Approximately one in 10 older people living in the United States has experienced physical, sexual, psychological or financial abuse or neglect, according to the National Center on Elder Abuse.
To understand how to keep your elderly loved ones safe, whether in your care or in the care of others, Patricia Speck, DNSc, a board-certified family nurse practitioner who specializes in forensic nursing, family and sexual violence at the University of Alabama at Birmingham School of Nursing, explains the different types of elder abuse and how to spot signs of and report suspected abuse.
Physical and sexual abuse
Physical abuse is defined as the intentional use of physical force that results in illness, injury, pain or functional impairment.
“Unexplained bruises, cuts, burns and bedsores are signs of physical abuse,” Speck explained. “If you notice sudden changes in behavior, particularly when the suspected abuser is around, that is a sign that you should seek help for your loved one.”
Speck says health care providers should suspect abuse if they see subdural hemorrhages (or bleeding that occurs outside the brain as a result of a head injury) and eye, nose and mouth injuries.
“Nurses should particularly look for signs of intentional injuries, such as contusions of lips, cheeks, soft palate, facial fractures, missing hair, particularly in odd places and not where you would expect to see balding,” Speck said. “Bruising and skin tears in odd places, like the abdomen or under the arm or in the crotch, are also common signs.”
Another common indication of abuse is for people who spend most of their time in wheelchairs.
“If there is injury to an older person who is being restrained in a wheelchair, you would look for friction burns on the abdomen or wrists, different patterns in bruising and skin tears,” Speck said.
The majority of sexual assault cases to older adults are in the community; but many are reported from institutions, and in most cases the perpetrator is known by the victim.
Speck says signs of sexual abuse include unexplained venereal diseases, genital infections, and bleeding and tearing in the genital area. They also include bruises to the buttocks and around the inner and outer thighs.
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