Elder Abuse: Review and Protocols

This assignment requires a thorough review of scholarly articles and resources on elder abuse. Students are expected to analyze the prevalence, types, risk factors, and legal ramifications of elder abuse. Additionally, the assignment delves into established protocols and guidelines for identifying, reporting, and addressing cases of elder abuse in various settings.

Running head: LEGAL AND PROFESSIONAL ISSUES
Legal and professional issues
Name of the student:
Name of the University:
Author’s note

1LEGAL AND PROFESSIONAL ISSUES
Older people have all the right to be treated with respect and dignity whether they are
being cared for in home or aged care setting. However, elderly people living in residential setting
are often vulnerable to risk for abuse and neglect. The elderly abuse may be seen in different
forms such as physical abuse, sexual abuse, abandonment, passive neglect and exploitation and
perpetrators of abuse may be either family members, health care or assisted living staffs and
children. Health care workers may come in contact with elderly people who may disclose them
about harm or experiences of abuse and in such case it would be necessary for the health care
staffs to report about the issue in a legal and professional manner (Lachs and Pillemer 2015).
This essay particularly discusses the legal and professional reporting that occurs post the
disclosure of abuse or harm by elderly people. It also discusses the implications of the process
for registered nurse and the delivery of nursing care.
There are difference explanations for abuse in elderly people. It may take various forms
such as physical, social, sexual, psychological abuse and neglect. For instance, physical abuse is
inflicted by hitting, pushing or striking elderly people with any object. Secondly, elderly people
are also vulnerable to psychosocial or verbal abuse where intention pain or distress is given to
people in the form of humiliation or intimidation through verbal or non-verbal acts. In addition,
the neglect of older person is seen when a care giver fail to carry out all obligations related to
care of older person and come in the way of well-being of the person (Bond and Butler 2013).
Hence, it can be said that elder abuse is multifaceted and a major public health issues and it has
become paramount for health care worker to report about such issues to adults protective service.
As nurses spend maximum time with elderly people, the compulsory reporting document by the
Australian Nursing & Midwifery Federation (ANMF) gave the position statement for nurse and

2LEGAL AND PROFESSIONAL ISSUES
assistants in nursing to compulsory report about abuse in age care setting (ANMF Position
Statement 2017).
According the Aged Care Act 2007, compulsory reporting is necessary in case of
unlawful sexual contact and unreasonable use of force in elderly people living in age care home.
Compulsory reporting is the response that nurses must take on identification of abuse in elderly
people and the key action is taken in accordance with the organization policies and protocol
present at particular aged care setting or nursing home. Another legal obligation is to make the
person report about alleged abuse so that adequate investigation and action is taken to protect
individuals. Another key responsibility of the reporting person is to ensure that the person is not
victimized due to the reporting process (ANMF Position Statement 2017). Ensuring this is
important because elderly abuse is always associated with psychological distress, hence it
warrants more attention be given to affected person as the negative experience lead to
depression, anxiety and loneliness (Dong 2015). The key implication of identifying and reporting
about abuse in elderly person is that it will lead to improvement in education for health care
professionals. This enable them to understand all the cultural and psychological nuance
associated with abuse and improve the quality of care delivered to elderly people (Dong et al.
2013).
There is no comprehensive legislation for adult prptection in Australia, however the Aged
Care Act 1997 gives a framework for provision of elderly care. The requirement for health care
staffs regarding the reporting about abuse in elderly people also given by the National Legal
Response report of the Australian Law Reform Commission. To protect the elderly people, it
mandates that care gives or other support staffs should be encourages to report about abuse to
adult safeguarding agencies (Reporting abuse | ALRC 2017). However, as people disclosing

3LEGAL AND PROFESSIONAL ISSUES
about elder abuse resist doing so because of fear of breaching confidentiality laws or fear of
reprisals from employers, the Public Guardian Act 2014 gives the mandates that head of an
organization should be responsible for protecting whistleblower and ensure that they are not
subjected to adverse consequences (Falk and Hoffman 2014).
For health professionals like nurses and others staffs who have come to know about elder
abuse in particular patient, they have variety of ways to report about the abuse. As per the
mandatory reporting law, they can report about abuse to Adult Protective Services. There are
also different protocols present in residential care centre or geriatric facility for report about
abuse. However, the care giver or other professional must be aware about reporting elder abuse
in a safe and efficient manner (Queensland Government 2017). Following is the stepwise
procedure used to safely report about elder abuse:
Documenting the signs when suspecting abuse:
To report about abuse situations professionally, it is necessary that the reporting person
must keep all documents to prove abuse in affected person. For this, proper assessment of the
elderly person is required. For instance, they need to consider cognitive capacity, health and
functional status of the person. Secondly, they need to preserve signs of abuse by taking
photographs of injuries in patients. Changes in behavior of older adults might also be an
indication of abuse cases (Rankine 2017). The most important and crucial think is getting written
statement of patient related to experience of abuse as this legally important to prove suspicions
and start legal actions against the perpetrator quickly (Piel 2015). In addition, identifying the
type of relationship between the abuser and older adult to understand whether the client wish to

