Ger 12 Elder Maltreatment Flashcards
This is an act or omission that results in harm or threatened harm to the health or welfare of an elderly person.
Elder maltreatment
This ia n act carried out with the intention of causing physical pain.
Physical abuse
True or False: in addition to slapping, trauma, pinching, and restraining, the use of overmedication or undermedication are also types of physical abuse.
True
True or False: abrasions and contusions over bony prominences, long bones, as well as vertebral fractures should be worrisome for abuse.
FALSE.
these are accidental trauma indicators
Contusions to what 6 areas are worrisome trauma indicators?
3 on head, 1 on trunk, 2 on extremities
Head- scalp, ear, mastoid area
Trunk- buttocks
Extremities- inner arms/thighs, palms/soles
Case: you’re visiting your grandmother (who is progressing with alzheimers) in her nursing home and find abrasions in her armpits, wrists, and ankles. What mode of physical abuse are u suspecting?
Restraint use
What are the 3 possible findings from punching someone in the face with glasses on?
Nasal bridge injury
Temple injury
Periorbital ecchymoses
Where do normal ulcers take place?
Lumbar/sacral areas
What type of physical injury is a common cause of death in elder abuse?
Subdural hemorrhage
True or False: restraints can be physical or chemical.
True
What is the #1 chemical restraint used?
Haloperidol
Normal disease on what 5 areas can mimic abuse?
Skin findings Bleeding Fractures Malnutrition Anogenital findings
In addition to aging and becoming more bedridden, which 3 cardiovascular anomalies can cause changing of the skin, which can mimic abuse?
Diabetes
Anemia
PVD
Many drugs like anticoagulants and chronic conditions like cirrhosis can cause what mimicker of abuse?
Bleeding
True or False: bleeding from the nose, in the brain, or from the butt are worrisome types of bleeding from abuse.
FALSE
nose could be from american gladiator battles, in the brain could be from a stroke, and from the butt could be from hemorrhoids
A ↓ bone mass from osteopenia and osteoporosis, ↓ vit D intake, and organic diseases can set up the elderly for what mimicker of abuse?
Fractures
What are the 4 common non-abusive fractures?
Femoral neck
Proximal humerus
Vertebrae
Ribs from CPR
With a ↓ metabolic rate, 25 adipose tissue, nerve and GI disorders, and meds, what change in the elderly is a mimicker of abuse?
Malnourishment and dehydration
In addition to postmenopausal bleeding and infections, what change to vaginas can occur that mimic abuse?
Uterine prolapse
Which drug can a man be using that mimics sexual abuse or contact burn?
tetracycline
So to summarize, the following atraumatic pathologies can mimic what form of abuse?
Diabetes, UTI, dehydration, vaginits, constipation, and poor wound healing.
Neglect
And the following atraumatic pathologies can mimic what form of abuse?
Senile purpura, steroid purpura, cushing syndrome purpura, drug reactions, and bleeding disorders
Contusion
The following atraumatic pathologies can mimic what form of abuse?
Fractures, bleeding disorders, subdural hemorrhage secondary to fall, contact dermititis, and allergic reactions.
Blunt force trauma
Finally, the following atraumatic pathologies can mimic what form of abuse?
Cystocele, uterine prolapse, vaginal vleeding, ↓ anal sphincter function, perineal excoriation due to incontinence, vaginitis, lichen sclerosis, constipation, and IBD.
Sexual Assault
This si the most underreported type of elder maltreatment.
Sexual abuse
What are the 4 age-related changes that increases the risk for anogenital injury in sexual abuse?
↓ estrogen, atrophy, vaginal dryness, and a thinning wall
What things can u find in the lab to catch the perp in sexual assault cases?
sperm, prostatic acid phosphate, P30 glycoprotein, and DNA
What is the most common form of elder maltreatment?
Neglect
This is the form of neglect when the cargiver intentionally fails to meet his or her obligations toward the elder.
Active neglect
If there’s active neglect, there’s passive neglect. But what is “passive” neglect?
the failure is unintentional, where the caretaker is misinformed, misinterprets Sy/Sx, or is distracted
What are findings of neglect?
Malnutrition, starvation, dehydration, poor hygiene, and untreated decubiti
What cholesterol levels are indicative of severe malnutrition?
< 160 mg/dL
What BMI is indicative of severe malnutrition?
< 21
What form of neglect is common because caretakers dont wana change the bed sheets all the time?
Dehydration
True or False: the victim of abuse is usually close to the perpetrator (family, friend, caregiver, neighbor).
True
True or False: perps usually have been abused by the victim
True
True or False: it doesnt really matter where the perp lives in relation to the victim.
False. they’re usually close.
True or False: 35% of perps have a history of mental illness and/or substance abuse
True
True or False: perps usually have a history of violence within or outside the family.
True
True or False: male victims are usually abused by their children.
False. By their wives.
even into our senile states, or wives still remain money leeches.
True or False: female victims are usually abused by their husbands.
False. By their children.
See? us men are honest and loyal. women are the devil.
Now is the stats game! not in the objectives but in the reading. Get ready for the horror.
What % of the elderly lives in nursing homes?
5-10%
What % % of nursing home residents are the elderly?
90%
What % of nursing home resident suffer from dementia, so they can’t seek help if they’re being abused?
50%
What % of nurse’s aides reported that they had committed at least 1 act of physical abuse in the preceding year?
10%
What % of aides reported committing at least 1 act of psychological abuse?
40%
What % of elder deaths are autopsied, which makes it hard to quantify how many old people are abused?
1%
By 2020, what % of the US population will be older than 65?
22%
What % of the community-dwelling elders are victims of maltreatment?
5%
What % of cases of elder abuse are ever reported?
1/13
How many cases of abuse are there for every 1000 elder americans?
8.3
