Post on 28-Dec-2015
Protecting Our Elders
Kelly Steagall
PAS 645
Spring 2007
Elderly Population is on the Rise
Baby Boom occurred 1946-1964 Of the 70 million people born during the baby
boom generation, 65 million are alive today. It is estimated that by the year 2030, the number
of Americans over the age of 65 will be 71.5 million (This is about 1 In 5)
With this increase in elderly population comes an increased likelihood of elder abuse
Elder Abuse
Under-diagnosed Estimated 2.1 million elderly adults are
abused each year Victims have decreased quality of life,
increased feelings of helplessness and increased stress and psychological disorders (results in increased ER visits, hospitalization, and higher mortality rates)
Forms of Elder Abuse
Physical Emotional Sexual Neglect & Self Neglect Abandonment Financial Exploitation
Physical Abuse
Any act that intends to cause physical injury
Shaking Improper Restraining Hitting Over-/Under- medicating Depriving the individual of food
Signs and Symptoms of Physical Abuse
Unexplainable/Questionable Injuries Sudden behavioral changes Patchy hair loss Broken eye glasses Check medications for any signs of
over/under use Be wary if the caregiver refuses to allow
the pt. to be examined alone!
Emotional Abuse
Infliction of mental anguish or fear
Belittlement Threatening acts of violence Treating the elder adult as if they were a child
Signs and Symptoms of Emotional Abuse
Changes in emotional state or attitude• Withdrawn• Evasive or fearful• Ambivalent attitude toward caregiver
* Many times emotional abuse is difficult to identify unless the abuse has been witnessed
Sexual Abuse
Can range from forcing elderly adults to view pornographic material to rape
Often overlooked in the elderly population
Signs and Symptoms of Sexual Abuse
Unexplained vaginal or anal bleeding Torn or bloody undergarments Bruising of the breasts, inner thighs, and/or
genital area Unusual/Unexplainable difficulty in walking or
sitting Presence of an STI, oral venereal lesions, or
bruising of the uvula and/or palate Insomnia
Signs and Symptoms of Sexual Abuse cont…
Behavioral changes• Withdrawn• Depressed• Angry• Frightened• Heightened interest in sex or elicit sexual or
aggressive behavior
Neglect
Neglect occurs when a caregiver refuses or is unsuccessful in their attempts to provide adequate care
The victims are often Denied: • Food • Water• Shelter
Signs and Symptoms of Neglect
Poor personal hygiene Multiple Deep Decubiti Weight loss Malnutrition and/or dehydration
Self Neglect
Self inflicted and often unintentional
Elderly may refuse to eat, drink or take medication
May become abusive to the caregiver and/or become destructive
Signs and Symptoms of Self Neglect
Poor personal hygiene Malnutrition and/or dehydration Untreated health conditions Unsanitary living conditions Soiled or ragged clothing Refuses to take medication Lacks basic necessities at residence Admits to or shows signs of depression
Financial Exploitation
Ranges from simply misusing funds to committing embezzlement
Forgery or even forcing the elder adult to unknowingly transfer their property over to the caregiver
Signs and Symptoms of Financial Exploitation
Sudden changes in bank accounts Abrupt changes to the elder’s will Funds or personal property disappearing without
explanation Unpaid bills
Financial Exploitation is uncommonly reported by health care providers simply because they are usually unaware of the patient’s financial affairs
Who is at risk?
Elder adults who are:• Frail• Unable to accomplish basic daily activities• Dependent on a caregiver
Nearly all victims live with their abuser Women>Men Occurs most frequently in individuals with:
• Short term memory loss• Psychiatric disorders• Alcohol abuse
Reporting Elder Abuse
All states have APS laws but they differ from state to state
All APS laws provide protection from liability for those who report in good faith and with no malicious intent
You DO NOT need to obtain the pt.’s permission to report suspected abuse
Nearly all states (44) have mandatory reporting of suspected cases
Conclusion
Our Physician Assistant Professional Oath states:
“I will hold as my primary responsibility the health, safety, welfare and dignity of all human beings.”
Failure to properly report suspected cases of elder abuse completely disregards our professional oath
References
www-medlib.med.utah.edu/kw/derm/mml www.seniorjournal.com www.elderabusecenter.org www.centeronelderabuse.org www.oceansidepolice.com/Images/Elder_abuse_pl (SAAAPA) Student Academy of the American Academy of Physician
Assistants. 2007 Feb. [cited 2007 Feb 13] Available from: http://saaapa.aapa.org/students/grad/oath.htm
Pearsall C. Forensic Biomarkers of Elder Abuse: What Clinicians Need to Know. J Foren Nurs. 2005: 1(4):182-186
Dong X. Medical Implications of Elder Abuse and Neglect. Clin Geriatr Med. 2005; 21(2):293-313. PreMedline Identifier: 15804552
References cont…
American Psychological Association (APA) Elder Abuse and Neglect: In Search of Solutions 2006 January [cited 2006 Sept 26] Available from: http://www.apa.org/pi/aging/elderabuse.html
Herbers J., Wei GS. Reporting Elder Abuse: A Medical, Legal, and Ethical Overview. J Am Med Women’s Assoc. 2004; 59(4):248-54. PreMedline Identifier:16845753
The AGS Foundation for Health in Aging. Elder Mistreatment. 2005 Feb 28. [Cited 2006 Sept 26] Available from: http://www.healthinaging.org/agingintheknow/chapters_ch_trial.asp?ch=9
Geller A., Zenick H. Aging and the Environment: A Research Framework. Environ Health Perspect. 2005 Sept.; 113(9): 1257-1262
Mayo Clinic. Elder Abuse: When You Suspect A Loved One’s Mistreatment. 2005 Jan 13. [updated 2006 Jul 24; cited 2006 Oct 2] Available from: http://www.mayoclinic.com/health/elder-abuse/HA00041
Mangione C., Rodriguez M., Wallace S., Woolf N. Mandatory Reporting of Elder Abuse: Between a Rock and a Hard Place. Annals of Family Medicine: 2006 Sept-Oct: 4 (5): 403-409