Lesson 1 - Ageing and Elder abuse

Introduction to Ageing and Elder Abuse

• The lesson on ageing addresses important aspects regarding the care of older individuals, particularly focusing on elder abuse, which includes physical and sexual abuse. It is crucial to approach these sensitive subjects with care and understanding.

Australia’s Ageing Population

Demographic Trends

• Australia, like many developed nations, faces an ageing population due to sustained low fertility rates and increased life expectancy.

• This demographic shift means there are fewer children under 15 years old, while the proportion of individuals aged 65 and over is growing, influenced also by migration patterns that include older adults.

Life Expectancy Improvements

• Several factors contribute to the improvement of life expectancy in Australia:

  • Enhanced health services

  • Safer working environments

  • Advances in medical technology and treatments

Gender Differences in Life Expectancy

• Life expectancy has increased more rapidly for males than females recently.

• The increase over the past decade:

  • Males: Life expectancy rose by 1.7 years

  • Females: Life expectancy rose by 1.3 years

• Historical Context:

  • In 1990, life expectancy was 73.9 years for males and 80.1 years for females, a gap of 6.2 years.

  • By 2018-2020, this gap had narrowed to 4.1 years.

Increase in Older Population

Population Metrics

• As of June 30, 2019, the population aged 65 years and older grew by 125,400 people (3.2%), a trend observed across all Australian states and territories.

• Over the past two decades, individuals aged 85 years and over saw a 117.1% increase, showcasing the rising number of the oldest segment of the population.

Changing Health Status in Ageing

Physical and Psychological Aspects

• Ageing is a natural process with noticeable physical changes, but also subtle psychosocial changes that may not be immediately apparent to others.

• It raises questions regarding normal ageing versus pathological conditions.

Challenges in Nursing Care

• Care for older adults poses unique challenges due to the diverse range of physiological, cognitive, and psychosocial health statuses.

• Most older adults are independent and active, but a minority may require assistance and show signs of confusion, withdrawal, or decision-making impairments.

The Effects of Ageing on Body Systems

Integumentary System

• Ageing effects include:

  • Thinned skin and increased wrinkling due to collagen loss

  • Dry skin due to reduced gland activity

  • Hair loss and greying caused by inactive hair follicles and dying melanocytes

Musculoskeletal System

• Ageing results in decreased muscle mass, slower reaction times, and reduced proprioception, increasing fall risks.

• Bone density decreases, leading to osteoporosis and potential fractures.

• Joint cartilages wear down, causing pain and mobility issues.

Cardiovascular System

• Heart efficiency declines with age leading to decreased cardiac output, potential heart failure, and susceptibility to arrhythmias.

• Atherosclerosis increases, impacting blood flow.

Respiratory System

• Long-term smoking damages respiratory capacity, leading to conditions like emphysema.

• Weaker muscles and loss of elasticity in the lungs contribute to respiratory challenges.

Urinary and Digestive Systems

• Aging affects kidney function, bladder tone, and increases the likelihood of urinary infections.

• Decreased dental health and peristaltic activity affects digestion.

Nervous System and Sleep Patterns

• Reaction times and sensory perceptions diminish.

• Older adults require less sleep, around 5-7 hours, and prolonged sleep can harm their mental and physical functioning.

Understanding Elder Abuse

Definition

• Elder abuse is defined as any act resulting in harm to an older person within a context of trust, often occurring within familial settings. It is rightfully viewed as a severe form of ageism.

Risk Factors

• Vulnerable individuals may exhibit dependency due to:

  • Cognitive impairments (e.g., dementia)

  • Physical disabilities

  • Isolation and language barriers

  • Lack of support services.

• Abuse crosses gender and socioeconomic lines.

Types of Abuse

• Physical Abuse: Using force resulting in injury. Indicators include unexplained bruises and fearfulness in the victim.

• Emotional/Psychological Abuse: Induces feelings of fear and worthlessness, marked by social withdrawal and negative self-image.

• Sexual Abuse: Any sexual contact without consent, often exploiting vulnerable situations. Signs may include injuries or sexually transmitted infections.

• Neglect: Failing to provide necessary care, leading to health deterioration.

• Financial Abuse: Misuse of an elderly person's finances. Indicators include unexplained financial changes and fear when discussing financial matters.

• Social Abuse: Isolation from family and friends, leading to emotional distress.

Reporting and Prevention of Elder Abuse

Mandatory Reporting

• Healthcare professionals are legally obligated to report suspected abuse. Mandatory reporters include police, doctors, and teachers, and specific regulations vary by state.

Serious Incident Response Scheme (SIRS)

• A government initiative designed to mitigate abuse in residential aged care facilities. It necessitates providers to manage and report incidents effectively, ensuring consumer safety and well-being.

Support Mechanisms

• Advocacy programs, internal complaint systems, and protective services help safeguard older adults.

• External agencies like Senior Rights Victoria provide support and information to ensure the rights of the elderly are maintained.