Elder Abuse, comment

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I wanted to post on the subject of elder abuse and how important it is to do a very thorough assessment when admitting a patient to the hospital who you suspect might have suffered some abuse. I work in an ICU unit and we received a patient from home who was bed bound and had several strokes in the past. He was being cared for at home by his wife. She also was taking care of two mentally handicapped adult children in their home as well. Upon admitting him to the hospital, we found that he had two very large areas on his buttocks directly beside his coccyx. They already had eschar on them. We immediately took pictures of the wounds. When the wife came in to see the patient, we asked about those areas and described them to her. She immediately became defensive and asked if we were accusing her of neglect. We told her that we were not accusing her of anything, but that we had to document any present on admission findings. She became very irate and demanded that she speak with the doctor. After talking to the doctor, he assured her that maybe that happened on the "O.R. table and that we would just treat the pt. The patient was only in the OR for an hour and a half so it seemed unlikely that this happened there. The wife stated that he was "not like this" when he came in and therefore, we must have caused them. There was an investigation and APS became involved and did find that there were some issues in the home. Had it not been for the assessment and documentation of the admitting nurse, then we may have thought that those wounds may have happened in the OR and not at home like they really turned out to be.

Original Post
April 14, 2010
Title: Elder Abuse
I wanted to comment on the importance of the assessment facilitated when the skilled nurse performs a head to toe on the elderly client. The skilled nurse not only has a responsibility to assess the body, but the holistic aspects of that client. I am a home health nurse, so from my perspective, the head to toe is a portion of the bigger scope of what I need to address. As we move into this new millennium with advances in technology, we are learning that the geriatric population is growing. More older adults are being placed in the position of caring for aging parents which can, for some, be an extreme balancing act to between their own lives and responsibilities, coupled with caring for their parents business affairs. All of these dynamics can place stress to that child of the older adult. Some of the abuse we as healthcare professionals need to assess is emotional and financial. Some parents, based on my experience, are made to feel guilty when the child needs to pick up a prescription or be taken to the doctors office. We need to ensure that the caregivers have as much support available to them to decrease stress, and increase the relationship dynamic between client and caregiver which will in part, keep the client healthy knowing that they have a good support system.

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