Module 10
NCOA
I. Older Adult Abuse
a. Professional Standards
i. Nurses and other healthcare providers have a moral and legal
responsibility to operate within defined standards of practice and care.
ii. Standards of care
1. Are expectations and guidelines to ensure the safety and quality of
care provided to clients.
2. Provides a systematic way to evaluate if appropriate levels of care
are being provided or not.
3. The Scope and Standards of Gerontological Nursing Practice,
established by the American Nurses Association in 1994, is
an example of a published standards of professional practice
in gerontological nursing care.
b. Types of Older Adult Abuse
i. Elder abuse has been reported as occurring in 1 out of every 10 people
ages 60 and older according to the Centers for Disease Control as of
2017.
1. Many older adults respond to abuse by having this idea that they
will be treated worse if they report the abuse or many fear that one
will be institutionalized or abandoned. These factors may prevent
the victim from seeking help and reporting the abusive behavior.
ii. Elder abuse is typically categorized in three main areas: domestic
elder abuse, institutional elder abuse and self-neglect or self-abuse.
This extends to neglect and abandonment.
1. Domestic elder abuse
a. May involve a physical attack on a frail elderly person who
is unable to defend him- or herself from younger, stronger
family members.
b. Physical abuse is any action that causes physical pain or
injury.
c. Neglect is a passive form of abuse in which caregivers fail
to provide for the needs of the older person such as food,
clothing, toileting etc.
d. Emotional abuse includes behaviors such as isolating,
ignoring, or depersonalizing older adults
e. Financial abuse involves resources of an older person are
stolen or misused by a person whom the older adult trusts.
f. Sexual abuse involves nonconsensual sexual contact with
an older adult.
, g. Abandonment occurs when dependent older persons are
deserted by the persons responsible for their custody or
care under circumstances in which a reasonable person
would continue to provide care.
2. Institutional abuse
iii. Refers to abuse that often occurs in a residential institutions such as a
nursing facility
iv. Is usually committed by a paid caregiver or staff member.
c. Self-neglect
i. Self-neglect is defined as failure to provide for self because of a lack of
ability or lack of awareness.
ii. Self-neglect is more likely to be seen when an older person has few or no
close family or friends.
iii. Self-neglect can also occur despite the presence of a caregiver.
iv. Many times self-neglect is recognized by ones in close proximity to the
client including neighbors for example.
v. Self-neglect is often connected with some form of mental illness or
dementia
II. Signs of abuse
a. Nurses must be alert to the signs and symptoms of older adult abuse.
b. Older adult abuse is determined during the assessment stage of the nursing
process.
c. Some signs of abuse or visible, however some signs may be very mild requiring
the nurse to have keen assessment skills.
d. Some of the more visual signs of older adult abuse include:
i. Demonstrates agreement or excessive compliance with the caregiver or
family member.
ii. Poor hygiene such as body odor, uncleanliness, or soiled clothing
or undergarments.
iii. The older adult may have signs of malnutrition or dehydration.
iv. The client may have multiple burns or pressure sores, bruises on trunk or
upper arms and may have bruises or wounds in various stages of healing.
v. Signs of neglect include:
1. Lack of adequate clothing or footwear
2. Lack of adequate medical attention.
3. Lack of food, medication, or care
4. Being left alone or isolated for long periods of time.
5. The older adult may report fear of the caregiver or a family
member.
6. Multiple ulcers
e. Less obvious signs may include:
NCOA
I. Older Adult Abuse
a. Professional Standards
i. Nurses and other healthcare providers have a moral and legal
responsibility to operate within defined standards of practice and care.
ii. Standards of care
1. Are expectations and guidelines to ensure the safety and quality of
care provided to clients.
2. Provides a systematic way to evaluate if appropriate levels of care
are being provided or not.
3. The Scope and Standards of Gerontological Nursing Practice,
established by the American Nurses Association in 1994, is
an example of a published standards of professional practice
in gerontological nursing care.
b. Types of Older Adult Abuse
i. Elder abuse has been reported as occurring in 1 out of every 10 people
ages 60 and older according to the Centers for Disease Control as of
2017.
1. Many older adults respond to abuse by having this idea that they
will be treated worse if they report the abuse or many fear that one
will be institutionalized or abandoned. These factors may prevent
the victim from seeking help and reporting the abusive behavior.
ii. Elder abuse is typically categorized in three main areas: domestic
elder abuse, institutional elder abuse and self-neglect or self-abuse.
This extends to neglect and abandonment.
1. Domestic elder abuse
a. May involve a physical attack on a frail elderly person who
is unable to defend him- or herself from younger, stronger
family members.
b. Physical abuse is any action that causes physical pain or
injury.
c. Neglect is a passive form of abuse in which caregivers fail
to provide for the needs of the older person such as food,
clothing, toileting etc.
d. Emotional abuse includes behaviors such as isolating,
ignoring, or depersonalizing older adults
e. Financial abuse involves resources of an older person are
stolen or misused by a person whom the older adult trusts.
f. Sexual abuse involves nonconsensual sexual contact with
an older adult.
, g. Abandonment occurs when dependent older persons are
deserted by the persons responsible for their custody or
care under circumstances in which a reasonable person
would continue to provide care.
2. Institutional abuse
iii. Refers to abuse that often occurs in a residential institutions such as a
nursing facility
iv. Is usually committed by a paid caregiver or staff member.
c. Self-neglect
i. Self-neglect is defined as failure to provide for self because of a lack of
ability or lack of awareness.
ii. Self-neglect is more likely to be seen when an older person has few or no
close family or friends.
iii. Self-neglect can also occur despite the presence of a caregiver.
iv. Many times self-neglect is recognized by ones in close proximity to the
client including neighbors for example.
v. Self-neglect is often connected with some form of mental illness or
dementia
II. Signs of abuse
a. Nurses must be alert to the signs and symptoms of older adult abuse.
b. Older adult abuse is determined during the assessment stage of the nursing
process.
c. Some signs of abuse or visible, however some signs may be very mild requiring
the nurse to have keen assessment skills.
d. Some of the more visual signs of older adult abuse include:
i. Demonstrates agreement or excessive compliance with the caregiver or
family member.
ii. Poor hygiene such as body odor, uncleanliness, or soiled clothing
or undergarments.
iii. The older adult may have signs of malnutrition or dehydration.
iv. The client may have multiple burns or pressure sores, bruises on trunk or
upper arms and may have bruises or wounds in various stages of healing.
v. Signs of neglect include:
1. Lack of adequate clothing or footwear
2. Lack of adequate medical attention.
3. Lack of food, medication, or care
4. Being left alone or isolated for long periods of time.
5. The older adult may report fear of the caregiver or a family
member.
6. Multiple ulcers
e. Less obvious signs may include:
