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Geriatrics 1 > Elderly Mistreatment > Flashcards

Elderly Mistreatment Flashcards

1
Q

Estimated that __-__% of elderly are abused yearly

A

5-10 (probably underestimated)

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2
Q

It’s estimated that up to ___% of cases of elderly mistreatment go unreported

A

80

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3
Q

_______ is defined as Intentional act, or failure to act, by a caregiver or another person in a relationship involving an expectation of trust that causes of creates a risk of harm to an older adult

A

Elder abuse

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4
Q

Example of elder abuse

A

Withholding food, water, medications

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5
Q

How do EM and self-neglect impact the risk of death?

A

Elevate it (independent of chronic illness, functional status, etc.)

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6
Q

Screening for EM is done as apart of an initial nursing assessment in what healthcare setting?

A

ED

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7
Q

Risk factors for EM

A
  • Cognitive impairment of patient or caregiver
  • Excessive dependency (caregiver on pt. or pt. on caregiver)
  • Family conflict
  • FH of abusive behavior, alcohol or drug misuse, mental illness, cognitive impairment
  • Financial stress
  • Isolation of pt. or caregiver
  • Inadequate living arrangements
  • Stressful events (e.g. death, loss of employment)
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8
Q

90% of abusers are

A

Family members

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9
Q

About half of abusers are the patient’s

A

Children (~47%)

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10
Q

Interview patient & caregiver

A

Separately & privately

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11
Q

What are the two EM screening tools?

A

EASI (FP clinic)

H-S/EAST (ER or OP clinic)

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12
Q

Types of abuse

A
  • Physical
  • Psychological/emotional
  • Sexual
  • Medical
  • Financial
  • Rights violation (speech, privacy, restraints, choice of physician)
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13
Q

Most common type of abuse

A

Self-neglect

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14
Q

Examples of self-neglect

A
  • Hoarder
  • Uncleanliness (refusal to bathe)
  • Noncompliance with med regimen
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15
Q

Second most common type of abuse

A

Neglect

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16
Q

Most common physical sign of abuse

A

Bruising

17
Q

Characteristics of suspicious bruises

A
  • Various stages of healing

- Location: inner thigh, bilateral or inner arms

18
Q

Signs & sx of physical abuse

A
  • Anxiety or nervousness in presence of caregiver
  • Deference to caregiver
  • Fractures
  • Burns (cigarette, chemical)
  • Lacerations (face, lip, eyes)
  • Head injuries
  • Genital abnl discharge, injury
  • Delay in seeking treatment, inconsistent f/u, consistently switching HCP
19
Q

Signs & sx of psychological abuse

A
  • Impatience, demeaning statements by caregiver
  • Ambivalence of pt. to caregiver or anger
  • Unexpected depression or withdrawal
  • Lack of adhere to treatment regimens or frequently cancelled appointments
  • Frequent request for sedative meds
20
Q

_______ is defined as intentional or unintentional withholding of food, medication, or other necessity resulting in the older person’s failure to thrive

A

Neglect

21
Q

S&S of neglect

A
  • Contractures
  • Dehydration/malnutrition
  • Depression
  • Diarrhea, fecal impaction, urine burns
  • Failure to respond to obvious disease
  • Inappropriate medication use
  • Pressure ulcers
  • Repeated falls
  • Repeated hospital admissions
22
Q

Signs of financial exploitation

A
  • Disparity of pt living conditions & apparent assets
  • Poor accounting of money and property
  • Demands for money or goods in exchange for care
  • Unexplained loss of social security/pension
23
Q

Signs of abandonment

A
  • Pt. is left alone without adequate arrangements for care

- Sudden withdrawal of care by caregiver

24
Q

How do we manage self-neglect

A
  • Assess pt. understanding of consequences

- HCP MUST honor the pt. right to autonomy and self-determination

25
Q

Causes of institutional mistreatment

A

Aggravated by

  • Poor working conditions
  • Low salaries
  • Inadequate staff training and supervision
  • Prejudiced attitudes
  • Behavior by the older adult
26
Q

Who is responsible for investigations, balancing the rights of staff with the rights of patients?

A

State departments of health

27
Q

Sometimes the older adult serves as a _____ for EM

A

Trigger (the relationship may be mutual abusive)

28
Q

Factors governing the course of action

A
  • The nature & degree of EM

- The ability or willingness of the pt. AND caregiver to cooperate

29
Q

_______ are required to assess & report suspected EM

A

Clinicians

30
Q

Barriers to reporting EM

A
  • Cognitive impairment
  • Fear of violence/retaliation
  • Embarrassment
  • Fear of placement > fear of abuse
  • Family/ friends may not be aware of situation/how to recognize it
  • “Not my business”
  • Do not want to cause trouble
  • Fear of retaliation
  • Belief that their actions will not make things better

Geriatrics 1 (8 decks)

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