Elder Abuse and Neglect: Warning Signs and Implications to Nursing Practice

This presentation discusses the warning signs of elder abuse and neglect, implications to nursing practice, and government policies to prevent elder abuse. It also covers the prevalence of elder abuse in Canada, types of elder abuse, and experiences with elder abuse.

Elder abuse, neglect or mistreatment refers to the recurrent or
single act that encompasses inappropriate action towards the
elderly, thus causing distress or harm to the older adults. Elder
neglect and abuse comprises of harm towards older people from a
person who shares a close association with the former such as,
partner, spouse, children, neighbour or friends (Glauser & Hustey,
2016). Paid caregivers of the elderly are also considered
responsible for elder abuse.
Warning signs
Implications to nursing
practice
Aging population-specifically abuse-
neglect
Name of the Student
Policy and legislation
The key to deterrence and management of elder abuse and
neglect is the competence to identify the warning signs that are
given below:
• Unexplained cuts, bruises, burn marks and bleeding
• Signs of injury that happen time and again
• Broken bones, fractures and sprain without definite cause
(Clarysse et al., 2018)
• Reluctance of the elderly to visit a doctor for treatment
• Sudden onset of sexually transmitted diseases
• Bruises, particularly near the genitals or breasts
• Bloody, soiled or torn clothes
• Bleeding from the genitals (Kourkouta et al., 2016)
• Frightened or withdrawn behaviour
• Confusion, depression, and loss of interest in things that
were once enjoyed
• Sleeping problems
• Speaking to oneself
• Government also addresses elder neglect and abuse through
New Horizons for Seniors Program that ensures that all older
adults contribute to and gain benefit from active living and
social participation
• 8 million adults will be aged over 65 years by 2031.
• Not less than three quarters of Canadian older adults have
been subjected to abuse in 2016 (Podnieks, 2017)
• Most common are financial abuse and psychological abuse
• 4-10% older adults are subjected to abuse
• 20% incidents are only reported to a person who can offer
some help
• Around 9,900 older adults suffered from police-reported
violence in 2015
• 60% older adults suffering from family violence are women
(Statistics Canada, 2017)
• Family violence was most commonly reported in 2015
• Elder neglect and abuse can typically occur in any situation,
however, it is most common in community setting
• Within global population, it is the role of nurses to ensure that
older adults are protected from neglect and maltreatment (Corbi et
al., 2015)
• Creating a provision for safe environment that focuses on
physical, psychological, financial, and social security forms a major
component of nursing practice
• Nurses have the responsibility of promoting a safe
environment and patient advocacy, while shaping healthcare
policies and imparting education on abuse prevention
Introduction
Prevalence in Canada
Types of elder abuse
The essential common denominator of elder abuse focuses on use
of control and power by one person, with the aim of affecting the
status of health and wellbeing of the victim. There are different
types of abuse and neglect of older individuals such as:
•Psychological and emotional- yelling, humiliating, name calling,
accusations, blaming, or ridiculing
•Physical- punching, hitting, kicking, slapping, confinement or
restraint
•Financial- misappropriate use of monetary resources by
strangers, caregivers and family members, lack of financial
support (Jackson, 2016)
•Neglect- depriving older people of food, clothing, medicines,
comfort and necessary services
•Sexual- forceful engagement in sexual activity or conversations
without consent
•Abandonment- deserting older adults or leaving them unattended
that endangers their health
Policy cycle
With the aim of preventing and elder abuse and providing support
to the victims, government policies must focus on the following
aspects:
• Creating elder abuse and neglect crimes that acknowledge the
defencelessness of older adults
• Penalty enhancements like prison sentence for the perpetrators
• Expediting or prioritising criminal and civil cases where older
adults are victims
• Providing compensation for the economic hardship that the older
adults have to face, as a result of financial abuse
• Creating special provisions for the victims in restitution
regulations, such as, formulating reimbursement for
psychological and medical treatment compulsory for the older
victims
• Offering incentives to the private attorneys, in order to
encourage them for accepting elder abuse cases
• Denying or revoking permits and licensure to healthcare
organisations where the employees breach the legislation and
commit offenses against older adults
• Creating provisions for providing protection to the whistle-
blowers who report neglect and abuse of the elderly
References
• Government of Canada aims to safeguard the most vulnerable
older adults in the society to prevent abuse and neglect
• Amendments have been made to the Criminal Code in order to
recognise offence that creates significant impact on financial
situation and health of older adults as an aggravating factor
(Ejaz, Olsen & Lamont, 2017)
• Federal Elder Abuse Initiative (FEAI) has been launched by
the government in 2008 for helping seniors and other people
identify the warning signs of elder abuse, besides providing the
much needed support (Bobitt, Carter & Kuhne, 2018)
Conclusion
Elder abuse encompasses actions that injure, harm, or jeopardise
the welfare and health of older adults. Prevention and effective
management of elder abuse is a matter of public health concern.
Senior victims of police-reported family-related physical assault
(2009-2015)
Source- (Statistics Canada, 2017)
Experiences with elder abuse
Source- (CARP, 2019)
Bobitt, J., Carter, J., & Kuhne, J. (2018). Advancing national policy on elder abuse.
Public Policy & Aging Report.
Canadian Association for Retired Persons. (2019). 89 per cent say government must
address elder abuse, yet it has hardly registered this election. Retrieved from https://
www.carp.ca/2018/05/30/89-per-cent-say-government-must-address-elder- abuse-
yet-hardly-registered-election/
Clarysse, K., Kivlahan, C., Beyer, I., & Gutermuth, J. (2018). Signs of physical abuse
and neglect in the mature patient. Clinics in dermatology, 36(2), 264-270.
Corbi, G., Grattagliano, I., Ivshina, E., Ferrara, N., Cipriano, A. S., & Campobasso, C.
P. (2015). Elderly abuse: risk factors and nursing role. Internal and emergency
medicine, 10(3), 297-303.
Ejaz, F. K., Olsen, B., & Lamont, H. (2017). ELDER ABUSE PREVENTION:
LESSONS FROM FOUR INITIATIVES. Innovation in Aging, 1(suppl_1), 994-
994.
Glauser, J., & Hustey, F. M. (2016). Abuse of the elderly and impaired. Tintinalli’s
emergency medicine: A comprehensive study guide, 8e New York, NY: McGraw-
Hill.
Jackson, S. L. (2016). All elder abuse perpetrators are not alike: the heterogeneity of
elder abuse perpetrators and implications for intervention. International journal of
offender therapy and comparative criminology, 60(3), 265-285.
Kourkouta, L., Monios, A., Plati, P., Ouzounakis, P., Mihalache, A., & Iliadis, C. (2016,
March). Elder Abuse. In International Journal of Health Administration and
Education Congress. Full Text Part. Gebze, Turkey in (pp. 26-27).
Podnieks, E. (2017). ELDER ABUSE IN CANADA: A GROWING DILEMMA IN AN
AGING SOCIETY. Innovation in aging, 1(Suppl 1), 106.
Statistics Canada. (2017). Section 5: Police-reported family violence against seniors.
Retrieved from https://www150.statcan.gc.ca/n1/pub/85-002-
x/2017001/article/14698/05-eng.htm