Geriatrics: elder abuse Flashcards

1
Q

what is the prevalence of elder abuse in the US?

A

2 million older adults in the US each year

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2
Q

screening for elder abuse?

A

AMA suggests screening geriatric patients, even in the absence of symptoms

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3
Q

Only through ________, ________ and __________are physicians able to detect elder mistreatment.”

A

awareness, a healthy suspicion and the performing of certain procedures

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4
Q

what are the two types of elder abuse?

A

domestic and institutional

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5
Q

APS: 4 requirements for Validity (of elder abuse report)

A
  1. Adult must be 60 years or older OR age 18-59 and incapacitated
  2. Adult must be living and identifiable
  3. Circumstances must allege abuse, neglect, or exploitation; and
  4. The local department must be the agency of jurisdiction.
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6
Q

6 types of elder abuse

A
Physical
Emotional
Sexual
Exploitation
Neglect
Abandonment
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7
Q

what pt population is most likely to experience elder abuse?

A

old white women living alone

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8
Q

what type of abuse accounts for the majority of reports to APS?

A

self-neglect

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9
Q

4 reasons for elder abuse

A
  1. Physical and mental impairment of the patient
  2. Caregiver stress
  3. Transgenerational violence
  4. Psychopathology in the abuser: Drug and alcohol addiction, Personality disorders, Mental retardation
    Dementia
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10
Q

two types of assessment for elder abuse

A
  1. Hwalek-Sengstock Elder Abuse Screening Test
    (H-S/EAST)
  2. Indicators of Abuse (IOA) Screen
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11
Q

Hwalek-Sengstock Elder Abuse Screening Test
(H-S/EAST)
versus
Indicators of Abuse (IOA) Screen

A

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

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12
Q

two of the biggest risk factors for elder abuse

A
  1. Cognitive impairment
  2. A need for assistance with activities of daily living (functional debility)
    * both render the pt very vulnerable
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13
Q

interviewing the pt, what questions to start with? what to follow up with?

A

Start with general questions about the patient’s sense of safety at home
Move to questions about who is responsible for helping the patient

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14
Q

three things to note on PE?

A
General appearance/interaction with alleged abusers
Size, location, and number of skin lesions
Mental status  (dementia is a risk factor for abuse)
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15
Q

lab workup, what should we look for (kinda weeds)

A

Evaluate for evidence of infection, dehydration, electrolyte abnormalities, malnutrition, improper medication administration and substance abuse.

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16
Q

who are “mandated reporters”?

A

“any person licensed, certified, or registered by health regulatory boards…”

Mandated reporters must report immediately when suspected while performing official job duties.

17
Q

what 3 things must mandated reporters report?

A
  1. Age of abused individual
  2. Identity of the adult or location of the adult about whom the report is being made
  3. Circumstances about the risk or suspected abuse, neglect and exploitation
18
Q

3 places where mandated reporters can report?

A
  1. APS Unit of your local DSS in which the adult resides or in which the abuse occurred
  2. If appropriate, to law enforcement and ME
  3. 24-hour VA DSS Adult Abuse Hotline
    1-888-83-ADULT
19
Q

3 rights of mandated reporters

A
  1. Immunity from civil and criminal liability
  2. Protection of identity
  3. Permitted to release confidential information without penalty
20
Q

what is the “main determinant of capacity” is …

A

cognition, and any condition or treatment that affects cognition may potentially impair decision-making capacity.