Introduction to Elder Abuse
According to the World Health Organisation, elder abuse is “a single or repeated act, or lack of appropriate action, occurring within any relationship where there is expected to be trust which causes harm or distress to an older person”. Elder abuse can affect both physical and mental health, leading to serious health risks for older people.
When assessing the risk of elder abuse, it is crucial to check for both the presence of abusive behaviors, as well as the potential factors that may have provoked it. It’s important to identify these potential factors so they can be addressed in a nursing care plan.
- history of physical or mental health issues;
- loneliness or isolation;
- aggressive behavior;
- excessive alcohol or drug use;
- poor social relationships;
- dependence on caregivers;
- frailty or mobility restrictions.
Once the assessment has been completed and key points identified, the nurse needs to develop a nursing diagnosis. This should include providing support and attention to the individual affected by the elder abuse.
- Wounds related to physical abuse – these can range from mild abrasions to more severe trauma such as broken bones;
- Anxiety-related to fear of physical aggression – this could manifest as recurring nightmares, withdrawal from activities, and paranoia;
- Loss of physical abilities related to age-related illness or injury – this could lead to difficulties walking, getting dressed, or attending to personal hygiene;
- Depression-related to feelings of loss and diminished self-esteem – this could cause symptoms like extreme sadness, difficulty concentrating and sleeping, significant weight loss/gain, suicidal thoughts, and difficulty interacting with others;
- Social isolation related to inadequate resources, impaired mobility, family feuds -this could exacerbate existing mental health issues, or create depressive states or altered behavior.
After establishing the relevant nursing diagnosis, it is important to set out outcomes for the nursing care plan for elderly abuse.
- The individual should be able to report feeling less fearful, and have improved self-esteem;
- They should have increased physical functioning – greater mobility and strength;
- They should be able to communicate effectively with those around them;
- They should be able to access services that are needed to support them;
- They should be able to recognize their own worth and capabilities.
Once the nursing diagnosis and outcomes have been established, the nurse needs to devise a series of interventions that are tailored to the individual’s needs.
- Provide trusted sources of emotional and social support – these can include family members, friends, or a specialized service;
- Ensure medical advice is sought in cases of physical abuse;
- Encourage relaxation and stress relief activities, such as yoga or meditation;
- Provide ongoing education to the patient on issues relating to aging, such as health risks, nutrition, and safety;
- Arrange readily available emotional support, either through counseling or support groups;
- Help the patient build new social relationships, either by arranging outings with friends or involving them in activities led by professional care workers;
- Ensure access to local services for the patient, including food banks and charitable associations;
- Provide cognitive-behavioral therapy to help the individual cope with difficult thoughts or situations.
The intervention should aim to address the core issues and provide a safe and supportive environment. The rationales are based on the goals of the intervention and how they can be achieved.
- Establishing trusted support systems will enable the patient to open up about their experience and get access to help when needed;
- Ensuring timely medical treatment to any physical injuries will help reduce further long-term damage;
- Relaxation and stress relief activities can reduce tension and anxiety, helping a person build resilience;
- Education can increase awareness and understanding of their rights and allow them to make informed choices;
- Seeking emotional support can help the patient develop new coping skills that can be used in future situations;
- Building new social relationships can help improve feelings of loneliness and isolation;
- Accessing local services and organizations can strengthen community connections which reduces risk of elder abuse;
- Cognitive-behavioral therapy can help individuals manage their emotions and reactions to stressful situations.
The evaluation of a nursing care plan for elderly abuse should focus on how successful the outcome was. This can involve monitoring the treatment and identifying any obstacles that may arise.
- Monitoring the success of the interventions;
- Checking the patient’s ability to communicate openly with their support system and other professionals;
- Ascertaining if there is any evidence of further abuse;
- Measuring the patient’s ability to access services, both public and private;
- Examining the patient’s emotional wellbeing – looking for signs of anxiety, depression, isolation;
- Watching for any changes in the patient’s level of physical activity;
- Identifying any financial concerns that could arise as a result of neglect;
- Assessing the strength of social ties.
Nursing care plans for elderly abuse need to take a holistic approach to ensure that individuals are supported as much as possible. This means ensuring that all physical, mental, and social needs are met with equal importance. When creating a care plan, it is essential that assessments are carried out carefully, goals and interventions are reviewed often, and evaluations are conducted to assess the success of the program.
- What is Elder Abuse? Elder abuse is the mistreatment of a vulnerable older person. It can involve physical violence, psychological harm, financial exploitation, and neglect.
- Are there different types of Elder Abuse? Yes, there are different forms of elder abuse, including physical, psychological, financial, and neglect.
- How can I tell if someone is being abused? Abusers may use subtle tactics to attempt to control or manipulate the person they are abusing, including isolation, ridicule, or threats. If you notice changes in behavior, physical signs of abuse, or a worsening of anxiety or depression, seek help.
- What should I do if I suspect someone is being abused? If you suspect abuse, report it to the relevant authorities. Elder abuse is a crime, and perpetrators should be held accountable.
- How can we prevent Elder Abuse? Awareness is key to preventing elder abuse. Everyone should be educated on the signs of elder abuse, and responsibility should be taken to create a safe and supportive environment for anyone susceptible to abuse.