elder abuse

- Acts of omission or comission that results in harm or threatened harm to the health or welfare of an older adult
-intentional
-unintentional
-3-5% of older population
-1/8 cases reported
-47 states have mandatory reporting

->65 yrs old
-men and women
-women suffer greater injury
-men > women
-competent and impaired
-all socioeconomic backgrounds

-65% spouses
-23% adult children
-other caregivers

1. intellectual or mental impairment
2. dependency in ADL
3. dependency for social interactions
4. financial dependence
5. demanding and authoritative

-Cargiver stress:
1. lifestyle change
2. financial dependency
3. lack of support
-psychopathology
1. drug or alcohol abuse
2. emotional
3. psychiatric
-family violence
-role reversal
-unable to unwilling to leave elder
-limited knowledge of aging process
-frustration or resentment
-believes home care is better than nursing care

Abuse: pushing, striking, force feeding, restraints
Neglect: withold of hydration or feeding, health care needs
suspect if: unexplained injuries, briuses, fractures, under or over meds, dehydration, poor hygiene

-sexual contact or exposure without consent
-suspect if venereal disease or genital infections

1. verbal harassment
2. threats
3. isolation
4. leaving elder alone for long periods
5. silent treatment
Suspect if: withdrawal, agitation, depression, fear, insomnia, appetite loss

1. denying a home or shelter
2. stealing money or possession
3. coercing into signing contracts
4. failure to use resources or funds to sustain their needs
suspect if: substandard care at home, no knowledge of financial situation, sudden transfers of assets, inability to pay for bills or services

-victims and perpetrators
-general health status, functional status, cognitive and emotional status, financial status
-living situations
-social support
-documentation of findings
-requires team approach

-with pt:
with capacity: voluntary
without capacity: voluntary, involuntary
-with abuser