Elder Abuse Power Point


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  • Refer to appendix Three for the recommended Elder abuse Action and Protection Plan
  • The discussion can be with family/whanau, lead practitioner, line manager, Age concern elder abuse and neglect prevention coordinator and any other relevant agencies or professionals. A decision may need to be made immediately regarding an urgent course of action
  • A strategy meeting needs to be held if the alleged abuse is serious, the risk of abuse is continuing, is serious, the case is complex or ongoing, the alleged abuse is of a criminal nature or if the allegation is serious or complex.
  • The main thing is to check whether or not the abuse and or neglect is still occurring adn then to see if other areas have improved, i.e. Is the older person eating properly and the carer less stressed.
  • Age Concern shoudl arrange for older person, carer, family/whanau and all other service providers to attend the case plan review on the date set in the original plan. (refer to appendix five)
  • Elder Abuse Power Point

    1. 1. Elder Abuse <ul><li>Elder Abuse is:- </li></ul><ul><li>“ ....a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm of distress to an older person” </li></ul><ul><li>(Action on Elder Abuse, 2004; WHO/INPEA 2002) </li></ul>
    2. 2. Elder Abuse <ul><li>Older persons may be abused by:- </li></ul><ul><li>Partner, adult child or other relative </li></ul><ul><li>Friend, neighbour or visitor </li></ul><ul><li>Patient or resident </li></ul><ul><li>Health care provider, caregiver or other social or support worker </li></ul>
    3. 3. Elder Abuse and Neglect <ul><li>Residential care facility owner or manager </li></ul><ul><li>Volunteer worker </li></ul><ul><li>Person managing an older person’s affairs (e.g. Attorney or guardian) </li></ul>
    4. 4. ELDER ABUSE & NEGLECT <ul><li>From 1998-2001 Age Concern saw 2441 cases of elder abuse and neglect </li></ul><ul><li>Psychological abuse (56%) </li></ul><ul><li>Financial abuse (46%) </li></ul><ul><li>Physical abuse (22%) </li></ul><ul><li>Active & passive neglect (18%) </li></ul><ul><li>Sexual abuse (3%) </li></ul>
    5. 5. Elder Abuse and Neglect <ul><li>Analyses of cases seen by elder abuse services found that family members were most often identified as the abuser, in particular adult sons or daughters (40% of abusers) or the spouse or partner of an older person (15% of abusers) </li></ul><ul><li>(Age Concern NZ, 2005; Hong et al, 2004) </li></ul>
    6. 6. ELDER ABUSE AND NEGLECT <ul><li>Discounting of Abuse by Professionals: </li></ul><ul><li>There is no problem </li></ul><ul><li>There is a problem but it’s not my problem </li></ul><ul><li>There is a problem but it’s too big for me </li></ul><ul><li>There is a problem and there’s nothing I can do about it </li></ul>
    7. 7. ELDER ABUSE AND NEGLECT <ul><li>Discounting of Abuse by Victims </li></ul><ul><li>Makes excuses for perpetrator </li></ul><ul><li>Blames self </li></ul><ul><li>Influence of tradition/religion </li></ul><ul><li>Blaming others (not perpetrator) </li></ul><ul><li>Denies severity & causes of injuries </li></ul>
    8. 8. ELDER ABUSE AND NEGLECT <ul><li>Denial of Injury (failure to acknowledge being hurt) </li></ul><ul><li>Example:- </li></ul><ul><li>She wasn’t really abusive. She just shoved me. </li></ul><ul><li>She didn’t hurt me that bad. Just a few bruises </li></ul>
    9. 9. ELDER ABUSE AND NEGLECT <ul><li>Denial of the victimizer (blame on external factors) </li></ul><ul><li>Example:- </li></ul><ul><li>His boss has been picking on him </li></ul><ul><li>His daughter has been acting up </li></ul><ul><li>He doesn’t get paid enough </li></ul>
    10. 10. ELDER ABUSE AND NEGLECT <ul><li>Denial of options (both practical and emotional) </li></ul><ul><li>Example:- </li></ul><ul><li>I couldn’t make it without him/her. I don’t have the ability. </li></ul><ul><li>No one else would want me </li></ul>
    11. 11. ELDER ABUSE AND NEGLECT <ul><li>Denial of victimization (victim self-blame) </li></ul><ul><li>Example:- </li></ul><ul><li>If only I hadn’t kept on about needing the bath/toilet/tea </li></ul><ul><li>I knew better than to say anything </li></ul>
