Emergency departments across the country receive more than 23 million older adults every year. According to a recent study, only 1 in 7,700 national emergency visits from older adults results in a formal diagnosis of elder abuse from emergency providers. With elder abuse as common as 1 in 10, are ERs missing an opportunity?
The problem with elder abuse, besides how common it is, is the fact that is difficult to detect. Bones and blood vessels become frailer as we age, so accidents and bruises are bound to happen. How is a physician to know whether a bruise was caused by abuse or just a common bump or fall?
Identifying Elder Abuse
Elder abuse comes in different forms so the practice of inquiring about the home life of elderly patients is one of the best ways to identify it. It gives you a better understanding of the relationship the senior has with their caregiver and grounds to be suspicious of certain signs of abuse.
Signs of Physical, Sexual, and Emotional Abuse
- Bruising, grip marks, or restraint marks around the neck, arms, wrists or ankles
- Repeated unexplained injuries
- Caregiver’s refusal to allow you to see the elder alone
- Bruising around breasts or genitals
- Torn or bloody undergarments
- Unexplained vaginal or anal bleeding
- Unexplained venereal disease or infections
- Witnessing threatening or controlling caregiver behavior
- Uncommunicative or unresponsive
- Unreasonably fearful or suspicious
- Unexplained changes in behavior
- Isolated or lack of interest in social contact
(Source: Senior Caring)
Abuse vs. Neglect
Neglect is a passive form of abuse. Most forms of abuse are intentional, but neglect can be both intentional and unintentional. Passive negligence is unintentional and often stems from undertrained or overwhelmed caregivers. On the other hand, the intentional disregard for the well-being of a senior is known as active negligence. A few signs of neglect are malnourishment, untreated bedsores, lack of basic hygiene and medical aids.
Not all negligence is the fault of the caregiver but by the senior themselves. Self-negligence can be a result of mental illness, overmedication, substance abuse, and/or poverty.
How ERs Can Fight Elder Abuse
It all boils down to training. Well-trained physicians should be able to identify the signs of abuse and neglect among their elderly patients. On this matter it is better to be proved wrong than right, so be overly suspicious of potential signs and ask the right questions.