1. Child, Partner and Elder Abuse Chapter 18

2. Family violence and abuse is prevalent among all ethnic, socioeconomic, age & social groups Family abuse, trusted authority figures, spiritual abuse and caregiver abuse Emotional abuse  Kills the spirit & ability to succeed later in life, feel deeply or make emotional contact with others Physical abuse: Includes emotional abuse in addition to potential for long term physical deformity, internal damage,acute painful tissue damage, bone damage and death Abuse

3. Social Learning Theory  Intergenerational violence theory: family violence relies on role modeling, identification & human interaction Societal & Cultural Factors  Correlates that may exist when family abuse is high: poverty, unemployment, inadequate resources, overcrowding & social isolation Psychological Factors: Focus on abuser having personality traits that cause abusiveness Theory

4. Takes place when child is harmed by someone else physically, psychologically, sexually or by acts of neglect 4 types of abuse Cases are typically underreported Parents account for 78.9 % of child abuse Children < 4 yrs old greatest risk Child abuse

5. Assessment  Child: the abused child is excessively fearful of parent or caregiver  Parent or caregiver: vary by degrees of intelligence, education, socioeconomic backgrounds & religious affiliations Diagnosis & Outcomes Identification  Ensures child’s safety & well being Implementation: when child abuse is suspected nurses are legally responsible to report  Followup  Primary Prevention: 40 % child abuse cases linked to substance abuse Application of nursing process

6. Defined as current or former emotional, psychological, physical or sexual abuse between current or former partners of intimate relationship  Abusive relationship is about instilling fear & wanting to have power & control Characteristics of IPV  The Battered Partner: lives in fear of next beating  The Batterer: violence is learned behavior, low sense of self, poor impulse control Cycle of Violence  Process that increases in intensity & escalates Why abused partners stayed  Fear of increased violence or danger to children Intimate partner violence

7. Assessment  3 questions reveal current or previous IPV Have you been hit, kicked, punched or hurt by someone within the past yr? If yes, who? Do you feel safe in your current relationship? Is there a partner from previous relationship who is making you feel uncomfortable? Diagnosis & Outcomes Identification  Situational crisis that threatens a woman's physical & psychological health, her life and her children's lives  Women treatment in ER may admit to IPV but seldom come for treatment  Safe environment: safe house, safety plan, hotlines, support groups Implementation: It is not her fault, does not deserve to be beaten, cannot make anyone hurt you Application of nursing process

8. Serious & rapidly growing problem 1 out of 20 elderly abused yearly Adult Protective Services: investigates suspected elder abuse Characteristics of elder abuse  The abused elder: 80+ yrs 2-3x more likely to be abused  The abuser: caretaker stress and burden causative factor Elder abuse

9. Assessment Health care workers mandated to report elder abuse  2x as many MD & clinic visits  Bedsores, begging for food, malnutrition, in need of medical or dental care, fear of being alone with caregiver Diagnosis & Outcomes Identification  Neglect & financial exploitation Implementation  Interventions include medical, legal and social services Evaluation: Failures are related to social, economical & political systems Application of nursing process