Elder abuse is a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person.
- Elder Mistreatment or abuse is acts that cause harm to vulnerable elderly persons
- It occurs deliberately or through neglect
- It is meted out by caregivers or persons held in trust
- It may occur in home or institutional settings
- It may affect older persons across all social classes
- It may affect males as well as females
- Diagnosis may be missed if not carefully sought
For suffering abuse
- Advanced age
- Disability (physical or mental)
- Lack of financial skills
- Recent bereavement or other personal loss
- Conditions that increase dependence
For committing abuse
- Elder dependence
- Family caregiving
- Lone caregiver and stress.
- Mental illness
- Physical abuse in the past
- Substance abuse
- Financial or material neglect:
- Exploitation, theft of financial
documents, forcible transfer of property, etc.
- Neglect or abandonment neglect:
Caregiver fails to meet the older person’s needs e.g. clothing, hygiene, healthcare, shelter, social stimulation, etc.
- Physical neglect:
- Injury inflicted through striking, force feeding, use of restraints, etc.
- Psychological neglect:
- Mental anguish inflicted through insulting statements, threats, social isolation, etc.
- Self-neglect neglect:
- Acts by older adult that threaten their own wellbeing or safety
- Sexual neglect:
- Forced sexual activity, touching or fondling without consent
- Bruising in unusual locations
- Burns in patterns suggesting intentional injury
- Delay in seeking medical care
- Inattention to personal hygiene.
- Injury patterns suggesting use of restraints
- Traumatic alopecia
- Unexplained fractures
- Unexplained weight loss
- Allergic reactions
- Adverse reactions to medications
- Contact dermatitis
- Mental illness
- Senile purpura
- Systemic diseases presenting with
features of neglect e.g. diabetes mellitus, malabsorption, urinary tract infection, etc.
- Physical harm
- Psychological harm e.g. living in fear, depression, anxiety, etc.
- Morbidity worsening
- As indicated by history and clinical
- Improve safety
- Improve health status
- Improve overall wellbeing
Individualized, multi-disciplinary approaches:
- Assess decision making capacity
- Social work referral
- Comprehensive geriatric assessment
- Other referrals as indicated.
- As indicated by the clinical scenario e.g. analgesia for pain
- Recognize warning signs (in the older adult, caregiver, home or institution) and intervene