DQ 8-2 Responses
Given the patient’s age and Alzheimer's condition some of these things can actually be what the caregivers reasons are for them, but it is always very important to look into any suspected case of elder abuse when the signs are there. Common risk factors of elder abuse include advanced age, alcohol abuse, dementia, difficulty with finances, females, history of domestic violence, institutionalization, lack of support, and physical or developmental disabilities. There are also characteristics of the abuser to look out for such as financial dependence on the elder, history of violence, mental illness, and substance abuse. Things that we may suspect as signs could be a part of worsened by the medical issues the patient has, but again if there is any presence of clues they should be further looked into for example: unexplained injuries, fractures, lacerations, patterns of defensive injuries, or multiple injuries in different healing stages; inconsistent stories of the occurrence of injuries; poor hygiene, malnutrition, and dehydration (Shenvi, 2013). The first thing to do would be to talk to the patient in private, however if the patient is unable to talk you could still try to ask specific questions and look for non-verbal responses. Also look into their medical history to see if the caregiver’s story is consistent with their medical records, if there is a blood disorder that should be something to easily confirm and look for other visits that have had injuries that would raise red flags. Talk to the family, depending on if the caregiver is a family member or staff at a nursing home, you can ask if there are concerns that have been raised with the family or in the case if the family is the caregiver maybe they are unaware of the level of care needed or unable to adequately care for the elder. Finally, if there is substantial reasons to suspect and report elder abuse then the hospital should communicate and document all concerns and admit the patient if possible, you would not want to send them back to an unsafe environment. Additionally, Involve the patients case manager or social worker and report to adult protective services. I would also want to make sure staff is properly trained and aware to identify potential elder abuse and make sure that local and state resources are accessible, and that staff is educated on the reporting obligations.
Shenvi, C. (2013). Elder Abuse and Neglect: What to do in the Emergency Department.
It is very likely that the patient is suffering physical elder abuse. This should be reported and investigated by adult protective services. It would also be helpful to get a case manager and ethics committee involved. The patinet's principle of autonomy is being violated at home, and should be upheld in the healthcare setting. "In reviewing the indicators of abuse and maltreatment, the reporter does not have to be absolutely certain that abuse or maltreatment exists before reporting" (Pozgar & Santucci, 2016, p. 347).Symptoms should be described accurately, with witness accounts and photographs as necessary (Pozgar & Santucci, 2016, p. 350).
In addition to using the resources of a case manager and ethics committee, the National Center on Elder Abuse (NCEA) can be a resource. They have local partners that could help in this situation.
Pozgar, G. D., & Santucci, N. M. (2016). Legal Aspects of Health Care Administration. (12th ed.). Burlington, MA: Jones & Bartlett Learning.