Elder Abuse: Key Concepts and Reporting

Elder Abuse: Core Concepts

Definition & Scope

  • Elder abuse: Any intentional action by a caregiver or trusted person causing harm, risk of harm, or failure to provide basic needs to an older adult.

  • Location: Occurs in homes and nursing homes.

  • Statistics: 1 in 10 older Americans experience abuse, but only 1 out of 24 cases are reported.

Types of Abuse

  • Self-neglect: Failure of the older adult to care for themselves.

  • Physical abuse: Inappropriate physical contact, use of restraints, or poor pain management. Signs include unexplained injuries.

  • Sexual abuse: Non-consensual sexual contact or exposure to inappropriate material.

  • Neglect:

    • Passive: Unintentional failure to visit or leaving alone for long periods.

    • Active: Intentional failure to provide adequate nutrition, hygiene, medication, or shelter. Signs include low body weight, poor hygiene, or untreated sores.

  • Emotional abuse: Verbal (yelling, threats, humiliation) or nonverbal (ignoring, isolating, terrorizing). Signs include withdrawal, depression, fear, agitation, or confusion.

  • Other forms: Abandonment, financial exploitation, and health care fraud.

Victim Characteristics

  • Most victims are women, often over 65 years old.

  • Often suffer from physical handicaps or memory problems.

  • 90\% of abuse is committed by a family member.

Assessment & Detection

  • Screening tests: Elder Assessment Instrument.

  • Indicators: Review signs/symptoms, subjective complaints of abuse/neglect (e.g., clothing, skin integrity, lacerations, fractures, burns, malnutrition).

  • 3 R's: Recognize, Respond, Report.

Barriers to Obtaining Help

  • Fear of reprisal.

  • Cultural traditions.

  • Difficulty in questioning the abused about injuries.

Reporting Abuse

  • Mandatory Reporting Law: All healthcare workers, administrators, licensed providers, students, and visitors have an ethical and legal responsibility to report suspected abuse.

  • Reporting process: Follow chain of command, report to NYS DOH, which starts an investigation within 48 hours.

  • Agencies: NYS Dept of Health (OHSM) and Adult Protective Services (APS).

  • Nurse's role: Professional responsibility to detect and report signs of abuse or neglect.