4LEGAL AND PROFESSIONAL ISSUES
protect the person or retain the relationship. On the basis of this information, safe and effective
reporting process can be planned.
Responding to elder abuse:
The caregivers act of responding to abuse may differ by analyzing whether the situation
is an emergency or not. If the situation is an emergency which may cause life threat to the
person, the staff need to initiate emergency service without delay. In this situation, the main
focus should be on protecting the evidence and not asking too much question from client. After
taking adequate emergency action for patient, it will be necessary to debrief and document about
incident in accordance with the agency protocol and policies (Rankine 2017).
If there is no emergency situation during the identification of abuse, one necessary step
by the health care staff will be to assess whether the client has capacity or impaired capacity.
According to the Guardianship and Administration Act 2000, the capacity of the person is
determined by checking the capability of the person for understanding effect of decision,
voluntary decisions and communicating decisions (Barry and Sage-Jacobson 2015). Hence, if the
client lacks capacity, then psychogeriatric assessment is required and after consultation with the
Office of the Public Advocate, appropriate actions regarding safeguarding client may be taken
(Cohen 2016). If there is serious issues, the caregiver can also propose shifting the client to
alterative care unit. If a person has capacity, then counseling support may be given to them. They
can also contact the Aged Rights Advocacy Service (ARAS) to discuss possible actions needed
to address abuse in elderly adult (Rankine 2017).
Taking decision regarding consent or no consent of client:

5LEGAL AND PROFESSIONAL ISSUES
It will be necessary for staff to document client’s consent or no consent to contact police
and take legal actions against the perpetrator of abuse. From a legal perspective, taking consent
regarding appropriate action is necessary in accordance with people’s right to self-determination.
In times emergency, the reporting person gets the liberty to contact police without client’s
consent, however in other situation taking consent is crucial for maintain good relationship with
client (Falk and Hoffman 2014). There is a need to balance the organizational duty of care and
client’s right to self determinant to avoid conflicting situations. In case of no content situation, it
is necessary to follow agency protocol and stay away from reporting process (Hoover and Polson
2014). However, duty of care needs to be implemented such as determining the possible
intervention to protect the elderly people.
Choices in abuse response:
Based on the client’s capacity and consent parameters, if it is confirmed that reporting
and taking legal actions is necessary, there can be two options for client. Firstly, the reporting
person may inform the client about the option of civil intervention or criminal intervention. In
case of civil intervention, the case may be brought into the court and in case of criminal
intervention, the police can intervene to take actions against the abuser and protect the person
(Rankine 2017). Based on the severity of abuse, different actions can be imposed on the abuser.
For instance, a protection order may be given by which conditions will be set against the action
of the abuser. If the abuser is a close relative of elderly client, then the formal strategy will be to
avoid reliance on the person for support and shifting the person to private aged care service.
Informal support options may include encouraging client to take part in community activities to
overcome the shock of abuse (Du Mont et al. 2015).

6LEGAL AND PROFESSIONAL ISSUES
The process of responding and reporting about elder abuse cases also has many important
implications for registered nurse. This is also comprehensively mandated in the compulsory
reporting document for abuse in aged care setting. In the context of responding to elder abuse,
registered nurse act as the frontline health care staffs for assessment of signs of abuse in elder
people and providing preventive care and interventions to them. At the stage of documenting
about abuse, they play a critical role in interview with patients and finding signs of unexplained
injuries (Corbi et al. 2015). Secondly, after all the legal procedures related to reporting and
documenting about abuse had been done, the nurse plays a role in empowerment of patients and
addressing signs of depression in patient. Some elderly client experience social isolation due to
abuse. In such situations, registered nurse acts as the main source for emotional support by
speaking with them and counseling them. They also play a role in referring them to community
related activities where they get the chance to interact in fun filled activities and removed the
emotional scarring that has occurred due to experience of elder abuse (Friedman et al. 2015).
As part of the duty of care and professional responsibility in nursing practices, nurses
plays a major role in addressing health and psychological issues related to abuse in elderly
people. They must have the skills of surveillance and constantly monitoring patients to ensure
their safety. This is particularly important in case of aggressive patients. As there is high
incidence of elderly maltreatment in long-term care facilities, the role of nurse in delivering safe
care becomes necessary in such situation. The research by Rosen et al, (2016) states that
continued illness in elderly people often leads to negative verbal and physical interaction and this
becomes the reason for physical or psychological distress in elderly people. In an attempt to
minimize maltreatment in long-term care facility, the nurses physical intervene to separate
residents, calm the resident and emotionally supporting them to overcome the situation.

