Elder Mistreatment Flashcards
What does elder mistreatment consist of?
Complex syndrome:
- Abuse
- Neglect
- Exploitation
- Abandonment
What is the definition of elder mistreatment from the Older Americans Act of 1975?
The willful infliction of pain, injury or mental anguish
What are the 4 patterns of abuse related to elder mistreatment?
- Physical
- Psychological
- Financial
- Neglect
Prevalence of elder mistreatment?
2-5%
Approx how many domestic abuse cases come to the attention of authorities?
1 in 14
Pathophys of elder mistreatment
- Transgenerational violence theory
- Dependency theory
- Psychopathology of the Abuser theory
What is the transgenerational violence theory?
Abuse is learned
What is the dependency theory of elder mistreatment?
Occurs as a result of a stressed caregiver
What is the psychopathology of the abuser theory?
The origin of elder mistreatment results as a result of the abuser who may have mental health and/or substance abuse issues
Risk factors for elder mistreatment
- Very old
- Female
- Poor mental and/or physical health
- Cognitive impairment
- Poor social support
- Low income
- History of violence
MC abuser of the elderly?
Spouses and adult children
Are sons or daughters more likely to commit elder mistreatment?
EQUAL, but one study did show daughters to be more frequent abusers (maybe take on the caregiver role more often)
Possible characteristics of the elder’s abuser?
- Dependent on victim for financial or living support
- Substance abuse disorder
- Mental health disorder
Describe abuse in nursing homes
- Less common now due to increased scrutiny, laws, and regulations
- Resident on resident abuse is far MC
- Residents (esp dementia) assault employees
MC type of elder abuse in nursing homes?
Resident on resident
also, dementia residents on employees
What nursing home characteristics may predict better care?
- Quality increases w/# of beds
- Non profit homes (money isn’t the focus)
- Increased cost of the nursing home (spending more $ for the care)
- Nurses more empathetic than aides
- Staff with more experience working with the elderly
What nursing home characteristics may predict more abuse?
- Younger and lower educated staff
- Aides (less empathetic than nurses)
Elder mistreatment in assisted living facilities?
- Unclear if mistreatment is higher
- Less regulation, staff and supervision
- More research needed
Patient presentation of elder mistreatment
- Difficult clinical challenge
- Many chronic disease symptoms can mimic abuse (fractures, depression, malnutrition)
Chronic diseases and elder mistreatment
Many chronic diseases have clinical manifestations that mimic abuse (fractures, depression, malnutrition)
What is an easy approach to assessing elder mistreatment?
Do you feel safe in your home?
What behaviors from the caregiver should raise suspicion for elder mistreatment?
- Loss of control or fears losing control
- Contradictory hx for an injury
- Projects cause of injury onto a third party
- Delay in bringing pt in for care
- Over/underreact to seriousness of situation
- Complain about other unrelated issues
- Refuse consent for procedures or tx
- Remove a pt from a facility
Management of elder mistreatment
- Ensure safety for victim (call 911 if necessary)
- Mandatory reporting (state laws, fines, etc.)
- Use your resources with careful confrontation of abuser
Why is intervention of elder mistreatment critical?
Victims are at 3-fold risk of death or nursing hime placement
