Elder Abuse/Vulnerable Adult

Elder Abuse/Vulnerable Adult home were overflowing, and inside, there was debris and old food left on the bedroom and kitchen floors. John is complaining of pain in his feet, which he attributes to his diabetes. The son reports that his current caregiver is a family friend who has a history of drug addiction and may have relapsed. The patient is alert and oriented and admits to feeling sickly. He does not remember when he last had a glass of water. There is a distinct smell of feces and urine. Upon closer assessment, there are dried feces in his perirectal area with a large red swollen scrotum and redness in his groin folds. There is also evidence of skin tears/bleeding on the left lateral thigh that appeared to be of a friction/shear type mechanism. Mr. Peterson states that he has not had a bath in three weeks. He also reports being unable to get up from the chair by his bed without assistance for the last three days because of increasing weakness and fatigue. Personal/Social History: Mr. Peterson’s son, Frank, reports that the patient was relatively healthy and self-sufficient up until the age of about 77. His first wife, Frank’s mother, died 20 years ago. He remarried two years after his first wife died. Frank and his father’s second wife, Janet, did not get along well, which resulted in a more distant relationship between father and son. Frank lives about four hours away, is an only child, and visits 2-3 times a year. When Janet died a year ago, it first became apparent that John needed help with day to day functioning. John was resistive to leaving his home or having “strangers” come into his house but finally agreed to let a family friend help out. During a previous visit, Frank noticed that his father had a frailer appearance and was more forgetful. It has been about three months since his last visit. Frank reports that his father does not have many visitors or close friends that are still alive. What data from the histories is important & RELEVANT; therefore, it has clinical significance to the nurse? (Reduction of Risk Potential) RELEVANT Data from Present Problem: Clinical Significance: - Soaked in urine Patient is unable to perform his ADLs without assistance and the caregiver is - Spoiled food neglecting the patient. His health is deteriorating and skin integrity has been - Dried vomit on his clothing compromised. He is at risk for infection. - Trash cans overflowing - Old food left on bedroom and kitchen Patient is also showing signs of dehydration with weakness, fatigue, dried vomit floors on his clothing and patient is unable to recall the last time he had a glass of water. - Pain in his feet This is also significant because the patient has diabetes. He could become a risk - Feels “sickly” for renal related issues. - Cannot recall last time he drank water - Dried feces in perirectal area with large red swollen scrotum/redness in groin - Skin tears/bleeding in L lateral thigh – friction/shear type mechanism - Has not had a bath in 3 weeks - Unable to ambulate from chair to bed because he has increased weakness and fatigue - Distinct smell of feces and urine - Hx of diabetes RELEVANT Data from Social History: Clinical Significance: - Lives alone Patient does not engage in social interactions and is distant from his son. He does - Caregiver to help with ADLs not have a reliable social network who can help take care of him. His current - Current caregiver is a family friend who caregiver is showing neglect based on the patient’s physical status. Patient is has hx of drug addiction who may have isolated and may not have a method to contact anyone for help.