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

2. 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

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

4. 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

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

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

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

8. 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

9. 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?

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

11. 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

12. 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

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

14. Resources
Visit the Hartford Institute for Geriatric Nursing (
and view issue 15 Elder Mistreatment Assessment