Elder mistreatment

Question 1

what are the 4 patterns of abuse?

Answer 1

Physical, Psychological, Financial, and Neglect

Question 2

what is elder mistreatment

Answer 2

Complex syndrome including actions such as abuse, neglect, exploitation, and abandonment of an older person

Question 3

Epidemiology of elder mistreatment

Answer 3

Prevalence is in the 2%-5% range
Estimated that only 1 in 14 domestic abuse cases comes to the attention of authorities
Elder mistreatment crosses all ethnic and socioeconomic boundaries

Question 4

3 main theories of elder mistreatment

Answer 4

Transgenerational Violence Theory-Abuse is learned
Dependency Theory-Stressed Caregiver
Psychopathology of the Abuser Theory

Question 5

risk factors for elder mistreatment?

Answer 5

Very Old
Female
Poor mental and/or physical health
Cognitive impairment
Poor social support
Low income
Hx of violence

Question 6

What are some characteristics of abusers?

Answer 6

Spouses and Adult Children are the most common perps
Sons and daughters equally implicated
Dependent on victim for financial or living support
Substance Abuse
Mental Health Conditions

Question 7

3 facts about abuse in nursing homes?

Answer 7

Less common now due to increased scrutiny, laws, and regulations
Resident on resident abuse far more common
Residents assaulting employees

Question 8

characteristics that may predict abuse in the nursing home setting

Answer 8

Quality of care increases with # of beds
Non profit homes superior to for profit
Increased nursing home costs=better care
Nurses/aides with lower levels of education tend to be more abusive
Younger staff =increased negative attitudes toward the elderly
Nurses more empathetic than aides

Question 9

What are some behaviors from caregivers that should raise suspicion

Answer 9

Loss of control or fears losing control
Presents a contradictory hx that does not explain injury
Project cause of injury onto a third party
Delay in bringing pt in for care
Over/underreact to seriousness of situation
Complain about other issues unrelated to the injury
Refuse consent for procedures or tx
Remove a pt from a facility

Question 10

Management for elder mistreatment?

Answer 10

ensure safety for the victim
report the suspected abuse
order a home visit
support group
home health care/nursing home

Question 11

What is Intimate Partner Violence

Answer 11

Intentional controlling behavior consisting of physical, sexual, or psychological assaults in the content of an intimate relationship

Question 12

epidemiology for intimate partner violence

Answer 12

silent epidemic
28% of couples reported violence at some point in their relationship
4% of women reported severe violence
Pregnancy may double risk 
10% detection rate

Question 13

Red flags that may point to intimate partner violence

Answer 13

Delay in seeking care
Illogical explanation of injury
Black eyes are not caused by a door knob
depression/anxiety
multiple somatic complaints
pregnancy
substance abuse
overbearing partner

Question 14

What are some things found on physical exam

Answer 14

Injuries tend to occur to the center of the body
Head, neck, chest, abdomen, breasts
Injury to upper arms from fending off attacks
Bruises, lacerations, burns, bites, fractures
Injuries at different stages of healing

Question 15

5 basic tasks for treatment of intimate partner violence

Answer 15

Validate the problem
Assess patient safety
Document clearly and completely
Provide information and appropriate referrals
Reporting requirements

Question 16

what are some provider barriers to intimate partner violence

Answer 16

Lack of provider training
Lack of institutional support
Lack of time
Provider discomfort

Question 17

what are 5 patient barriers to intimate partner violence

Answer 17

Fear
Economic
Psychological
Social Support
Lack of options