Abuse and Neglect

1. Abuse and Neglect

2. Statistics of Abuse • It is estimated that hundreds of thousands of elders are abused at home and in institutions each year • Estimated that only one in every 14 cases is reported • The number of victims is expected to rise as the population ages

3. Abuse – The hidden problem • Our picture of elder abuse is limited, due to the problems hidden and complex nature • Secrecy surrounds those involved • Victims remain unnoticed and untreated because they are isolated • Subtle forms of mistreatment can be hard to spot • Fear of retaliation by the abuser • Fear of being institutionalized

4. Break the Cycle • Learn to recognize abuse • Respond to mistreatment • Prepare yourself

5. What is Abuse and Neglect • Physical mistreatment • Psychological mistreatment • Financial mistreatment

6. Physical Abuse • Most obvious form of abuse because of telltale physical signs • Some forms are hard to spot • Rushing an elder or pulling him to fast when helping him to walk • Tying wandering seniors to a chair so they cannot get lost • Giving them to much or to little medication

7. Psychological Abuse • Inflict emotional pain or distress • Verbal scolding • Harassment • Intimidation • Threatening punishment or deprivation • Threatening the victim like a child • Isolating the elder from family or friends

8. Psychological Abuse • Hard to spot unless you witness it • Generally the victims demeanor or behavior offers clues • Depression • Fear • Hopelessness • Withdrawal or isolation

9. Financial Abuse • Taking control of resources through misrepresentation, coercion, or outright theft for gain • Stealing money or possessions • Forcing to sign contracts or durable power of attorney • Charging for unnecessary services or services not rendered

10. Physical Neglect • Failure to provide goods and services necessary for the health and well-being of the elder • Withholding adequate meals or hydration • Withholding physical therapy or hygiene • Failure to provide physical aides such as glasses, hearing aides, or false teeth • Unkempt, dirty, body odor, fleas or lice • Malnourished and dehydrated

11. More Examples • Taking your time answering call lights • Moving the call button out of reach • Leaving a person on the toilet to long • Removing a cane or walker from reach • Failure to reposition every 2 hours when ordered to in the plan of care

12. Psychological Neglect • Failure to provide social stimulation • Leaving alone for long periods of time • Ignoring him or her • Giving “the silent treatment” • Unusual confinement • Failure to provide companionship or links to the outside world

13. Financial Neglect • Failure to use available resources to sustain or restore the health and security of the adult • Seeking care that does not meet the needs although money is available • Elders confusion about their financial situation or a sudden transfer of assets

14. Warning signs of physical abuse • Bruises, welts, lacerations, fractures, burns, or restraint marks are physical evidence of abuse. • Injuries are inconsistent with medical findings • Laboratory evidence of under medicating or overmedicating • Unexplained venereal disease • Dehydration, malnutrition, decubitus, and poor hygiene

15. Warning Signs of Psychological abuse • Fearful of speaking in front of caregiver • Trembling and lack of eye contact • Sudden eating disorders • Depression • Agitation • Withdrawn • Angry

16. Warning Signs of Financial Abuse • Illegal and improper use of an incapacitated adults resources – some examples include: • Withdrawing large amounts of money at the encouragement of another person • Unusual banking activity • Confused about missing funds • Frequent expensive gifts from elder to caregiver • Frequent checks made out to cash • Signatures that do not match the elder persons

17. Violation of Rights • Violation of a patients or residents rights • Denying privacy • Staying in the bathroom of a capable patient • Staying in the room when the person has guests • Not provided the opportunity to make decisions • Turning off the radio or television • Forcing the person to bathe when told

18. Who gets Abused • All walks of life; men, women, all racial, ethnic, and economic groups • According to the National Elder Abuse Incidence Study – more than half of reported elder abuse victims are women

19. Who are the Abusers • Family members • Caregivers • Strangers • Men • Women

20. Characteristics of an abuser • Prevents the elder from speaking to others • Threatening remarks • Shows anger, indifference, or aggressive behavior toward the elder • Withholds attention or affection • Talks about the elder as a burden • Unusual fatigue and/or depression

21. Shocking Survey • In one study, 40% of healthcare staff who participated in the survey admitted to committing psychological abuse in the preceding year, while 10% admitted physically abusing residents

22. WHY • Misunderstanding and ignorance • Feeling frustrated • Caregivers pattern of dealing with stress • Seniors who are abusive to caregivers compound the stress factor • Unresolved conflicts between family or elders history of abusive relationships • Mental illness, alcoholism, or drug abuse • Inadequate building and grounds security can leave an elder vulnerable to strangers

23. Whatever the cause, elder abuse and neglect are NEVER acceptable

24. Policy • Hospice of the Southwest does not condone patient abuse by anyone including staff members, other patient consultants, volunteers, and staff of other agencies serving the patients, family, members, legal guardians, sponsors, friends, or any other individual

25. Procedure • Cases of suspected sexual assault, physical abuse, or neglect will be immediately reported in the organization, given priority, and investigated thoroughly • The organizations staff refers appropriately or conducts assessment of victims of abuse, neglect, or exploitation

26. Procedure continued • Careful assessment and documentation of physical findings can help provide the data that are believed to confirm diagnosis. History taking and examination of all patients will be done promptly and in privacy. • All cases of suspected abuse/neglect will be reported to the authorities

27. Procedure Continued • A nonjudgmental approach should be maintained toward patients and family members at all times • To protect the patient from real or suspected mental, physical, sexual, and verbal abuse, neglect, and/or exploitation staff will safeguard the patient from the offending individual

28. Summary • Elder abuse is a common problem you are likely to encounter in healthcare • Be alert for signs of abuse or neglect • Document any risks or evidence • Report any suspicions or incidences

29. Conclusion • Do your part to bring this hidden problem into the open • Show you care, become an advocate for elders you encounter at work or anywhere

30. References • Arizona Attorney General . Elder abuse information and training guide. 2009. from https://www.azag.gov/seniors/elder-abuse-information-and-training-guide#33 [accessed 3, Jan 2013] • State of Arizona. Elder Abuse Coalition. Break the silence. Report elder abuse. Retrieved from https://www.azdes.gov/InternetFiles/Pamphlets/pdf/AAA-1139AOTH_BTS_Brochure_Final.pdf [accessed 3, Jan 2013. • Elder Abuse. Retrieved from http://www.mesaaz.gov/police/crimeprevention/ElderAbuse.aspx [accessed 3 Jan, 2013. • Robinson, L., Benedictis, T., Segal, J. Elder Abuse and Neglect. Warning signs, risk factors, prevention. 2012. Retrieved from http://www.helpguide.org/mental/elder_abuse_physical_emotional_sexual_neglect.htm [accessed 4, Jan 2013.