Mary, 88 is admitted to the unit with a diagnosis of dehydration and malnutrition. The staff learns that she lives with her son and hasn’t had any health care in 10 years. When they assess Mary, they note that she has difficulty seeing, even with her glasses, and she can’t hear well. She admits that her eyeglasses are old and that her son hates “wasting money on stuff like that”. Could Mary be a victim of abuse? ” Elder abuse can occur at any place at home or in resident’s facility at the hands of family members or caregiver.
There are four types of abuse. Neglect, which occurs when a caregiver fails to provide an older person with adequate food, clothing, shelter, medical care, or assistance with daily activities Emotional abuse, which is the willful affliction of anguish through threats, intimidation, humiliation and isolation, is involved with 30% of the cases. Financial abuse is the misuse of someone’s property and resources by another person. Physical abuse, the use of physical force that results in pain. Impairment, or bodily injury.
Hitting, slapping, restraining, biting, burning, pushing, or pulling all qualify as physical abuse. It is suggested that about 10% of older adults are victims of abuse. “At age 88 and depending on her son for her physical needs, Mary has several risk factors. Women over 80, who need partial or total assistance with daily activities such as bathing, dressing, and meal preparation, are the likeliest victims. Warning signs of abuse Indicators of physical abuse can be: Multiple injuries in various stages of healing, multiple fractures in various stages of healing.
Injuries in the “bathing suit” zone, like trunk, abdomen, genitalia, buttocks and upper thighs, or tooth fractures, burns to the soles, palms or buttocks. Sprains or dislocations caused by pulling or pushing. Indicators of neglect are: Deterioration of health, dehydration or malnutrition, pressure ulcers or contractures, presence of fleas or lice, urine burns, listlessness and fatigue. Indicators of emotional abuse are: Confusion and disorientation, fear of strangers, quietness when caregiver is present, low self-esteem and hunger for attention and socialization.
Indicators of financial abuse are: Unexpected loss of Social Security and pension checks, anxiety about personal finances, pressure to endorse checks and failure to provide contracted services. ASSESSMENT RADAR The nurses need to assess the patient in order to determine whether or not the patient has been abused. This is because normal effects of aging, disease pathology, and functional limitations can mask signs and symptoms. For instance, thin aging skin is susceptible to tearing and bruising; because bruises are common in older adults, nurses may tend to accept them as normal.
Relationships between patient and caregiver can tell a lot in terms of whether they talk, laugh together or sit in total silence. If the nurses suspect any kind of abuse, they must ask several questions, to assess the situation. They may ask questions like the following: did someone hurt you? did someone do this to you? Has anyone ever touched you without your consent? does anyone yell at you? Are you afraid of your caregiver? Etc. After the assessment the nurses must document the information and explanation of injury from both the caregiver and the patient and report it to responsible authorities.