Elder Mistreatment

Question 1

Elder Abuse includes…

Answer 1

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

Question 2

What is the true prevalence of elder abuse?

Answer 2

It is unknown

Question 3

How many cases of reported elderly abuse involve women?

Answer 3

2/3rds

Question 4

How many elderly people experience maltreatment annually?

Answer 4

820,000-1.9 mil

Question 5

How many injuries in domestic violence involves head/neck?

Answer 5

75%

Question 6

What is the most common form of abuse?

Answer 6

Neglect

Question 7

What is the second and third most common form of abuse?

Answer 7

#2: physical abuse
#3: financial exploitation

Question 8

Verbal abuse is more common than physical abuse.

True/False

Answer 8

True

Question 9

What are some causes of elder mistreatment?

Answer 9

Social Isolation(subject & trusted other)

Dementia

Mental illness, hostility, EtOH/substance abuse

Shared living arrangement
Abuser dependency

Question 10

If the caretaker experienced child abuse then it is likely that the caretaker will abuse the elder.

True/False

Answer 10

True

Question 11

What was once thought to be a major cause and predictor of elder abuse?

Answer 11

Caregiver stress

Question 12

Describe caregiver stress.

Answer 12

Frail elders are difficult to care for and this leads to caregiver stress. This stress may lead to an abusive caregiver

Question 13

Who are the main perpetrators in elderly abuse?

Answer 13

Adult children (40%)

Question 14

Who are the second and third perpetrators of elderly abuse?

Answer 14

2: Spouse #3 grandchildren

Question 15

What are risk factors for abusive or inadequate caregiving?

Answer 15

1. Cognitive impairment in pt and/or caregiver
2. Excessive dependency of the caregiver on the elderly or of the elder on the caregiver
3. family conflict or FH of
   - abusive behavior
   - EtOH or drug misuse
   - Mental illness
   - mental retardation
4. Financial stress
5. Isolation of the pt and/or caregiver
6. Living arrangements inadequate for the needs of the pt
7. Stressful events in the family
   - death of a loved one
   - loss of employment

Question 16

You are to interview the older person and the caregiver separately and privately .

True/ False

Answer 16

True

Question 17

What is the initial question who should be asked during a history with an elderly patient?

Answer 17

Do you feel safe at home?

Question 18

If the initial response suggests elderly abuse, which follow-up questions should be asked?

Answer 18

“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?”

Question 19

What are some general signs of possible elderly abuse?

Answer 19

Clothing: inappropriate, soiled, or in disrepair

Poor hygiene

Deficient nutritional status

Compromised skin integrity

Question 20

What are some signs and symptoms of physical abuse?

Answer 20

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

Question 21

What are some signs and symptoms of psychcological abuse?

Answer 21

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

Question 22

What are some possible signs and symptoms of neglect?

Answer 22

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

Question 23

What are some possible signs of financial exploitation?

Answer 23

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

Question 24

What are some possible signs of abandonment?

Answer 24

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