Geriatric Trauma

1
Geriatric Trauma

• Elder Abuse Neglect

2
Problem Origin Theories

• Social Isolation
• Role reversal
• Psychopathology mental illness
• drug and alcohol abuse

• Trans-generation
• violence is a learned behavior
• Caregiver Stress
• professional
• home caregivers

3
Maltreatment Categories

• Neglect
• active
• passive
• Self
• Psychological abuse
• Violation of personal rights
• Physical and/or sexual abuse
• Financial abuse or exploitation

4
Abuse Risk Factors

• Age gender
• Dependency level
• Economic stresses
• Drug/alcohol abuse
• Inexperience caregiver
• Compromised communication

5
More Risk Factors

• Confined living space
• Lack of respit support
• Sandwich generation
• Sudden change in condition

6
Prevalence of Problem ?

• 4 to 10 of population over 60
• CDC estimates 75 - 80 unreported
• 2.5 - 6.4 million cases annually by 2020

7
Victim Profile

• Socially isolated
• Live with their abuser
• Women over 75 years
• Exhibit problematic behavior
• violence
• screaming
• wandering
• incontinence
• Chronic physical or mental impairment

8
Offender Profile

• Drug and alcohol problems
• Over age 50 Lives with victim
• Financially dependent on victim
• Adult child (30) spouse (13)
• Ill prepared or reluctant caregiver
• Poor impulse control history of domestic
  violence

9
History

• Patients hygiene
• Past medical history
• from the patient
• from the caregiver
• Patients environment
• check with EMT
• History of current event
• from the patient
• from the caregiver

10
Assessment

• Do Assessment findings correlate with
• Patients physical capacity?
• Patients version of incident?
• Caregivers version of incident?

11
Assessment

• Medications, drugs, alcohol?
• Is injury compatible with usual kinetics of
  accident described?

12
How did this happen ?
13
How did this happen ?
14
How Did This Happen?
15
How did this happen ?
16
Actions Risks

• Required report
• State law
• Provide physical care
• consider admission
• Provide information
  referrals
• Where can they go ?
• What alternatives ?

17
Questions ?