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Old 08-29-2007, 04:50 AM
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Exclamation Elder Abuse

A report in the UK today says that as many as half of UK nurses would not report someone they suspected of causing elder abuse. Age Concern who published the report say that not enough nurses are supported or adequately enough trained to detect and deal with Elder Abuse. I wonder why when Child Protection is considered so important, that the abuse of vulnerable and older adults seems to be ignored / neglected.
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Old 08-29-2007, 01:21 PM
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wow, that was one confusing report--I'd like to see the actual study as I'm not sure what they were saying, or if they even reported things correctly (all too often media reports of research gets things wrong). Are they looking at abuse in the home or in institutional settings? Who was the sample?

That said, I think that there's lots of reasons that elder abuse isn't reported. One is lack of training/education (although this article seemed to think that there was adequate training), another is that it is often a complicated situation, and a third is the fact that people are afraid that if they report it (specifically abuse in the community), the person will be forced to leave their home and be moved into an institution, which can be seen by the older adult as a worse option. Also complicating things are issues of autonomy. Minors are not seen, in general as being able to make decisions in their best interests while adults are. However this is complicated by issues of capacity and competence (capacity is a medical delineation, competence is a legal one).

There also the multifaceted aspects--there is abuse (physical, psychological, sexual), financial exploitation, neglect, and self-neglect. Trying to tease all that out can be tricky.

Then there are issues related to prior histories of abuse (i.e. an abused child coming back and abusing their now vulnerable elder), current condition (dementia-related behavior issues), etc., etc., etc.

I haven't really answered your query, and I feel like I'm rambling, but maybe I can just put into the category of "food for thought."
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Old 08-29-2007, 05:13 PM
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As you say this is indeed a complex issue. I will see if I can track the original report when I have a moment and post something about it.
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Old 09-04-2007, 02:12 PM
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I wonder if there is a bit of embarrassment involved on the part of the elderly patient if they realize the abuse is happening?
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Old 09-04-2007, 08:33 PM
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I think embarrassment can be an issues, particularly if it is financial abuse -- no one wants to think of themselves as gullible.

And I think sometimes there is also a desire to protect the person -- for example, someone with a prescription for narcotics that are being stolen by a family member -- they may not want that person prosecuted b/c then they may have to move out of their home, or because they don't want to go to jail.

As for sexual abuse, well all ages of women are reluctant to report that.

And don't forget, if there's any cognitive impairment, that comes into play as well.
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Old 09-05-2007, 02:06 AM
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Unhappy Financial abuse

Financial abuse by family members is something I have encountered but which might be difficult to prove. Even in my own husband's family there is a daughter who only takes the 300 mile journey to see her mother if the mother pays for her train fair. This same woman took her mother to her own home following the death of her husband (not the woman's father) then booked her into a guest house rather than house her in her own home. This place turned out to be overlooking a graveyard. Not overt abuse but equally very unpleasant behaviour.
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Old 09-06-2007, 02:19 PM
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Cool Financial Abuse

I've often wondered how often we, as health care professionals, discount elderly "confused" patients when they accuse their children of "taking all of their money."

More than one time I've wondered if this patient, who is confused, but talkative, has been taken advantage of financially because the family members are aware that it is easier and more acceptabe to believe a non-confused family member than to believe a patient who is confused and doesn't even know the correct date or year.

"You didn't live through the depression child, believe me when I tell you that I know exactly where all my money is." More than once has that comment or comments similar to that made me raise a questioning eyebrow; but of course, its only a gut feeling and you can't move on gut feelings, or can you?
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Old 09-07-2007, 08:10 AM
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Gut feelings are totally legit, it's just a matter of collecting data to support it (can you tell I'm in an assessment class?).

I say "just" but I know it isn't easy at all. Here in CA, even a suspicion can be reported to Adult Protective Services and they can handle the fact finding.

As most things in nursing, it's always easier said than done.
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