Geriatrics: elder abuse Flashcards
what is the prevalence of elder abuse in the US?
2 million older adults in the US each year
screening for elder abuse?
AMA suggests screening geriatric patients, even in the absence of symptoms
Only through ________, ________ and __________are physicians able to detect elder mistreatment.”
awareness, a healthy suspicion and the performing of certain procedures
what are the two types of elder abuse?
domestic and institutional
APS: 4 requirements for Validity (of elder abuse report)
- Adult must be 60 years or older OR age 18-59 and incapacitated
- Adult must be living and identifiable
- Circumstances must allege abuse, neglect, or exploitation; and
- The local department must be the agency of jurisdiction.
6 types of elder abuse
Physical Emotional Sexual Exploitation Neglect Abandonment
what pt population is most likely to experience elder abuse?
old white women living alone
what type of abuse accounts for the majority of reports to APS?
self-neglect
4 reasons for elder abuse
- Physical and mental impairment of the patient
- Caregiver stress
- Transgenerational violence
- Psychopathology in the abuser: Drug and alcohol addiction, Personality disorders, Mental retardation
Dementia
two types of assessment for elder abuse
- Hwalek-Sengstock Elder Abuse Screening Test
(H-S/EAST) - Indicators of Abuse (IOA) Screen
Hwalek-Sengstock Elder Abuse Screening Test
(H-S/EAST)
versus
Indicators of Abuse (IOA) Screen
H-S/EAST: Direct questioning of the elder person aimed at eliciting disclosure of abusive behaviors by caregivers or others
IOA: identification of risk factors
two of the biggest risk factors for elder abuse
- Cognitive impairment
- A need for assistance with activities of daily living (functional debility)
* both render the pt very vulnerable
interviewing the pt, what questions to start with? what to follow up with?
Start with general questions about the patient’s sense of safety at home
Move to questions about who is responsible for helping the patient
three things to note on PE?
General appearance/interaction with alleged abusers Size, location, and number of skin lesions Mental status (dementia is a risk factor for abuse)
lab workup, what should we look for (kinda weeds)
Evaluate for evidence of infection, dehydration, electrolyte abnormalities, malnutrition, improper medication administration and substance abuse.