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Intra-Family Abuse: Elderly Abuse

Prepared by: Maverick Ulysis A. Velez

Elder Abuse
‡ may involve physical, psychological, financial and social abuse

Factors that contribute to abuse and neglect include:

‡ long-standing family family violence ‡ caregiver stress ‡ and the individual's increasing dependence. ‡ Elders who are at most risks include those who are dependent because of immobility or altered status

‡ The abuse may take place in elderly who are adults living in either private residence or institutions and may caused by their spouses, children, other family members, caregivers, or other individuals on situations of power or trust

‡ The victim may be reluctant to talk about the abuse because: a. The individual fear being sent to an institution b. The individual may blame self poor child rearing if the abuser are his own children.

Four common categories of elder abuse

1. Material abuse or exploitation
‡ involves illegal or improper use of the older adult's resources, especially financial resources.

2. Physical Abuse
‡ involves any act of violence whether or not it results in physical injury.

3. Neglect
‡ involves intentionally or unintentionally failing to meet the needs of older adults who cannot meet their own needs or failure to provide services necessary for the older adults physical and mental health. ‡ Neglect can be abandonment and leaving incapacitated older adults alone too long or failing to remain with those who need help.

4. Sexual Abuse
‡ includes all forms of sexual assault, harassment, or sexual exploitation.

5. Spiritual Abuse
‡ Using the individual's religion to exploit, manipulate, dominate or control him or her ‡ Ridiculing the person's beliefs ‡ Preventing the person from engaging in spiritual or religious practices ‡ Acting in a disrespectful way toward the person's spirituality

6. Self-neglect
‡ Occurs when the person chooses to avoid medical care or other services that would promote optimal functioning

Factors that contribute to Elderly Abuse

1. Individuals who have witnessed or have been victims of abuse themselves are more likely to excibit abusive behavior. 2. Older adults who became more powerless, vulnerable and dependent on their caregivers may be at higher risk for abuse. 3. Abuse of older adult may be a continuation of a longstanding pattern of spousal abuse.

4. Care providers who are inadequately trained may lack the awareness, knowledge or skills to address abusive behaviours. These persons may experience high level of stress and burn out, which may contribute to abuse. 5. Institutions may have procedures an dpolicies that do not adequately protect against harmful situation, or there may poor enforcement of institutional standards.

‡ 6. Institutions may be situated far from residents' home communities, and they may not provide residents with access to or involvement in community or traditional activities.

‡ 7. Negative social attitudes about agingand discrimination against older adults in society that devalue the elderly.

ASSESSMENT
The nurse should be alert for signs of abuse

1. Depression, fear, anxiety, passivity 2. Unexplained physical injuries such as abrasions, lacerations, burns and bruises, sprains. 3. Dehydration, malnutrition 4. Poor hygiene, rashes, pressure sores

5. Oversedation or excessive drowsiness 6. Frequent falls 7. Untreated medical problems 8. Overmedication or under medication 9. Expression of fear in response to touch

Interventions

‡ 1. Assess for signs of abuse and neglect. a. Older adults living in private homes are more likely to be financially or emotionally abused by family members or others. b. Older adults residing in long-term care facilitites may be abused in relation to the often-intimate processes in which staff and residents are involved

2. Provide information to older adults that they can and have right to report any abuse done on them. Many older adults may be unwilling to report abuse because of the following reason: ‡ cognitive impairment or disability such as dementia ‡ Physical Frailty or disability ‡ Literacy, language or cultural barriers that prevent access to information, resources, and support ‡ social isolation ‡ fear of retalliation or being put in an insitution ‡ Fear of abandonment because the victim is dependent on the abuser emotionally, physically or financially

‡ Fear of outside intervention that they can result in their loss of independence and control ‡ Fear of not being believed ‡ shame or stigma ‡ Belief about importance of marriage and family ‡ Pressure to maintan in the family/community reputation

‡ 3. Tell older adults who are victims or suspected victims of abuse that they are not alone, it is not their fault that they are abused or being abused, they do not deserve to be abused and that help is available for them ‡ 4. Report cases of abuse and neglect as mandated by the law

‡ 5. Initiate protective services

‡ 6. Assess for dysfunctional family systems that may contribute to elderly abuse. Promote family functioning and initiate contact with resources

7. To prevent abuse to the elderly population: a. pass laws for the protection of older adults b. Provide more penalty and punishment for perpetrators of physical or sexual abuse and mental cruelty to the elderly c. increase public awareness about issue of abuse of older adults. d. Increase education regarding older adults' legal rights and laws that protect the older adult's rights

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