Elder abuse is an umbrella term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to an older adult. Elder abuse includes physical abuse, neglect, sexual abuse, emotional or psychological abuse, financial or material exploitation or abandonment. Elder abuse can happen within the family. It can also happen in settings such as hospitals or nursing homes or in the community. Elder abuse is a serious problem in this country, affecting as many as 2 million elderly persons. Elder abuse occurs among all racial, ethnic and economic groups. Healthy, as well as frail, aging adults may be victimized. Although elderly men may be victims, the profile of the older adult at greatest risk for abuse is a disabled woman, older than 75 years of age, who is physically, socially or financially dependent on others. Perpetrators may be acquaintances, sons, daughters, grandchildren or others. Most often, physical and emotional abuse stems from stressful caregiving situations. Abuse is also associated with a family history of violence, alcohol or substance problems and emotional or cognitive dysfunction of the abused and/or perpetrator. All elderly patients should be screened for abuse in privacy. An abuser may be reluctant to leave the patient’s side or become angry, overprotective or defensive. Questions about abuse are less threatening when asked, matter-of-factly, in the context of a social history. To ease into a more in-depth screening for abuse, you might say, “Just to make sure you’re okay, we ask all patients questions related to their safety.” A full inspection of the elder’s body should be performed. After assessing and screening the patient, the elder’s response, as well as any suspicious assessment findings should be documented in detail. Being alert for patterns of abuse, as well as paying attention to the patient and caregiver’s interactions, are essential when caring for elderly patients. Additionally, reporting suspected elder abuse is the law in all 50 states. Healthcare providers must know the system for reporting suspected abuse in their state. Although elder abuse occurs to a lesser extent in healthcare facilities, maltreatment in institutions also needs to be policed and violators reported. Dunlap, MAEd, RN, M. (2008). Assessment of elderly abuse. Grown Up, volume 13 (3).
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