Makindo Medical Notes

About Elder Abuse and Safeguarding in the NHS

Elder abuse is an act or omission that results in harm to the health or welfare of an elderly person. It encompasses physical, emotional, sexual, and financial abuse, as well as neglect and exploitation. Approximately 1 in 10 people aged 60 and older who live at home experience some form of abuse, though it is likely underreported.

Types of Elder Abuse

• Physical Abuse: Inflicting bodily harm through actions like hitting, pushing, or slapping. This may also include restraining an older adult against their will, such as locking them in a room or tying them to furniture.
• Emotional or Psychological Abuse: Involves verbal assaults, threats, intimidation, humiliation, or harassment. This includes yelling, insulting, or repeatedly ignoring the older adult, as well as isolating them from friends and family.
• Neglect: The failure of a caregiver to meet the basic needs of an older adult, including physical, emotional, and social necessities. This may involve withholding food, medications, or access to healthcare.
• Abandonment: Deserting an older adult who needs assistance, without arranging for their care.
• Sexual Abuse: Non-consensual sexual contact of any kind with an older adult, including forcing them to witness or participate in sexual acts.
• Financial or Material Exploitation: Unauthorized use of an elder's funds or property. This includes forging signatures, stealing money or possessions, or coercing them to change legal documents like wills or property titles. Financial abuse is on the rise, often perpetrated by family members, exacerbated by factors like technological advances and increased use of online banking.

Risk Factors

• Older adults with disabilities, memory problems, or dementia.
• Those who depend on others for daily activities such as bathing, dressing, or medication management.
• Individuals who are socially isolated or have no family or friends nearby.
• Frail seniors who may appear to be easy targets.
• While both men and women can be victims, women are more commonly affected.

Signs of Elder Abuse

• Withdrawal from normal activities or social interactions.
• Unexplained weight loss, malnutrition, or dehydration.
• Poor hygiene or unattended physical needs, such as unwashed hair or dirty clothes.
• Changes in behavior, such as increased agitation, depression, or violent actions.
• Physical signs like bruises, burns, cuts, scars, or broken bones.
• Bed sores or other preventable conditions due to neglect.
• Unexplained financial changes, such as unpaid bills, sudden changes in wills, or missing funds.
• Hazardous or unsanitary living conditions.

Management and Safeguarding

• Immediate Safety: Ensure the immediate safety and well-being of the elder. Provide necessary medical attention and support.
• Reporting: Follow local policies to report the abuse to appropriate authorities, such as social services or the police, especially if a crime is suspected.
• Safeguarding Teams: Involve multidisciplinary safeguarding teams to assess the situation and plan interventions.
• Documentation: Keep detailed records of all observations, conversations, and actions taken, which may be important for legal proceedings.
• Support Services: Provide information on available support services, such as counseling, legal advice, and community resources.
• Training and Awareness: Healthcare professionals should receive training on recognizing and responding to signs of elder abuse.

Safeguarding in the NHS

The National Health Service (NHS) has a duty to protect vulnerable adults from abuse and neglect. Safeguarding policies are in place to ensure that healthcare professionals are equipped to identify and respond to concerns about elder abuse.

• Policy Compliance: All NHS staff must adhere to local and national safeguarding policies and procedures.
• Interagency Collaboration: Work with social services, law enforcement, and other agencies to coordinate a comprehensive response.
• Confidentiality: Respect the patient's privacy while ensuring that essential information is shared appropriately to protect them.
• Legal Framework: Actions should be compliant with relevant legislation, such as the Care Act 2014 and the Mental Capacity Act 2005.

Conclusion

Elder abuse is a significant concern that requires prompt and effective action. By understanding the types, risk factors, and signs of abuse, healthcare professionals can play a crucial role in safeguarding older adults. Through adherence to NHS policies and collaboration with safeguarding teams, we can work towards preventing abuse and ensuring the safety and dignity of elderly patients.