OLDER ABUSE
OLDER:
- A human being is more than age of 60 years.
DESCRIPTION:
- Abuse of an older adult involves physical, emotional, or sexual abuse; neglect; and economic exploitation.
- Older adults at most risk include individuals who are dependent because of illness, immobility, or altered mental status.
- Factors that contribute to abuse and neglect include long-standing family violence, caregiver stress, and the older adult's increasing dependence on others.
- Victims may attempt to dismiss injuries as accidental, and abusers may prevent victims from receiving proper medical care to avoid discovery.
- Victims often are isolated socially by their abusers.
- Domestic mistreatment takes place in the home of the older adult and is usually carried out by a family membrane or significant others; this can include physical maltreatment, neglect, or abandonment.
- Institutional mistreatment takes place when an older adult experiences abuse when hospitalized or living somewhere other than home (e.g., long term care facility).
- Self-neglect is the choice by a mentally competent individual to avoid medical care or other services that could improve optimal function, to not care for one-self, and engage in actions that negatively effect his or her personal safety; unless declared legally incompetent, an individual has the right to refuse care.
ASSESSMENT:
PHYSICAL ABUSE:
- Sprains, dislocation, or fractures
- Abrasions, bruises, or lacerations
- Pressure sores
- Puncture wounds
- Burns
- Skin tears
SEXUAL ABUSE:
- Torn or stained underclothing
- Discomfort or bleeding in the genital areas
- Difficulty in walking or sitting
- Unexplained genital infections or disease
EMOTIONAL ABUSE
- Confusion
- Fearful and agitated
- Changes in appetite and weight
- Withdrawn and loss of interest in self and social activities
NEGLECT
- Disheveled appearance
- Dressed inadequately or inappropriately
- Dehydration and malnutrition
- Lacking physical needs, such as glasses, hearing aids, and dentures
SIGNS OF MEDICATION OVERDOSE
ECONOMICS EXPLOITATION:
- Inability to pay bills and fearful when discussing finances
- Confused, inaccurate, or no knowledge of finances
INTERVENTIONS:
- Assess for physical injuries and treat physical injuries.
- Report case of suspected abuse to appropriate authorities (follow state and agency guidelines).
- Separate the older adult from the abusive environment, if possible, and contact adult protective services for assistance in placement while the abuse is being investigated.
- Explore alternative living arrangements that are least restrictive and disruptive to the victim.
- The older adult who has been abused may need assistance for financial or legal matters.
- Provide referrals to emergency community resources.
- When working with caregivers, assess the need for respite care or counselling if needed to deal with caregiver stress.
ACTIONS TO TAKE WHEN AN OLDER CLIENT IS PHYSICALLY ABUSED:
- Assess and treat the wounds.
- Ensure the victim is removed from the threatening environment.
- Adhere to mandatory abuse reporting laws.
- Notify the caseworker of the situation.
- Document the occurrence, findings, actions taken, and the victim's response.
- When a victim is abused, the priority is to assess and treat any physical injuries.
- We need to stay with the victim and provides comfort and support.
- After physical injuries are treated, we ensures that client is safe and is removed from the threatening environment.
- Eider abuse needs to be reported.
- We should also contact the caseworker of the situation so that the incident is reported and follow-up can occur.
- If there is no caseworker, contacts social services or the appropriate service to initiate this process.
