RECOGNIZIN

G ELDER
ABUSE
BY
VIDA KWOFIE
COPPIN STATE UNIVERSITY
FAMILY NURSE PRACTITIONER
PROGRAM

INTRODUCTION
DEFINITION:-

Elder abuse is an act of

causing harm/distress to an elderly
individual (Yaffe & Tazkarji ,2012)

DHHS-AoA:- refers to elder abuse as any

intentional, or negligent act by a
caregiver or any other person that
causes harm or a serious risk of harm to
a vulnerable adult

STATISTICS/PREVALENCE
According

to the Adult Protective

Services (APS), only 1 out of 14 cases of
elderly abuse get reported to the
appropriate authorities (APS, 2014).

Physicians

reporting of abuse among

the elderly has been found to be the
lowest amongst healthcare and social
service workers (Yaffe & Tazkarji, 2012).

STATISTICS/PREVALENCE
CONTS
40

million of the US population constitutes

individuals 65yrs and older (DHHS).

This

constitute about 13% the total US

population

By

the year 2050, individuals 65yrs and

older will make up ~20% US population
(DHHS).

STATISTICS/PREVALENCE
CONTS
Approximately

10 % of the elderly
population was abused in 2010.

OUR ROLE AS FNPs

Health

care providers, including FNPs are

mandated by law to report any suspected
case of elderly abuse to the appropriate
authorities.

With

this overwhelming rise in the number

of the elderly, FNPs working with the
elderly need to be conscious, alert and
receptive to indications of abuse.

INDICATIONS OF ABUSE
Bruises,

pressure marks, broken bones,

abrasions, and burns

Unexplained

withdrawal from normal

activities, a sudden change in alertness,
and unusual depression

INDICATIONS OF ABUSE
CONTs
Sudden

changes in financial situations

Bedsores,

unattended medical needs,

poor hygiene, and unusual weight loss

Other

behaviors include belittling, and

threats.

TYPES OF ELDER ABUSE

NCEA

RELATIONSHIP OF ABUSER
(DHHS-AoA)

REVIEW OF LITERATURE
A

research study was conducted by

Taylor, Bachuwa, Evans, and
Jackson-Johnson (2008), and the result
revealed that majority of the primary
care providers lack understanding of
reporting procedures. The result also
indicated that a large proportion of the
providers were not able to recognize the
common signs of abuse.

REVIEW OF LITERATURE
CONTS
Yaffe,

Wolfson, Lithwick, and Weiss,

(2008) conducted a study to determine
the rate at which health care providers
report abuse. The surprising report
indicated that out of the 100% reported
cases of abuse, physicians reported only
2%. Nurses reported 26% and social
workers 25%

IDENTIFICATION TOOL
The

Elder Abuse Suspicion Index (EASI)

(Yaffe MJ, Wolfson C, Lithwick M, & Weiss
D., 2008)
Recognized worldwide
specificity = 0.75
sensitivity = 0.47
The instrument has 6 questionnaires
Takes < 2mins
Detects signs and symptoms of abuse
over a 12 month period.
Q1-Q5 is asked of the patient, Q6 is
answered by the provider

1) Have you relied on people for any

of the following: bathing, dressing,
shopping, banking, or meals?

Yes

No

Did not
answer

2) Has anyone prevented you from

getting food, clothes, medication,
glasses, hearing aides or medical care,
or from being with people you wanted
to be with?

Yes

No

Did not
answer

3) Have you been upset because

someone talked to you in a way that
made you feel shamed or threatened?

Yes

No

Did not
answer

4) Has anyone tried to force you to

sign papers or to use your money
against your will?

Yes

No

Did not
answer

5) Has anyone made you afraid,

touched you in ways that you did not
want, or hurt you physically?

Yes

No

Did not
answer

Yes

No

Not sure

6) Doctor: Elder abuse may be

associated with findings such as: poor
eye contact, withdrawn nature,
malnourishment, hygiene issues, cuts,
bruises, inappropriate clothing, or
medication compliance issues. Did you
notice any of these today or in the last
12 months?

Interpretation
While

all six questions should be asked,

a response of yes on one or more of
questions 2-6 may establish concern

AGENCIES THAT HAVE TAKEN

THE INITIATIVES TO HELP
National

Center on Elder Abuse (NCEA)

The

Department of Health and Human

Services(DHHS) -Administration on
Aging (AOA)

Adult

Protective Services (APA)

CONCLUSION
The

FNP with frequent interaction with

the elderly as a care provider can
contribute enormously in recognizing
abuse among the elderly.
The use of quick and easy EASI
questionnaire has been recognized to be
effective and efficient in helping to
identify abuse among the elderly.

CONCLUSION
Once

indication of abuse is suspected, it

must be reported for further
investigation and interventions.

CONCLUSION
The

American Nurses Association (ANA)

code of ethics, provision 3state that the
nurse promotes, advocates for, and
strives to protect the health, safety,
and rights of the patient (ANA).

The

Code of Ethics therefore guides the

provider to focus on the well-being of
the client; including detecting and
reporting abuse among the elderly.

Rise in the presence of the

aged, show respect for the
elderly and fear your God.
I am the Lord. (Leviticus
19:32, NI)

REFERENCE