Vol.5-Ch.6 "Abuse, Neglect, & Assault" Flashcards
Who are at risk of being abuse by a partner in “Partner Abuse”?
Everyone, man, women, even same sex couples. However the most common is men abusing women.
(the term “partner” does not just apply to married couples, it involves girl/boyfriend, or someone sharing the same residence)
What are some reasons why abuse may not be reported in a Partner Abuse situation?
- Fear of reprisal
- Fear of humiliation
- Denial (the hope that the abuser will change b/c of the abusers promises to do so ; a common reaction after a violent outburst)
- Lack of knowledge or financial resources
(Fear is the biggest one)
What are some ways to identify Partner Abuse as well as what are some forms it may take?
Physical abuse is the most obvious form and can leave obvious bruising or fractures and can exacerbate ongoing conditions such as asthma, diabetes, or hypertension
Verbal abuse can cause damage to ones self esteem, depression, substance abuse, and other self destructive behavior
Sexual abuse also occurs
What are 10 factors that place a person at risk for Partner Abuse, and what source are the 10 factors from?
10 factors sourced from “Domestic Violence: Cracking the Code of Silence”:
1) Male is unemployed
2) Male uses illegal drugs at least once a year
3) Partners have different religious backgrounds
4) Family income is below the poverty line
5) Partners are unmarried
6) Either partner is violent toward children at home
7) Male did not graduate from high school
8) Male is unemployed or has a blue-collar job
9) Male is between 18-30 years old
10) Male saw his father hit his mother
Characteristics of the Abusers and the Abused
ABUSERS:
- Usually lower socioeconomic status
- history of family violence (the PRIMARY RISK FACTOR)
- aggressive personality with low self-esteem
- alcohol or drug abuse makes them more likely to loose control
- after an outburst they will often feel regret and shame and promise to change, they may even be loving for a while
ABUSED: may be hard to determine but share characteristics
- Pregnancy
- Substance Abuse
- Emotional Disorders
(They may also avoid eye contact, exhibit nervous behaviors, and/or watch the abuser if present)
Keys to approaching an patient of Partner Abuse
- Direct questions
- Avoid judgmental questions
- Listen carefully as this will often give the pt relief to know someone else knows of the abuse
- If the patient does not know, make them aware that if the spouse is reported and taken into custody, they may be released within as early as hours but let them know that there are protection programs available
Factors related to the increase in elder abuse
- increased life expectancies
- increased dependency on others, as a result of longevity
- decreased productivity in later years
- physical and mental impairments, especially among the old-old
- limited resources for long term care
- economic factors, such as strained family finances
- stress on the middle-aged caretakers responsible for two generations - children and parents
The problem of elder abuse is expected to grow over the next 20-30 years as the baby-boomers turn 65 and older
What are the 2 types of elder abuse?
- Domestic Elder Abuse: when an elderly person is being cared for in a home-based setting, usually by relatives
- Institutional Elder Abuse: occurs when an elder is being cared for by a person with a legal contractual responsibility to provide care, such as paid caregivers, nursing homes, or other professionals.
Both types of abuse can either be acts of COMMISION (acts of physical, sexual, or emotional abuse) or OMISSION (neglect)
What are the 4 theories about causes of elder abuse?
1) Caregivers feel stressed and over-burdened
2) Patients physicals and/or mental impairment. (elders in poor health are more likely to be abused
3) Family history, or the cycle or violence within
4) abuse increases proportionately with the personal problems of the caregiver
Characteristics of the Elder Abusers and Abused
ABUSERS:
- Most typical is adult children who are either overstressed by care of the elder or who were abused themselves
- Exhibit alcoholic behavior
- Drug addiction
- Mental impairment
- Abuser may be dependent on the income or assistance of the elder, as situation that can cause resentment, anger, or violence
ABUSED:
- involves all demographics
- Most Common is elderly women abused by their sons
- Most frequently occurs among those who are dependent for care, especially if physically or mentally challenged
- Most commonly live alone
- Commonly will be afraid to complain out of fear of being put in a nursing home and loosing independence or afraid of reporting abuse and getting reprisal by abusive caregiver
Characteristics of Child Abusers and Abused children
ABUSERS:
- Most were abused themselves
- Mostly when it’s physical abuse it is by men
- use of drug or alcohol
- immaturity and preoccupation with self
- lack of feeling for the child, doesn’t look/touch them
- lack of concern for child safety
- open criticism of the child
- little identification with the child’s pain, whether it is physical or emotional
ABUSED: (most important indicator of abuse is the child’s behavior)
- under 6yo are often passive, until over 6yo when they get very aggressive
- crying, often hopelessly, during treatment or not crying at all
- avoiding the parents or showing little concern for their absence
- unusual wariness or fear of physical contact
- apprehension and/or constant alertness for danger
- being prone to sudden behavioral changes
- absence of nearly all emotional
- neediness, constantly requesting favors, food, or things
Age of Bruise by it’s color
- Red (swollen/tender) = 0-2 days
- Blue, Purple = 2-5 days
- Green = 5-7 days
- Yellow = 7-10 days
- Brown = 10-14 days
What are 4 conditions that may be mistaken for child abuse?
- Car seat burns
- Staphylococcal scalded skin syndrome
- Chicken pox (for cigarette burns)
- Hematologic disorders that cause easy bruising
If the child offers the source of injury freely and the parent gives the same story with no other clues to abuse then it may be legit, not an abuse scenario
What are some easy to find warning sign of physical child abuse?
- Soft tissue injuries (the most common) such as Bruising of different colors
- defensive wounds on the hands and forearms
- symmetrical injuries such as bites or burns
- Burns or scalds often on the palms, soles of feet, back, or buttocks (remember that kids burn easier than adults)
- Fractures (second most common form) (remember kid bones are soft and don’t break easily so this should give you high suspicion when bones are broke, especially the ribs)
- Head injuries (often injuries go from extremities and trunk to the head, when it gets to the head is when the highest number of fatalities are scene)
- shaken baby syndrome (can lead to permanent brain damage, subdural hematomas, brain swelling, neck/spine injury, blindness, or death) most often occurs when the baby won’t stop crying
- abdominal injuries
What are some problems that arise when a mother takes alcohol or cocaine while pregnant?
Alcohol abuse will lead to Fetal-Alcohol Syndrome and cocaine or crack cocaine can lead to premature births and a number of other things
