• Sexual assault / rape o Assessment findings p 270 / examination PCCM p 192 o Management p 270 / PCCM 193  Objective data p 270 / History PCCM 192  Emergency box 15.11 o Collection of rape evidence Box 15.1 • Child abuse PCCM p 193 (T&E Periods) o Suspected sexual abuse  Common presentations  History  Examination  Common causes  management • Elder abuse p 1063 (T&E Periods) o Types of abuse table 53.7 o Guidelines for investigating elder abuse

1. TRAUMA,
CHILD & ELDER
ABUSE
By C Settley

2. Sexual assault/rape:
Assessment findings
■ Treat patient with kindness & respect
■ Privacy
■ Emotional support
■ Confidentiality
■ Subjective data on the following:
– History of the assault
– Nature and extent of injuries
– Length and time since the assault
– Location
– Other information
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3. Sexual assault/rape:
Assessment findings
■ Objective data:
– Obtain medical history
– Date of last menstrual period
– Request permission to collect evidence and explain procedure
– Head to toe exam
– Vital signs
– Obvious injuries
– Control bleeding, if any
– Assess emotional state- crying, sad, shock
– Nausea
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4. Sexual assault/rape:
Emergency management
■ Emotional support
■ Kindness
■ Sensitivity
■ Sexual assault examination
■ Collect evidence
■ Document findings….. Lawsuit may follow
■ HIV test and pregnancy
■ Prophylaxis
■ Refer
■ Basic advice
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5. Child abuse
■ Refer to Applied Sociology
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6. Elder abuse
Types of elder abuse
PHYSICAL ABUSE PHYSICAL NEGLECT
Assault
Rough handling
Burns
Sexual abuse
Unreasonable physical restraint
Dehydration
Malnutrition
Poor hygiene
Soiled or inappropriate clothing
Medications given incorrectly or omitted
Lack of medical attention
PHYCHOLOGICAL ABUSE MATERIAL ABUSE
Verbal and emotional abuse
Threats
Isolation
Confinement
Financial neglect
Exploitation and misuse of funds/pension
Theft
Withholding income
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7. Guidelines for investigating elder abuse
■ Multidisciplinary team
■ Be aware that it occurs in all economic groups
■ Educate professionals concerning:
– Symptoms
– Assessment
– Management
– Legislation
– Obligation
■ Educate elderly
– Awareness
– Methods of reporting
– Counselling
– Rights
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8. Guidelines for investigating elder abuse
■ Feedback
■ Complaints to be taken seriously
■ Ensure that there is an agreed upon system and methods of dealing with complaints in
an institution:
– Open door policy
– Procedures to be known
– Accuracy of information
– Protection of rights
– Elder’s statement in form of legal affidavit to protect them from intimidation
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9. Reference list
■ https://www.agefotostock.com/age/en/Stock-Images/Rights-Managed/PHA-214496
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