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There is often great reluctance and/or fear on the part of the elder
to report abuse. Threats of placement in a nursing home or shame that
a family member may be involved often prevent the elder from seeking help.
Therefore, sensitivity to these issues must guide those wishing to
offer assistance in suspected abuse cases.
Suspect a problem if the answers aren't consistent with the injury or if the patient or caregiver is unwilling or unable to respond. If you believe that the patient may be a victim of abuse, settle him in a safe, private location away from his primary caregiver and ask:
Follow up immediately if the patient tells you he's been abused or if he has a suspicious history of repeated falls. Getting down to documentation For the patient's protection, document all the objective and subjective data you gather, including the patient's and caregiver's explanations of the injuries. Place quotation marks around their words and note any discrepancies in their stories. Document injury sites on a body map and identify the types. Conclude with photographs of the injuries Finally, follow your facility's policy for reporting elder abuse. A special facility response team may follow through or you may have to contact a state agency. The following agencies may be available in your area:
With careful patient assessment, you can recognize elder abuse. With meticulous documentation, you can show others what you've detected. And with appropriate reporting, you can direct your patient and his caregiver to the help they need to end a dangerous situation. A close-up on photo documentation If you suspect elder abuse, follow your facility's policy for documenting abuse. Generally, you'd ask the patient or his caregiver for signed permission to take photographs for the medical record. Here are picture-taking guidelines:
PEG GRAY-VICKREY, RN,C, DNS Associate Professor College of Health Professions
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