    12. 12. ELDER ABUSE AND NEGLECT <ul><li>Appeal to the salvation ethic (help him/her overcome his/her problem and endure abuse until that is achieved) </li></ul><ul><li>Example:- </li></ul><ul><li>I know s/he is basically good. I’m sure with a little time and understanding s/he may stop...................... </li></ul>
    13. 13. ELDER ABUSE AND NEGLECT <ul><li>Appeal to higher loyalties (endure violence for ‘higher purpose’ such as religion or tradition) </li></ul><ul><li>Example:- </li></ul><ul><li>This is the will of Allah/God. I am being punished for................................. </li></ul><ul><li>I don’t believe in revealing private family matters </li></ul>
    14. 14. ELDER ABUSE AND NEGLECT <ul><li>Who is protected and who is harmed when abuse is discounted? </li></ul>
    16. 16. ELDER ABUSE AND NEGLECT <ul><li>Know what abuse is </li></ul><ul><li>Understand how it can happen </li></ul><ul><li>Be alert to indicators of abuse </li></ul><ul><li>Know the procedures for reporting concerns and poor practice </li></ul><ul><li>Provide support through good assessment and care planning </li></ul>
    17. 17. ELDER ABUSE & NEGLECT <ul><li>TYPES OF ABUSE </li></ul><ul><li>Physical </li></ul><ul><li>Sexual </li></ul><ul><li>Psychological and Emotional </li></ul><ul><li>Financial or material abuse </li></ul><ul><li>Neglect and acts of omission </li></ul><ul><li>Institutional abuse </li></ul>
    18. 18. ELDER ABUSE & NEGLECT <ul><li>Physical Signs:- </li></ul><ul><li>Multiple injuries, especially of different ages; bruises, welts, cuts, abrasions; </li></ul><ul><li>Scalds & burns, especially sock & glove patterns; </li></ul><ul><li>Genital Injuries </li></ul><ul><li>Poisoning especially if recurrent </li></ul>
    19. 19. ELDER ABUSE & NEGLECT <ul><li>Sexually transmitted diseases; </li></ul><ul><li>Patterned bruising; </li></ul><ul><li>Unexplained failure to thrive; </li></ul><ul><li>Poor hygiene; </li></ul><ul><li>Dehydration or malnutrition; </li></ul><ul><li>Fractures, especially if in specific patterns; </li></ul>
    20. 20. ELDER ABUSE & NEGLECT <ul><li>Behavioural Indicators </li></ul><ul><li>Fear of particular person/persons </li></ul><ul><li>Appears worried and/or anxious </li></ul><ul><li>Becomes easily irritable or upset </li></ul><ul><li>Appears depressed or withdrawn </li></ul><ul><li>Avoids physical eye or verbal contact with carer or service provider </li></ul>
    21. 22. ELDER ABUSE & NEGLECT <ul><li>Behavioural Indicators </li></ul><ul><li>Difficulty in walking or sitting </li></ul><ul><li>Pain or itching in genital area </li></ul><ul><li>Recoiling from being touched </li></ul><ul><li>Fear of bathing or toileting </li></ul>
    22. 23. ELDER ABUSE & NEGLECT <ul><li>Indicators of Financial or Material Abuse </li></ul><ul><li>Lack of money for necessities </li></ul><ul><li>Depletion of savings </li></ul><ul><li>Disappearance of possessions </li></ul><ul><li>Sale of property by older person who seems confused about the reasons for the sale </li></ul>
    23. 24. ELDER ABUSE & NEGLECT <ul><li>Indicators of Neglect & Acts of Omission </li></ul><ul><li>Malnourishment or dehydration </li></ul><ul><li>Poor personal hygiene </li></ul><ul><li>Clothing in poor repair </li></ul><ul><li>Absence of appropriate dentures, glasses or hearing aids </li></ul><ul><li>Left unattended for long periods </li></ul><ul><li>Medicines not purchased or administered </li></ul>
    24. 26. ELDER ABUSE & NEGLECT <ul><li>Indicators of Self Neglect </li></ul><ul><li>Reclusive, filthy and unhealthy living environments </li></ul><ul><li>Collecting and/or hoarding rubbish </li></ul><ul><li>Poor personal hygiene </li></ul><ul><li>Inappropriate or unusual clothing </li></ul><ul><li>Menagerie of pets </li></ul>
    25. 27. ELDER ABUSE & NEGLECT <ul><li>INSTITUTIONAL ABUSE </li></ul><ul><li>Institutional abuse is the collective failure of an organization to provide an appropriate and professional service. </li></ul>
