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.