2. Learning Objectives
1. Discuss current trends in elder
mistreatment, including incidence and
prevalence.
2. Review key reasons why elder
mistreatment occurs.
3. Conduct clinical assessment for
screening and detection of elder
mistreatment.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
3. Learning Objectives
4. Create a nursing care plan for the
ongoing well-being of older patients.
5. Summarize key resources for elder
mistreatment information.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
4. Introduction
• The nurse has a role in identifying and
managing the serious and potentially
life-threatening syndrome of elder
mistreatment.
• Elder mistreatment is a part of a larger
societal problem, domestic violence.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
5. Introduction
• Elder mistreatment is the outcome of
abuse, neglect, exploitation, or
abandonment of older adults and
represents some of the most tragic
behavior in the area of family violence.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
6. Theories of Elder Mistreatment
• Psychopathology of the abuser refers to
caregivers who have preexisting
conditions that impair their capacity to
give appropriate care.
• Theories:
– Transgenerational Violence
–Situational Theory
– Isolation Theory
Gerontological Nursing, Third Edition
Patricia A. Tabloski
7. Theories of Elder Mistreatment
• The identification of elder mistreatment
is most often done by healthcare
professionals.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
8. Definition for Elder Mistreatment
• Physical abuse, sexual abuse,
emotional/psychological abuse, neglect,
abandonment, financial/material
exploitation, and self-neglect are all
subtypes of elder mistreatment.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
9. Cultural Perceptions of Elder
Mistreatment
• Elder mistreatment needs to be
understood in the context of individual
cultures.
• Elder mistreatment cannot be
tolerated, despite differing cultural
perceptions.
• Cultural and linguistic competences are
important for successful intervention in
cases of elder mistreatment.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
10. Legal Issues
• All states have some mechanism,
whether mandatory or voluntary, for
reporting elder mistreatment. State-by-state
variations exist in terms of
definitions, mechanisms for reporting,
and appropriate governmental intake
agencies.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
11. Current Evidence
• Low household income, unemployment,
poor health self-report, prior family
violence, and poor social support are
consistent contextual factors for the
outcome of elder mistreatment.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
12. Table 10-2 Elder Mistreatment
Gerontological Nursing, Third Edition
Patricia A. Tabloski
Characteristics
Source: *Lachs, M. S., Berkman, L.,
Fulmer, T., & Horwitz, R. (1994). A
prospective community-based pilot study
of risk factors for the investigation of elder
mistreatment. Journal of the American
Geriatrics Society, 42(2), 169–173.
+Lachs, M. S., Williams, C., O’Brien, S.,
Hurst, L., & Horwitz, R. (1996). An 11-
year longitudinal study of adult protective
service use. Archives of Internal Medicine,
156(4), 449–453.
13. Institutional Mistreatment
• There is a dearth of information about
mistreatment in nursing homes and
other residential care facilities.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
14. Assessment
• Interdisciplinary comprehensive
geriatric assessment of the older adult’s
cognitive and psychosocial function is
essential in identifying elder
mistreatment, and the nurse’s role is of
utmost importance.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
15. Physical Examination
• The physical symptoms of elder
mistreatment are often difficult for
clinicians to discern because older
adults may suffer from chronic and
acute illnesses that mask or mimic the
presence of mistreatment.
• Cognitively impaired older adults
provide an additional challenge.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
16. Nursing Diagnoses
• Elder mistreatment may be addressed
by the following nursing diagnoses from
the North American Nursing Diagnosis
Association:
–Caregiver Role Strain
–Coping, Ineffective Family
Compromised
–Coping, Ineffective Family
Disabled
Gerontological Nursing, Third Edition
Patricia A. Tabloski
17. Nursing Diagnoses
• Elder mistreatment may be addressed
by the following nursing diagnoses from
the North American Nursing Diagnosis
Association:
–Coping, Ineffective Individual
– Protection, Ineffective
–Rape-trauma Syndrome
Gerontological Nursing, Third Edition
Patricia A. Tabloski
18. Nursing Diagnoses
• Elder mistreatment may be addressed
by the following nursing diagnoses from
the North American Nursing Diagnosis
Association:
–Self-care Deficit
–Self-esteem Situational Low
–Social Isolation
Gerontological Nursing, Third Edition
Patricia A. Tabloski
19. Interventions
• Nurses working with older adults must
be aware of the elder mistreatment
reporting laws in their states.
• Elder mistreatment requires an
interdisciplinary team approach.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
20. Documentation
• Excellent documentation is extremely
important in elder mistreatment cases.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
21. Future Considerations
• Accurate and uniform data must be
continuously collected at state and
national levels so that elder
mistreatment trends can be monitored.
• Future research focusing on evidence-based
interventions to prevent elder
mistreatment is needed.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
22. QSEN Recommendations Related
to Elder Mistreatment
• The Quality and Safety Education for
Nurses (QSEN) project addresses the
challenge of preparing future nurses
with the knowledge, skills, and
attitudes (KSAs) to continuously
improve the quality and safety of the
healthcare systems in which they work.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