    26. 29. ELDER ABUSE & NEGLECT <ul><li>Indicators of Institutional Abuse </li></ul><ul><li>Low staff morale </li></ul><ul><li>High staff turnover </li></ul><ul><li>High sickness rates </li></ul><ul><li>Excessive hours worked and frequent use of agency staff </li></ul>
    27. 30. ELDER ABUSE & NEGLECT <ul><li>General Lack of consideration for Privacy </li></ul><ul><li>Residents appear unusually subdued </li></ul><ul><li>Lack of care with personal clothing (including loss of clothes, being dressed in other peoples’ clothes, dirty or unkempt, spectacles not clean, wearing other peoples’ spectacles, hearing aids or teeth) </li></ul>
    28. 31. ELDER ABUSE & NEGLECT <ul><li>Poor hygiene with noticeable smell of urine </li></ul><ul><li>Residents in dirty clothing and/or bed linen </li></ul><ul><li>Inappropriate use of equipment </li></ul><ul><li>Over reliance on sedating medication, catheterisation and enemas </li></ul><ul><li>Lack of communication between staff, staff and residents and staff and relatives </li></ul>
    29. 32. ELDER ABUSE & NEGLECT <ul><li>Power and Control </li></ul><ul><li>Being a vulnerable adult instantly determines the balance of power in a relationship with the carer in a position of power </li></ul>
    30. 34. ELDER ABUSE & NEGLECT <ul><li>As a carer, use your power and control wisely and be aware of when power and control can turn in abusive care practice </li></ul>
    31. 35. ELDER ABUSE & NEGLECT <ul><li>Responding to a Report of Abuse </li></ul><ul><li>Listen and ask ‘open’ questions like ‘what happened next?’ </li></ul><ul><li>Validate feelings </li></ul><ul><li>State that you cannot keep what they are saying confidential and you will have to pass it to your line manager </li></ul>
    32. 36. ELDER ABUSE & NEGLECT <ul><li>Documenting Abuse Concerns </li></ul><ul><li>On blank piece of paper/daily record sheet </li></ul><ul><li>Include:- </li></ul><ul><li>What was said to you using his/her words </li></ul><ul><li>What you said to them </li></ul><ul><li>Include date/time of disclosure and full names of who was present </li></ul>
    33. 37. ELDER ABUSE & NEGLECT <ul><li>Making an Assessment </li></ul><ul><li>Any investigation must start with the approach that the safety, wellbeing and rights of the older person is the main focus. </li></ul>
    34. 38. ELDER ABUSE & NEGLECT <ul><li>Safety Planning (Strategy Discussion) </li></ul><ul><li>The purpose of the strategy discussion is to: </li></ul><ul><li>Gather information </li></ul><ul><li>Assess the risk </li></ul><ul><li>Determine course of action to be taken </li></ul><ul><li>Establish who will take the lead in any subsequent action </li></ul>
    35. 39. ELDER ABUSE & NEGLECT <ul><li>Safety Planning (Strategy Meeting) </li></ul><ul><li>It is recommended that the strategy meeting is chaired by the elder abuse and neglect prevention coordinator for Age concern who will: </li></ul><ul><li>Establish facts of the abuse </li></ul><ul><li>Assess the needs of the person for protection from further abuse </li></ul>
    36. 40. ELDER ABUSE & NEGLECT <ul><li>Determine a course of action </li></ul><ul><li>Agree responsibilities </li></ul><ul><li>Circulate copies of the protection plan to all parties present at the strategy meeting </li></ul>
    37. 41. ELDER ABUSE & NEGLECT <ul><li>Monitoring the Situation </li></ul><ul><li>The Age Concern elder abuse and neglect prevention coordinator will ensure services are coordinated in accordance with action plan. </li></ul><ul><li>The Health & Disability Advocate will monitor whether services are fulfilling the intended functions. </li></ul>
    38. 42. ELDER ABUSE & NEGLECT <ul><li>Review and Evaluation </li></ul><ul><li>Purpose of the review is to assess effectiveness of the services by exchanging information about progress and determine if situation has changed and whether new services are required </li></ul>
    39. 43. ELDER ABUSE & NEGLECT <ul><li>References </li></ul><ul><li>Age Concern NZ Incorporated ‘Promoting the Rights and Well-being of Older People and Those Who Care for Them’ (1992) </li></ul><ul><li>Ministry of Health ‘Elder Abuse and Neglect’ Guidelines (2007) </li></ul>