West Coast University NURS 204 Elder Abuse Chapter 24 West Coast University NURS 204

Elder Abuse Two million older adults are mistreated each year. Elder abuse is underreported and underdetected. Only one in ten cases of elder abuse is reported Greatest risk for abuse and neglect are those who are dependent on others for care It is mandatory for health care providers to report elder abuse or neglect

Physical Abuse Direct beating Infliction of pain Coercion Abrasion Sprains Dislocation Dehydration Malnutrition Over sedation Sexual abuse

Neglect Withholding food Withholding fluids Withholding medical attention Withholding necessities, glasses, walker, hearing aid Fecal or urine smell on person Dirt, fleas, lice, on person Pressure ulcers, sores, skin rash

Exploitation Taking Social Security or pension checks Taking possessions against elder’s will

Abandonment Dropping elder off at the emergency room Leaving incapacitated elder alone at home Failing to provide for basic services

Psychological Abuse Continuous degrading Verbal assault Threatening Using other scare tactics when the elder cannot provide for his or her own needs

Characteristics of Perpetrators Close relative or nonrelated caretaker Person lives in the home or residence Factors contributing to abuse: Lack of support Personal problems Alcohol or drug abuse History of violence Unresolved family conflict Low self-esteem Narcisistic

Nursing Process Overview for Elder Abuse Assessment: Identify assessment data indicative of possible abuse Interview the client to validate that abuse has occurred Assessment question: I notice you have a number of bruises. Could you tell me what happened? You seem frightened by your caregiver; are you? When you disagree with your caregiver, what happens? Many patients tell me they have been hurt by someone close to them, could this be happening to you?

Nursing Diagnoses Anxiety Ineffective coping Fear Injury, risk for Pain Post-trauma response Skin integrity, impaired

Planning and Outcome Identification Patient will maintain safety Patient will receive treatment for physical and psychological injuries Patient will ventilate feelings by discussing the abusive situation

Implementation Provide reports to state protective services, social services for elder abuse Thoroughly document all injuries and the treatment provider Listen empathetically to the victim’s report of current and past abuse Respect the client’s dignity and be nonjudgmental Discuss options for ensuring safety, such as temporary hospitalization, placement in a safe home. Provide list of resources and support services, including adult protective services If elderly person is not competent to make own decisions, guardianship arrangement need to be made

Outcome Evaluation The victim of violence achieves and maintains safety The victim of violence demonstrates improved self-esteem and self empowerment

Resources Visit the Hartford Institute for Geriatric Nursing (http://www.hartfordign.org/trythis) and view issue 15 Elder Mistreatment Assessment