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Nurse detection of elder abuse
Lucy Price on September 24, 2018 at 9:43 pm
As the elderly population increases, so has the prevalence of elder abuse.
According to the World Health Organization, around 1 in 6 people aged 60 or over have experienced some form of abuse in the past year. This abuse is often perpetrated by someone trusted by the victim. It is therefore essential that healthcare professionals are able to detect abuse and know the appropriate action to take.
A recent article published in the Dove Medical Press journal, Nursing: Research and Reviews, examines the role of the nurse in protecting this vulnerable patient group. The article entitled The role of the nurse in detecting elder abuse and neglect: current perspectives highlights the importance of elder abuse knowledge and detection strategies amongst nursing staff.
The author, Dr Amanda Phelan (University College Dublin, Ireland), examines the different types of abuse suffered by elderly patients which may be physical, psychological, emotional or financial. Some patients may also suffer sexual abuse and neglect.
Financial abuse in dementia patients poses a significant challenge for healthcare providers. Dr Phelan highlights the importance of an early financial capacity assessment. A timely assessment provides older people with the opportunity to organise their finances before their condition advances, and they no longer have financial capacity.
The article reports that there was no policy response to elder abuse until the early 2000s, and that the prevalence of elder abuse in older people with capacity challenges is much higher than those without. WHO suggest that 2 out of 3 people living with dementia have suffered abuse.
Despite the challenges of screening for elder abuse, several assessment tools have been used in practice. Dr Phelan references two screening methods that have been recommended for piloting in Ireland; the Elder Abuse Suspicion Index (EASI) and the Older Adult Financial Exploitation Measure.
Author Dr Amanda Phelan commented that “Ensuring appropriate safeguarding for older people is a fundamental aspect of a nurse's responsibility. It is essential that safeguarding is examined using a variety of lens, such as human rights, contextual factors, organisational issues and societal attitudes. This paper examines these multiple impacting factors and provides guidance for both prevention and intervention so that human flourishing in ageing is enabled.”
The paper emphasises the complex nature of elder abuse and the detection challenges faced by healthcare professionals. The author highlights the importance of trust and communication between healthcare professionals and their patients, in order to encourage the disclosure of elder abuse. Dr Phelan also calls for safeguarding of older people and highlights nursing staff as ‘key professionals to detect suspected cases of abuse and trigger appropriate interventions.’
In response to the publication of this piece, Editor-in-Chief of the journal, Dr Cindy Hudson, said “While people are living longer, society is more industrialized, a youth-oriented culture has developed, and overall respect and reverence for elders appear to be decreasing globally. It is essential that nurses and other health care providers are aware of the risk factors for elder abuse, assess for it, and take action to safeguard elders from maltreatment as standard care. This important article examines the issue of ageism, human rights in the context of elder abuse and the nurse’s role in detection and intervention.”