1. Kristen Currie MSN 6104 Kristen Currie, RN, BSN, MSN

2.  Objectives The learner will understand the background of elder abuse. The learner will understand the importance of elder abuse. The learner will be aware of assessment findings in indicate abuse. The learner will understand the importance of communicating with abuse victims and what questions to ask during nurse- patient interviews. The learner will understand risk factors to elder abuse. The learner will know where to report abuse if suspected. The learner will understand and be provided with ways of how to educate other about this issue and ways of how to prevent this issue.

3.  Introduction: An Overview of Elder Abuse The older adult population is steadily growing each day. They are living healthier and longer lives. Worldwide, there will be an estimated 1.2 billion individuals older than 60 years by 2025. The population of the world is aging, therefore, societies must develop a strong focus on the care and protection of older adults in order to prevent elder abuse (Starr, 2010). Elder abuse has been going on for many years. It is important that research is done thoroughly and consistently in order to understand the seriousness of this problem, and find realistic goals in order to prevent this issue.

4.  Background of Elder Abuse Elder abuse was first nationally recognized in 1981 when the House Select Committee on Ageing issued its landmark report examining this hidden problem. This committee performed a national study on this issue after receiving a letter about an 80 year old paraplegic that was sexually abused for six years by her son-in- law. Once this was known nationally, the House Select Committee on Ageing defined different types of elder abuse in their report Elder Abuse: An Examination of a Hidden Problem (Frisch &Frisch, 2006, pg. 657)

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6.  Importance of Elder Abuse According to the National prevalence, there may be more than 5 million elder abuse victims in the United States (Quinn & Benson, 2012). Elder abuse impacts the wellness of the older adult because they are not safe in there own environment, they are being mistreated in a harmful way, and it affects their wellbeing. Abuse affects older adults mind, body and spirit. Elder abuse is important to nurses because it is our job and duty to report abuse. It is indicative that we know how to communicate to patients and be provided with thorough education about this topic to provide prevention.

7.  What to Look for?  Bruising, cuts, burns or fractures that are not consistent with explanations  Bruising in various stages in healing  Cigarette burns  Sigs of medication misuse  Nervous or flinching behavior  Unexplained burns on soles, palms & back, rope burns or carpet burns  Hair loss  Bite marks  Finger marks on thighs and arms’  McGarry, & Simpson, 2009

9.  Communication It is very important when the nurse suspects abuse, that questions are asked in a appropriate manner. In order for questions to be answered, the nurse must build a trusting relationship with the older adult. The nurse must talk to the older adult and family in a nonjudgmental way. The nurse should be empathetic and make the older adult comfortable in answering questions. Communication is important because it can help with quickly performing interventions and keeping the older adult safe.

10.  What to Ask? Do you feel safe at home? Is anyone hurting you? Does anyone hit, slap or kick you at home? Are you left alone for a long period of time? Are you forced to stay in your room? Do you feel safe at home? Is anyone hurting you? Does anyone hit, slap or kick you at home? Are you left alone for a long period of time? Are you forced to stay in your room?

11.  Risk Factors Inability to cope with stress Depression, which is common among caregivers Lack of support from other potential caregivers The caregiver’s perception that taking care of the elder is burdensome and without psychological reward Substance abuse/alcohol dependency History of domestic violence in the home The intensity of the elders illness Social Isolation

12.  Reporting Reporting abuse is very important in order to keep our patients safe. Reporting can protect the older adult from any harm. “The goals of interventions are to stop the abuse of older adults and hold the perpetrators accountable” (Westley, 2005). If nurses suspect abuse, it is by law that we report it. Our safety of our patients is important. Nurses should know where to go when abuse is suspected. There is a specific federal program in which all cases are reported to. This service is called the Adult Protective Services (APS). APS investigates allegations, find alternatives or improve living arrangements, assist elders in obtaining benefits, and help with environmental cleanup and assistance (Quinn & Benson, 2012). Once the APS is involved in the case then, they are responsible in protecting the adult and keeping them away from harm.

13. Unrelated caregiver 3.3% Law Enforcement 4.7% Private Provider 15.1% Physician 22.5% APS worker 6.0% Unknown 1.1% Family Member 16.3 Other 13.4% Friend/Neighbor 7.7% Elder Victim 3.8% (Westley, 2005) Reporters of Elder Abuse

14. Encourage the use of respite care and daycare Provide counseling for troubled families Teach families stress management techniques Help families develop and nurture informal support systems Educate professionals about potentially abusive situations Educate the public about normal ageing processes Listen to seniors and their caregivers carefully Intervene when you suspect elder abuse Educate others about how to recognize and report elder abuse Benedictis, Robinson, & Segal, 2012 Westley, 2005 Education and Prevention

17. References Benedictis, T., Robinson, L. & Segal, J. (2012). Elder Abuse and Neglect: Warning signs, Risk Factors, Prevention, and Help Retrieved November 9, 2012 from http://www.helpguide.org/mental elder_abuse_physical_emotional_sexual_neglect.htm Frisch, N. C., & Frisch, L. E. (2006). Psychiatric mental health nursing (3rd ed.). Clifton Park, NY. Thomson Delmar Learning McGarry, J., & Simpson, C. (2009). Identifying, reporting and preventing elder abuse in the practice setting. Nursing Older People, 21(1), 33-38. Quinn, K. M., & Benson, W. F. (2012). The States' Elder Abuse Victim Services: A System inSearch of Support. Generations, 36 (3), 66-72 Starr, L. (2010). Preparing those caring for older adults to report elder abuse. Journal OfContinuing Education In Nursing, 41 (5), 231-235. doi:10.3928/0022012420100423-06 Westley, C. (2005). Elder mistreatment: self-learning module. MEDSURG Nursing, 14(2), 133-137