Elder abuseKate Atkinson ST1

what is elder abuse?

“a single or repeated act or lack of appropriate action occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person” WHO 2002

types of elder abuse

In order of prevalence:• neglect• financial• emotional• physical• sexual• unintentional• mixed

prevalence

• 4.0% of over 66yrs = 342,400 people UK Study of Abuse and Neglect of Older People, 2007

• …likely to be a gross underestimate

who abuses?

• two thirds of abuse is committed at home by someone in a position of trust

analysis of calls to the Action on Elder Abuse helpline

• partner• family• carers• friend• neighbour• acquaintance• stranger

vulnerabilities

• reliance on the abuser for care/support/financial• family member • isolation• communication difficulties• not knowing who to approach, lack of awareness • fear, worry, shock, sadness, embarrassment,

shame. feel they have deserved it or won’t be believed

recognition of elder abuse: history

• suspicious history

• changes in personality/behaviour

• changes in routine

• unusual/new financial problems

recognition of elder abuse: examination

what to doAbuse suspected/discovered or a disclosure is made

Fax a Vulnerable Adult Referral to the Vulnerable Adult Unit

Speak to patient & gain information about the alleged abuse

+/- video interview+/- forensic evidence

EARLY STRATEGY MEETINGTo be held within 48hrs

Professionals only

?capacity

IMCA

ADULT PROTECTION CONFERENCE

Other family may attend

CLOSEcircumstances

unsubstantiatedPROSECUTION

Highlight to SW department ASAP

Contacts (S&W)

• Vulnerable adult leads in RUH:Neil Boyland blp 7528, Claire Fullbrook Scanlon ex 5535, Francesca Thompson (directornursing) ex 4040

• Vulnerable Adults Unit (based Melksham police station):

Andy Guy, Steve Lever, Paula GriffinTel 01225 794760

case study

• 87yr female, GP referral

• Severe vascular dementia

• Faecal incontinence

• Dehydration

• Weight loss

• Adverse housing situation

what to doAbuse suspected

Vulnerable Adult Referral faxed to Vulnerable Adult Unit

EARLY STRATEGY MEETING

SW department informed

Placement planned

Outcome: needs placement in a dementia registered

residential home

Summary of incidentBackgroundDiscussion

Action plan:1) Meeting with husband

2) +/- IMCA3) +/- security

4) CMHT notified re husband

Learning points

• elder abuse is more prevalent than we think and is under reported

• recognition of elder abuse

• what to do

• if in doubt report and seek advice

references

• Help the aged literature• Age concern literature• O’Keeffe M, Hills A, Doyle M, McCreadie C, Scholes S,

Constantine R, Tinker A, Manthorpe J, Biggs S, Erens B, UK Study of Abuse and Neglect of Older People, 2007 Prevalence Survey Report. National Centre for Social Research & King’s College London, June 2007

• Ogg J, Bennett GCJ. Elder abuse in Britain. BMJ 1992; 305: 998-999

• Pillemer KA, Finklehor D. The prevalence of elder abuse: a random sample survey. Gerontologist 1988; 28: 51-57

• Everybody's business: taking action on elder abuse. London: Action on Elder Abuse,1995.