Tackling Elder Abuse; Nurses' Role

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As we age the incidence of illness and disability increases. This often leads to changes in living arrangements, and the ability to manage personal affairs is compromised. This means that many older adults turn the management of certain activities over to others, often opening the door to mistreatment or elder abuse (Eliopoulos 2010). Elder abuse may be defined as “A single or repeated act or lack of appropriate action occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person or violates their human and civil rights” (HSE, 2002a, p25). Elder abuse is a significant social challenge in contemporary western society. There were 1,870 referrals of alleged abuse made to the HSE service in 2009 (HSE, 2010).This illustrates the seriousness of the issue in Irish society today. Elder abuse takes many forms including physical abuse, sexual abuse, psychological abuse, financial abuse and neglect. It can take place in the home or outside the home - in institutional care. Perpetrators of elder abuse include relatives and family members, professional staff, paid care workers, friends and associates (Leuckenotte 2000). Nurses play an important role in protecting older people from abuse. Their roles include reporting the abuse, assessing the patient, ensuring there is a safety plan in place and assessing the frequency, severity and intent of abuse (Mauk 2006). Nurses need to be educated in abuse so they can clearly and quickly recognise the signs and symptoms of suspected abuse and begin to protect patients (Daly and Coffey 2010).

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Abuse of the older adult takes many different forms, some involving intimidation or threats against the elderly, some involving neglect, and others involving financial chicanery. It is of great importance that nurses and other healthcare professionals understand exactly what elder abuse is and are aware of local and national policies regarding the matter in order to facilitate the detection of abuse and protection of the older adult (INO, 2004).

(a) Physical elder abuse is non-accidental use of force against an elderly person that results in physical pain, injury, or impairment. Such abuse includes not only physical assaults such as hitting or shoving but the inappropriate use of drugs, restraints, or confinement (Eliopoulos 2010 and Mauk 2006).

(b) “Sexual abuse includes rape and sexual assault or sexual acts to which the older person has not consented to, or could not consent, or in which he or she was compelled to consent” (HSE 2002a).

(c) In emotional or psychological senior abuse, people speak to or treat elderly persons in ways that cause emotional pain or distress (Heath and Schofield 1999).

(d) Financial abuse includes illegal or improper use of an elder’s funds, property or assests or inflicting pressure on the elder with regard to wills, inheritance or financial transactions (HSE 2002a).

(e) Neglect, the refusal or failure of a person to fulfil any part of his/her obligations be it medical, physical or emotional duties to an older adult (Lueckenotte 2000).

There are other forms of elder abuse that older adults fall victim to but the ones defined above are the most recognised in society today. Nurses need to be aware of and educated in issues around elder abuse and have knowledge of the definitions and reporting policies within their area of practice.

Elder abuse has only recently been recognized as a huge social problem in the developed world. It is a violation of human rights as well as a significant cause of injury, illness, lost productivity, isolation and despair (WHO 2002). In November 2010 The National Study of Elder Abuse and Neglect which was conducted by researchers at University College Dublin (UCD), was released in Ireland. It is the first report into the prevalence of abuse and neglect, and the types of abuse,...
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