Abuse and Neglect

It is estimated that hundreds of thousands of elders are abused at home and in institutions each year

Estimated that only one in every 14 cases is reported

The number of victims is expected to rise as the population ages

Statistics of Abuse

Our picture of elder abuse is limited, due to the problems hidden and complex nature◦ Secrecy surrounds those involved◦ Victims remain unnoticed and untreated because

they are isolated◦ Subtle forms of mistreatment can be hard to spot◦ Fear of retaliation by the abuser◦ Fear of being institutionalized

Abuse – The hidden problem

Learn to recognize abuse

Respond to mistreatment

Prepare yourself

Break the Cycle

Physical mistreatment

Psychological mistreatment

Financial mistreatment

What is Abuse and Neglect

Most obvious form of abuse because of telltale physical signs

Some forms are hard to spot◦ Rushing an elder or pulling him to fast when

helping him to walk◦ Tying wandering seniors to a chair so they cannot

get lost◦ Giving them to much or to little medication

Physical Abuse

Inflict emotional pain or distress◦ Verbal scolding◦ Harassment◦ Intimidation◦ Threatening punishment or deprivation◦ Threatening the victim like a child◦ Isolating the elder from family or friends

Psychological Abuse

Hard to spot unless you witness it Generally the victims demeanor or behavior

offers clues◦ Depression◦ Fear◦ Hopelessness◦ Withdrawal or isolation

Psychological Abuse

Taking control of resources through misrepresentation, coercion, or outright theft for gain◦ Stealing money or possessions◦ Forcing to sign contracts or durable power of

attorney◦ Charging for unnecessary services or services not

rendered

Financial Abuse

Failure to provide goods and services necessary for the health and well-being of the elder◦ Withholding adequate meals or hydration◦ Withholding physical therapy or hygiene◦ Failure to provide physical aides such as glasses,

hearing aides, or false teeth◦ Unkempt, dirty, body odor, fleas or lice◦ Malnourished and dehydrated

Physical Neglect

Taking your time answering call lights Moving the call button out of reach Leaving a person on the toilet to long Removing a cane or walker from reach Failure to reposition every 2 hours when

ordered to in the plan of care

More Examples

Failure to provide social stimulation◦ Leaving alone for long periods of time◦ Ignoring him or her ◦ Giving “the silent treatment”◦ Unusual confinement◦ Failure to provide companionship or links to the

outside world

Psychological Neglect

Failure to use available resources to sustain or restore the health and security of the adult

◦ Seeking care that does not meet the needs although money is available

◦ Elders confusion about their financial situation or a sudden transfer of assets

Financial Neglect

Bruises, welts, lacerations, fractures, burns, or restraint marks are physical evidence of abuse.

Injuries are inconsistent with medical findings

Laboratory evidence of under medicating or overmedicating

Unexplained venereal disease Dehydration, malnutrition, decubitus, and

poor hygiene

Warning signs of physical abuse

Fearful of speaking in front of caregiver Trembling and lack of eye contact Sudden eating disorders Depression Agitation Withdrawn Angry

Warning Signs of Psychological abuse

Illegal and improper use of an incapacitated adults resources – some examples include:◦ Withdrawing large amounts of money at the

encouragement of another person◦ Unusual banking activity◦ Confused about missing funds◦ Frequent expensive gifts from elder to caregiver◦ Frequent checks made out to cash◦ Signatures that do not match the elder persons

Warning Signs of Financial Abuse

Violation of a patients or residents rights◦ Denying privacy

Staying in the bathroom of a capable patient Staying in the room when the person has guests

◦ Not provided the opportunity to make decisions Turning off the radio or television Forcing the person to bathe when told

Violation of Rights

All walks of life; men, women, all racial, ethnic, and economic groups

According to the National Elder Abuse Incidence Study – more than half of reported elder abuse victims are women

Who gets Abused

Family members Caregivers Strangers Men Women

Who are the Abusers

Prevents the elder from speaking to others Threatening remarks Shows anger, indifference, or aggressive

behavior toward the elder Withholds attention or affection Talks about the elder as a burden Unusual fatigue and/or depression

Characteristics of an abuser

In one study, 40% of healthcare staff who participated in the survey admitted to committing psychological abuse in the preceding year, while 10% admitted physically abusing residents

Shocking Survey

Misunderstanding and ignorance Feeling frustrated Caregivers pattern of dealing with stress Seniors who are abusive to caregivers

compound the stress factor Unresolved conflicts between family or

elders history of abusive relationships Mental illness, alcoholism, or drug abuse Inadequate building and grounds security

can leave an elder vulnerable to strangers

WHY

Whatever the cause, elder abuse

and neglect are NEVER acceptable

Hospice of the Southwest does not condone patient abuse by anyone including staff members, other patient consultants, volunteers, and staff of other agencies serving the patients, family, members, legal guardians, sponsors, friends, or any other individual

Policy

Cases of suspected sexual assault, physical abuse, or neglect will be immediately reported in the organization, given priority, and investigated thoroughly

The organizations staff refers appropriately or conducts assessment of victims of abuse, neglect, or exploitation

Procedure

Careful assessment and documentation of physical findings can help provide the data that are believed to confirm diagnosis. History taking and examination of all patients will be done promptly and in privacy.

All cases of suspected abuse/neglect will be reported to the authorities

Procedure continued

A nonjudgmental approach should be maintained toward patients and family members at all times

To protect the patient from real or suspected mental, physical, sexual, and verbal abuse, neglect, and/or exploitation staff will safeguard the patient from the offending individual

Procedure Continued

Elder abuse is a common problem you are likely to encounter in healthcare

Be alert for signs of abuse or neglect Document any risks or evidence Report any suspicions or incidences

Summary

Do your part to bring this hidden problem into the open

Show you care, become an advocate for elders you encounter at work or anywhere

Conclusion

Arizona Attorney General . Elder abuse information and training guide. 2009. from https://www.azag.gov/seniors/elder-abuse-information-and-training-guide#33 [accessed 3, Jan 2013]

State of Arizona. Elder Abuse Coalition. Break the silence. Report elder abuse. Retrieved from https://www.azdes.gov/InternetFiles/Pamphlets/pdf/AAA-1139AOTH_BTS_Brochure_Final.pdf [accessed 3, Jan 2013.

Elder Abuse. Retrieved from http://www.mesaaz.gov/police/crimeprevention/ElderAbuse.aspx [accessed 3 Jan, 2013.

Robinson, L., Benedictis, T., Segal, J. Elder Abuse and Neglect. Warning signs, risk factors, prevention. 2012. Retrieved from http://www.helpguide.org/mental/elder_abuse_physical_emotional_sexual_neglect.htm [accessed 4, Jan 2013.

References