Module 17- Elder Abuse

Elder Abuse

A. Key Terminology

  • Abuse: An intentional act or failure to act by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult (age 60 or older).

  • Elder abuse often affects those who depend on others for help with activities of everyday life.

  • Likely targets: older people with no nearby family/friends, people with disabilities, memory problems, cognitive problems, or dementia.

B. Types of Elder Abuse

Verbal Abuse

  • Teasing, profanity, racial slurs, threats.

Physical Abuse

  • Battery: kicking, biting, hitting, shoving, etc.

  • Rough handling.

Psychological/Emotional Abuse

  • Ridiculing or saying hurtful words.

  • Repeatedly ignoring.

  • Manipulating, yelling at or threatening.

Involuntary Seclusion

  • Isolation.

  • Keeping the person from seeing close friends and relatives.

Abandonment

  • Leaving someone unattended.

  • No planning for patient’s/resident’s care.

Neglect

  • Failure to provide care that a reasonable person would provide.

  • Not answering call light.

  • Smells of urine and not being cleaned/changed.

Sexual Abuse

  • Overtures or innuendos.

  • Inappropriate gestures.

  • Inappropriate touching.

  • Forcing an older adult to watch or be part of sexual acts.

Financial Abuse

  • Stealing money or borrowing items.

  • Accepting gifts.

  • Forging checks.

  • Using credit cards, etc.

Healthcare Fraud

  • Overcharging.

  • Billing twice for the same service.

  • Falsifying Medicaid claims.

C. Issues Related to Elder Abuse

Signs of Elder Abuse

  • New onset sleeping issue

  • Seems confused or depressed

  • Weight loss

  • Agitated or violent

  • Unexplainable bruises

  • Becomes withdrawn

  • Less active and engaged

Definition Issues

  • Poorly or imprecisely defined.

  • Defined specifically to reflect statutes or conditions in specific locations (states, counties, cities).

  • Defined specifically for research purposes.

Recognizing and Observing Elder Abuse

  • Evaluate how a series of actions and reactions might lead to abuse.

  • Define local, state, and federal regulations regarding abuse (mandated reporter).

Factors Contributing to Risk of Abuse

  • Combination of individual, relational, community, and societal factors.

  • Current diagnosis of mental illness.

  • Current abuse of alcohol.

  • High levels of hostility.

  • Poor or inadequate preparation or training for care giving responsibilities.

  • Assumption of caregiving responsibilities at an early age.

  • Inadequate coping skills.

  • Exposure to abuse as a child.

  • High financial and emotional dependence upon a vulnerable elder.

  • Lack of support.

  • Unsympathetic or negative attitudes toward patients/residents.

Prevention Strategies

  • Effective monitoring systems.

  • Institutional policies and procedures regarding patient care.

  • Training on elder abuse and neglect for employees

  • Education and clear guidance on durable power of attorney and how it is to be used.

  • Promoting regular visits by family members, volunteers, and social workers.

  • Coordination of resources and services among community agencies and organizations.

  • Provide services to relieve the burden of care giving, such as housekeeping and meal preparation, respite care, education, support groups, and day care.

  • Not signing documents without first consulting an attorney or trusted family member.

  • Shredding financial records before disposing of them.

  • Review Mandated Reporter Role – define facility, state, and federal policies and procedures related elder abuse

Caregiver Stress

  • Caregiver may need to be available around the clock to fix meals, provide nursing care, take care of laundry and cleaning, drive to doctors' appointments, and pay bills, which contributes to caregiver stress

  • Make sure you have time to rest and take care of your needs

Resources for Caregivers

  • Ask a family member or friend to help out for a weekend, or even for a few hours, so that you can take some time for yourself

  • ARCH National Respite Network and Resource Center's National Respite Locator to find respite services in your area

  • Caregiving support groups may also help

  • Exercise could even help with stress

D. Nurse Assistant Role in Abuse Prevention

Reporting Abuse

  • Discuss your observations with a licensed nurse and/or other appropriate personnel.

  • If Nurse Assistant observes the abuse incident, the Nurse Assistant is responsible for reporting; mandated reporter

  • LVN or RN may assist the Nurse Assistant in completing mandated forms and in submitting required forms to reporting agencies

  • Report observations as a mandated reporter, following federal mandate for reporting suspected or actual elder abuse and/or patients’/residents’ rights violations

  • Follow agency policies regarding abuse reporting

  • Follow up on reported incident with licensed personnel