Exam 1 Elder Abuse
DCF
-DCF can not forcibly remove a competent adult from a situation he or she refuses to leave -Only if the person is *mentally impaired* and the worker intervene.
Behaviors to Recognize in Caregiver
-Nervous when questioned -Try to prevent private conversation with the elderly person -Give explanations for injuries that do not seem to make sense Impatient, irritable, negative, demeaning statements about the elderly person
Abuse
-Psychological (intimidation, humiliation/ridicule, blaming, ignoring, isolating, terrorizing) -Physical (shoving, hitting, inappropriate use of drugs, restraints) -Financial (misuse of checks/credit cards, stealing cash, forging signatures, identity theft) -Sexual -Abandonment "Granny dumping"
2013 Florida Statutes
415.1034 Mandatory reporting of abuse, neglect, or exploitation of vulnerable adults; mandatory reports of death.
Things to watch for while interacting with elders
Avoid eye contact Nervous/ Fearful Quiet and passive Sit a distance from the caregiver Cringe/ startle easily Allow the caregiver to respond/answer questions
Nursing Actions
Find a way to speak with the individual alone Provide care Ensure safety Develop trust Know the institution policies- resources
What makes an elder susceptible to abuse?
Longer life Dependency** Caregiver stress Learned violence Lack of Planning for Elder care
Behaviors of elders who have been abused
Often minimize or deny Unwilling to disclose
Signs to Recognize Abuse: Sexual
Pain or itching in the genital region Bruising or bleeding in external genitalia, vaginal, anal areas Unexplained sexually transmitted disease Vaginal drainage
What can the RN do to help?
Report to regulatory bodies for a complete investigation Area on aging Names and phone numbers for assistance *Encourage elder planning for care* Prevention Caregiver stress groups Providing respite
Signs to Recognize Abuse: Physical
Unexplained injuries Injuries for which the explanation does not make sense Old wounds/ fractures Bruises/welts/scares that are both sides of the body Broken eyeglasses Signs of being restrained- wrist/ ankle/ chest marks Burns
Signs to Recognize Abuse: Neglect
Unexplained skin rashes Inappropriate clothing Malnutrition- hunger Poor hygiene Lack of medication- medical treatment Left in unsafe situation
RN Role in Identifying Abuse
Vulnerable adults Change in behavior, sleep Depressive symptoms Obvious bruise, lacerations, Genital complaints Unexplained, insufficient funds
Risk factors for elder abuse
White Female Over 70 Mentally or Physically impaired Unable to meet daily needs Having needs that surpass the caretakers ability
Intentional Neglect:
deliberate failure to do the obvious necessary things for an elder (administer medications or withhold transportation to MD appointment)
Unintentional Neglect
inadvertent (didn't know better)