Recognizing and Identifying Elder Abuse & Neglect - #35
Take QuizApproximately 11.4% of adults over the age of 60 years will experience some form of mistreatment.
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Types of Abuse/Neglect |
Description |
|---|---|
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1. Abuse |
A. Physical abuse
B. Emotional abuse C. Sexual abuse |
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2. Financial Exploitation |
A. Fraud or identity theft B. Diverting income, deception regarding money or property, or mismanagement of funds |
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3. Neglect |
A. Failure by caregiver to provide food, shelter, clothing, or medical/dental care B. Causing danger to elder (whether intentional or not) |
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4. Self-Neglect |
A. Failure by elder to provide food, shelter, clothing or medical/dental care to self B. Causing danger to self (whether intentional or not) |
Although there are risk factors associated with elder abuse, there is no characteristic elder abuse victim.
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Types of Abuse/Neglect |
Signs of Possible Abuse or Neglect |
|---|---|
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1. Abuse |
A. Injuries not matching with history elicited by patient or caregivers/family B. Frequent use of emeegency services or frequent changing of healthcare providers C. inadequate medication management D. Lack of access to assistive devices (e.g., walker, cane, etc.) E. Behavioural cues (e.g., anxiety, withdrawal, fear, etc.)2 |
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2. Financial Exploitation |
A. Recent disparity between living conditions or appearance and elder's assets B. Caregiver acquiring expensive possessions that seem above their financial means C. New inability to pay bills1 |
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3. Neglect |
A. Caregiver stress B. Unkempt appearance (discheveled, soled clothes, body odor) C. Recent increase in illness resulting from poor health care OR frequent "missed visits" to medical providers |
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4. Self-Neglect |
A. Lower level of social network and engagement1 B. Unkempt appearance (discheveled, soled clothes, body odor) C. Recent increase in illness resulting from poor health care OR frequent "missed visits" to medical providers |
The Elder Abuse Suspicion Index (EASI) is a screening tool that can be used to help identify cases of elder abuse. A response of “yes” on one or more of questions 2-6 should be followed by a consultation with adult protective or social services.
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Elder Abuse Suspicion Index (EASI) Q.1-Q.5 asked of patient; Q.6 answered by doctor within the last 12 months |
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| 1. Have you relied on people for any of the following: bathing, dressing, shopping, banking, or meals? | yes | no | did not answer |
| 2. Has anyone prevented you from getting food, clothes, medication, glasses, hearing aides or medical care, or from being with people you wanted to be with? | yes | no | did not answer |
| 3. Have you been upset because someone talked to you in a way that made you feel shamed or threatened? | yes | no | did not answer |
| 4. Has anyone tried to force you to sign papers or to use your money against your will? | yes | no | did not answer |
| 5. Has anyone made you afraid, touched you in ways that you did not want, or hurt you physically? | yes | no | did not answer |
| 6. Doctor: Elder abuse may be associated with findings such as: poor eye contact, withdrawn nature, malnourishment, hygiene issues, cuts, bruises, inappropriate clothing, or medication compliance issues. Did you notice any of these today or in the last 12 months? | yes | no | did not answer |
Recognizing cues regarding elder mistreatment during a patient-physician encounter in a clinic, hospital or other care setting.
Understand the types of mistreatment and how to sensitively screen geriatric patients for possible mistreatment.
“Intentional actions that cause harm or create a serious risk of harm (whether or not harm is intended) to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder or [a] failure by a caregiver to satisfy the elder’s basic needs or to protect the elder from harm” (National Research Council).
Approximately 11.4% of adults over the age of 6o years will experience some form of mistreatment. Annually, 450,000 cases of mistreatment of geriatric patients occur in the United States. Several factors contribute to the likelihood of an elder experiencing abuse or neglect, including low socioeconomic status, dependency (disability, frailty), older age, race, and cognitive impairment. Those in a low socioeconomic status have fewer resources available to them, leading to an increased number of these elders experiencing some form of mistreatment. About 5% of elders experience financial exploitation by family members.1
• Identify the 4 types of elder abuse and neglect and their characteristic features. • Use the Elder Abuse Suspicion Index Tool to screen geriatric patients for possible abuse.
Review of Systems (ROS)
Geriatric Topics
ACGME Compentencies
Science Principles
- Durso SM, Sullivan GM. Geriatrics Review Syllabus (8th edition). American Geriatrics Society, 2013.
- S.A.N.E. Stop Abuse & Neglect of Elders- Helping Professionals Identify and Stop Elder Abuse. SANE Project Team, Medical College of Wisconsin Center for Healthy Communities and Milwaukee County Department on Aging. ©Medical College of Wisconsin, Inc. and Milwaukee County Department on Aging, 2009. http://county.milwaukee.gov/ElderAbuse/SANETrainingCurriculum.htm
- Yaffe MJ, Wolfson C, Lithwick M, Weiss D. Development and validation of a tool to improve physician identification of elder abuse: The Elder Abuse Suspicion Index (EASI) ©. Journal of Elder Abuse and Neglect 2008; 20(3). http://www.ncbi.nlm.nih.gov/pubmed/18928055
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