for: MRSA, pediculosis, scabies, C. diff

Question 14

MRSA meds (2)

Answer 14

vancomycin, linezolid

Question 15

community-associated MRSA teaching (5)

Answer 15

• perform frequent hand hygiene
• avoid close contact with people with infectious wounds
• avoid large crowds
• avoid contaminated surfaces
• good overall hygiene