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14 Cards in this Set
- Front
- Back
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Elder Abuse
Definition |
Defined as the mistreatment, neglect, physical, sexual and/or emotional abuse, and financial exploitation associated with those age 65 and older
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90% of abusers are these
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caretakers or relatives or
Someone with an ongoing relationship or duty to that elderly person |
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Abuse definition
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Willful infliction of physical pain or injury or unnecessary restraint (physical abuse)
Willful nonconsensual sexual contact (sexual abuse) Willfull infliction of emotional harm (psych abuse) |
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Neglect:
definition |
Failure of a person to provide for the needs and protection of a vulnerable elder when that person has had an ongoing relationship with the elder or has a duty to provide those needs and protection
Abandonment (can be neglect/abuse) is the desertion of a vulnerable elderly person by a caregiver/taker |
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Financial exploitation
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The nonconsensual appropriation of an elderly person’s resources, for the benefit of another, by someone with an ongoing relationship and duty toward that elderly person
Ie, bank accounts/savings, deeds to houses/cars, monthly SS checks, items of value |
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Examples of financial exploitation
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Illegal or improper use of an elder’s funds, property, assets
Cashing elder’s checks without their permission and/or knowledge Misusing/stealing money or possessions Coercing or deceiving elder into signing documents (ie, wills, contracts) Improper use of guardianship or POA |
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Vulnerable elder is:
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is an elderly person with an impairment, usually cognitive, that renders him/her unable to arrange or execute adequate self-care and protection
Have a diminished capacity for self-care and protection Poor/diminished decisional capacity as in the following: Unable to communicate a choice Unable to understand relevant information Unable to appreciate the situation and its consequences Unable to reason about treatment options |
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Institutional Abuse/Neglect
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Staff ignoring call lights and requests for assistance
Accidents or improper handling Staff attitudes related to dignity or respect Symptoms unattended to Personal property, lost, stolen, used by others, destroyed Staff unresponsive/unavailable Physical abuse Resident to resident abuse Verbal/mental abuse Gross/willful neglect |
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Health consequences of abuse/ neglect include:
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Multiple hospitalizations
Medical non-adherence Living in squalor Pressure ulcers Untreated psychiatric/medical illness Falls Loss of independence Death Elder abuse/neglect is associated with shorter survival and increase mortality Risk of death is increased 3-fold |
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Risk Factors for elder abuse/ neglect
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Age: >80
Gender: Women Ethnicity: African Americans overreported, Hispanics underreported Disability in self care: unable to perform ADLs/IADLs Dementia: Cognitive impairment found to be a predictor of self-neglect Depression: Also a warning sign H/O hip fracture or stroke |
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Risk Factors of elder abuse/ neglect
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Social isolation
Lower socioeconomic status (lower education and income levels) External family stressors: Illness, financial hardship, family death Unfavorable caretaker characteristics: Mental illness, substance abuse, h/o violent/antisocial behavior, financial dependence Indicators of financial exploitation: Transfer of property/monies by an elderly who lacks the capacity to consent |
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Warning Signs of elder abuse/ neglect
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Skin
Tears—increase incidence in NH Abrasions Lacerations Bruises Burns Fractures—common in elderly, however be suspicious of spiral fractures of long bones, sites other than wrist, hip, vertebrae…fractures that are not r/t falls or osteoporotic effects Malnutrition Dehydration Pressure ulcers Indicators of sexual abuse, ie, evidence of STDs, anal-genital pain, bruises/lacerations of vulva, abdomen, breasts. Mental Status changes—psychomotor retardation, insomnia, s/sx of depression, worsening dementia or cognitive impairment |
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Abuser Characteristics
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90% of elder abuse is by a family member
Gender: Female/male almost 50/50 Age: varied from 18->65 Relationship to victim: 30% Spouse 18% Adult child 21% Other/unknown 8% Service provider 8% Other family member 5% Facility/institution staff 3% Friend/neighbor 2% Grandchild 2% Parent 2% Sibling Adult children who are still dependent on parents for financial assistance, housing or other means of support Mental illness Substance abuse Caregiver stress/burnout |
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Example of screening for elder abuse/ neglect
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Has anyone at home ever hurt you?
Has anyone ever touched you without your consent? Has anyone taken anything that was yours without asking? Has anyone ever yelled at you or threatened you? Have you signed any documents that you didn’t understand? Are you afraid of anyone at home? Are you alone a lot of the time? Has anyone ever failed to help you take care of yourself when you needed help? |
