Recognizing Elder Abuse Flashcards
what is elder abuse
single or repeated act or lack of appropriate action, occurring w/i relationship in which there is an expectation of trust, that causes harm or distress to older people
what is a limitation with screening for elder abuse
no gold standard screening tool
what are the 6 main risk factors for elder abuse
- functional dependence
- cog impairment
- financial vulnerability
- advanced age
- female
- racial/ethnic minorities
what are some examples of psych/emotional abuse
threatening to place in nursing home
ridiculing (ie for incontinence)
disrespect (ie treat like child assuming lack of understanding)
bullying
what are some indicators of psychological abuse
individual becomes uncommunicative/unresponsive
evasive or isolation
lack of interest in social contact
anxiety/depression
difficulty sleeping
behavior mimicking dementia (rocking, mumbling)
what are examples of physical abuse
hitting
slapping
pushing
pinching
restraints
what are indicators of physical abuse
unexplained cuts, bruises, burns, bleeding
sprains or fx
maxillofacial fx on L side
- perp is R handed
frequent ED visits
refuse to go to same ED
dismissive statements ab injuries
caregiver refusal to leave pt alone w provider
what are the 6 domains of needs that need to be fulfilled in order to not be considered neglect
essential med care
nutrition
hydration
hygiene
clothing
shelter
why is neglect a gray area and why is this significant
difficult to substantiate and prove as intentional
often underreported as a result bc people hesitant to call it neglect unless obvious
what are examples of caregiver neglect
withholding appropriate attention
failure to provide proper nourishment, adequate food, appropriate clothing
isolating individuals from society and human contact
failure to provide safe living conditions
use of sedatives to control workload
what are indicators of neglect
poor personal hygiene
- oral health often suffers
skin breakdown or rashes
exacerbation of chronic dz despite care plan
difficulty sleeping
sudden wt loss
worsening dementia
meds not filled
abuse vs neglect
abuse - do something that may cause harm
neglect - don’t do something that may prevent harm (passive omission)
what is the difference w self-neglect
self-neglectors often cognitive intact
- neglected elders often not
how common is self-neglect
60% of reported cases
what is procedural neglect
failings in care that fall short of objective and observable institutional and professional standards
- violation of institutional procedure
what is caring neglect
failings in care that are below threshold of being proceduralized, but lead to pts, family, and public to believe that staff are unconcerned ab physical and emotional well being of their pts
what is the difficulty w caring neglect
very gray area
- difficult to detect
what are common causes of procedure and caring neglect
factors like high workload and organizational failure
what is the least prevalent abuse among elders
sexual
what are examples of sexual abuse
unwanted touching
forced nudity
rape, sodomy
making person look at porn
what are indicators of sexual abuse
torn or bloody undergarments
bruises in genital area
vaginal or anal bleeding
panic attacks, PTSD
what are 3 recommended screening tools as there is no gold standard
elder abuse suspicion index (EASI)
hwalek-sengstock elder abuse screening test (H-S/EAST)
elder assessment instrument (EAI)
EASI: advantage, disadvantage, purpose
advantage - 6 items, easy to admin
disadvantage - must be cog intact
purpose - use to prompt a referral
H-S/EAST: advantages, disadvantages
advantages
- 15 item test
- can be used various settings
- multiple domains of abuse covered
disadvantages
- poorly studied
- longer test
- too detailed and difficult as a PT
- low validity
EAI: advantage, disadvantage
advantage - assess field of negligence
disadvantage - designed for ED and inpatient use
what are the 2 main things we can do as PTs to manage this
- report suspected cases of abuse or neglect
- interact w team members to establish norms for behavior and quality of care
what are important things to remember when we report suspected cases
purpose: trigger response to be connected w resources and promote health/wellness
- doesn’t mean being charged, jail, or removal from home
suspected victim can refuse adult protect services visit or any assistance
