Elder Abuse

Setho Hadisuyatmana, S.Kep.Ns., M.NS

Dept. Jiwa & Komunitas
Fakultas Keperawatan Universitas Airlangga
contact: setho.hs@fkp.unair.ac.id
 Review
Ageing Process and impact

Demography

Social Wellbeing and Supports

Data BPS 2010
 Resources
Natural Artifisial
Spontan Dirancang dan memiliki
Intensive dan/atau tekanan
berkelanjutan Di luar kehendak lansia
Contoh: Contoh:
Keluarga Bantuan sosial bencana
Orang-orang terdekat Perawat
Masyarakat Tinggal di Panti
What do elders need (Social provision element)?

Emotional
attachment

Opportunity
Social
of
integration
nurturance

Social
provision

Reliable
Guidance
reliance

Reassurance
of worth
Acceptance toward social support

Negative Positive
Tidak puas Puas
Menggerutu Menikmati proses
Murung/ Kecewa menua
Mengumpat Menerima
dukungan
But as we grow old . . .
Vulnerabilities
Hard to defend oneself
Getting more dependent toward others
Fear of losing independency

All of which is contributing to abuse

 Elder Abuse
Act of harm committed toward an older adult
Infliction of injury, unreasonable confinement,
intimidation, or punishment, with resulting
physical harm, pain, or mental anguish
most elder abuse is believed to be non-
accidental or intentional.
 Prevalence Unknown
Under-diagnosed
Mistreated/misreported
Why is it unreported?
Shame, fear of being moved, fear of losing
independence
Older adults often disappear quietly
Incapacitated to report
Signs might be mistaken due to ageing process
 Who does this?
family members trans generational (social
learning) theory
Hired caregivers Exchange theory,
Psychopathology of the caregiver theory,
Situational theory
Friends Political economic theory
Neighbors
 Forms of Elder Abuse
Abandonment
Emotional or psychological abuse
Financial or material exploitation
Neglect
Physical abuse
Sexual abuse
 Neglect examples
Ones lying on feces or urine for hours/days
Ones living with filthy/dirty condition
Malnourished elder
Deep open pressure sores
Case example
 Dementia is a special case, why?

Impaired/ Unable to report

compromised:
Short-term
memory May not be
Judgment believed
Insight
Reasoning Unable to
Learning ability recognise abuse
Nurse Posts

Detection Management Prevention

 Detecting EA
Challenging

Vague signs and symptoms

Complex social implications

 Nurses Awareness
causes
screening questions
symptoms of abuse
resources in the community
 Biasing and Aliasing
Beware of 3Ds (Dementia, Delirium/Delusion,
Depression)
Cognitive impairment (Mini-Cog Test)
Mental deprivation (SPMSQ or MMSE)
 Tools
Actual Abuse Tool
Elder Abuse Suspicion Index
Elder Assessment Instruments
Health, Attitudes Toward Aging,
Living Arrangements, and
12Finances (HALF) Assessment
Hwalek-Sengstock Elder Abuse
Screening Test
Index of Spouse Abuse
Indicators of Abuse Screen
Partner Violence Screen
Questions to Elicit Elder Abuse
Risk of Abuse Tool
Screen for Various Types of Abuse or
Neglect
Suspected Abuse Tool
Two-Question Abuse Screen
Vulnerability to Abuse Screening
Scale
 Questions to ponder
What are our responsibilities as
family/neighbor?
What are our responsibilities as society?
What roles should the government play?
What policies currently exist to allow/prevent
abuse?
Why should we care?
 Assignment
1. What is: SPMSQ and MMSE?
2. Make your class into eight group. Each group have to
search one tool to assess EA. The tool should be
distinct from one to another group. Each tool selected
should be described in the aspect of:
a. Who is/are the author?
b. How is the tool look like?
c. How do nurses use the tool?
d. How can nurses diagnose the possibility of EA using the
tool?
 Cues
Use database Provided By pnri.go.id (EBSCO,
Taylor and Francis) and scopus.com
Or
Use the available channel (lib-unair, pnri.go.id or
else)
And
Use journal article as main resource
 Submitting Assignment
1. In a MS Word .doc or .docx or .pdf
2. Identify your group member
3. Approximately 1000 words and/or 10%
leeway (1.5 space, Calibri or Arial font size
11)
4. Submit it to setho.h@fkp.unair.ac.id
5. Due: Today, max. 16.00 WIB
 Reference
Daly, J. M. (2011). Evidence-based practice guideine: Elder abuse prevention. Journal of Gerontological
Nursing, 37(11), 11-17.

Hoover, R. M., & Polson, M. (2014). Detecting elder abuse and neglect: Assessment and Intervention.
American Family Physician, 89(6), 453-460.

Muehlbauer, M. R. N. M. S. N. (2011). Elder Abuse and Neglect. Journal of Psychosocial Nursing, 44(11),
43-48.

Yaffe, M. J., & Tazkarji, B. (2012). Understanding elder abuse in family practice. Canadian Family
Physician Mdecin De Famille Canadien, 58(December 2012), 1336-1340.

Ziminski, C. E., & Phillips, L. R. (2011). Clinical concepts. The nursing role in reporting elder abuse:
specific examples and interventions. J Gerontol Nurs, 37(11), 19-23. doi: 10.3928/00989134-20111010-
01