Elder Mistreatment Flashcards
Elder Abuse includes…
Psychological harm Sexual abuse Financial exploitation \+/- Neglect Infliction of physical pain/injury Infliction of mental suffering/anguish Isolation Deprivation Unreasonable confinement Abandonment Inappropriate use of medication and/or restraints in the institutional setting
What is the true prevalence of elder abuse?
It is unknown
How many cases of reported elderly abuse involve women?
2/3rds
How many elderly people experience maltreatment annually?
820,000-1.9 mil
How many injuries in domestic violence involves head/neck?
75%
What is the most common form of abuse?
Neglect
What is the second and third most common form of abuse?
#2: physical abuse #3: financial exploitation
Verbal abuse is more common than physical abuse.
True/False
True
What are some causes of elder mistreatment?
Social Isolation(subject & trusted other)
Dementia
Mental illness, hostility, EtOH/substance abuse
Shared living arrangement
Abuser dependency
If the caretaker experienced child abuse then it is likely that the caretaker will abuse the elder.
True/False
True
What was once thought to be a major cause and predictor of elder abuse?
Caregiver stress
Describe caregiver stress.
Frail elders are difficult to care for and this leads to caregiver stress. This stress may lead to an abusive caregiver
Who are the main perpetrators in elderly abuse?
Adult children (40%)
Who are the second and third perpetrators of elderly abuse?
2: Spouse #3 grandchildren
What are risk factors for abusive or inadequate caregiving?
- Cognitive impairment in pt and/or caregiver
- Excessive dependency of the caregiver on the elderly or of the elder on the caregiver
- family conflict or FH of
- abusive behavior
- EtOH or drug misuse
- Mental illness
- mental retardation - Financial stress
- Isolation of the pt and/or caregiver
- Living arrangements inadequate for the needs of the pt
- Stressful events in the family
- death of a loved one
- loss of employment
You are to interview the older person and the caregiver separately and privately .
True/ False
True
What is the initial question who should be asked during a history with an elderly patient?
Do you feel safe at home?
If the initial response suggests elderly abuse, which follow-up questions should be asked?
“Is there any difficult behavior in your family you would like to tell me about?”
“Has anyone tried to hurt or hit you?”
“Has anyone made you do things that you did not want to do?”
“Has anyone taken your things?”
What are some general signs of possible elderly abuse?
Clothing: inappropriate, soiled, or in disrepair
Poor hygiene
Deficient nutritional status
Compromised skin integrity
What are some signs and symptoms of physical abuse?
Anxiety or nervousness in presence of caregiver
Excessive deference to the caregiver
Bruises or welts in various healing stages, especially bilateral or on inner arms or thighs
Fractures, especially in various healing stages
Cigarette, rope, chain, or chemical burns
Lacerations and abrasions on face, lips, or eyes
Pressure ulcers
Unexplained bruises, long bone fractures
Subdural hematomas
What are some signs and symptoms of psychcological abuse?
Impatience, irritability, or demeaning statements of caregiver
Ambivalence of patient to caregiver, or high levels of anxiety, fearfulness, or anger
Unexpected depression or withdrawal
Lack of adherence to treatment regimen or frequently canceled appointments
Frequent requests for sedating medication
What are some possible signs and symptoms of neglect?
Contractures: limbs are locked into place(they are not moved frequently)
Dehydration or malnutrition
Depression
Diarrhea, fecal impaction, or urine burns
Failure to respond to obvious disease
Medication use that is inadequate, excessive, or otherwise inappropriate
Pressure ulcers
Repeated falls
Repeated hospital admissions
Statements about neglect by the patient
What are some possible signs of financial exploitation?
Recent marked disparity between patient’s living conditions or appearance and his/her assets
Inability of patient to account for money and property, or to pay for essential care
Reports of demands for money or goods in exchange for caregiving or services
Unexplained loss of Social Security/pension checks
Statements about exploitation by the patient
What are some possible signs of abandonment?
Evidence that patient is left alone without adequate arrangements for care
Evidence of sudden withdrawal of care by caregiver
Statements about abandonment by the patient
