Transcript Protecting Our Elders

Protecting Our Elders
Kelly Steagall
PAS 645
Spring 2007
Elderly Population is on the Rise
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Baby Boom occurred 1946-1964
Of the 70 million people born during the baby
boom generation, 65 million are alive today.
It is estimated that by the year 2030, the number
of Americans over the age of 65 will be 71.5
million (This is about 1 In 5)
With this increase in elderly population comes
an increased likelihood of elder abuse
Elder Abuse
Under-diagnosed
 Estimated 2.1 million elderly adults are
abused each year
 Victims have decreased quality of life,
increased feelings of helplessness and
increased stress and psychological disorders
(results in increased ER visits, hospitalization,
and higher mortality rates)
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Forms of Elder Abuse
Physical
 Emotional
 Sexual
 Neglect & Self Neglect
 Abandonment
 Financial Exploitation
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Physical Abuse
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Any act that intends to cause physical
injury
Shaking
 Improper Restraining
 Hitting
 Over-/Under- medicating
 Depriving the individual of food
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Signs and Symptoms of Physical
Abuse
Unexplainable/Questionable Injuries
 Sudden behavioral changes
 Patchy hair loss
 Broken eye glasses
 Check medications for any signs of
over/under use
 Be wary if the caregiver refuses to allow
the pt. to be examined alone!
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Emotional Abuse
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Infliction of mental anguish or fear
Belittlement
 Threatening acts of violence
 Treating the elder adult as if they were a child
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Signs and Symptoms of
Emotional Abuse
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Changes in emotional state or attitude
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Withdrawn
Evasive or fearful
Ambivalent attitude toward caregiver
* Many times emotional abuse is difficult to
identify unless the abuse has been witnessed
Sexual Abuse
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Can range from forcing elderly adults to
view pornographic material to rape
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Often overlooked in the elderly population
Signs and Symptoms of Sexual
Abuse
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Unexplained vaginal or anal bleeding
Torn or bloody undergarments
Bruising of the breasts, inner thighs, and/or
genital area
Unusual/Unexplainable difficulty in walking or
sitting
Presence of an STI, oral venereal lesions, or
bruising of the uvula and/or palate
Insomnia
Signs and Symptoms of Sexual
Abuse cont…
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Behavioral changes
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Withdrawn
Depressed
Angry
Frightened
Heightened interest in sex or elicit sexual or
aggressive behavior
Neglect
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Neglect occurs when a caregiver
refuses or is unsuccessful in their
attempts to provide adequate care
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The victims are often Denied:
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Food
Water
Shelter
Signs and Symptoms of Neglect
Poor personal hygiene
 Multiple Deep Decubiti
 Weight loss
 Malnutrition and/or dehydration
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Self Neglect
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Self inflicted and often unintentional
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Elderly may refuse to eat, drink or take
medication
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May become abusive to the caregiver
and/or become destructive
Signs and Symptoms of Self
Neglect
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Poor personal hygiene
Malnutrition and/or dehydration
Untreated health conditions
Unsanitary living conditions
Soiled or ragged clothing
Refuses to take medication
Lacks basic necessities at residence
Admits to or shows signs of depression
Financial Exploitation
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Ranges from simply misusing funds to
committing embezzlement
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Forgery or even forcing the elder adult to
unknowingly transfer their property over to
the caregiver
Signs and Symptoms of Financial
Exploitation
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Sudden changes in bank accounts
Abrupt changes to the elder’s will
Funds or personal property disappearing without
explanation
Unpaid bills
Financial Exploitation is uncommonly reported
by health care providers simply because they
are usually unaware of the patient’s financial
affairs
Who is at risk?
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Elder adults who are:
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Frail
Unable to accomplish basic daily activities
Dependent on a caregiver
Nearly all victims live with their abuser
Women>Men
Occurs most frequently in individuals with:
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Short term memory loss
Psychiatric disorders
Alcohol abuse
Reporting Elder Abuse
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All states have APS laws but they differ from
state to state
All APS laws provide protection from liability for
those who report in good faith and with no
malicious intent
You DO NOT need to obtain the pt.’s permission
to report suspected abuse
Nearly all states (44) have mandatory reporting
of suspected cases
Conclusion
Our Physician Assistant Professional Oath
states:
“I will hold as my primary responsibility the
health, safety, welfare and dignity of all
human beings.”
Failure to properly report suspected cases of
elder abuse completely disregards our
professional oath
References
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www-medlib.med.utah.edu/kw/derm/mml
www.seniorjournal.com
www.elderabusecenter.org
www.centeronelderabuse.org
www.oceansidepolice.com/Images/Elder_abuse_pl
(SAAAPA) Student Academy of the American Academy of Physician
Assistants. 2007 Feb. [cited 2007 Feb 13] Available from:
http://saaapa.aapa.org/students/grad/oath.htm
Pearsall C. Forensic Biomarkers of Elder Abuse: What Clinicians Need to
Know. J Foren Nurs. 2005: 1(4):182-186
Dong X. Medical Implications of Elder Abuse and Neglect. Clin Geriatr
Med. 2005; 21(2):293-313. PreMedline Identifier: 15804552
References cont…
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American Psychological Association (APA) Elder Abuse and Neglect: In
Search of Solutions 2006 January [cited 2006 Sept 26] Available from:
http://www.apa.org/pi/aging/elderabuse.html
Herbers J., Wei GS. Reporting Elder Abuse: A Medical, Legal, and Ethical
Overview. J Am Med Women’s Assoc. 2004; 59(4):248-54. PreMedline
Identifier:16845753
The AGS Foundation for Health in Aging. Elder Mistreatment. 2005 Feb 28.
[Cited 2006 Sept 26] Available from:
http://www.healthinaging.org/agingintheknow/chapters_ch_trial.asp?ch=9
Geller A., Zenick H. Aging and the Environment: A Research Framework.
Environ Health Perspect. 2005 Sept.; 113(9): 1257-1262
Mayo Clinic. Elder Abuse: When You Suspect A Loved One’s Mistreatment.
2005 Jan 13. [updated 2006 Jul 24; cited 2006 Oct 2] Available from:
http://www.mayoclinic.com/health/elder-abuse/HA00041
Mangione C., Rodriguez M., Wallace S., Woolf N. Mandatory Reporting of
Elder Abuse: Between a Rock and a Hard Place. Annals of Family
Medicine: 2006 Sept-Oct: 4 (5): 403-409