7LEGAL AND PROFESSIONAL ISSUES
However, there is still lack of competency in nursing staff regarding the way to recognize,
prevent and address elder abuse. Hence, this paper give the implication that nursing students
must be better trained in identify signs and symptoms of elder abuse, finding legal and
professional document for reporting about suspected abuse and neglect, improving
communication skills related to talking with elder abuse victims and referring people to relevant
community support group.
The essay brought into the attention the need to protect the dignity of elderly people by
means of legal and professional compulsion given to health care professional to mandatorily
report about such case. The process employed by health care staffs to report about abuse gives
the indication that different reporting protocols exist in organization and the reporting must
comply with them while reporting about abuse. Secondly, safe and efficient reporting is
dependent on proper documentation process and assessment of signs related to abuse. As the
registered nurse plays a key role in promoting recovery of elder abuse patients, it is critical to
increase their knowledge and awareness regarding preventing elder abuse.

8LEGAL AND PROFESSIONAL ISSUES
Reference
ANMF Position Statement 2017. Compulsory reporting of abuse in aged care settings for nurses
and assistants in nursing. [online] Available at:
http://anf.org.au/documents/policies/PS_Compulsory_reporting.pdf [Accessed 22 Sep. 2017].
Barry, L. and Sage-Jacobson, S., 2015. Human Rights, Older People and Decision Making in
Australia.
Bond, M.C. and Butler, K.H., 2013. Elder abuse and neglect: definitions, epidemiology, and
approaches to emergency department screening. Clinics in geriatric medicine, 29(1), pp.257-273.
Cohen, C., 2016. 4.5 Psychosocial Aspects of Care in Geriatric Psychiatry. Geriatric Psychiatry
Review and Exam Preparation Guide: A Case-Based Approach, p.364.
Corbi, G., Grattagliano, I., Ivshina, E., Ferrara, N., Cipriano, A.S. and Campobasso, C.P., 2015.
Elderly abuse: risk factors and nursing role. Internal and emergency medicine, 10(3), pp.297-
303.
Dong, X., Chen, R., Chang, E.S. and Simon, M., 2013. Elder abuse and psychological well-
being: A systematic review and implications for research and policy-A mini
review. Gerontology, 59(2), pp.132-142.
Dong, X.Q., 2015. Elder abuse: systematic review and implications for practice. Journal of the
American Geriatrics Society, 63(6), pp.1214-1238.

9LEGAL AND PROFESSIONAL ISSUES
Du Mont, J., Macdonald, S., Kosa, D., Elliot, S., Spencer, C. and Yaffe, M., 2015. Development
of a comprehensive hospital-based elder abuse intervention: an initial systematic scoping
review. PloS one, 10(5), p.e0125105.
Falk, E. and Hoffman, N., 2014. The role of capacity assessments in elder abuse investigations
and guardianships. Clinics in geriatric medicine, 30(4), pp.851-868.
Falk, E. and Hoffman, N., 2014. The role of capacity assessments in elder abuse investigations
and guardianships. Clinics in geriatric medicine, 30(4), pp.851-868.
Friedman, B., Santos, E.J., Liebel, D.V., Russ, A.J. and Conwell, Y., 2015. Longitudinal
prevalence and correlates of elder mistreatment among older adults receiving home visiting
nursing. Journal of elder abuse & neglect, 27(1), pp.34-64.
Hoover, R.M. and Polson, M., 2014. Detecting elder abuse and neglect: assessment and
intervention. American family physician, 89(6).
Lachs, M.S. and Pillemer, K.A., 2015. Elder abuse. New England Journal of Medicine, 373(20),
pp.1947-1956.
Piel, J., 2015. Expanding Slayer Statutes to Elder Abuse. Journal of the American Academy of
Psychiatry and the Law Online, 43(3), pp.369-376.
Queensland Government (2017). A Guide for Elder Abuse Protocols. [online] Available at:
https://www.eapu.com.au/uploads/EAPU_general_resources/EA_Protocols_FEB_2012-
EAPU.pdf [Accessed 22 Sep. 2017].
Rankine, J. 2017. Protocol For Responding To Abuse Of Older People Living At Home In The
Community. [online] Available at:

10LEGAL AND PROFESSIONAL ISSUES
http://www.sa.agedrights.asn.au/files/49_1095_aras_abuseprotocols_final3.pdf [Accessed 22
Sep. 2017].
Reporting abuse | ALRC. 2017 Alrc.gov.au. [online] Available at:
https://www.alrc.gov.au/publications/reporting-abuse [Accessed 22 Sep. 2017].
Rosen, T., Lachs, M.S., Teresi, J., Eimicke, J., Van Haitsma, K. and Pillemer, K., 2016. Staff-
reported strategies for prevention and management of resident-to-resident elder mistreatment in
long-term care facilities. Journal of elder abuse & neglect, 28(1), pp.1-13.